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.”

Answer and Explanation

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.

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Correct Answer is C

Explanation

A) Orthostatic hypotension is indicated by a decrease in diastolic blood pressure of 5 mm Hg:
Orthostatic hypotension is typically defined by a decrease in systolic blood pressure of 20 mm Hg or more or a decrease in diastolic blood pressure of 10 mm Hg or more within three minutes of standing up. Diastolic blood pressure alone is not the primary indicator of orthostatic hypotension.

B) Orthostatic hypotension is indicated by a decrease in systolic blood pressure of 5 mm Hg:
While a decrease in systolic blood pressure is a component of orthostatic hypotension, the criterion for diagnosing orthostatic hypotension is a decrease in systolic blood pressure of 20 mm Hg or more or a decrease in diastolic blood pressure of 10 mm Hg or more within three minutes of standing up.

C) Orthostatic hypotension increases a client's risk of a fall:
This statement is correct. Orthostatic hypotension, characterized by a sudden drop in blood pressure upon standing, can lead to dizziness and lightheadedness, increasing the risk of falls, particularly in older adults.

D) Orthostatic hypotension increases a client's risk of a pulmonary emboli:
Orthostatic hypotension is not directly associated with an increased risk of pulmonary emboli. Pulmonary embolism is a separate condition involving a blockage in the pulmonary artery or its branches, typically caused by a blood clot."

A. Is it caused by demyelination of the nerve fibers. B. Is it thought to be an autoimmune disease. C. It is associated with destruction of acetylcholine receptor sites. D. Once symptoms present, it has a 5-year survival rate. E. It is a chronic and progressive muscular disease. F. Is it best treated with antibiotics.

Correct Answer is ["B","C","E"]

Explanation

A) Is it caused by demyelination of the nerve fibers:
Myasthenia gravis is not primarily caused by demyelination of nerve fibers. It is characterized by dysfunction at the neuromuscular junction, specifically involving the acetylcholine receptors.

B) Is it thought to be an autoimmune disease:
This is correct. Myasthenia gravis is considered an autoimmune disorder in which the body's immune system mistakenly targets and attacks its own tissues, particularly the acetylcholine receptors at the neuromuscular junction.

C) It is associated with destruction of acetylcholine receptor sites:
This is correct. In myasthenia gravis, there is a reduction in the number of functional acetylcholine receptors due to autoimmune-mediated destruction or blocking of these receptors.

D) Once symptoms present, it has a 5-year survival rate:
This statement is inaccurate. Myasthenia gravis is a chronic condition, but survival rates are not determined by the onset of symptoms. With appropriate treatment, many individuals with myasthenia gravis can manage their symptoms effectively and have a normal life expectancy.

E) It is a chronic and progressive muscular disease:
This is correct. Myasthenia gravis is a chronic neuromuscular disorder characterized by fluctuating muscle weakness and fatigue. While it is chronic, it is not necessarily progressive in all cases, as symptoms may stabilize or improve with treatment.

F) Is it best treated with antibiotics:
Antibiotics are not the primary treatment for myasthenia gravis. Treatment typically involves medications that enhance neuromuscular transmission, such as acetylcholinesterase inhibitors or immunosuppressive drugs, along with other supportive measures.

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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?

Rationale:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a newly licensed nurse about orthostatic hypotension. Which of the following information should the nurse include?

Correct Answer is C

Explanation

A nurse is explaining myasthenia gravis to a family. Which of the following points would be included in the explanation? (Select All that Apply.)

Correct Answer is ["B","C","E"]

Explanation

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