A nurse is caring for a client who has a new diagnosis of amyotrophic lateral sclerosis (ALS), and a new prescription for riluzole. The nurse understands that this medication works in which of the following ways?
It suppresses the virus which is responsible for causing the inflammation of the nerve.
It prevents the breakdown of acetylcholine to increase the amount available at the neuromuscular junction.
It reduces inflammation in the CNS to prevent further demyelination of nerves in the central nervous system.
It slows the progression of the disease by decreasing the release of glutamate in the brain.
The Correct Answer is D
A. ALS is not caused by a virus or inflammation of the nerves. It is a progressive neurodegenerative disease affecting the motor neurons in the brain and spinal cord.
B. While acetylcholine breakdown is involved in other neurological conditions (such as myasthenia gravis), ALS primarily affects motor neurons and does not directly involve acetylcholine metabolism at the neuromuscular junction.
C. ALS does not typically involve significant inflammation or demyelination (which is more characteristic of conditions like multiple sclerosis). Therefore, reducing CNS inflammation is not a therapeutic target in ALS.
D. Riluzole, the medication prescribed for ALS, works by decreasing the release of glutamate, which is a neurotransmitter that can be toxic to nerve cells in high amounts. In ALS, excessive glutamate release is believed to contribute to motor neuron degeneration. By reducing glutamate release, riluzole may help protect motor neurons and slow the progression of the disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Headache is a common side effect of nitroglycerin due to its vasodilatory effects, especially in the head. Most headaches associated with nitroglycerin are mild and transient. Patients are generally advised to continue using the medication as prescribed unless the headache is severe or persistent.
B. Nitroglycerin tablets are used for the immediate relief of angina symptoms. If the first tablet does not adequately relieve chest pain within 5 minutes, the patient can take a second tablet. If the pain persists after the second tablet, emergency medical attention should be sought. However, it's important to note that the maximum number of tablets that can be taken within a short period should be specified by the healthcare provider, typically 2 or 3 tablets in 15 to 30 minutes.
C. Nitroglycerin can cause orthostatic hypotension, which is a drop in blood pressure upon standing up. This can lead to dizziness or fainting. Therefore, patients should be advised to stand up slowly after taking nitroglycerin to minimize the risk of falls or injury.
D. Nitroglycerin tablets are sensitive to light, heat, and moisture, which can reduce their effectiveness over time. Therefore, it's recommended to replace nitroglycerin tablets every 3 to 6 months to ensure potency and effectiveness.
Correct Answer is B
Explanation
A. Carbidopa itself does not cross the blood-brain barrier. Its primary role in Sinemet is to inhibit the peripheral breakdown of levodopa (the precursor of dopamine) into dopamine before it reaches the brain.
B. It is true that it may take a few weeks to see the full effects of this medication, as the body needs time to adjust to it.
C. Parkinson's disease is progressive, and as the disease advances, the dosage and frequency of levodopa with carbidopa may need to be adjusted to maintain symptom control. Over time, higher doses or additional medications may be required to manage symptoms effectively.
D. Levodopa does not protect Carbidopa; rather, Carbidopa protects Levodopa from early conversion to dopamine outside the brain, which would make it less effective.
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