Question 1

Which receptors carry out primary functions of the parasympathetic nervous system? Select all that apply.&#10;A) NMDA&#10;B) COX-1&#10;C) COX-2&#10;D) Nicotinic&#10;E) Muscarinic

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?&#10;A) Galantamine ( Razadyne )&#10;B) Memantine ( Namenda )&#10;C) Rivastigmine ( Exelon )&#10;D) Donepezil ( Aricept )

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.&#10;A) Facial flushing and leg cramps might worsen.&#10;B) It acts by making more dopamine available.&#10;C) Report slow heartbeat immediately.&#10;D) Restrict fluid intake to 1500 ml/day.&#10;E) Side effects include GI symptoms.

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?&#10;A) ChE inhibitor&#10;B) Secretase inhibitor&#10;C) NDMA antagonist&#10;D) Nonsteroidal antiinflammatory drug

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, &#34;I take vitamins B and E to prevent AD, but these vitamins are so expensive.&#34; Select the nurse's most informative response.&#10;A) &#34;Yes, these vitamins are very expensive, but it is money well spent to prevent AD.&#34;&#10;B) &#34;There is conflicting research evidence about effectiveness of these vitamins for prevention of AD.&#34;&#10;C) &#34;Most researchers now believe that preventing anemia is more important than taking vitamins to prevent AD.&#34;&#10;D) &#34;Aspirin is much cheaper. You should take it instead if you want to prevent AD.&#34;

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:&#10;A) irreversible acetylcholinesterase stimulation.&#10;B) inhibition of butyrylcholinesterase(BChE).&#10;C) neurodegeneration in the hippocampus.&#10;D) cytochrome P-450 system activation.

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, &#34;Can you give me a simple explanation of what happened in my partner's brain?&#34; Select the nurse's best response.&#10;A) &#34;Dementia developed.&#34;&#10;B) &#34;The brain became overstimulated with chemical messages.&#34;&#10;C) &#34;Brain cells and chemical messengers that form memories are dying.&#34;&#10;D) &#34;The substantia nigra, a tissue that makes dopamine, has degenerated.&#34;

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:&#10;A) maintain present cognitive ability.&#10;B) show improved cognitive ability.&#10;C) engage in abstract thinking.&#10;D) communicate clearly.

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, &#34;I want to take estrogen to prevent AD, but my doctor won't prescribe it.&#34; Select the nurse's most informative response.&#10;A) &#34;Perhaps you should seek a second opinion. Estrogen clearly provides protection against AD.&#34;&#10;B) &#34;Most researchers now believe that estrogen is not actually deficient after menopause. It simply works in different ways.&#34;&#10;C) &#34;Most online resources indicate that estrogen provides important protection against development of AD.&#34;&#10;D) &#34;There is conflicting evidence about whether estrogen prevents Alzheimer's disease, but research clearly shows cardiovascular problems with estrogen therapy.&#34;

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, &#34;I take provastatin (Pravachol) for my high cholesterol. It will prevent stroke and heart attack.&#34; Select the nurse's most informative response.&#10;A) &#34;That's correct. I'm glad to see you taking such good care of yourself.&#34;&#10;B) &#34;There is limited research-based evidence of the effectiveness of statin medications.&#34;&#10;C) &#34;Some research indicates that statin drugs may also interfere with development of AD.&#34;&#10;D) &#34;Perhaps you should discuss your family history with your doctor. Statin drugs may cause early development of AD.&#34;

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:&#10;A) monoamine oxidase reuptake systems.&#10;B) serotonin and norepinephrine production.&#10;C) cholinergic pathways, enzymes, and receptors.&#10;D) the Krebs cycle and GABA neuronal inhibition.

Accepted Answer

The answer of Most drugs used to treat AD affect:&#10;A)...

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?

A) Temperature
B) Blood pressure
C) Pulse rate
D) Respiratory rate

Accepted Answer

The answer of A patient takes donepezil (Aricept) for AD....

Question 13

An adult tells the nurse, &#34;I'm taking large doses of vitamin B. I read that it prevents AD, but I don't understand how it works.&#34; Which statements would be applicable as the nurse responds to the individual? Select all that apply.&#10;A) &#34;Research has not proven the effectiveness of B vitamins in Alzheimer's prevention.&#34;&#10;B) &#34;B vitamins lower the amino acid homocysteine, which is associated with a lower incidence of AD.&#34;&#10;C) &#34;A favorable response occurs when these vitamins block NMDA.&#34;&#10;D) &#34;B vitamins may reduce risk of AD by lowering cholesterol levels.&#34;&#10;E) &#34;B vitamins reduce the body's inflammatory response.&#34;

Accepted Answer

The answer of An adult tells the nurse, &#34;I'm taking...

Question 14

Which statement by a family member of a patient diagnosed with AD demonstrates that medication education was effective? &#34;The medication my parent is receiving:&#10;A) affects glutamate receptors and will stabilize late-stage dementia.&#34;&#10;B) inhibits the action of dopamine and will restore short-term memory.&#34;&#10;C) offers no positive effects on performance of activities of daily living.&#34;&#10;D) inhibits breakdown of an important neurotransmitter and may slow disease progression.&#34;

Accepted Answer

The answer of Which statement by a family member of...

Question 15

The family of a patient diagnosed with AD asks the nurse, &#34;How can drugs help our parent?&#34; The reply that provides the most realistic expectations would be:&#10;A) &#34;Unfortunately, drugs are not helpful.&#34;&#10;B) &#34;Drugs are available to stop the disease process.&#34;&#10;C) &#34;Drugs can help preserve mental abilities for a time.&#34;&#10;D) &#34;We will teach you ways of helping your parent adjust.&#34;

Accepted Answer

The answer of The family of a patient diagnosed with...

Deck 18: Antidementia Drugs