During a home visit, the nurse assesses a client with Alzheimer's disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?

Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started.

Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed.

Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's safety.

Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's insomnia.

Answer and Explanation

The Correct Answer is A

Choice A reason: Insomnia can be a common and temporary side effect when starting rivastigmine. Educating the caregiver about this potential side effect helps them understand that it may resolve over time and reassures them about the safety of the medication.

Choice B reason: Advising that the purpose of the medication is to promote sleep is incorrect. Rivastigmine is used to improve cognitive function in Alzheimer's disease, not specifically to promote sleep.

Choice C reason: Instructing the caregiver to withhold the medication without consulting the healthcare provider is not advisable. Adjusting or discontinuing medication should always be done under medical supervision.

Choice D reason: Notifying the healthcare provider about increasing the dosage for insomnia is inappropriate. The focus should be on managing the side effect without altering the intended therapeutic effect of the medication.

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Correct Answer is C

Explanation

Choice A reason: Calcium acetate is used to bind phosphate in the gastrointestinal tract to reduce phosphate absorption, which is often elevated in clients with CKD. A decrease in serum calcium is not the intended effect of this medication.

Choice B reason: Potassium levels are not directly affected by calcium acetate. This medication specifically targets phosphate binding.

Choice C reason: A decrease in phosphate levels indicates that calcium acetate is effectively binding phosphate and reducing its absorption from the diet. This is the desired effect, as elevated phosphate levels can lead to complications in CKD.

Choice D reason: The pH of the blood is not directly influenced by calcium acetate. The primary purpose of this medication is to manage phosphate levels, not to alter blood pH.

A. The drops increase the fluid in the eyes and cloud the visual field. B. The eye drops slow pupil response to accommodate for darkness.

Correct Answer is A

Explanation

Choice A reason: Increased fluid in the eyes and clouding of the visual field is a concern for clients using certain types of eye drops. This information is relevant and important for the client to understand potential side effects and how to manage them.

Choice B reason: Slowing of pupil response to accommodate for darkness may be a side effect of some eye drops, but it is not as immediately concerning as clouding of the visual field. Clients should be aware of changes in vision, but this information may not require as urgent instruction as other potential side effects.

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During a home visit, the nurse assesses a client with Alzheimer's disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

Correct Answer is C

Explanation

The nurse discontinues the client's patient-controlled analgesia (PC

Correct Answer is A

Explanation

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