Deck 6: Pharmacology and Older Adults

Question 1

An older client does not take a prescribed diuretic as planned because of the inconvenience of having to urinate frequently, which interrupts scheduled activities. What action should the nurse take with this client?
1) Insist the drug be taken as prescribed.
2) Contact the physician to order another drug.
3) Advise to take the drug in divided doses, half in the morning and half in the evening.
4) Discuss the daily activity schedule and adjust the drug administration time accordingly.

Answer 1

4

Question 2

The nurse is preparing an educational program about the use of over-the-counter (OTC) medications for residents of an assisted living community. What information should the nurse include in this program? Select all that apply.
1) Medications purchased without a prescription can be used with alcohol.
2) Herbal supplements are not considered medications.
3) A person can overdose on medications containing acetaminophen.
4) Health insurance does not pay for medications that are not prescribed.
5) There are increased drug interactions between prescribed and OTC medications.

Answer 2

3, 4, 5

Question 3

The nurse is preparing an educational program regarding adverse drug reactions (ADR). What information should the nurse include? Select all that apply.
1) Older adults are more likely to have adverse drug events.
2) Drug side effects that are serious are considered ADRs.
3) Adverse drug reactions are handled on an outpatient basis.
4) Adverse drug reactions are often due to anticoagulants or antidiabetics.
5) Reactions can occur from drug-drug interactions and polypharmacy.

Answer 3

1, 2, 4, 5

Question 4

An older client being treated for pneumonia is given a sedative to sleep. A few hours afterwards, the client has a respiratory rate of 12 and cannot be aroused. What does this assessment finding indicate to the nurse?
1) The sedative was not absorbed.
2) The sedative has reached a therapeutic blood level.
3) The medication for sleep caused excessive sedation.
4) The client is experiencing complications of pneumonia.

Question 5

A prescribed medication is not producing the expected therapeutic effect in an older client. What should the nurse do in response to this finding?
1) Document that the client has not been taking the medication.
2) Discuss changing the medication with the healthcare provider.
3) Ask the client to describe how they take their medications each day.
4) Review the client's current diet and medication list for potential interactions.

Question 6

It has been determined that nonpharmacological approaches will be used to help an older client manage pain. What should the nurse explain as the reasons for using these approaches? Select all that apply.
1) Nonpharmacological approaches can alleviate the pain.
2) Nonpharmacological approaches can delay the need for medication.
3) Nonpharmacological approaches can prevent the need for medication.
4) Nonpharmacological approaches can complement current medication therapy.
5) Nonpharmacological approaches do not cost the client anything to use or implement.

Question 7

After completing a medication history, the nurse notes that an older client is prescribed 22 different medications and sees five different healthcare providers. What is the nurse most concerned about for this client?
1) Hospital readmission potential is higher for this client.
2) Medication doses may be missed or not taken regularly.
3) The healthcare providers may not know all the medications the client takes.
4) Cognitive impairment and inability to keep up with the medications prescribed.

Question 8

An older client has an elevated blood urea nitrogen (BUN) level, but the creatinine clearance is within normal limits. The nurse notes that the client's appetite has been poor the past few days. What should the nurse do about these laboratory findings?
1) Perform a daily weight and document.
2) Inform the physician of the BUN result.
3) Assess intake, output, and dietary intake of protein.
4) Monitor for increased medication levels.

Question 9

The nurse is instructing an older client on ways to prevent esophageal irritation from taking medication. Which information should the nurse include in this teaching? Select all that apply.
1) Drink at least 8 ounces of water with morning medications.
2) Crush any pills to make them easier to swallow.
3) Take several sips of water before taking oral medications.
4) Sit up in a chair for at least 30 minutes after taking oral medications.
5) Coffee can be used as a substitute for water when taking medications.

Question 10

The nurse teaches the client about measures to prevent constipation. What does the nurse teach the client? Select all that apply.
1) Do not take fiber supplements with juice or coffee.
2) Take diphenhydramine doses with a laxative.
3) Take psyllium-seed preparations with a full glass of water.
4) Calcium-carbonate should be taken separate from other medications.
5) Take any narcotic doses with a stool softener or laxative.

