Question 1

Which receptors carry out primary functions of the parasympathetic nervous system? Select all that apply.

Accepted Answer

Nicotinic and muscarinic receptors are involved in the action of ACh, the primary neurotransmitter for the parasympathetic nervous system. The other options are not involved.

Question 2

Of the drugs given to treat AD, which one has a potential to slow neurodegeneration?

Accepted Answer

Memantine acts as an N-methyl-D-aspartate (NMDA) antagonist, preventing glutamine from overstimulating neurons causing neuronal death. This interference would hypothetically slow the advance of AD. The other drugs act as ChE inhibitors. This process does not slow cellular death.

Question 3

A nurse explains galantamine ( Razadyne ) therapy to family members of a patient who is to begin treatment with the drug. What information should be included? Select all that apply.

Accepted Answer

Anticipated side effects include nausea and vomiting, diarrhea, facial flushing, sweating, rhinitis, bradycardia, and leg cramps. The incorrect options include fluid restriction and stimulation of dopamine. Adequate intake is necessary to address GI symptoms. Galantamine stimulates action of ACh, not dopamine.

Question 4

A nursing assistant reports to the nurse that a patient diagnosed with AD is experiencing severe diarrhea. Administration of which classification of medication is most associated with this problem?

Accepted Answer

ChE inhibitors used in treatment of AD increase the availability of ACh, which stimulates action of the parasympathetic nervous system. This stimulation is likely to produce diarrhea. The other classifications work by different actions.

Question 5

An adult says, "I take vitamins B and E to prevent AD, but these vitamins are so expensive." Select the nurse's most informative response.

Accepted Answer

Research findings about the effectiveness of vitamins B and E for the prevention of AD are inconclusive. The adult in this scenario may benefit more from using health care dollars on proven causes. The distracters are incorrect statements.

Question 6

A patient diagnosed with AD is being treated with a ChE inhibitor drug. The patient develops facial flushing, sweating, and leg cramps. The nurse should attribute these symptoms to:

Accepted Answer

Gastrointestinal (GI) and other peripheral side effects of ChE inhibitor drugs are attributable to inhibition of BChE. The other options are not viable explanations.

Question 7

The spouse of a patient with Alzheimer's disease ( AD ) asks, "Can you give me a simple explanation of what happened in my partner's brain?" Select the nurse's best response.

Accepted Answer

The pathology that should be simply explained is that AD is characterized by neuronal degeneration of the brain and deficiencies of neurotransmitters. Degeneration of the substantia nigra is associated with Parkinson's disease.

Question 8

Select the most realistic short-term goal for the care of a patient with mild AD who takes donepezil (Aricept). The patient will:

Accepted Answer

Donepezil can be expected to inhibit cholinesterase (ChE), increasing the amount of intrasynaptic ACh. This drug does not cure AD, nor will it stop its eventual progression. For the present it should, however, preserve the patient's level of cognitive function.

Question 9

A 63-year-old woman says, "I want to take estrogen to prevent AD, but my doctor won't prescribe it." Select the nurse's most informative response.

Accepted Answer

Research findings about the effectiveness of estrogen for prevention of AD are inconclusive; however, estrogen therapy is clearly associated with increased risk of cardiovascular events. The distracters are incorrect statements.

Question 10

An adult says, "I take provastatin (Pravachol) for my high cholesterol. It will prevent stroke and heart attack." Select the nurse's most informative response.

Accepted Answer

Statin drugs may provide protection against AD, in addition to reducing the incidence of cardiovascular and cerebrovascular incidents. The distracters are incorrect statements.

Question 11

Most drugs used to treat AD affect:

Accepted Answer

The drugs most prescribed to treat AD are agents that restore ACh. The cholinergic pathways, enzymes, and enzyme inhibition are most related to drug action. The other systems are not relevant to AD.

Question 12

A patient takes donepezil (Aricept) for AD. Vital signs for this patient are: temperature 98.2°F; blood pressure 135/82 mm Hg; pulse 54 beats/min; respirations 18 breaths/min. Which variance should the nurse consider most likely attributable to donepezil therapy?

Accepted Answer

Donepezil selectively inhibits ACh; however, some peripheral effects, including bradycardia, are sometimes seen. The other parameters are within normal limits.

Question 13

An adult tells the nurse, "I'm taking large doses of vitamin B. I read that it prevents AD, but I don't understand how it works." Which statements would be applicable as the nurse responds to the individual? Select all that apply.

Accepted Answer

The keyed statements provide correct information regarding the inconclusiveness of B vitamin therapy in prevention of AD and its effects on lowering Homocysteine levels. The distracters provide misleading or incorrect information.

Question 14

Which statement by a family member of a patient diagnosed with AD demonstrates that medication education was effective? "The medication my parent is receiving:

Accepted Answer

ChE inhibitors act by increasing the brain's supply of ACh, a neurotransmitter that is lacking in individuals with AD. They do not provide a cure but do often have a positive effect on cognitive function.

Question 15

The family of a patient diagnosed with AD asks the nurse, "How can drugs help our parent?" The reply that provides the most realistic expectations would be:

Accepted Answer

Medication can elevate acetylcholine (ACh) levels and maintain cognitive abilities for a time. The progress of the disease is not slowed or halted, however. Stating that no help is available is neither therapeutic nor true. Stating that the family will be taught how to help the patient adjust might not be realistic.

Quiz 18: Antidementia Drugs