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A home health nurse is planning care for a client who has Alzheimer's disease. Which of the following actions should the nurse include in the plan of care?

Encourage physical activity prior to bedtime.

Replace the carpet with hardwood floors.

Wear clothing with zippers instead of buttons.

Place locks at the tops of exterior doors.

Answer and Explanation

The Correct Answer is D

A. Physical activity should be scheduled earlier in the day to prevent overstimulation and promote restful sleep.

B. Hardwood floors increase the risk of falls; carpets provide better traction and cushioning.

C. Zippers can be difficult for clients with Alzheimer's; clothing with Velcro or simple fasteners is preferred.

D. Placing locks at the tops of doors reduces the risk of wandering, a common safety concern in clients with Alzheimer's.

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Correct Answer is C

Explanation

A. Ranitidine: An H2 receptor blocker, typically used to reduce stomach acid, is unnecessary since the stomach has been removed.

B. Vitamin K: Although important for clotting, vitamin K absorption is not significantly affected by total gastrectomy.

C. Vitamin B12: Clients require lifelong vitamin B12 supplementation (usually via intramuscular injections) after total gastrectomy to prevent deficiency and associated complications such as anemia and neurological impairments.

D. Metoclopramide: A prokinetic agent used to enhance gastric motility, which is not relevant after total gastrectomy.

A. Bupropion 100 mg, PO three times daily B. Levomilnacipran 20 mg PO daily C. Citalopram 20 mg PO daily D. Fluoxetine 20 mg PO daily

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"}}

Explanation

Potential prescription	Anticipated	Contraindicated
Bupropion 100 mg PO three times daily		✓
Levomilnacipran 20 mg PO daily	✓
Citalopram 20 mg PO daily	✓
Fluoxetine 20 mg PO daily	✓

Rationale

Bupropion 100 mg PO three times daily: Contraindicated
- Bupropion is generally contraindicated for clients with a history of bulimia nervosa due to the increased risk of seizures.
Levomilnacipran 20 mg PO daily: Anticipated
- Levomilnacipran is an SNRI that can be used to treat major depressive disorder and is generally safe for clients with bulimia nervosa.
Citalopram 20 mg PO daily: Anticipated
- Citalopram is an SSRI commonly used to treat major depressive disorder and can be effective for clients with bulimia nervosa.
Fluoxetine 20 mg PO daily: Anticipated
- Fluoxetine is an SSRI that is effective in treating both major depressive disorder and bulimia nervosa.

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A home health nurse is planning care for a client who has Alzheimer's disease. Which of the following actions should the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client following a total gastrectomy. The nurse should instruct the client about which of the following medications?

Correct Answer is C

Explanation

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"}}

Explanation

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