Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse in a long-term care facility is providing care for a client who has been receiving donepezil. Which of the following findings indicates that the medication is effective?
A. Improved short-term memory
Correct. Donepezil is a medication used to treat Alzheimer's disease and is expected to improve cognitive function, including short-term memory.
B. Increased food intake
Incorrect. Donepezil is not typically associated with changes in food intake.
C. Can perform ADLs independently
Incorrect. While improved functional ability is a goal of treatment, performing ADLs independently might not be solely indicative of donepezil's effectiveness.
D. Enhanced mood
Incorrect. Donepezil is primarily focused on improving cognitive function rather than mood enhancement.
This question is an excerpt from Nurse Dive's nursing test bank - RN Comprehensive Predictor Proctored Exam. Take the full exam now
Full Explanation
A. Correct. Donepezil is a medication used to treat Alzheimer's disease and is expected to improve cognitive function, including short-term memory.
B. Incorrect. Donepezil is not typically associated with changes in food intake.
C. Incorrect. While improved functional ability is a goal of treatment, performing ADLs independently might not be solely indicative of donepezil's effectiveness.
D. Incorrect. Donepezil is primarily focused on improving cognitive function rather than mood enhancement.
Similar Questions
A nurse is planning to teach a client about taking prednisone. Which of the following instructions should the nurse include?
A. Take on an empty stomach.
Prednisone should generally be taken with food or after a meal to reduce the risk of gastric irritation or ulcer formation. Taking it on an empty stomach can irritate the stomach lining and increase the risk of gastrointestinal side effects, such as gastritis or peptic ulcers.
B. Schedule dosage at bedtime.
While some medications are best taken at bedtime (such as those with sedative effects), prednisone is a corticosteroid that can affect the body's circadian rhythm and may interfere with sleep. It typically causes insomnia or restlessness, so it’s usually advised to take it in the morning.
C. Increase dietary calcium.
Prednisone and other corticosteroids can lead to bone loss (osteoporosis) over time, especially with long-term use. One of the side effects of corticosteroid therapy is decreased calcium absorption and bone density loss, making individuals at higher risk for fractures.
D. Monitor for weight loss.
Prednisone more commonly causes weight gain rather than weight loss. Corticosteroids increase appetite and can lead to fluid retention, both of which can result in weight gain. Additionally, prednisone can cause redistribution of fat, often leading to characteristic side effects like "moon face" or increased abdominal fat.
Full Explanation
A. Prednisone should generally be taken with food or after a meal to reduce the risk of gastric irritation or ulcer formation. Taking it on an empty stomach can irritate the stomach lining and increase the risk of gastrointestinal side effects, such as gastritis or peptic ulcers.
B. While some medications are best taken at bedtime (such as those with sedative effects), prednisone is a corticosteroid that can affect the body's circadian rhythm and may interfere with sleep. It typically causes insomnia or restlessness, so it’s usually advised to take it in the morning.
C. Prednisone and other corticosteroids can lead to bone loss (osteoporosis) over time, especially with long-term use. One of the side effects of corticosteroid therapy is decreased calcium absorption and bone density loss, making individuals at higher risk for fractures.
D. Prednisone more commonly causes weight gain rather than weight loss. Corticosteroids increase appetite and can lead to fluid retention, both of which can result in weight gain. Additionally, prednisone can cause redistribution of fat, often leading to characteristic side effects like "moon face" or increased abdominal fat.
B. Incorrect. Prednisone is often prescribed as a single daily dose in the morning to coincide with the body's natural cortisol release.
C. Incorrect. While calcium supplementation might be necessary for some individuals on long-term prednisone therapy, it is not a primary instruction related to taking prednisone.
D. Correct. Monitoring for weight loss is important due to the potential for weight changes (both weight gain and weight loss) as a result of prednisone's effects on metabolism and appetite.
A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of the following factors places the client at risk for aspiration?
A. A residual of 65 mL 1 hr postprandial
Incorrect. A residual of 65 mL may indicate delayed gastric emptying, but it alone does not directly correlate with an increased risk of aspiration unless it leads to significant overdistension or the client is unable to tolerate further feedings.
B. Sitting in high-Fowler's position during the feeding
Incorrect. Sitting in high Fowler's position during feeding is actually a preventive measure against aspiration.
C. A history of gastroesophageal reflux disease
Correct. his factor increases the risk for aspiration. Clients with gastroesophageal reflux disease (GERD) are more prone to refluxing contents from the stomach into the esophagus, which can lead to aspiration, especially during or after feedings.
D. Receiving a high-osmolarity formula
Incorrect. The osmolarity of the formula might affect tolerance but is not directly related to aspiration risk.
Full Explanation
A. Incorrect. A residual of 65 mL may indicate delayed gastric emptying, but it alone does not directly correlate with an increased risk of aspiration unless it leads to significant overdistension or the client is unable to tolerate further feedings.
B. Incorrect. Sitting in high Fowler's position during feeding is actually a preventive measure against aspiration.
C. Correct. his factor increases the risk for aspiration. Clients with gastroesophageal reflux disease (GERD) are more prone to refluxing contents from the stomach into the esophagus, which can lead to aspiration, especially during or after feedings.
D. Incorrect. The osmolarity of the formula might affect tolerance but is not directly related to aspiration risk.
A nurse is planning care for a client who has a prescription for continuous enteral feedings through an NG tube. Which of the following actions should the nurse plan to take?
A. Measure gastric residual volumes every 4 hr.
Correct. Measuring gastric residual volumes every 4 hours is important to assess gastric emptying and to determine if the client can tolerate the feedings. If residuals are high, it may indicate delayed gastric emptying and the need to adjust the feeding rate.
B. Flush the NG tube with 30 mL 0.9% sodium chloride before and after medication.
Incorrect. While flushing the NG tube before and after medications is important to maintain patency, it is typically done with sterile water, not sodium chloride, unless otherwise specified by a protocol. Therefore, this statement may not be fully accurate.
C. Maintain the head of the bed at a 20° angle.
Incorrect. The head of the bed should be elevated to a 30-45° angle to help prevent aspiration during enteral feedings.
D. Advance the rate of the feeding every 2 hr.
Incorrect. The rate of the feeding should be advanced gradually to prevent overloading the client's gastrointestinal tract. This does not involve advancing the rate every 2 hours.
Full Explanation
A. Correct. Measuring gastric residual volumes every 4 hours is important to assess gastric emptying and to determine if the client can tolerate the feedings. If residuals are high, it may indicate delayed gastric emptying and the need to adjust the feeding rate.
B. Incorrect. While flushing the NG tube before and after medications is important to maintain patency, it is typically done with sterile water, not sodium chloride, unless otherwise specified by a protocol. Therefore, this statement may not be fully accurate.
C. Incorrect. The head of the bed should be elevated to a 30-45° angle to help prevent aspiration during enteral feedings.
D. Incorrect. The rate of the feeding should be advanced gradually to prevent overloading the client's gastrointestinal tract. This does not involve advancing the rate every 2 hours.