1
NURS 5338 Advanced Pharmacology Final Examination 100
Original Questions with Detailed Answers
SECTION 1: ALZHEIMER'S DISEASE AND DEMENTIA
(Questions 1-25)
Question 1
The nurse is caring for a 76-year-old client who has experienced a slow,
progressive memory decline over the past five years. The client has a history
of peptic ulcer disease and has demonstrated difficulty adhering to
medication regimens in the past. The prescriber is considering donepezil for
this client. Which factor makes donepezil the most appropriate choice for this
client?
A) Donepezil has no gastrointestinal side effects and will not aggravate the
client's peptic ulcer disease
B) Donepezil can be administered once daily, which improves adherence in
clients with a history of nonadherence
C) Donepezil is the only cholinesterase inhibitor that does not require dose
titration
D) Donepezil has no drug interactions and is safe for clients with
cardiovascular disease
Correct Answer: B) Donepezil can be administered once daily, which improves
adherence in clients with a history of nonadherence**
, 2
*Rationale: The psychiatrist diagnoses probable Alzheimer's dementia and
chooses donepezil with its easy once-daily dosing schedule because of the
client's history of nonadherence. Donepezil's GI tolerability is also a factor in
this choice because of the client's peptic ulcer disease, as donepezil is
generally better tolerated than other cholinesterase inhibitors .*
---
Question 2
The nurse is educating a client newly diagnosed with Alzheimer's disease
about the prescribed cholinesterase inhibitor. Which statement by the client
indicates understanding of the mechanism of action of this medication?
A) "This medication will stop the progression of my Alzheimer's disease"
B) "This medication will increase the amount of acetylcholine in my brain"
C) "This medication will dissolve the amyloid plaques that are causing my
memory loss"
D) "This medication will repair the damaged neurons in my brain"
**Correct Answer: B) "This medication will increase the amount of
acetylcholine in my brain"**
*Rationale: Cholinesterase inhibitors work by reducing the breakdown of
acetylcholine in the brain, a chemical which helps neurons to communicate.
These medications can help stabilize cognitive function but do not stop
disease progression or repair damaged neurons .*
, 3
Question 3
An 82-year-old client presents with gradual memory loss, shuffling gait,
slowness of movement, visual hallucinations, and episodic confusion. The
client's current medications include warfarin and digoxin for atrial fibrillation.
The prescriber chooses rivastigmine for this client. Which statement best
explains the rationale for selecting rivastigmine?
A) Rivastigmine is the only cholinesterase inhibitor that also treats
hallucinations
B) Rivastigmine has shown efficacy in dementia with Lewy bodies and is not
known to interact significantly with cardiovascular medications
C) Rivastigmine is the safest cholinesterase inhibitor for clients with atrial
fibrillation
D) Rivastigmine does not require dose titration and can be started at a
therapeutic dose immediately
**Correct Answer: B) Rivastigmine has shown efficacy in dementia with Lewy
bodies and is not known to interact significantly with cardiovascular
medications**
*Rationale: The client is diagnosed with probable dementia with Lewy bodies.
Rivastigmine is chosen because it has shown efficacy in this type of dementia
and is not known to interact significantly with cardiovascular medications.
Rivastigmine has demonstrated positive effects on parkinsonian symptoms in
Dementia with Lewy Bodies, including improvements in rigidity, gait, and
postural abnormalities .*
, 4
---
Question 4**
A client diagnosed with probable vascular dementia has been prescribed
galantamine. The family asks the nurse how this medication will help their
loved one. Which response by the nurse is most accurate?
A) "Galantamine dissolves the blood clots that caused your loved one's
strokes"
B) "Galantamine has shown efficacy in vascular dementia by improving
cognition, global function, and activities of daily living"
C) "Galantamine prevents future strokes by controlling blood pressure"
D) "Galantamine repairs the damaged blood vessels in your loved one's brain"
**Correct Answer: B) "Galantamine has shown efficacy in vascular dementia
by improving cognition, global function, and activities of daily living"**
*Rationale: Galantamine has demonstrated efficacy in clients with vascular
dementia and Alzheimer's disease with cerebrovascular components. Clinical
studies show galantamine improves cognition, global functioning, behavioral
abnormalities, and maintains activities of daily living in clients with vascular
dementia .*
---
NURS 5338 Advanced Pharmacology Final Examination 100
Original Questions with Detailed Answers
SECTION 1: ALZHEIMER'S DISEASE AND DEMENTIA
(Questions 1-25)
Question 1
The nurse is caring for a 76-year-old client who has experienced a slow,
progressive memory decline over the past five years. The client has a history
of peptic ulcer disease and has demonstrated difficulty adhering to
medication regimens in the past. The prescriber is considering donepezil for
this client. Which factor makes donepezil the most appropriate choice for this
client?
