A patient who has Alzheimer's disease begins taking donepezil (Aricept). After 3 months of treatment, the patient does not show improvement of symptoms. The primary care NP should:
a. switch to rivastigmine (Exelon).
b. switch to galantamine (Razadyne).
c. switch to memantine (Namenda).
d. continue donepezil and reevaluate in 3 months.
D
Patients should be switched to other medications if initial therapy fails, but switching to another medication should be considered only after a minimum of 6 months of treatment.
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A 42-year-old patient presents to the health care provider's office complaining of difficulty "remembering things." The patient's spouse adds that the patient has been making "a lot of funny faces and hasn't been himself lately."
The nurse anticipates the need to evaluate the patient for which disorder? 1. Huntington disease 2. Parkinson disease 3. Traumatic brain injury 4. Human Immunodeficiency Virus
An older diabetic patient has impaired mobility and decreased vision. The nurse examines the patient's feet at each clinical visit. The patient asks why this is necessary. What response by the nurse is best?
a. "It's part of our diabetic clinic visit pro-tocol." b. "You may not be able to see a sore on your feet." c. "Limited mobility may keep you from checking your feet. d. "You may get an ulcer and not be able to feel it."
In review of a nursing home patient's chart, the nurse practitioner discovers that the neurology consult identified that the client has a homonymous hemianopsia. Which of the following statements accurately describes these findings?
A. Partial loss of visual acuity in the ipsilateral peripheral fields B. Diplopia in the eye contralateral to the cerebral lesion C. Loss of vision in either the right or left halves of the visual fields D. Nystagmus in both eyes with asymmetrical movement
Absolute contraindications that clinicians must consider when initiating estrogen therapy include:
1. Undiagnosed dysfunctional uterine bleeding 2. Deep vein or arterial thromboemboli within the prior year 3. Endometriosis 4. 1 and 2 5. All of the above