Chapter 42: Medications for Dementia

Chapter 42: Medications for Dementia

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient is identified as having stage 2 Alzheimer’s disease and elects to take donepezil (Aricept). The patient asks the primary care nurse practitioner (NP) how long the medication will be needed. The NP should tell the patient that donepezil must be taken:

ANS:  B

Cholinesterase (ChE) inhibitor drugs such as donepezil diminish symptoms; when the drug is stopped, the symptoms return. Cognitive function will show improvement at about 24 weeks, but the drug must be continued indefinitely.

DIF:    Cognitive Level: Understanding (Comprehension)             REF:   459

2. A patient who has Alzheimer’s disease has been taking donepezil for 1 year. The patient’s spouse reports a worsening of symptoms. The primary care NP should consider:

ANS:  D

Memantine hydrochloride can be added to therapy when symptoms worsen. Ginkgo biloba may be useful but is not recommended as adjunct therapy. Antidepressants given to patients with Alzheimer’s disease who have depression appear not to be effective and often cause adverse effects or produce unwanted drug interactions. Galantamine is part of first-line therapy but should not be given with donepezil because both are ChE inhibitors.

DIF:    Cognitive Level: Applying (Application)                           REF:   459

3. Early-stage Alzheimer’s disease is diagnosed in a patient, and the primary care NP recommends therapy with a ChE inhibitor. The patient asks why drug treatment is necessary because most functioning is intact. The NP should explain that medication may:

ANS:  A

Pharmacologic treatment should begin as soon as Alzheimer’s disease is suspected because early treatment can slow disease progression. Medication does not produce disease remission or prevent depression. The disease eventually progresses despite medication, and adjunct therapies are often required.

DIF:    Cognitive Level: Applying (Application)                           REF:   459

4. A patient has a diagnosis of depression and Alzheimer’s disease with mild, intermittent symptoms. The primary care NP should prescribe a(n):

ANS:  B

Antidepressants given to patients with Alzheimer’s disease do not appear to be effective and cause adverse effects and unwanted drug interactions.

DIF:    Cognitive Level: Applying (Application)                           REF:   459