A nurse is caring for a client who has heart failure.
Which of the following manifestations should the nurse expect?

Choice A rationale:

Improved short-term memory. Donepezil is a medication used to treat Alzheimer's disease and other forms of dementia. It works by increasing the levels of certain chemicals in the brain that are involved in memory, thinking, and reasoning. Therefore, improved short-term memory is an indication that the medication is effective, as it suggests enhanced cognitive function in the client.

Choice B rationale:

Enhanced mood. While improved mood can be a positive outcome of treating dementia, it is not the primary goal of donepezil therapy. The main focus is on cognitive improvement, particularly in memory and thinking skills. Enhanced mood alone may not be a reliable indicator of the medication's effectiveness in this context.

Choice C rationale:

Can perform ADLs independently. The ability to perform activities of daily living (ADLs) independently is an important aspect of a patient's overall well-being. However, this improvement may not solely be attributed to the effects of donepezil. Other factors, such as rehabilitation or support services, can also contribute to the patient's ability to perform ADLs. While it is a positive outcome, it is not a specific indication of donepezil's effectiveness.

Choice D rationale:

Increased food intake. Increased food intake is not a direct effect of donepezil. Donepezil does not have a primary role in regulating appetite or food intake. Therefore, this finding is not a reliable indicator of the medication's effectiveness in treating dementia.

The correct answers are Choices A, C, D, E, F, and G.

Choice A rationale: Antihypertensive medication is indicated due to sustained elevated BP (≥160/110 mm Hg), which increases risk for stroke, placental abruption, and eclampsia. Prompt control reduces maternal and fetal morbidity.

Choice B rationale: Routine vaginal exams are contraindicated unless signs of labor are present. Frequent exams increase infection risk and are not part of standard care for hypertensive or preeclamptic clients.

Choice C rationale: A low-stimulation environment (dim lights, quiet room) reduces CNS irritability and seizure risk in preeclampsia. It supports neuroprotection and aligns with seizure precaution protocols.

Choice D rationale: Betamethasone promotes fetal lung maturity in preterm gestation when delivery is likely. It reduces neonatal respiratory distress syndrome and improves outcomes in hypertensive pregnancies.

Choice E rationale: A 24-hour urine specimen quantifies proteinuria, essential for diagnosing preeclampsia severity. Protein 3+ on dipstick warrants confirmation via timed collection for accurate staging.

Choice F rationale: Hourly intake and output monitoring detects fluid shifts, renal compromise, and early signs of pulmonary edema. It’s critical in hypertensive disorders to guide fluid management.

Choice G rationale: Bed rest minimizes physical stress, stabilizes BP, and reduces risk of placental disruption. Left lateral positioning enhances uteroplacental perfusion and supports fetal oxygenation.