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 C

Explanation

A) Glaucoma:
While propranolol can exacerbate symptoms of glaucoma, it is not an absolute contraindication. However, caution is warranted in clients with glaucoma due to its potential to increase intraocular pressure.

B) Depression:
Propranolol is not contraindicated in clients with a history of depression. In fact, it is sometimes used to manage anxiety symptoms associated with certain types of depression.

C) Asthma:
Propranolol is contraindicated in clients with a history of asthma or bronchospasm because it can exacerbate bronchoconstriction and potentially precipitate an acute asthma attack.

D) Migraines:
Propranolol is often used prophylactically in clients with migraines to reduce the frequency and severity of attacks. It is not contraindicated in clients with a history of migraines."

A. Severe pain. B. Frequent episodes of painful urination C. An inability to void D. Bladder spasms

Correct Answer is C

Explanation

Bethanechol is not indicated for the relief of severe pain following a transurethral resection of the prostate (TURP). Pain management for postoperative discomfort typically involves analgesics such as opioids or nonsteroidal anti-inflammatory drugs (NSAIDs), depending on the severity of pain. Therefore, this option is incorrect.

B) Frequent episodes of painful urination:
While frequent episodes of painful urination may occur after a TURP due to irritation of the urinary tract, bethanechol is not typically administered to address this symptom. Painful urination is often managed with analgesics and may improve as the urinary tract heals. Therefore, this option is incorrect.

C) An inability to void:
This is the correct response. Bethanechol is a cholinergic agonist that stimulates bladder contraction and can be used to treat urinary retention or an inability to void following surgical procedures such as TURP. By increasing bladder tone and promoting urination, bethanechol helps relieve urinary retention and prevents complications associated with prolonged bladder distension.

D) Bladder spasms:
While bladder spasms may occur postoperatively following a TURP, bethanechol is not typically administered to address this symptom. Bladder spasms are often managed with anticholinergic medications or muscle relaxants to reduce involuntary contractions of the bladder. Therefore, this option is incorrect.”

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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse caring for a client”who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

Correct Answer is C

Explanation

A nurse is caring for a client who is postoperative following a transurethral resection of the prostate (TURP). The nurse should plan to administer the client’s PRN bethanechol when the client reports which of the following manifestations?

Correct Answer is C

Explanation

The client has been ordered a nonselective beta-blocking agent called propranolol, PO. Propranolol is used in the treatment of which disorders (Select All that Apply.)

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