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 B

Explanation

Lactulose is a medication commonly used in the management of hepatic encephalopathy. It works by reducing the absorption of ammonia in the gut, which is a toxin that can accumulate in the blood in patients with liver dysfunction.

Monitoring serum electrolytes and ammonia levels can help the nurse evaluate the eﬀectiveness of lactulose therapy. Elevated ammonia levels can indicate that the medication is not eﬀectively reducing ammonia absorption and may require adjustment in dose or frequency. Additionally, monitoring electrolyte levels can help detect any imbalances that may occur because of lactulose therapy.

Fingerstick glucose levels (option A) are not relevant to evaluating the therapeutic response of lactulose in hepatic encephalopathy.

Stool color and character (option C) may be monitored to assess the side eﬀects of lactulose, such as diarrhea, but are not the best assessments to evaluate therapeutic response.

Serum hepatic enzymes (option D) may be useful in assessing the severity of liver disease but are not the best assessment to evaluate the therapeutic response of lactulose in hepatic encephalopathy.

A. Review the client’s culture and sensitivity reports. B. Inform the client that the medication has been successful. C. Implement neutropenic precautions. D. Assess the clients’ vital signs.

Correct Answer is B

Explanation

Filgrastim is a medication used to increase the production of white blood cells. An increase in the client’s white blood cell count from 2,500/mm3 to 5,000/mm3 after receiving five doses of filgrastim indicates that the medication has been eﬀective in increasing the client’s white blood cell count. The nurse should inform the client of this positive outcome.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the nest information to evaluate the client’s therapeutic response to the drug?

Correct Answer is B

Explanation

After receiving five doses of filgrastim, the nurse notes that the clients white blood cell count has increased from 2,500/mm3 to 5,000/mm3. Which action would the nurse take?

Correct Answer is B

Explanation

A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse eﬀect is most important for the nurse to report?

A client with anemia secondary to chronic kidney disease started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is eﬀective?

A male client has been receiving the antibiotic gentamicin sulfate IV piggyback every 12 hours for several days. Which observations by the nurse indicate that the client may be experiencing an adverse eﬀect of gentamicin?

The nurse is preparing a client with Chronic Obstructive Pulmonary Disease (COPD) and a chronic productive cough for discharged home. Which prescribed medication should the nurse review with the client to manage this symptom?

A client receives a new prescription for levothyroxine. Which statement made by client indicates to the nurse that the education was eﬀective?

Which assessment data indicated to the nurse that a client is having an anaphylactic reaction to a medication?

A client who is taking albendazole reports experiencing fatigue, nausea, and dark urine. The nurse observes a yellowing of the client’s skin and sclera. Which lab results should the nurse review?

Two months after taking nitrofurantoin for a bacterial infection, a client reports the onset of severe, watery diarrhea to the home care nurse. How should the nurse respond?