Deck 12: Geropharmacology

Question 1

An 81-year-old patient is being discharged from the hospital to home.She is on seven different medications,which are to be taken at four different times during the day.What would be most useful in helping this patient manage her medications?

A) Providing package inserts from all of the medications for the patient to read
B) Providing a pillbox with compartments for each day and each of the doses
C) Providing a written list of the medications
D) Asking the patient's daughter to administer the patient's medications

Answer 1

Providing a pillbox with compartments for each day and each of the doses

Question 2

You are the nurse performing the initial assessment on a new patient in the geriatric outpatient practice.What approach would be most effective in eliciting an accurate medication assessment?

A) Asking the patient to make a list of all her prescription medications
B) Asking the patient's daughter to make a list of her mother's prescription medications
C) Asking the patient to bring in all of the medications that she is taking,including prescription drugs,over-the-counter drugs (OTC),and herbal and dietary supplements
D) Obtaining a list of the patient's medications from her previous primary care provider

Answer 2

Asking the patient to bring in all of the medications that she is taking,including prescription drugs,over-the-counter drugs (OTC),and herbal and dietary supplements

Question 3

A 72-year-old patient tells his nurse that he is allergic to Lasix.What is the nurse's first response?

A) "Let me write that down on your chart and put an allergy alert wrist band on you."
B) "Tell me what happened to you when you took Lasix."
C) "It is unusual for a patient to have a reaction to Lasix."
D) "Were you taking a generic form of Lasix?"

Answer 3

"Tell me what happened to you when you took Lasix."

Question 4

What is an important contributing factor to polypharmacy in older adults?

A) Inadequate communication among medical care providers
B) Implementation of Medicare Part D prescription drug benefit
C) Use of generic medications
D) Increasing popularity of dietary and herbal supplements

Question 5

The Beers list is a list of medications that should not be used in older adults.The reason that the medications should not be used is that:

A) they are not covered by Medicare Part D prescription drug benefit.
B) they have a higher than usual risk for older adults.
C) they are likely to be abused by older adults.
D) they cause allergic reactions in older adults.

Question 6

Your 68-year-old client asks why she reacts differently to some medications than she did when she was younger.In discussing pharmacological considerations with her,what do you keep in mind regarding drug therapy and the elderly?

A) Age-related changes affect the way drugs are metabolized by older adults
B) Elders should exercise caution with prescription medications but need not worry about over-the-counter (OTC)drugs.
C) Older adults may need larger doses of medication due to pharmacokinetic changes.
D) Adverse drug reactions occur with the same frequency in older adults as they do in younger adults.

Question 7

Which pharmacokinetic/pharmacodynamic parameter is least affected by the aging process?

A) Absorption
B) Distribution
C) Metabolism
D) Excretion

Question 8

Factors that affect pharmacokinetics in the elderly include:

A) greater lean body mass.
B) decreased total body water.
C) increased glomerular filtration rate.
D) increased creatinine clearance.

Question 9

An 87-year-old Hispanic Catholic widow lives alone in the community.Her daughter lives nearby.She is being discharged home after a hospitalization for congestive heart failure.She is on eight different medications.She is at risk for noncompliance.What would not be a contributing factor to noncompliance?

A) Language barrier
B) Living alone
C) Large number of medications
D) Ethnic and religious background

Question 10

Your patient is prescribed a transdermal morphine patch for severe chronic pain.You are providing medication teaching for her.What is important to include in your teaching?

A) Make sure to cut the patch to enhance medication release.
B) Take care not to touch the "skin side" of the patch.
C) Place the new patch next to the old patch.
D) Apply patch only to the chest.

Question 11

The area in which nurses have the greatest effect on medication use is:

A) educating clients.
B) ensuring adherence.
C) marketing beneficial products.
D) encouraging alternative/herbal remedies.

Question 12

A 90-year-old female patient has a PEG (percutaneous enteral gastrostomy)tube placed due to a recent cerebrovascular accident,difficulty swallowing,and repeated episodes of aspiration pneumonia.You are teaching her son to administer her medications.What advice is important to convey to the son?

A) Ask the pharmacist which of the medications are available in liquid form.
B) Crush all medications and add them to the tube feeding.
C) Medications cannot be given via the PEG tube; they should be crushed and given orally.
D) Medications should be administered via the PEG all at once,one time daily.

Question 13

Tardive dyskinesia is defined as an irreversible movement disorder characterized by:

A) a compulsion to be in motion.
B) facial movements and involuntary twisting of the limbs,trunk,neck,and face.
C) an inability to move.
D) a bilateral tremor and rigidity.

Question 14

You are developing a teaching plan for your newly diagnosed elderly diabetic client.When discussing his oral hypoglycemic medications,what strategy would be most effective?

A) Providing the package insert from the medication
B) Providing the client with the website address for the American Diabetes Association
C) Providing oral explanations and sending the client home with a written copy
D) Presenting the information in paragraph form as opposed to numbered line fashion