The nurse has been teaching the caregiver about Aricept. The nurse knows teaching has been effective by which of the following statements?

Let's hope this medication will stop the Alzheimer's disease from progressing any further

It is important to take this medication on an empty stomach

I'll be eager to see if this medication makes any improvement in concentration

This medication will slow the progress of Alzheimer's disease temporarily

Answer and Explanation

The Correct Answer is D

Choice A reason: Aricept (donepezil) is a cholinesterase inhibitor that increases acetylcholine levels in the brain, temporarily improving cognitive symptoms in Alzheimer’s disease. It does not stop disease progression, as Alzheimer’s involves progressive neuronal loss due to amyloid plaques and tau tangles. This statement is scientifically inaccurate, as no medication halts Alzheimer’s neurodegenerative process.

Choice B reason: Taking Aricept on an empty stomach is not required, as it can be taken with or without food. Its absorption is not significantly affected by food, as it is metabolized hepatically via CYP2D6 and CYP3A4. This statement is incorrect, as it misrepresents the administration guidelines, potentially causing unnecessary restrictions for the patient.

Choice C reason: While Aricept may improve concentration by enhancing cholinergic activity in Alzheimer’s, this statement focuses on expectation rather than understanding its therapeutic role. It does not address the drug’s primary effect of temporarily slowing cognitive decline. Concentration improvement is a secondary benefit, not the primary mechanism, making this less precise scientifically.

Choice D reason: Aricept temporarily slows Alzheimer’s disease progression by inhibiting acetylcholinesterase, increasing acetylcholine, and supporting cognitive function in mild to moderate cases. It does not cure or stop the disease, as neuronal degeneration continues due to amyloid and tau pathology. This statement accurately reflects the drug’s mechanism and temporary symptomatic relief, aligning with clinical evidence.

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Correct Answer is A

Explanation

Choice A reason: Fine motor tremors are a common early side effect of lithium, affecting cerebellar function due to its narrow therapeutic index and sodium channel interactions. These typically subside within weeks as the body adjusts to stable serum levels (0.5–1.2 mEq/L), making this an accurate, reassuring response.

Choice B reason: Dismissing tremors as unimportant unless persistent for a month is incorrect. Lithium tremors, linked to cerebellar effects, often resolve sooner, but persistent tremors may indicate toxicity (levels >1.5 mEq/L), risking neurological damage. This response delays necessary monitoring, ignoring the drug’s neuropharmacological impact.

Choice C reason: Acknowledging tremors but implying the client’s concern is excessive is dismissive. Tremors result from lithium’s cerebellar effects, a legitimate side effect. This response fails to educate about the expected resolution timeline or need for monitoring, risking patient distrust and ignoring the drug’s neurobiological effects.

Choice D reason: Labeling tremors as a potential toxicity sign is misleading, as early fine tremors are typically benign, not indicative of toxicity (>1.5 mEq/L), which involves severe symptoms like confusion. This overstates risk, causing unnecessary alarm, and does not address the common, transient cerebellar effect of lithium.

A. If you stop yelling, I will get your dessert B. Don’t you want to finish your meal? C. Let's look at what is on television D. I don't understand what you are saying

Correct Answer is A

Explanation

Choice A reason: Offering dessert to stop yelling uses bargaining, not distraction, and may reinforce agitation in Alzheimer’s, where cortical and amygdala damage impairs emotional regulation. This approach risks escalating distress by focusing on the behavior, which the client cannot control due to neurocognitive deficits, making it ineffective.

Choice B reason: Asking if the client wants to finish the meal focuses on the agitation’s context, potentially worsening distress in Alzheimer’s due to impaired reasoning from cortical degeneration. This confrontational approach does not redirect attention, failing to leverage preserved procedural memory, which distraction techniques use to calm neurobiological agitation.

Choice C reason: Suggesting to watch television is a distraction technique, redirecting attention from agitation triggers in Alzheimer’s. By engaging preserved sensory and procedural memory, it reduces amygdala-driven emotional distress without confronting cognitive deficits, aligning with neurobiological strategies to manage agitation and promote calm in dementia care.

Choice D reason: Stating misunderstanding focuses on the client’s communication deficits, likely increasing frustration in Alzheimer’s due to hippocampal and cortical damage. This does not distract from agitation triggers and may exacerbate distress, as the client cannot process or correct their behavior, making it an ineffective response compared to redirection.

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The nurse has been teaching the caregiver about Aricept. The nurse knows teaching has been effective by which of the following statements?

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Correct Answer is A

Explanation

Correct Answer is A

Explanation

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