A patient has been taking donepezil for 2 weeks as part of the treatment for early stages of Alzheimer's disease. Her daughter calls the prescriber's office and is upset because "Mother has not improved one bit!" Which response by the nurse is appropriate?
"Increase the dosage to twice daily."
"Take the medication on an empty stomach for Improved absorption."
"It takes time for the cure to take effect."
"It may take up to 6 weeks to see an improvement."
The Correct Answer is D
A. "Increase the dosage to twice daily.": Changing the dosage should only be done under the guidance of the prescriber based on clinical assessment, not in response to perceived lack of improvement.
B. "Take the medication on an empty stomach for improved absorption.": While taking donepezil with or without food may affect absorption, this instruction is not directly related to the timing of improvement in symptoms.
C. "It takes time for the cure to take effect.": Alzheimer's disease cannot be cured, and this statement may provide false hope to the patient's daughter.
D. "It may take up to 6 weeks to see an improvement.": This response provides accurate
information about the expected timeline for therapeutic effects of donepezil and encourages patience in observing improvement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The drug level is at a toxic level, and the dosage needs to be reduced. Phenytoin has a narrow therapeutic range, and levels above 20 mcg/mL are considered to be in the toxic range.
Symptoms of phenytoin toxicity can include nystagmus, ataxia, slurred speech, and confusion. Therefore, if a patient's phenytoin level is 23 mcg/mL, the nurse should be concerned about potential toxicity and consult with the healthcare provider to adjust the dosage.
B. The patient's seizures should be under control if she is also taking a second antiepileptic drug.
While combination therapy with multiple antiepileptic drugs can help control seizures, a phenytoin level of 23 mcg/mL is still concerning for toxicity and requires intervention.
C. The patient is at risk for seizures because the drug level is not at a therapeutic level. A phenytoin level of 23 mcg/mL is actually above the therapeutic range and is more indicative of toxicity rather than subtherapeutic levels.
D. The patient's seizures should be under control because this is a therapeutic drug level. A phenytoin level of 23 mcg/mL is not within the therapeutic range but rather in the toxic range, so the patient may experience symptoms of toxicity rather than having adequate seizure control.
Correct Answer is D
Explanation
A. Tachycardia is not typically associated with cholinergic drug effects. Cholinergic stimulation tends to slow down the heart rate rather than increase it.
B. Palpitations may occur with certain cardiac arrhythmias or in response to sympathetic stimulation, but they are not typically associated with cholinergic drug effects.
C. Cholinergic drugs are more likely to cause vasodilation rather than vasoconstriction.
Therefore, vasoconstriction is not a common cardiovascular effect of cholinergic drug therapy.
D. Bradycardia is a common cardiovascular effect of cholinergic drug therapy. Cholinergic stimulation slows down the heart rate by increasing parasympathetic activity, particularly at the
sinoatrial (SA) node. Therefore, bradycardia is the cardiovascular effect that nurses should monitor for when administering cholinergic drugs.
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