A nurse is teaching the family of a client who has Alzheimer’s disease about donepezil. Which of the following information should the nurse include in the teaching?
“Syncope episodes may occur when taking this medication.”
“You will need to monitor for constipation.”
“This medication may cause tachycardia.”
“You should administer the medication each morning.”
The Correct Answer is A
Answer: A. “Syncope episodes may occur when taking this medication.”
Rationale:
A) “Syncope episodes may occur when taking this medication.”
Syncope (fainting) is a possible side effect of donepezil, a cholinesterase inhibitor used to treat Alzheimer’s disease. Donepezil can cause bradycardia, which may lead to a decrease in blood pressure and reduced blood flow to the brain, resulting in syncope. It's important for family members to monitor for episodes of dizziness, fainting, or lightheadedness, particularly when the client changes positions (orthostatic hypotension).
B) “You will need to monitor for constipation.”
Constipation is not commonly associated with donepezil use. In fact, donepezil may cause diarrhea or gastrointestinal upset due to its cholinergic effects. Family members should be more concerned about potential gastrointestinal disturbances such as nausea, vomiting, or diarrhea rather than constipation.
C) “This medication may cause tachycardia.”
Donepezil is more likely to cause bradycardia (a slower-than-normal heart rate) rather than tachycardia (a fast heart rate). Bradycardia is a known side effect because the medication increases acetylcholine, which enhances parasympathetic activity, leading to a slower heart rate.
D) “You should administer the medication each morning.”
Donepezil is typically administered in the evening before bed. This schedule helps reduce the risk of daytime gastrointestinal side effects, like nausea and vomiting, which can interfere with daily activities. Administering the medication at night can also reduce the impact of potential dizziness or syncope during the day.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) "Reduce intake of potassium-rich foods":
Hydrochlorothiazide is a diuretic medication that can cause potassium loss through increased urinary excretion. Therefore, instructing the client to reduce intake of potassium-rich foods could further decrease potassium levels, leading to hypokalemia. Instead, clients taking hydrochlorothiazide should be encouraged to consume potassium-rich foods to help maintain normal potassium levels, unless otherwise instructed by their healthcare provider.
B) "Take this medication before bedtime":
While hydrochlorothiazide can be taken once daily, it is typically recommended to take it in the morning rather than before bedtime. Taking the medication earlier in the day can help minimize the need to wake up during the night to urinate, as it is a diuretic that increases urine production. Therefore, instructing the client to take hydrochlorothiazide before bedtime is not the optimal recommendation.
C) "Avoid grape juice":
There is no significant interaction between hydrochlorothiazide and grape juice. In general, grapefruit juice is known to interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, grape juice is not known to interact with hydrochlorothiazide, so advising the client to avoid grape juice is not necessary.
D) "Monitor for leg cramps":
This is the correct instruction. Leg cramps can be a potential side effect of hydrochlorothiazide therapy due to electrolyte imbalances, particularly hypokalemia. By monitoring for leg cramps, the client can promptly report any symptoms to their healthcare provider for further evaluation and management. This instruction promotes client safety and awareness of potential adverse effects associated with the medication."
Correct Answer is C
Explanation
Bethanechol is not indicated for the relief of severe pain following a transurethral resection of the prostate (TURP). Pain management for postoperative discomfort typically involves analgesics such as opioids or nonsteroidal anti-inflammatory drugs (NSAIDs), depending on the severity of pain. Therefore, this option is incorrect.
B) Frequent episodes of painful urination:
While frequent episodes of painful urination may occur after a TURP due to irritation of the urinary tract, bethanechol is not typically administered to address this symptom. Painful urination is often managed with analgesics and may improve as the urinary tract heals. Therefore, this option is incorrect.
C) An inability to void:
This is the correct response. Bethanechol is a cholinergic agonist that stimulates bladder contraction and can be used to treat urinary retention or an inability to void following surgical procedures such as TURP. By increasing bladder tone and promoting urination, bethanechol helps relieve urinary retention and prevents complications associated with prolonged bladder distension.
D) Bladder spasms:
While bladder spasms may occur postoperatively following a TURP, bethanechol is not typically administered to address this symptom. Bladder spasms are often managed with anticholinergic medications or muscle relaxants to reduce involuntary contractions of the bladder. Therefore, this option is incorrect.”
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