A nurse in a long-term care facility is providing care for a client who has been receiving donepezil. Which of the following findings indicates that the medication is effective?

Rationale: A. This is not a primary indicator of donepezil effectiveness. Donepezil is a cholinesterase inhibitor used to manage symptoms of Alzheimer’s disease, primarily targeting cognitive function rather than appetite. While improved cognition might indirectly support better nutrition, increased food intake is not a direct or reliable measure of therapeutic effectiveness. B. Mood improvement may occur indirectly, but donepezil is not primarily used to treat mood disorders such as depression or anxiety. Therefore, changes in mood are not the best indicator that the medication is working as intended. C. Although improved cognitive function may help with activities of daily living (ADLs), donepezil typically does not restore full independence in clients with dementia. The disease is progressive, and the medication aims to slow cognitive decline rather than reverse functional loss. Therefore, full independence is not a realistic or primary expected outcome. D. Donepezil works by inhibiting acetylcholinesterase, increasing levels of acetylcholine in the brain, which helps improve communication between neurons. The most direct and clinically relevant sign of effectiveness is stabilization or improvement in cognitive function, particularly short-term memory and attention, which are commonly affected in Alzheimer’s disease.