Rivastigmine, a cholinesterase inhibitor, is prescribed for a female patient with early-stage Alzheimer’s Disease.
The patient’s daughter tells the nurse that she plans to start administering the drug when her mother’s symptoms worsen, hoping to avoid nursing home placement.
How should the nurse respond?

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

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

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

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

w should the nurse respond?

Answer and Explanation

The Correct Answer is B

Choice A rationale

While it’s understandable that the patient’s daughter wants to delay the use of medication until her mother’s symptoms worsen, this approach may not be beneficial. Rivastigmine, a cholinesterase inhibitor, is used to treat mild to moderate dementia caused by Alzheimer’s or Parkinson’s disease. It is not a cure for Alzheimer’s or Parkinson’s disease, but it can help manage the symptoms. Waiting until the symptoms worsen may not provide the desired benefits and could potentially lead to a faster progression of the disease.

Choice B rationale

Rivastigmine is most effective when used early in the disease process. It works by increasing the concentration of acetylcholine, a neurotransmitter, through reversible inhibition of its hydrolysis by cholinesterase. This can help improve the function of nerve cells in the brain and can slow the progression of symptoms in patients with Alzheimer’s disease. Therefore, starting the medication early can help manage the symptoms and potentially slow the progression of the disease.

Choice C rationale

While assessing the patient’s current mental status is an important part of care, it should not be the sole factor in deciding when to start medication. The decision to start medication should be based on a comprehensive evaluation of the patient’s condition, including the stage of the disease, the patient’s overall health, and the potential benefits and risks of the medication.

Choice D rationale

While it’s important for the daughter to understand the progressive nature of Alzheimer’s disease, this understanding alone does not determine when to start medication. The decision to start medication should be based on a comprehensive evaluation of the patient’s condition and the potential benefits and risks of the medication.

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Correct Answer is C

Explanation

Choice A rationale

Administering a narcotic reversal drug is not the first action the nurse should take. While it’s true that the client’s symptoms could be due to opioid overdose, the nurse should first confirm the cause of the symptoms. In this case, the nurse finds four patches on the client’s body, which is unusual and could lead to an overdose. Therefore, the first action should be to remove the patches to prevent further absorption of the drug.

Choice B rationale

Applying an oxygen face mask might be necessary if the client is having difficulty breathing. However, this would not address the underlying problem if the client is experiencing an overdose from the morphine sulfate patches. The nurse should first remove the patches to stop further drug absorption.

Choice C rationale

The nurse finds four patches on the client’s body. This is unusual and could lead to an overdose. Therefore, the nurse’s first action should be to remove the patches to prevent further absorption of the drug. After removing the patches, the nurse can assess the client’s condition and provide further interventions as needed.

Choice D rationale

Monitoring the client’s blood pressure is an important nursing intervention, but it should not be the first action in this situation. The nurse has already found a potential cause for the client’s symptoms (i.e., the four morphine sulfate patches). Therefore, the first action should be to address this problem by removing the patches.

A. Explain that the client needs to allow for sleep time of at least two hours. B. Advise the client to take the medication with the noon meal. C. Encourage the client to wait until bedtime to take the medication. D. Remind the client to drink plenty of fluids when taking the medication.

Correct Answer is C

Explanation

Choice A rationale

Explaining that the client needs to allow for sleep time of at least two hours after taking zolpidem is not the best action. While it’s true that zolpidem should be taken right before going to sleep, the client’s plan to take a short afternoon nap may not provide enough time for the effects of the medication to wear off, which could lead to drowsiness and potential safety issues.

Choice B rationale

Advising the client to take the medication with the noon meal is not the best action. Zolpidem should be taken on an empty stomach right before going to sleep. Taking it with food or right after a meal may decrease its effectiveness.

Choice C rationale

Encouraging the client to wait until bedtime to take the medication is the best action. Zolpidem is a sedative-hypnotic medication used to treat insomnia. It works quickly to put you to sleep and should be taken right before going to bed. Taking it during the day could lead to drowsiness and potential safety issues.

Choice D rationale

Reminding the client to drink plenty of fluids when taking the medication is not the best action. While staying hydrated is generally good advice, it’s not specifically related to the use of zolpidem. The key instruction for zolpidem is to take it right before going to bed.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A client has a new prescription for zolpidem, a hypnotic.The client tells the home health nurse that he plans to take a dose of the medication during the day because he is exhausted and needs to take a short afternoon nap prior to an evening activity in his home.Which action should the nurse take?

Correct Answer is C

Explanation

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