Solving the puzzle of Alzheimer disease

Nurse Practitioner:
doi: 10.1097/01.NPR.0000419289.53349.1f
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INSTRUCTIONS Solving the puzzle of Alzheimer disease


* To take the test online, go to our secure website at

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* Complete the registration information and course evaluation. Mail the completed form and registration fee of $24.95 to: Lippincott Williams & Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, Brick, NJ 08723. We will mail your certificate in 4 to 6 weeks. For faster service, include a fax number and we will fax your certificate within 2 business days of receiving your enrollment form.

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* Registration deadline is September 30, 2014.

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Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.5 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.5 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #FBN2454.

Your certificate is valid in all states. This activity has been assigned 2.0 pharmacology credits.

The ANCC's accreditation status of Lippincott Williams & Wilkins Department of Continuing Education refers only to its continuing nursing educational activities and does not imply Commission on Accreditation approval or endorsement of any commercial product.

Solving the puzzle of Alzheimer disease

General Purpose: To provide NPs with current evidence-based practices for management of patients with AD. Learning Objectives: After reading the preceding article and taking this test, the NP should be able to: 1. Describe the pathologic changes in AD. 2. Discuss treatment of AD with CEIs. 3. Outline management of AD with non-CEI therapy.

1. Which statement about Alzheimer's disease is true?

a. It primarily affects the hippocampus.

b. It is progressive and degenerative.

c. It results in hypertrophy of the cerebral cortex.

d. It affects approximately 6.2 million persons in the United States.

2. In general, symptomatic treatments for AD

a. have clinically marginal benefits.

b. have homogeneous and predictable responses.

c. are most helpful in the later stages of AD.

d. have a low likelihood of adverse reactions.

3. AD is characterized by all of the following except

a. neurofibrillary tangles.

b. lack of AChE.

c. beta-amyloid plaques.

d. neuronal degeneration.

4. CEIs target which symptom of AD?

a. sleep impairment

b. physical deconditioning

c. cognitive impairment

d. global functioning

5. Long-term use of CEIs may

a. significantly preserve functional autonomy.

b. slightly increase the rate of depression.

c. slow the progression of memory loss.

d. cause purposeless motor behaviors.

6. In general, CEIs may produce symptom improvement in about

a. 1 week.

b. 2 weeks.

c. 4 weeks.

d. 6 weeks.

7. Which statement about the dangers of CEIs is accurate?

a. Overdose will result in temporary lethargy but is not fatal.

b. Discontinuing CEIs may cause irreversible memory deterioration.

c. Stopping one CEI and starting another will not adversely affect symptoms.

d. Dangerous adverse reactions include cardiac tachydysrhythmias.

8. The most common adverse reactions of CEIs are

a. GI.

b. neurologic.

c. cardiac.

d. renal.

9. Donepezil is a

a. piperidine derivative.

b. nicotinic receptor antagonist.

c. carbamate derivative.

d. tertiary alkaloid agent.

10. The elimination half-life of donepezil is approximately

a. 12 hours.

b. 42 hours.

c. 64 hours.

d. 70 hours.

11. Compared to other CEIs, donepezil may be associated with

a. tachydysrhythmias.

b. excitotoxicity.

c. more sleep disturbances.

d. hepatotoxicity.

12. Compared to oral rivastigmine, the transdermal form

a. minimizes adverse reactions.

b. starts at a dose of 1.5 mg/24 hours.

c. reaches peak plasma concentration (Cmax) in 1 hour.

d. has a maximal dose of 12 mg/24 hours.

13. Galantamine reversibly inhibits AChE and

a. decreases the release of dopamine and norepinephrine.

b. reaches Cmax after oral administration in 30 minutes.

c. is available as a transdermal product.

d. inhibits nicotinic receptors.

14. The starting dose of standard-release memantine is

a. 5 mg/day.

b. 10 mg/day.

c. 15 mg/day.

d. 20 mg/day.

15. Memantine generally is prescribed

a. to decrease the adverse reactions of CEIs.

b. with a CEI in the later stages of AD.

c. for mild cognitive deterioration.

d. in the early stages of AD.

16. Discontinuation of symptomatic pharmacologic treatment should be considered when the patient

a. experiences nausea or GI upset.

b. no longer has sleep disturbances.

c. is unable to recognize family members.

d. reaches level 5 on the FAST scale.

17. Which is the most effective treatment for neuropsychiatric symptoms in AD?

a. light therapy

b. lecithin

c. folic acid

d. aromatherapy

18. Which substance is most likely to be beneficial for enhancing memory in adults with AD?

a. lavender

b. lemon balm

c. chamomile

d. valerian

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