Rivastigmine, a cholinesterase inhibitor, is prescribed for a female patient with early-stage Alzheimer’s Disease.
The patient’s daughter tells the nurse that she plans to start administering the drug when her mother’s symptoms worsen, hoping to avoid nursing home placement.
How should the nurse respond?

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

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

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

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

w should the nurse respond?

Answer and Explanation

The Correct Answer is B

Choice A rationale

While it’s understandable that the patient’s daughter wants to delay the use of medication until her mother’s symptoms worsen, this approach may not be beneficial. Rivastigmine, a cholinesterase inhibitor, is used to treat mild to moderate dementia caused by Alzheimer’s or Parkinson’s disease. It is not a cure for Alzheimer’s or Parkinson’s disease, but it can help manage the symptoms. Waiting until the symptoms worsen may not provide the desired benefits and could potentially lead to a faster progression of the disease.

Choice B rationale

Rivastigmine is most effective when used early in the disease process. It works by increasing the concentration of acetylcholine, a neurotransmitter, through reversible inhibition of its hydrolysis by cholinesterase. This can help improve the function of nerve cells in the brain and can slow the progression of symptoms in patients with Alzheimer’s disease. Therefore, starting the medication early can help manage the symptoms and potentially slow the progression of the disease.

Choice C rationale

While assessing the patient’s current mental status is an important part of care, it should not be the sole factor in deciding when to start medication. The decision to start medication should be based on a comprehensive evaluation of the patient’s condition, including the stage of the disease, the patient’s overall health, and the potential benefits and risks of the medication.

Choice D rationale

While it’s important for the daughter to understand the progressive nature of Alzheimer’s disease, this understanding alone does not determine when to start medication. The decision to start medication should be based on a comprehensive evaluation of the patient’s condition and the potential benefits and risks of the medication.

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Correct Answer is A

Explanation

Choice A rationale

Tamsulosin is an alpha-blocker that relaxes the smooth muscles of the prostate and bladder neck, improving urine flow. However, it can also cause hypotension, dizziness, and fainting as adverse effects. Therefore, monitoring blood pressure is essential for clients taking tamsulosin.

Choice B rationale

While assessing the client’s urine output is an important part of monitoring a client with benign prostatic hyperplasia, it is not specifically related to monitoring for adverse reactions to tamsulosin.

Choice C rationale

Performing a bladder scan can be useful in assessing the client’s urinary retention, a common symptom of benign prostatic hyperplasia. However, it is not specifically related to monitoring for adverse reactions to tamsulosin.

Choice D rationale

Obtaining the client’s daily weights can be useful in monitoring fluid balance, but it is not specifically related to monitoring for adverse reactions to tamsulosin.

A. Serum potassium level of 3.8 mEq/L (3.8 mmol/L) B. Hemoglobin level of 13.5 g/dL (135 g/L). C. Serum glucose level of 120 mg/dL (6.7 mmol/L) D. Serum ammonia level of 30 Mcg/dL (17.62 Mermol/L)

Correct Answer is A

Explanation

Choice A rationale

Sodium polystyrene sulfonate is a medication used to treat high levels of potassium in the blood, a condition known as hyperkalemia. Hyperkalemia is a common complication of acute kidney injury (AKI). The medication works by exchanging sodium ions for potassium ions in the intestine, which are then excreted from the body. Therefore, a decrease in serum potassium levels to within the normal range (3.5-5.0 mEq/L) would indicate that the medication has been effective.

Choice B rationale

Hemoglobin levels are not directly affected by sodium polystyrene sulfonate. Hemoglobin is a protein in red blood cells that carries oxygen. While it’s an important indicator of overall health, changes in hemoglobin levels would not indicate whether treatment for hyperkalemia is working.

Choice C rationale

Sodium polystyrene sulfonate does not directly affect glucose levels. While it’s important to monitor glucose levels in patients with kidney disease, changes in glucose would not indicate whether treatment for hyperkalemia is working.

Choice D rationale

Sodium polystyrene sulfonate does not directly affect ammonia levels. While elevated ammonia levels can occur in certain conditions, such as liver disease, changes in ammonia levels would not indicate whether treatment for hyperkalemia is working.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with benign prostatic hyperplasia has been prescribed tamsulosin. What should the nurse do to monitor for an adverse reaction?

Correct Answer is A

Explanation

The nurse is administering sodium polystyrene sulfonate to a client with acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective?

Correct Answer is A

Explanation

Before administering the evening dose of carbamazepine, the nurse notes that the patient’s morning carbamazepine level was 84 mcg/mL. What action should the nurse take?

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