Lehne’s Pharmacotherapeutics for
Advanced 3rd Edition by Acemarket
Updated (2025-2026) Complete Questions
with Verified Answer Key |graded A + Pass
A patient will begin taking a cholinesterase inhibitor for early Alzheimer disease. The nurse
is teaching the patient’s spouse. Which statement indicates a need for further teaching?
A. “This medication may help improve memory for a while.”
B. “The drug helps increase acetylcholine levels in the brain.”
C. “Side effects may include nausea or dizziness.”
D. “This drug significantly slows the progression of the disease.”
Correct answer: D
Rationale: Cholinesterase inhibitors may temporarily improve cognitive symptoms but do
not significantly slow disease progression. Believing the drug alters the course of
Alzheimer disease reflects unrealistic expectations.
The spouse of a patient newly diagnosed with Alzheimer disease asks if medications will
prevent nursing home placement. What is the best response by the nurse?
A. “Drugs to treat Alzheimer disease may slow the progression of memory loss.”
B. “Medications cure Alzheimer disease if started early.”
C. “Drug therapy prevents functional decline.”
D. “Medication eliminates the need for long-term care.”
Correct answer: A
Rationale: Alzheimer medications may modestly slow cognitive decline but do not prevent
disease progression or eliminate future care needs.
A nurse is caring for a patient with Alzheimer disease who is taking a cholinesterase
inhibitor. Which side effect is most concerning?
A. Dry mouth
B. Insomnia
,C. Headache
D. Slowed heart rate and lightheadedness
Correct answer: D
Rationale: Cholinesterase inhibitors can cause bradycardia and syncope, which increase
fall risk, especially in older adults.
An older adult with Alzheimer disease becomes agitated, paces, and screams in the
hospital. What should the nurse do?
A. Administer a sedative immediately
B. Restrain the patient
C. Call security
D. Tell the spouse this is an expected progression of the disease
Correct answer: D
Rationale: Behavioral disturbances are common as Alzheimer disease progresses.
Education and reassurance are appropriate unless safety is compromised.
A nurse prepares to administer memantine and notes mildly impaired renal function.
What does the nurse expect the provider to order?
A. Discontinue memantine
B. Increase the dose
C. Add a cholinesterase inhibitor
D. Reduce the dose of memantine
Correct answer: D
Rationale: Memantine is excreted by the kidneys. Dose reduction is required with renal
impairment.
Which statement by a spouse using a rivastigmine transdermal patch indicates a need for
further teaching?
A. “We rotate patch sites daily.”
B. “We remove the old patch before applying a new one.”
C. “Skin irritation can occur.”
D. “We only need to change the patch every 2 weeks.”
Correct answer: D
,Rationale: Rivastigmine patches are changed once daily, not every two weeks.
A patient worried about Alzheimer disease asks about known risk factors. Which factors
should the nurse include? (Select all that apply.)
A. Advanced age
B. Smoking
C. Family history
D. High protein intake
Correct answers: A, C
Rationale: Advanced age and family history are well-established risk factors.
Which statement shows correct understanding of how memantine works?
A. “It increases acetylcholine levels.”
B. “It modulates glutamate to control calcium influx.”
C. “It prevents amyloid plaque formation.”
D. “It cures cognitive decline.”
Correct answer: B
Rationale: Memantine is an NMDA receptor antagonist that modulates glutamate activity.
A patient taking donepezil for 6 months experiences worsening symptoms. The spouse
asks about increasing the dose. What should the nurse say?
A. “The dose can be increased because the drug has been taken longer than 3 months.”
B. “Dose increases are unsafe.”
C. “The medication should be stopped.”
D. “Donepezil has no dose flexibility.”
Correct answer: A
Rationale: Donepezil dosing can be increased after adequate trial periods if tolerated.
A patient stares blankly, then smacks lips and wrings hands for about 60 seconds. What
should the nurse do?
A. Document normal behavior
B. Contact the provider to report a complex partial seizure
, C. Administer oxygen
D. Restrain the patient
Correct answer: B
Rationale: These findings are classic for a complex partial (focal impaired awareness)
seizure.
Which patient statement shows understanding of phenytoin teaching?
A. “I should brush and floss regularly.”
B. “I can stop the drug once seizures stop.”
C. “I should skip doses if I feel dizzy.”
D. “Dental care is unnecessary.”
Correct answer: A
Rationale: Phenytoin can cause gingival hyperplasia, making oral hygiene essential.
A patient reports no improvement after weeks on an AED. What should the nurse do?
A. Increase the dose
B. Request serum drug levels
C. Stop the medication
D. Reassure the patient
Correct answer: B
Rationale: AED effectiveness is assessed by serum drug levels, not just symptoms.
A patient taking oral contraceptives begins phenytoin. What teaching is needed?
A. Increase estrogen dose
B. Consider alternative contraception
C. Stop oral contraceptives
D. No change is needed
Correct answer: B
Rationale: Phenytoin induces liver enzymes, reducing contraceptive effectiveness.
A patient seizure-free for 6 months asks when AEDs can be stopped. What is the correct
response?
