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NurseDive Free Nursing Practice Question
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?
A. Explain that the drug should be used early in the course of the disease process.
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.
B. Affirm the decision to use the drug when the symptoms start to worsen.
C. Assess the client’s current mental health status before deciding to support the decision.
D. Confirm that the daughter is aware of the progressive nature of the disease.
This question is an excerpt from Nurse Dive's nursing test bank - HESI Pharmacology Proctored Exam. Take the full exam now
Full Explanation
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.
Similar Questions
The home health nurse observes a client self-administering an epinephrine injection using an auto-injector pen.
Which client action requires intervention by the nurse?
A. Administers onto the fleshy outer thigh.
Appropriate injection site:The fleshy outer thigh is a common and recommended injection site for epinephrine auto-injectors.It provides a large muscle mass with adequate blood flow for rapid absorption of the medication.
B. Inserts the injection pen through clothing.
Ineffective delivery of medication:Inserting the injection pen through clothing can impede the needle from reaching the muscle and delivering the medication effectively.Clothing can act as a barrier,absorbing or deflecting the medication,potentially leading to a suboptimal dose or delayed absorption. Risk of infection:Clothing may harbor bacteria or other contaminants that could be introduced into the injection site,increasing the risk of infection.This is particularly concerning in a home setting where clothing may not be as sterile as in a healthcare facility. Difficulty assessing injection site:If the injection is given through clothing,it can be challenging to accurately assess the injection site for any signs of redness,swelling,or other potential complications.This could delay identification and treatment of any adverse reactions.
C. Holding the pen in place for several seconds after injection
Ensures full dose delivery:Holding the pen in place for several seconds after injection is essential to ensure that the full dose of medication is delivered.This allows time for the medication to be fully expelled from the pen and absorbed into the muscle tissue.
D. Cleans the injector pen for re-use.
Not a reusable device:Epinephrine auto-injector pens are designed for single use only and should not be cleaned for re-use.Cleaning a used pen can compromise its sterility and functionality,potentially leading to infection or medication errors.
E. None
None
F. None
None
Full Explanation
A. Administers onto the fleshy outer thigh: This is the recommended site for epinephrine auto-injection because it allows for quick absorption into the bloodstream. The outer thigh is a large muscle area, which helps in the rapid distribution of the medication.
B. Inserts the injection pen through clothing: It is generally acceptable to inject epinephrine through clothing in an emergency situation. This practice ensures that there is no delay in administering the life-saving medication, which is crucial during an anaphylactic reaction.
C. Cleanses the injection pen for re-use: Epinephrine auto-injectors are designed for single use only. Reusing the pen can lead to contamination and reduced effectiveness of the medication. It is important to dispose of the used injector properly and obtain a new one for future use.
D. Holds the pen in place after injection: Holding the pen in place for a few seconds after injection ensures that the full dose of medication is delivered. This practice helps in maximizing the effectiveness of the treatment during an anaphylactic emergency.
A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this patient’s plan of care?
A. Replace salt with a salt substitute.
Option a (Replace salt with a salt substitute) is incorrect because salt substitutes often contain potassium, which can further increase the risk of hyperkalemia.
B. Limits intake of high-potassium foods.
Spironolactone is a potassium-sparing diuretic that works by blocking the actions of aldosterone, a hormone that can lead to potassium loss in the urine. However, in some cases, spironolactone can cause hyperkalemia (high levels of potassium in the blood), which can be dangerous for patients with heart failure. Therefore, it is important to instruct the patient to limit their intake of high-potassium foods such as bananas, oranges, tomatoes, spinach, and salt substitutes containing potassium.
C. Cover your skin before going outside.
Option c (Cover your skin before going outside) is unrelated to the use of spironolactone and hyperkalemia.
D. Monitor skin for excessive bruising.
Option d (Monitor skin for excessive bruising) is not directly related to the use of spironolactone and hyperkalemia, although it is a potential side effect of other medications used to treat heart failure.
Full Explanation
Spironolactone is a potassium-sparing diuretic that works by blocking the actions of aldosterone, a hormone that can lead to potassium loss in the urine. However, in some cases, spironolactone can cause hyperkalemia (high levels of potassium in the blood), which can be dangerous for patients with heart failure. Therefore, it is important to instruct the patient to limit their intake of high-potassium foods such as bananas, oranges, tomatoes, spinach, and salt substitutes containing potassium.
Option a (Replace salt with a salt substitute) is incorrect because salt substitutes often contain potassium, which can further increase the risk of hyperkalemia.
Option c (Cover your skin before going outside) is unrelated to the use of spironolactone and hyperkalemia.
Option d (Monitor skin for excessive bruising) is not directly related to the use of spironolactone and hyperkalemia, although it is a potential side effect of other medications used to treat heart failure.
A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client’s history, the nurse determines that the client has been self-administering St. John's Wort, an herbal preparation on the advice of a friend.
Which information is most significant about this finding?
A. The client probably used this herb to treat depression.
B. Wort can decrease plasma concentrations of the cyclosporine.
Cyclosporine is an immunosuppressive medication commonly used to prevent graft rejection after organ transplantation. St. John's Wort is known to induce cytochrome P450 enzymes, which can increase the metabolism and decrease the effectiveness of many medications, including cyclosporine. This interaction can lead to decreased plasma concentrations of cyclosporine, which can increase the risk of graft rejection. Therefore, it is important to advise the client to discontinue the use of St. John's Wort and inform their healthcare provider about any herbal or supplement use to prevent potential interactions with prescribed medications. Options a, c, and d are not directly related to the client's current condition and are not as significant as option b.
C. Ingestion of wort can reduce the client’s intake of sodium.
D. Adding the herb can decrease the need for corticosteroids.
E. Adding the herb can decrease the need for corticosteroids.
Full Explanation
Cyclosporine is an immunosuppressive medication commonly used to prevent graft rejection after organ transplantation. St. John's Wort is known to induce cytochrome P450 enzymes, which can increase the metabolism and decrease the effectiveness of many medications, including cyclosporine. This interaction can lead to decreased plasma concentrations of cyclosporine, which can increase the risk of graft rejection. Therefore, it is important to advise the client to discontinue the use of St. John's Wort and inform their healthcare provider about any herbal or supplement use to prevent potential interactions with prescribed medications. Options a, c, and d are not directly related to the client's current condition and are not as significant as option b.
