Rivastigmine, a cholinesterase inhibitor, is prescribed for a female client with early-stage Alzheimer’s disease. The client’s daughter tells the nurse that she plans to start administering the drug when her mothers’ symptoms are no longer manageable, in hopes that her mother will not have to go to a nursing home. How should the nurse respond?

Explain that the drug should be used early in the course of the disease process.

Affirm the decision to use the drug when the symptoms start to worsen.

Assess the client’s current mental health status before deciding to support the decision.

Confirm that the daughter is aware of the progressive nature of the disease.

Answer and Explanation

The Correct Answer is A

The nurse should explain to the client's daughter that Rivastigmine is most eﬀective when used early during Alzheimer's disease. Delaying the use of the medication until the symptoms are no longer manageable may result in the drug being less eﬀective.

The nurse should emphasize the importance of following the healthcare provider's instructions for administering the medication to maximize its therapeutic eﬀect. It is important to educate the client's daughter about the progressive nature of Alzheimer's disease and the need for ongoing monitoring and care.

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Correct Answer is C

Explanation

Restless legs syndrome is a condition that causes an uncomfortable sensation in the legs and an uncontrollable urge to move them. Melatonin is a natural hormone that helps regulate the sleep-wake cycle and can be used as a sleep aid. Therefore, when evaluating the eﬀectiveness of melatonin in an older adult client with restless legs syndrome, the nurse should assess the client's sleep patterns to determine if the herb is improving their ability to fall and stay asleep.

Assessing anxiety level (a) may be useful in other contexts, but it is not directly relevant to evaluating the eﬀectiveness of melatonin for restless legs syndrome. Observing for peripheral edema (b) and palpating pedal pulse volume (d) are important assessments in clients with peripheral vascular disease or other circulatory disorders, but they are not directly related to restless legs syndrome or the use of melatonin.

A. Fingerstick glucose. B. Serum electrolytes and ammonia. C. Stool color and character. D. Serum hepatic enzymes.

Correct Answer is B

Explanation

Lactulose is a medication commonly used in the management of hepatic encephalopathy. It works by reducing the absorption of ammonia in the gut, which is a toxin that can accumulate in the blood in patients with liver dysfunction.

Monitoring serum electrolytes and ammonia levels can help the nurse evaluate the eﬀectiveness of lactulose therapy. Elevated ammonia levels can indicate that the medication is not eﬀectively reducing ammonia absorption and may require adjustment in dose or frequency. Additionally, monitoring electrolyte levels can help detect any imbalances that may occur because of lactulose therapy.

Fingerstick glucose levels (option A) are not relevant to evaluating the therapeutic response of lactulose in hepatic encephalopathy.

Stool color and character (option C) may be monitored to assess the side eﬀects of lactulose, such as diarrhea, but are not the best assessments to evaluate therapeutic response.

Serum hepatic enzymes (option D) may be useful in assessing the severity of liver disease but are not the best assessment to evaluate the therapeutic response of lactulose in hepatic encephalopathy.

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Naxlex Comprehensive Predictor Exams

An older adult client with restless legs syndrome begins taking melatonin at bedtime. When evaluating the eﬀectiveness of the herb which client assessment should the nurse complete?

Correct Answer is C

Explanation

A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the nest information to evaluate the client’s therapeutic response to the drug?

Correct Answer is B

Explanation

When caring for a client with diabetes insipidus who is receiving antidiuretic hormone intranasally, which serum lab test is most important for the nurse to monitor?

A client is scheduled for a spiral computed topography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client’s history requires follow-up by the nurse?

A client with psychosis who is receiving an antipsychotic medication is continuously rubbing the back of the neck. Which nursing intervention is best for the nurse to implement?

The nurse assesses a client with intermittent claudication who is receiving pentoxifylline. Which assessment should the nurse perform to determine the eﬀectiveness of the medication?

A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse eﬀect is most important for the nurse to report?

A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

A client who receives multiple antihypertensive multiple medications experiences syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse’s decision to hold the client’s scheduled antihypertensive medications?

Two months after taking nitrofurantoin for a bacterial infection, a client reports the onset of severe, watery diarrhea to the home care nurse. How should the nurse respond?