NGR6172 Exam 1 Test bank Questions for Exam 1 With
Complete Solutions
108. The spouse of a patient who is newly diagnosed with
Alzheimer disease asks the nurse if medications will prevent the
need for nursing home care. Which response by the nurse is
correct?
a. "Drugs to treat Alzheimer disease may slow the progression
of memory loss."
b. "Drugs may be effective to stop the progression of the disease
if they are initiated early in the disease."
c. "Medications to treat Alzheimer disease are effective for
treating core symptoms of the disease."
d. "Medications for Alzheimer disease are effective in reducing
cognitive impairment."
ANS: A
Alzheimer disease is a disease in which symptoms progress
relentlessly from mild to moderate to severe. Medications have
not been clearly effective and do not stop the disease
progression, although they may slow loss of memory and
cognition and prolong independent function. There is no
indication that available drugs stop disease progression if begun
early in the course of the disease. There is no clearly effective
therapy for core symptoms, but associated symptoms such as
incontinence and depression may be treated.
109. A nurse is caring for an older adult patient who has
Alzheimer disease. The patient is taking a cholinesterase
,inhibitor drug. Which side effects would concern the nurse?
a. Confusion and memory impairment
b. Dizziness and headache
c. Nausea, vomiting, and diarrhea
d. Slowed heart rate and lightheadedness
ANS: D
Cardiovascular effects of cholinesterase inhibitor drugs are
uncommon but cause the most concern. Bradycardia and
fainting can occur when cholinergic receptors in the heart are
activated. Confusion and memory impairment are signs of the
disease and are not side effects of the drug. Dizziness, headache,
nausea, vomiting, and diarrhea are all expected adverse effects,
and although uncomfortable, they do not present an increased
risk to the patient.
110. An older adult patient with Alzheimer disease is admitted
to the hospital. The patient's spouse reports that the patient is
often confused and gets lost walking to the store, which is three
blocks from their home. That evening, the nurse observes the
patient pacing the hall and screaming. What will the nurse do?
a. Notify the provider of this patient's worsening symptoms.
b. Prepare the patient's spouse for impending death from
Alzheimer disease.
c. Request an increase in the medication dose to treat the
exacerbation in symptoms.
d. Tell the spouse that this is an expected progression of the
disease.
,ANS: D
This patient is showing signs of the natural progression of AD.
Behavior problems such as these occur in 70% to 90% of
patients with AD as the disease progresses. There is no need to
notify the provider to report these symptoms, because they are
expected. The time from onset of symptoms to death usually is 4
to 8 years, but it may be as long as 20 years; this progression
does not represent the final stages. Medications are not effective
for preventing disease progression, and their effects on memory
and cognition are modest, so requesting an increase in the drug
dose would not help in this situation.
111. A nurse is preparing to administer memantine [Nemenda]
to a patient and notes a slight elevation in the patient's creatinine
clearance level. What will the nurse expect the provider to order
for this patient?
a. Adding sodium bicarbonate to the patient's drug regimen
b. Continuing the memantine as ordered
c. Discontinuing the memantine
d. Reducing the dose of memantine
ANS: D
Patients with severe renal impairment may require a dosage
reduction. Adding sodium bicarbonate would alkalinize the
urine and increase memantine levels, causing toxicity. It is not
necessary to discontinue or decrease the dose of the memantine
with mild or moderate renal impairment.
112. The spouse of a patient with Alzheimer disease asks a nurse
for more information about the rivastigmine [Exelon]
, transdermal patch that is being used. Which statement by the
spouse indicates a need for further explanation?
a. "Doses are lower but more steady with the transdermal patch."
b. "Reduced side effects occur with the transdermal patch."
c. "We only need to change the patch every 2 weeks."
d. "We should remove the old patch before applying the new
one."
ANS: C
The rivastigmine transdermal patch needs to be changed daily.
Sites used should not be reused for 14 days. Transdermal dosing
provides lower, steady levels of the drug. Intensity of side
effects is lower with the transdermal patch. The old patch must
be removed prior to applying the new patch to prevent toxicity.
113. A patient is worried about the risk of developing Alzheimer
disease, because both parents had the disease. The nurse will tell
this patient that known risk factors include what?
Select all that apply.
a. Advanced age
b. Alcoholism
c. Family history
d. Gender
e. Obesity
ANS: A,C
The major known risk factor for AD is advancing age; the only
other known risk factor is a family history of AD. Alcoholism,
gender, and obesity are not known risk factors.
