INSTRUCTIONS Supportive approaches for Alzheimer disease
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Supportive approaches for Alzheimer Disease
General Purpose: To familiarize the NP with interventions for patients with AD and their families. Learning Objectives: After reading this article and taking this test, the NP will be able to: 1. Describe the pathophysiology and diagnosis of AD. 2. Explain therapy for AD. 3. Identify side effects of AD treatment.
1. AD accounts for what percentage of all dementia diagnoses?
2. AD is associated with which pathophysiology?
a. alpha-amyloid plaques
b. neurofibrillary tangles
c. low glutamate levels
d. high acetylcholine levels
3. Which of the following should prompt the NP to screen or investigate for AD?
a. age over 65 years
b. sudden loss of cognitive function
c. episodic memory impairment
d. unintentional psychomotor activity
4. With acute neuropsychiatric symptoms, which of the following is a priority?
a. rule out reversible causes
b. start treatment for AD as soon as possible
c. assess caregivers coping strategies
d. monitor executive functioning
5. Which of the following are clinical features of vascular dementia?
a. visual hallucinations, delusions, extrapyramidal symptoms
b. tremor, rigidity, slowness of movement
c. facial distortions, lip smacking, protruding tongue
d. stepwise deterioration, executive dysfunction, gait changes
6. Which of the following lab tests is necessary before diagnosing AD?
a. creatinine clearance
b. liver function tests
c. serum vitamin B12
d. glucose tolerance test
7. Which medication most effectively aids cognition in moderate-to-severe AD?
8. Which is considered the first-line drug for mild-to-moderate AD because of once daily dosing and a narrower adverse effect profile?
9. Which symptom is most likely to be a side effect of ACIs?
c. weight gain
10. Which medication is least likely to cause bradycardia in patients also taking an antiarrhythmic drug?
11. The risk of peptic ulcer is increased in patients taking NSAIDs and
12. Which of the following statements is correct?
a. ACIs may decrease gastric secretion.
b. ACIs given with antipsychotics increases risk of renal failure.
c. Memantine should not be given in combination with ACI therapy.
d. Memantine may require a lower dose in patients with renal disease.
13. Which class of drug is considered first-line therapy for treatment of depression in patients with AD?
b. tricyclic antidepressants
14. Which statement about haloperidol use in AD is correct?
a. It can produce extrapyramidal symptoms at any time during therapy.
b. Studies have shown that it is most effective for the behavioral symptoms of AD.
c. It is more expensive than second-generation antipsychotics.
d. It is associated with more anticholinergic effects.
15. Which class of drug is generally contraindicated with AD therapy?
d. tricyclic antidepressants
16. Which of the following is least likely to cause agitation in the patient with AD?
a. going to an art museum
b. having relatives from afar visit at home
c. eating breakfast with spouse at home
d. sitting alone in a quiet hospital room
17. Someone diagnosed with AD at age 62 may be expected to live to about age