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 ["42"]

Explanation

To calculate the infusion rate in gtt/min, we first need to calculate the infusion rate in mL/hr. The formula for this is:

Step 1: Calculate the infusion rate in mL/hr

Infusion rate (mL/hr)=Total time (hr)Total volume (mL) Substituting the given values: Infusion rate (mL/hr)=2 hr mL=250 mL/hr

Step 2: Convert the infusion rate from mL/hr to gtt/min Infusion rate (gtt/min)=60 min/hrInfusion rate (mL/hr)×Drop factor (gtt/mL).

Substituting the given values: Infusion rate (gtt/min)=60 min/hr mL/hr×10 gtt/mL ≈42 gtt/min Therefore, the nurse should regulate the infusion to approximately 42 gtt/min.

A. Administer a narcotic reversal drug. B. Apply an oxygen face mask. C. Remove the morphine patches. D. Monitor the client’s blood pressure.

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.

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Naxlex Comprehensive Predictor Exams

A patient is receiving a secondary infusion of azithromycin 500 mg in 500 mL of normal saline (NS) to be infused over 2 hours. The intravenous (IV) administration set delivers 10 gtt/mL. How many gtt/min should the nurse regulate the infusion?

Correct Answer is ["42"]

Explanation

Correct Answer is C

Explanation

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