Rivastigmine, a cholinesterase inhibitor, is prescribed for a female client with early-stage Alzheimer’s disease. The client’s daughter tells the nurse that she plans to start administering the drug when her mothers’ symptoms are no longer manageable, in hopes that her mother will not have to go to a nursing home. How should the nurse respond?

Explain that the drug should be used early in the course of the disease process.

Affirm the decision to use the drug when the symptoms start to worsen.

Assess the client’s current mental health status before deciding to support the decision.

Confirm that the daughter is aware of the progressive nature of the disease.

Answer and Explanation

The Correct Answer is A

The nurse should explain to the client's daughter that Rivastigmine is most eﬀective when used early during Alzheimer's disease. Delaying the use of the medication until the symptoms are no longer manageable may result in the drug being less eﬀective.

The nurse should emphasize the importance of following the healthcare provider's instructions for administering the medication to maximize its therapeutic eﬀect. It is important to educate the client's daughter about the progressive nature of Alzheimer's disease and the need for ongoing monitoring and care.

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Correct Answer is C

Explanation

Oxybutynin is a medicine used to treat symptoms of an overactive bladder. One of the side eﬀects of oxybutynin is that it can cause dry mouth, constipation, and dry skin21. These side eﬀects can increase the risk of dehydration. Additionally, oxybutynin can cause ﬂushing and heat stroke. Therefore, it is important for the client to take measures to avoid dehydration and over-heating while training for a marathon.

A. Weight change in the last month. B. Recent use of other antidepressants. C. Liver function lab results. D. Family history of mental illness.

Correct Answer is C

Explanation

The correct answer is C. Liver function lab results.

Choice A: Weight change in the last month

Weight change is a relevant factor to monitor in patients starting on antidepressants, including duloxetine, as some antidepressants can cause weight gain or loss. However, it is not the most critical information to obtain initially. Monitoring weight can help manage potential side effects and ensure the patient’s overall health, but it does not directly impact the immediate safety and efficacy of starting duloxetine.

Choice B: Recent use of other antidepressants

Recent use of other antidepressants is crucial information because combining duloxetine with other antidepressants, especially MAOIs (Monoamine Oxidase Inhibitors), can lead to serious interactions such as serotonin syndrome. This condition can be life-threatening and requires careful management. However, while this information is important, it is not as immediately critical as liver function tests when starting duloxetine.

Choice C: Liver function lab results

Liver function lab results are the most important information for the nurse to obtain. Duloxetine is metabolized in the liver, and patients with pre-existing liver conditions or impaired liver function are at higher risk for hepatotoxicity. Monitoring liver function is essential to prevent severe liver damage, which can be life-threatening. Baseline liver function tests help ensure that the patient can safely metabolize the medication and identify any potential issues early.

Choice D: Family history of mental illness

Family history of mental illness can provide valuable context for understanding the patient’s condition and potential genetic predispositions. It can also help in tailoring the treatment plan and anticipating the patient’s response to medication. However, while this information is useful for long-term management, it is not as immediately critical as liver function tests when initiating duloxetine therapy.

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Naxlex Comprehensive Predictor Exams

A female client starts a new prescription, oxybutynin, for symptoms of an overactive bladder. The client tells the nurse that she is training to run in a marathon. Which instruction should the nurse emphasize?

Correct Answer is C

Explanation

The nurse is planning care for a patient with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

Correct Answer is C

Explanation

An older adult client with restless legs syndrome begins taking melatonin at bedtime. When evaluating the eﬀectiveness of the herb which client assessment should the nurse complete?

On admission, the healthcare provider describes a broad spectrum of antibiotic, ticarcillin for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription?

The nurse administers risedronate to a client with osteoporosis at 07:00. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?

The nurse is providing instructions about a client’s new medication. How should the nurse explain the purpose of probenecid, a uricosuric drug?

The nurse is caring for a client who is taking diclofenac, an NSAID drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client’s serum laboratory values is most important for the nurse to review?

A client with muscle spasticity receives a prescription for baclofen. Which information provided by the client requires additional instruction by the nurse?

A client is scheduled for a spiral computed topography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client’s history requires follow-up by the nurse?

The nurse is preparing a discharge teaching plan for a clientwho is taking ciproﬂoxacin hydrochloride tablets which were prescribed because of a suspected anthrax exposure. Which instructions should be included in the teaching plan? (Select all that apply.)