A nurse in a clinic is caring for an adolescent client who is at 24 weeks of gestation and showing signs of preeclampsia. Which of the following findings should the nurse expect?

Choice A reason: Performing ADLs independently is not a specific indicator of donepezil’s effectiveness, as it treats cognitive symptoms in Alzheimer’s, not physical function. While improved cognition may indirectly aid ADLs, this outcome is too broad and not directly tied to the medication’s primary action, making it incorrect.
Choice B reason: Increased food intake is not an expected outcome of donepezil, which targets acetylcholinesterase to improve cognitive function in Alzheimer’s. Appetite changes are unrelated to its mechanism, and this finding does not indicate effectiveness, making it an incorrect measure of the drug’s impact.
Choice C reason: Enhanced mood is not a primary effect of donepezil, which focuses on slowing cognitive decline. While mood may improve indirectly, it is not a direct indicator of efficacy. Other medications address mood in Alzheimer’s, making this finding less relevant and incorrect.
Choice D reason: Improved short-term memory is a key indicator of donepezil’s effectiveness, as it increases acetylcholine levels to slow cognitive decline in Alzheimer’s. Enhanced memory reflects the drug’s intended action, aligning with clinical expectations, making this the correct measure of therapeutic success.

Choice A reason: Supplementing breastfeedings with water every 12 hours is not advised for newborns, as breast milk provides complete hydration and nutrition. Water can reduce milk intake, decreasing supply due to reduced demand. It risks electrolyte imbalances, like hyponatremia, in infants with immature kidneys. Exclusive breastfeeding for six months supports optimal growth, immune function, and maternal-infant bonding, making this recommendation inappropriate.
Choice B reason: Offering the breast at hunger cues, such as rooting or hand-sucking, supports demand-driven breastfeeding, which stimulates prolactin and oxytocin for milk production. This ensures adequate supply, promotes healthy weight gain, and aligns with the infant’s natural feeding rhythm. It prevents over- or under-feeding, fostering neonatal development and strengthening the maternal-infant bond, making this the correct advice.
Choice C reason: Limiting feeding to 10 minutes per breast can prevent adequate hindmilk transfer, which is high in fat and calories, essential for growth. Short sessions may reduce milk supply due to insufficient stimulation. Infants need variable feeding times to meet nutritional needs. This restriction risks poor weight gain and inadequate nutrition, indicating it’s not a suitable recommendation.
Choice D reason: Starting each feeding with the same breast can cause imbalanced milk production, as one breast may be understimulated, reducing overall supply. Alternating breasts ensures both are drained, supporting balanced lactation and preventing engorgement or mastitis. This practice maintains milk supply via prolactin release, making this advice incorrect for optimal breastfeeding.