While reviewing the medical record of a client with moderate dementia of the Alzheimer type, the nurse notes that the client has been receiving memantine. The nurse identifies this drug as which type?

Correct Answer: C

Rationale: The correct answer is C: NMDA receptor antagonist. Memantine is a medication used in the treatment of Alzheimer's disease by blocking the NMDA receptors, which helps regulate glutamate activity in the brain. This action can improve cognitive function in individuals with dementia. Choice A (Atypical antipsychotic) is incorrect because memantine is not classified as an antipsychotic medication. Choice B (Cholinesterase inhibitor) is incorrect because while cholinesterase inhibitors are also used in treating Alzheimer's disease, memantine works through a different mechanism by targeting NMDA receptors. Choice D (Benzodiazepine) is incorrect because benzodiazepines are not typically used in the treatment of Alzheimer's disease.

Correct Answer: C

Rationale: The correct answer is C - Keep bedroom cool at night. This is important because a cool environment promotes better sleep by helping the body lower its core temperature, which is essential for falling and staying asleep. Choice A is incorrect as exercising close to bedtime can actually stimulate the body and make it harder to fall asleep. Choice B is incorrect as taking a nap during the day can interfere with the ability to fall asleep at night. Choice D is incorrect as consuming a high carbohydrate snack at bedtime may disrupt sleep due to potential indigestion or fluctuations in blood sugar levels. In summary, maintaining a cool bedroom temperature is crucial for promoting quality sleep in individuals with insomnia.

Correct Answer: D

Rationale: The correct answer is D: Paranoia. Paranoia in patients with schizophrenia poses the greatest risk for injury to others as it can lead to aggressive behavior, violence, or harm towards others due to the patient's irrational belief that others are trying to harm them. This can result in dangerous situations where the patient may act out in self-defense or in an attempt to protect themselves from perceived threats. Explanation of other choices: A: Depersonalization does not typically lead to physical harm to others but rather a sense of detachment from oneself. B: Pressured speech may be a symptom of mania or anxiety disorders, but it is not directly linked to physical harm towards others. C: Negative symptoms refer to a decrease in normal emotional responses or other functions, which do not inherently pose a direct risk of injury to others.

Correct Answer: C

Rationale: The correct answer is C: Tolerance. Opioid use disorder is characterized by the need for increased amounts of opioids to achieve the desired effect over time, which is known as tolerance. This occurs due to physiological changes in the body. Choices A and B are incorrect as withdrawal symptoms, including pupillary constriction, sedation, and insomnia, are typically seen in opioid use disorder. Choice D is incorrect as individuals with opioid use disorder often require larger amounts of the drug to achieve the same high due to tolerance, not smaller amounts.

Correct Answer: C

Rationale: The correct answer is C: St. John's wort. St. John's wort can interact with antidepressant medications, leading to serotonin syndrome or decreasing the effectiveness of the antidepressants. It is important for the nurse to caution the patient about potential interactions. Fish oil (A), SAMe (B), and melatonin (D) do not have significant interactions with antidepressant medications, making them safe options for patients with major depression.