Chapter 18: Antidementia Drugs

Chapter 18: Antidementia Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. 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.

a.	“Dementia developed.”
b.	“The brain became overstimulated with chemical messages.”
c.	“Brain cells and chemical messengers that form memories are dying.”
d.	“The substantia nigra, a tissue that makes dopamine, has degenerated.”

 

 

ANS:  C

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.

 

DIF:    Cognitive level: Applying                REF:   pp. 193-194

TOP:   Nursing process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

2. 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:

a.	“Unfortunately, drugs are not helpful.”
b.	“Drugs are available to stop the disease process.”
c.	“Drugs can help preserve mental abilities for a time.”
d.	“We will teach you ways of helping your parent adjust.”

 

 

ANS:  C

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.

 

DIF:    Cognitive level: Applying                REF:   p. 196

TOP:   Nursing process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

3. Most drugs used to treat AD affect:

a.	monoamine oxidase reuptake systems.
b.	serotonin and norepinephrine production.
c.	cholinergic pathways, enzymes, and receptors.
d.	the Krebs cycle and GABA neuronal inhibition.

 

 

ANS:  C

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.

 

DIF:    Cognitive level: Understanding        REF:   pp. 193-194

TOP:   Nursing process: Implementation     MSC:  NCLEX: Physiologic Integrity

 

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

a.	maintain present cognitive ability.
b.	show improved cognitive ability.
c.	engage in abstract thinking.
d.	communicate clearly.

 

 

ANS:  A

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.

 

DIF:    Cognitive level: Applying                REF:   p. 196             TOP:   Nursing process: Planning

MSC:  NCLEX: Psychosocial Integrity

 

5. 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

 

 

ANS:  C

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

 

DIF:    Cognitive level: Applying                REF:   p. 196             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Physiologic Integrity