Complete Solutions
108. The spouse of a patient who is newly diagnosed with
Alzheimer disease asks the nurse if medications will prevent the
need for nursing home care. Which response by the nurse is
correct?
a. "Drugs to treat Alzheimer disease may slow the progression
of memory loss."
b. "Drugs may be effective to stop the progression of the disease
if they are initiated early in the disease."
c. "Medications to treat Alzheimer disease are effective for
treating core symptoms of the disease."
d. "Medications for Alzheimer disease are effective in reducing
cognitive impairment."
ANS: A
Alzheimer disease is a disease in which symptoms progress
relentlessly from mild to moderate to severe. Medications have
not been clearly effective and do not stop the disease
progression, although they may slow loss of memory and
cognition and prolong independent function. There is no
indication that available drugs stop disease progression if begun
early in the course of the disease. There is no clearly effective
therapy for core symptoms, but associated symptoms such as
incontinence and depression may be treated.
109. A nurse is caring for an older adult patient who has
Alzheimer disease. The patient is taking a cholinesterase
,inhibitor drug. Which side effects would concern the nurse?
a. Confusion and memory impairment
b. Dizziness and headache
c. Nausea, vomiting, and diarrhea
d. Slowed heart rate and lightheadedness
ANS: D
Cardiovascular effects of cholinesterase inhibitor drugs are
uncommon but cause the most concern. Bradycardia and
fainting can occur when cholinergic receptors in the heart are
activated. Confusion and memory impairment are signs of the
disease and are not side effects of the drug. Dizziness, headache,
nausea, vomiting, and diarrhea are all expected adverse effects,
and although uncomfortable, they do not present an increased
risk to the patient.
110. An older adult patient with Alzheimer disease is admitted
to the hospital. The patient's spouse reports that the patient is
often confused and gets lost walking to the store, which is three
blocks from their home. That evening, the nurse observes the
patient pacing the hall and screaming. What will the nurse do?
a. Notify the provider of this patient's worsening symptoms.
b. Prepare the patient's spouse for impending death from
Alzheimer disease.
c. Request an increase in the medication dose to treat the
exacerbation in symptoms.
d. Tell the spouse that this is an expected progression of the
disease.
,ANS: D
This patient is showing signs of the natural progression of AD.
Behavior problems such as these occur in 70% to 90% of
patients with AD as the disease progresses. There is no need to
notify the provider to report these symptoms, because they are
expected. The time from onset of symptoms to death usually is 4
to 8 years, but it may be as long as 20 years; this progression
does not represent the final stages. Medications are not effective
for preventing disease progression, and their effects on memory
and cognition are modest, so requesting an increase in the drug
dose would not help in this situation.
111. A nurse is preparing to administer memantine [Nemenda]
to a patient and notes a slight elevation in the patient's creatinine
clearance level. What will the nurse expect the provider to order
for this patient?
a. Adding sodium bicarbonate to the patient's drug regimen
b. Continuing the memantine as ordered
c. Discontinuing the memantine
d. Reducing the dose of memantine
ANS: D
Patients with severe renal impairment may require a dosage
reduction. Adding sodium bicarbonate would alkalinize the
urine and increase memantine levels, causing toxicity. It is not
necessary to discontinue or decrease the dose of the memantine
with mild or moderate renal impairment.
112. The spouse of a patient with Alzheimer disease asks a nurse
for more information about the rivastigmine [Exelon]
, transdermal patch that is being used. Which statement by the
spouse indicates a need for further explanation?
a. "Doses are lower but more steady with the transdermal patch."
b. "Reduced side effects occur with the transdermal patch."
c. "We only need to change the patch every 2 weeks."
d. "We should remove the old patch before applying the new
one."
ANS: C
The rivastigmine transdermal patch needs to be changed daily.
Sites used should not be reused for 14 days. Transdermal dosing
provides lower, steady levels of the drug. Intensity of side
effects is lower with the transdermal patch. The old patch must
be removed prior to applying the new patch to prevent toxicity.
113. A patient is worried about the risk of developing Alzheimer
disease, because both parents had the disease. The nurse will tell
this patient that known risk factors include what?
Select all that apply.
a. Advanced age
b. Alcoholism
c. Family history
d. Gender
e. Obesity
ANS: A,C
The major known risk factor for AD is advancing age; the only
other known risk factor is a family history of AD. Alcoholism,
gender, and obesity are not known risk factors.
