Week 11: Chapter 26

Question 1

Which statement about drug therapy for Alzheimer’s disease is accurate?

Answer 1

Medications prescribed to treat Alzheimer’s disease slow progression of the illness

Question 2

A pt is prescribed memantine (Namenda) for Alzheimer’s disease. For which common S/E should you monitor?

Answer 2

1. Constipation
2. Dizziness
3. Confusion
4. Headache

Question 3

Which lab tests should you check before and after administering memantine to a pt?

Answer 3

Hematocrit and hemoglobin

Question 4

When should you teach a pt and his or her caregivers to administer donepezil (Aricept) {Alzheimer’s Disease}?

Answer 4

In the evening at bed time

Question 5

A pt with Parkinson’s disease is prescribed the rotingotine (Neupro) patch. What must you do to ensure proper adherence of the patch to the pts skin?

Answer 5

Press firmly on the patch especially around the edges for 20 - 30 seconds

Question 6

How do cholinesterase/ acetylcholinesterase inhibitor drugs used for Alzheimer’s disease work?

Answer 6

The inhibit the break down of acetylcholine

Question 7

The spouse of a pt with Alzheimer’s disease asks you how memantine (Namenda) will help his wife. What is your best response?

Answer 7

Memantine will prevent overstimulation of certain receptors in the brain which seems to be one cause of Alzheimer’s disease

Question 8

Which assessments are essential before and after giving a drug for Alzheimer’s disease?

Answer 8

1. Language skills
2. Weight
3. Swallowing
4. Ability to perform simple tasks

Question 9

What do you teach the spouse and the pt who has been prescribed rivastigmine (Exelon) [Alzheimer’s med] about common S/E?

Answer 9

1. Check the pts BP before giving the drug
2. Rivastigmine can cause you to feel tired and weak
3. Remember to get up slowly because this drug can cause dizziness

Question 10

What precaution must you teach the spouse of an older frail female pt with Alzheimer’s disease prescribed donepezil (Aricept)?

Answer 10

Be sure to monitor your wife weight and report weight loss to the prescriber

Question 11

Which pt response indicates to you that benztropine (Cogentin) therapy for Parkinson’s disease is effective?

Answer 11

Reduced tremor and muscle rigidity

Question 12

For which dangerous A/E must you monitor in a pt who is taking carbidopa-levodopa (Sinemet)?

Answer 12

1. Decreased WBC
2. Suicidal thoughts
3. Neuroleptic malignant syndrome

Question 13

Which foods should you teach the pt prescribed rasagiline (Azilect) to avoid

Answer 13

1. Avocados
2. Yogurt
3. Raisins
4. Sauerkraut

Question 14

About which safety measures must you instruct the older adult who has been prescribed carbidopa-levodopa (Sinemet) for Parkinson’s disease?

Answer 14

1. Always wear shoes and use handrails for stability when going up or down stairs
2. Sit on the side of the bed for a few minutes before getting up

Question 15

The nurse is doing a physical assessment on a patient and notices “pill rolling.” The nurse knows that this is an initial symptom of which disease?

Answer 15

Parkinson’s disease

Question 16

A family member mentions that a patient who is taking medication for Alzheimer’s disease is drooling. What do you suspect is happening with this patient?

Answer 16

The medication dose is too high.

Question 17

The nurse is discharging a patient with a prescription for Parkinson’s disease. For which drug should the nurse instruct the patient to avoid becoming overheated?

Answer 17

Benztropine (Cogentin)

Question 18

A patient who is taking selegiline (Carbex) asks why eating foods containing tyramine is not allowed. The nurse responds that the combination of selegiline and tyramine can cause what problems?

Answer 18

Hypertensive crisis

Question 19

The nurse is discharging a patient with his family present with a prescription for donepezil (Aricept). What education point is important to teach the patient and family about taking donepezil (Aricept)?

Answer 19

Take the drug orally at bedtime.

Question 20

A patient with Parkinson’s disease who is taking a catechol-o-methyltransferase (COMT) inhibitor reports stiffness and soreness in the muscles and joints that is worse than ever. The patient’s spouse reports that the patient seems much weaker over the past few days. What adverse effect of COMT inhibitors is likely the cause of these symptoms?

Answer 20

Rhabdomyolysis

Question 21

Which are important considerations when providing patient care for an older adult who is prescribed drugs to treat Parkinson’s disease? (select all that apply)

Answer 21

1. Assess the patient for fall risk.
2. Teach the patient to change positions slowly.
3. Instruct the patient to wear shoes when getting out of bed.
4. Remind the patient to use handrails when going up or down steps.

Question 22

A patient with chronic obstructive pulmonary disease (COPD) has just been diagnosed with Alzheimer’s disease. What drug prescribed for the patient causes you to question the order?

Answer 22

Rivastigmine (Exelon)

Question 23

Which are early symptoms of Alzheimer’s disease? (select all that apply)

Answer 23

1. Difficulty recalling events and activities

2. Inability to solve simple mathematic problems

Question 24

A family member of a patient diagnosed with Alzheimer’s disease asks the nurse, “What is the greatest risk factor for the development of Alzheimer’s disease?” What does the nurse respond?

Answer 24

Age

Question 25

A patient with Parkinson’s disease is prescribed a new drug. The nurse tells the patient to use sunscreen and other sun protection when taking what drug?

Answer 25

Selegiline (Eldepryl) {MAOB Inhibitor}

Question 26

The nurse is admitting a patient with Parkinson’s disease. The nurse knows to assess the patient for narcolepsy because it is an adverse reaction of what drugs for Parkinson’s disease? (select all that apply)

Answer 26

1. Pramipexole (Mirapex)

2. Ropinirole (Requip)

Question 27

Which are motor symptoms of Parkinson’s disease? (select all that apply)

Answer 27

1. Decreased arm swing when walking
2. Lack of facial expression
3. Difficulty turning in bed

Question 28

The nurse is caring for a patient with Parkinson’s disease. The nurse knows that what drug is contraindicated for patients with a history of melanoma?

Answer 28

Carbidopa-levodopa (Sinemet)

Question 29

The nurse is helping an elderly patient to ambulate. The nurse knows that what percentage of people older than age 85 years in the United States are thought to have Alzheimer’s disease?

Answer 29

50%