A) Donepezil has no gastrointestinal side effects and will not aggravate the
client's peptic ulcer disease
B) Donepezil can be administered once daily, which improves adherence in
clients with a history of nonadherence
C) Donepezil is the only cholinesterase inhibitor that does not require dose
titration
D) Donepezil has no drug interactions and is safe for clients with
cardiovascular disease
Correct Answer: B) Donepezil can be administered once daily, which improves
adherence in clients with a history of nonadherence**
, 2
*Rationale: The psychiatrist diagnoses probable Alzheimer's dementia and
chooses donepezil with its easy once-daily dosing schedule because of the
client's history of nonadherence. Donepezil's GI tolerability is also a factor in
this choice because of the client's peptic ulcer disease, as donepezil is
generally better tolerated than other cholinesterase inhibitors .*
---
Question 2
The nurse is educating a client newly diagnosed with Alzheimer's disease
about the prescribed cholinesterase inhibitor. Which statement by the client
indicates understanding of the mechanism of action of this medication?
A) "This medication will stop the progression of my Alzheimer's disease"
B) "This medication will increase the amount of acetylcholine in my brain"
C) "This medication will dissolve the amyloid plaques that are causing my
memory loss"
D) "This medication will repair the damaged neurons in my brain"
**Correct Answer: B) "This medication will increase the amount of
acetylcholine in my brain"**
*Rationale: Cholinesterase inhibitors work by reducing the breakdown of
acetylcholine in the brain, a chemical which helps neurons to communicate.
These medications can help stabilize cognitive function but do not stop
disease progression or repair damaged neurons .*
, 3
Question 3
An 82-year-old client presents with gradual memory loss, shuffling gait,
slowness of movement, visual hallucinations, and episodic confusion. The
client's current medications include warfarin and digoxin for atrial fibrillation.
The prescriber chooses rivastigmine for this client. Which statement best
explains the rationale for selecting rivastigmine?
A) Rivastigmine is the only cholinesterase inhibitor that also treats
hallucinations
B) Rivastigmine has shown efficacy in dementia with Lewy bodies and is not
known to interact significantly with cardiovascular medications
C) Rivastigmine is the safest cholinesterase inhibitor for clients with atrial
fibrillation
D) Rivastigmine does not require dose titration and can be started at a
therapeutic dose immediately
**Correct Answer: B) Rivastigmine has shown efficacy in dementia with Lewy
bodies and is not known to interact significantly with cardiovascular
medications**
*Rationale: The client is diagnosed with probable dementia with Lewy bodies.
Rivastigmine is chosen because it has shown efficacy in this type of dementia
and is not known to interact significantly with cardiovascular medications.
Rivastigmine has demonstrated positive effects on parkinsonian symptoms in
Dementia with Lewy Bodies, including improvements in rigidity, gait, and
postural abnormalities .*
, 4
---
Question 4**
A client diagnosed with probable vascular dementia has been prescribed
galantamine. The family asks the nurse how this medication will help their
loved one. Which response by the nurse is most accurate?
A) "Galantamine dissolves the blood clots that caused your loved one's
strokes"
B) "Galantamine has shown efficacy in vascular dementia by improving
cognition, global function, and activities of daily living"
C) "Galantamine prevents future strokes by controlling blood pressure"
D) "Galantamine repairs the damaged blood vessels in your loved one's brain"
**Correct Answer: B) "Galantamine has shown efficacy in vascular dementia
by improving cognition, global function, and activities of daily living"**
*Rationale: Galantamine has demonstrated efficacy in clients with vascular
dementia and Alzheimer's disease with cerebrovascular components. Clinical
studies show galantamine improves cognition, global functioning, behavioral
abnormalities, and maintains activities of daily living in clients with vascular
dementia .*
---
