A 73-year-old man who is an inpatient in a geropsychiatric inpatient unit is ataxic, has anterograde and retrograde amnesia, has a sluggish gaze, and has nystagmus. What is the most appropriate treatment?
Memantine (Namenda) 20 mg PO 1 tablet daily
Thiamine (vitamin B1) 100 mg PO BID
Donepezil (Aricept) 10 mg PO 1 tablet daily
Rivastigmine (Exelon) 1.5 mg, 1 tablet BID
The Correct Answer is B
Choice A reason: Memantine is used to treat moderate to severe Alzheimer’s disease by modulating glutamate activity. It is not appropriate for acute neurologic syndromes like Wernicke’s encephalopathy, which this patient’s symptoms suggest.
Choice B reason: Thiamine deficiency is the hallmark of Wernicke’s encephalopathy, which presents with ataxia, ophthalmoplegia, and memory impairment. Prompt administration of thiamine is critical to prevent progression to Korsakoff syndrome and irreversible brain damage.
Choice C reason: Donepezil is a cholinesterase inhibitor used for Alzheimer’s disease. It does not address the acute vitamin deficiency or neurologic symptoms seen in Wernicke’s encephalopathy.
Choice D reason: Rivastigmine is another cholinesterase inhibitor used in dementia treatment. Like donepezil, it is not appropriate for thiamine deficiency-related neurologic syndromes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This question is more aligned with assessing general health or immune function and is not specific to substance use or behavioral addictions.
Choice B reason: This question targets anhedonia, a core symptom of depression. While relevant to psychiatric evaluation, it does not address addictive behaviors.
Choice C reason: This question is indicative of dissociative symptoms, which may be seen in dissociative identity disorder or trauma-related conditions. It is not specific to substance use or gambling.
Choice D reason: Gambling is a behavioral addiction and falls under the category of "substances and other addictions" in psychiatric ROS. This question directly assesses compulsive gambling behavior and its impact on functioning, making it the most appropriate for this system.
Correct Answer is C
Explanation
Choice A reason: Pearson’s r correlation measures the strength and direction of a linear relationship between two variables. It does not quantify the likelihood of an event.
Choice B reason: The p-value indicates the probability of obtaining the observed results assuming the null hypothesis is true. While it reflects statistical significance, it is not the general term for likelihood.
Choice C reason: Probability is the statistical concept that describes the likelihood of an event occurring. It is foundational to inferential statistics and underpins many statistical tests.
Choice D reason: ANOVA tests for differences among group means but does not directly measure the likelihood of an event. It uses probability concepts but is not itself a measure of probability.
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