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 B

Explanation

Choice A rationale

While a thyroid function test could be relevant in some cases, it is not the most pertinent in this situation. The symptoms described by the patient do not suggest a thyroid issue.

Choice B rationale

The symptoms described by the patient, such as fatigue, nausea, dark urine, and yellowing of the skin and sclera, are indicative of liver dysfunction. Albendazole is primarily metabolized in the liver, and its use can cause liver damage in some cases. Therefore, a liver function test would be the most appropriate laboratory result to review.

Choice C rationale

While a renal function panel could be relevant in some cases, it is not the most pertinent in this situation. The symptoms described by the patient do not suggest a kidney issue.

Choice D rationale

A basic metabolic panel could provide useful information about various aspects of the patient’s health, but it is not the most relevant test given the patient’s symptoms and medication.

A. The client underwent a coronary artery bypass procedure in 1995. B. The client had a colonoscopy performed for routine screening six months ago. C. The client suffered from depression following the death of their spouse in 1999. D. The client has been taking digoxin and furosemide daily since 1996.

Correct Answer is D

Explanation

Choice A rationale

While a coronary artery bypass procedure is a significant event in a patient’s medical history, it occurred in 1995, which is quite some time ago. Therefore, it may not be the most significant piece of data when planning this client’s care, given their current signs and symptoms.

Choice B rationale

A colonoscopy performed for routine screening six months ago is unlikely to be related to the client’s current symptoms of nausea, vomiting, and anorexia. Therefore, this choice is not the most significant piece of data when planning this client’s care.

Choice C rationale

Depression following the death of a spouse can significantly impact a person’s mental health. However, this event occurred in 1999, and while it may contribute to the client’s overall health status, it is not likely to be the most significant piece of data for planning care based on the client’s current symptoms.

Choice D rationale

The client has been taking digoxin and furosemide daily since 19962. Both of these medications are used to treat heart conditions. Digoxin strengthens the heart’s contractions, while furosemide is a diuretic that helps reduce fluid buildup. Given the client’s symptoms of nausea, vomiting, and anorexia, and their diagnosis of heart failure, this information is crucial. These symptoms could indicate a worsening of heart failure or side effects of the medication, which would significantly influence the plan of care.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient who is taking albendazole reports experiencing fatigue, nausea, and dark urine. The nurse observes a yellowing of the patient’s skin and sclera.Which laboratory result should the nurse review?

Correct Answer is B

Explanation

An elderly client with heart failure arrives at the emergency room due to nausea, vomiting, and anorexia.Based on the client’s signs and symptoms, which piece of data from the medical history is most significant when planning this client’s care?

Correct Answer is D

Explanation

A client has been prescribed ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (D5W) 200 mL. How many mL/hour should the nurse program the infusion pump to deliver? (Enter numerical value only.)

A patient is currently on an oral contraceptive and has been prescribed erythromycin. What advice should the nurse provide to the patient?

An adult patient at an outpatient clinic has been prescribed the antibiotic tetracycline HCI. What should the nurse include in the patient’s teaching plan?

A female patient with multiple sclerosis reports less fatigue and improved memory since she started using the herbal supplement, ginkgo biloba.What is the most important information for the nurse to include in the teaching plan for this patient?

The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication.What action should the nurse take?

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

The nurse is preparing to administer the anti-ulcer gastrointestinal agent sucralfate to a patient with peptic ulcer disease.What should be included in this patient’s care plan?

An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets.To promote the best absorption of the medication, what information should the nurse include in the discharge instructions?