A nurse is teaching the family of a client who has Alzheimer’s disease about donepezil. Which of the following information should the nurse include in the teaching?

“Syncope episodes may occur when taking this medication.”

“You will need to monitor for constipation.”

“This medication may cause tachycardia.”

“You should administer the medication each morning.”

Answer and Explanation

The Correct Answer is A

Answer: A. “Syncope episodes may occur when taking this medication.”

Rationale:

A) “Syncope episodes may occur when taking this medication.”
Syncope (fainting) is a possible side effect of donepezil, a cholinesterase inhibitor used to treat Alzheimer’s disease. Donepezil can cause bradycardia, which may lead to a decrease in blood pressure and reduced blood flow to the brain, resulting in syncope. It's important for family members to monitor for episodes of dizziness, fainting, or lightheadedness, particularly when the client changes positions (orthostatic hypotension).

B) “You will need to monitor for constipation.”
Constipation is not commonly associated with donepezil use. In fact, donepezil may cause diarrhea or gastrointestinal upset due to its cholinergic effects. Family members should be more concerned about potential gastrointestinal disturbances such as nausea, vomiting, or diarrhea rather than constipation.

C) “This medication may cause tachycardia.”
Donepezil is more likely to cause bradycardia (a slower-than-normal heart rate) rather than tachycardia (a fast heart rate). Bradycardia is a known side effect because the medication increases acetylcholine, which enhances parasympathetic activity, leading to a slower heart rate.

D) “You should administer the medication each morning.”
Donepezil is typically administered in the evening before bed. This schedule helps reduce the risk of daytime gastrointestinal side effects, like nausea and vomiting, which can interfere with daily activities. Administering the medication at night can also reduce the impact of potential dizziness or syncope during the day.

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Correct Answer is B

Explanation

A) Temperature and respiratory rate:
While monitoring temperature and respiratory rate are important aspects of a comprehensive assessment, they are not the priority assessments before administering metoprolol. Metoprolol is a beta-blocker primarily used to lower heart rate and blood pressure, so assessing the client's heart rate and blood pressure is more relevant.

B) Heart rate and blood pressure:
This is the correct answer. Before administering metoprolol, it is essential to assess the client's heart rate and blood pressure. Metoprolol is a beta-blocker medication that primarily affects heart rate and blood pressure. Monitoring these vital signs helps ensure that the medication is administered safely and effectively.

C) Level of consciousness and pain level:
Assessing the client's level of consciousness and pain level are important aspects of nursing care, but they are not the priority assessments before administering metoprolol. These assessments may be relevant depending on the client's overall condition and specific care needs, but they are not directly related to the action or side effects of metoprolol.

D) Oxygen saturation and respiratory rate:
Monitoring oxygen saturation and respiratory rate are important aspects of respiratory assessment, but they are not the priority assessments before administering metoprolol. While metoprolol can affect respiratory function as a potential side effect, its primary action is on heart rate and blood pressure. Therefore, assessing heart rate and blood pressure are more pertinent before administering this medication.

Correct Answer is ["32"]

Explanation

Find the concentration of heparin in the solution:

Total heparin (units): 25,000 units

Volume of solution (mL): 500 mL

Heparin concentration (units/mL) = Total heparin (units) / Volume of solution (mL)

Heparin concentration (units/mL) = 25,000 units / 500 mL = 50 units/mL

Set up the flow rate equation:

Desired heparin infusion rate (units/hr): 1600 units/hr

Heparin concentration in solution (units/mL): 50 units/mL

Flow rate (mL/hr): We need to solve for this

Flow rate (mL/hr) = Desired heparin infusion rate (units/hr) / Heparin concentration (units/mL)

Calculate the flow rate (mL/hr):

Flow rate (mL/hr) = 1600 units/hr / 50 units/mL = 32 mL/hr (round to nearest whole number as requested)

Therefore, the nurse should set the IV pump to deliver approximately 32 mL/hr.

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A nurse is teaching the family of a client who has Alzheimer’s disease about donepezil. Which of the following information should the nurse include in the teaching?

Rationale:

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Naxlex Comprehensive Predictor Exams

A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessment findings?

Correct Answer is B

Explanation

Correct Answer is ["32"]

Explanation

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