Advanced 3rd Edition by Acemarket
Updated (2025-2026) Complete Questions
with Verified Answer Key |graded A + Pass
A patient will begin taking a cholinesterase inhibitor for early Alzheimer disease. The nurse
is teaching the patient’s spouse. Which statement indicates a need for further teaching?
A. “This medication may help improve memory for a while.”
B. “The drug helps increase acetylcholine levels in the brain.”
C. “Side effects may include nausea or dizziness.”
D. “This drug significantly slows the progression of the disease.”
Correct answer: D
Rationale: Cholinesterase inhibitors may temporarily improve cognitive symptoms but do
not significantly slow disease progression. Believing the drug alters the course of
Alzheimer disease reflects unrealistic expectations.
The spouse of a patient newly diagnosed with Alzheimer disease asks if medications will
prevent nursing home placement. What is the best response by the nurse?
A. “Drugs to treat Alzheimer disease may slow the progression of memory loss.”
B. “Medications cure Alzheimer disease if started early.”
C. “Drug therapy prevents functional decline.”
D. “Medication eliminates the need for long-term care.”
Correct answer: A
Rationale: Alzheimer medications may modestly slow cognitive decline but do not prevent
disease progression or eliminate future care needs.
A nurse is caring for a patient with Alzheimer disease who is taking a cholinesterase
inhibitor. Which side effect is most concerning?
A. Dry mouth
B. Insomnia
,C. Headache
D. Slowed heart rate and lightheadedness
Correct answer: D
Rationale: Cholinesterase inhibitors can cause bradycardia and syncope, which increase
fall risk, especially in older adults.
An older adult with Alzheimer disease becomes agitated, paces, and screams in the
hospital. What should the nurse do?
A. Administer a sedative immediately
B. Restrain the patient
C. Call security
D. Tell the spouse this is an expected progression of the disease
Correct answer: D
Rationale: Behavioral disturbances are common as Alzheimer disease progresses.
Education and reassurance are appropriate unless safety is compromised.
A nurse prepares to administer memantine and notes mildly impaired renal function.
What does the nurse expect the provider to order?
A. Discontinue memantine
B. Increase the dose
C. Add a cholinesterase inhibitor
D. Reduce the dose of memantine
Correct answer: D
Rationale: Memantine is excreted by the kidneys. Dose reduction is required with renal
impairment.
Which statement by a spouse using a rivastigmine transdermal patch indicates a need for
further teaching?
A. “We rotate patch sites daily.”
B. “We remove the old patch before applying a new one.”
C. “Skin irritation can occur.”
D. “We only need to change the patch every 2 weeks.”
Correct answer: D
,Rationale: Rivastigmine patches are changed once daily, not every two weeks.
A patient worried about Alzheimer disease asks about known risk factors. Which factors
should the nurse include? (Select all that apply.)
A. Advanced age
B. Smoking
C. Family history
D. High protein intake
Correct answers: A, C
Rationale: Advanced age and family history are well-established risk factors.
Which statement shows correct understanding of how memantine works?
A. “It increases acetylcholine levels.”
B. “It modulates glutamate to control calcium influx.”
C. “It prevents amyloid plaque formation.”
D. “It cures cognitive decline.”
Correct answer: B
Rationale: Memantine is an NMDA receptor antagonist that modulates glutamate activity.
A patient taking donepezil for 6 months experiences worsening symptoms. The spouse
asks about increasing the dose. What should the nurse say?
A. “The dose can be increased because the drug has been taken longer than 3 months.”
B. “Dose increases are unsafe.”
C. “The medication should be stopped.”
D. “Donepezil has no dose flexibility.”
Correct answer: A
Rationale: Donepezil dosing can be increased after adequate trial periods if tolerated.
A patient stares blankly, then smacks lips and wrings hands for about 60 seconds. What
should the nurse do?
A. Document normal behavior
B. Contact the provider to report a complex partial seizure
, C. Administer oxygen
D. Restrain the patient
Correct answer: B
Rationale: These findings are classic for a complex partial (focal impaired awareness)
seizure.
Which patient statement shows understanding of phenytoin teaching?
A. “I should brush and floss regularly.”
B. “I can stop the drug once seizures stop.”
C. “I should skip doses if I feel dizzy.”
D. “Dental care is unnecessary.”
Correct answer: A
Rationale: Phenytoin can cause gingival hyperplasia, making oral hygiene essential.
A patient reports no improvement after weeks on an AED. What should the nurse do?
A. Increase the dose
B. Request serum drug levels
C. Stop the medication
D. Reassure the patient
Correct answer: B
Rationale: AED effectiveness is assessed by serum drug levels, not just symptoms.
A patient taking oral contraceptives begins phenytoin. What teaching is needed?
A. Increase estrogen dose
B. Consider alternative contraception
C. Stop oral contraceptives
D. No change is needed
Correct answer: B
Rationale: Phenytoin induces liver enzymes, reducing contraceptive effectiveness.
A patient seizure-free for 6 months asks when AEDs can be stopped. What is the correct
response?
