During a home visit, the nurse assesses a client with Alzheimer's Di’ease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?

Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's sa’ety.

Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's in’omnia.

Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed.

Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started.

Answer and Explanation

The Correct Answer is D

A) Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's sa’ety: Withholding the medication without consulting the healthcare provider may not be appropriate, especially if the client is experiencing improvements in cognitive function. The insomnia may be a temporary side effect that could resolve with continued use or adjustment of the dosage.

B) Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's in’omnia: Increasing the dosage of rivastigmine to manage insomnia may not be the most appropriate action. It's es’ential to assess the client further and explore other interventions before considering a dosage adjustment.

C) Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed: Rivastigmine is not typically used to promote sleep. It is a cholinesterase inhibitor used to treat cognitive symptoms associated with Alzheimer's di’ease. Therefore, advising a change in medication solely based on the client's in’omnia is not appropriate.

D) Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started: Rivastigmine and other cholinesterase inhibitors may cause insomnia, especially when therapy is initiated. Educating the caregiver about this common side effect helps manage expectations and provides reassurance that the insomnia may improve over time as the client's bo’y adjusts to the medication.

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Correct Answer is A

Explanation

A) Feverfew may interact with aspirin or nonsteroidal anti-inflammatory drugs: This information is crucial to include in the teaching plan because feverfew has been reported to interact with medications such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), potentially increasing the risk of bleeding. Clients need to be aware of potential drug interactions to prevent adverse effects and ensure safe use of feverfew.

B) Those with allergies to chamomile, ragweed, or yarrow should not take feverfew: While this is important information to consider, it may not be as immediately relevant to the client's current situation of experiencing fewer headaches with feverfew use. However, it is still important to assess for allergies and sensitivities to prevent allergic reactions.

C) Increased anxiety and nervousness have been reported by those taking feverfew: Although this is a potential side effect of feverfew, it may not be the most important information to include in the teaching plan for a client who is experiencing fewer headaches with feverfew use. The focus should be on the client's positive response to the herbal remedy and potential interactions with other medications.

D) Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew: While this is important information regarding potential side effects of feverfew, it may not be as immediately relevant to the client's current situation of experiencing fewer headaches with feverfew use. However, clients should be informed about possible adverse effects to monitor for and report to their healthcare provider if they occur.

A. Decreased blood urea nitrogen. B. Hearing has decreased. C. Reports of photophobia. D. White blood cell count of 6,000/mm3 (6 x 10/1)

Correct Answer is B

Explanation

A) Decreased blood urea nitrogen (BUN) is not a typical adverse effect of gentamicin. Gentamicin is primarily associated with nephrotoxicity (kidney damage), which would manifest as an increased BUN and serum creatinine rather than a decrease.

B) Hearing loss is a well-known adverse effect of gentamicin, particularly when the drug reaches high concentrations in the inner ear (ototoxicity). Gentamicin can cause irreversible damage to the cochlear and vestibular organs, leading to sensorineural hearing loss and balance disturbances.

C) Reports of photophobia are not typically associated with gentamicin. Photophobia (sensitivity to light) may occur with certain eye conditions or central nervous system disorders but is not a direct adverse effect of gentamicin.

D) A white blood cell count of 6,000/mm3 falls within the normal reference range, so it does not indicate an adverse effect of gentamicin. Gentamicin is not known to directly affect white blood cell count.

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During a home visit, the nurse assesses a client with Alzheimer's Di’ease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?

Correct Answer is A

Explanation

A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Reference Range: White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 10%)]

Correct Answer is B

Explanation

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