Question 11

An older client has taken a nonsteroidal anti-inflammatory drug (NSAID) medication for general muscle aches. Which finding is most concerning?
1) Diarrhea
2) Heartburn
3) Abdominal pain
4) Dark emesis

Question 12

An older client has recently been put on high risk for fall precautions after a medication for high blood pressure was started. The client's daughter questions why this precaution was put in place. How should the nurse respond to the daughter?
1) "Every older client is automatically put on fall risk precautions."
2) "The client is attached to IV tubing and sequential compression devices."
3) "The client is on multiple medications that may have an interaction."
4) "The client was recently started on a medication that could cause a fall."

Question 13

An older client is experiencing a change in mood. For which medications should the nurse assess as the possible cause of this client's cognitive change? Select all that apply.
1) Dexamethasone
2) Ketorolac
3) Fluconazole
4) Phenobarbital
5) Atenolol

Question 14

An older client with dementia has been medicated with sedatives. The healthcare provider now prescribes a lower dose of the sedative and the nursing staff is concerned that the client will resume agitated behavior. What should be explained to the staff about the use of this medication?
1) The client's condition warrants physical restraint only.
2) The client's physical condition does not warrant use of the drug.
3) The client's family members would be upset if they were aware of the use of chemical restraints.
4) The use of psychotropic drugs may be considered excessive and harm the client's health.

Question 15

The nurse is providing a psychotropic medication to an older client. Which findings are most concerning to the nurse? Select all that apply.
1) Intermittent, repetitive muscle movements
2) Frequent crossing and uncrossing of legs
3) Belief that a hooded figure is watching
4) Continual lip smacking and tongue movements
5) Disorganized speech and catatonic behavior

Question 16

The nurse is preparing an educational program regarding the appropriate use of antipsychotic medications in older clients. What information should the nurse include?
1) Fidgeting is an appropriate indication for the use of antipsychotic medications.
2) Use of antipsychotic medications would never be considered a chemical restraint.
3) People prescribed antipsychotic drugs must have efforts to discontinue these drugs.
4) Impaired memory is an appropriate indication for the use of antipsychotic medications.

Question 17

During a home visit, the nurse learns that an older client is taking herbal remedies in addition to prescribed medications. What should the nurse instruct the client about this practice? Select all that apply.
1) Some herbal remedies interact with medications.
2) Herbal remedies are natural products and do not harm the body.
3) Talk to the healthcare provider about the use of herbal remedies.
4) The Food and Drug Administration does not regulate herbal remedies.
5) For most herbal remedies, no studies have demonstrated effectiveness.

Question 18

An older client admitted with chest pain is prescribed Restoril 15 mg at bedtime. The usual dosage given to adults is 30 mg. What intervention would the nurse use for this client?
1) Administer the drug as ordered.
2) Monitor the client's renal function.
3) Ask the physician to change the dosage to 30 mg.
4) Give the drug and contact the doctor for a second dose if the client does not fall asleep.

Question 19

An older client who takes digoxin has not eaten in 2 days. Which finding most concerns the nurse?
1) The client is experiencing nausea and vomiting.
2) A new prescription for an antacid is administered.
3) A recent weight loss of several pounds is documented.
4) The client is exhibiting weakness and visual disturbances.

Question 20

Which statement made by a nurse best indicates an understanding about the nurse's role in medication management for the older adult client?
1) "In the client with new onset constipation, I'll advocate for a daily laxative dose."
2) "When a client has difficulty sleeping, an as-needed dose of a benzodiazepine should be used."
3) "The client with acute pain should get pain medications around the clock and as needed."
4) "I should encourage the person with heartburn to sit up after medications and meals."

Question 21

Which nursing action indicates that medication reconciliation for an older client is most complete?
1) All prescribed medications are accounted for in the medical record.
2) Medications were identified and compared with written orders.
3) Herbal supplements, vitamins, and medication were reviewed.
4) Medication reconciliation occurred prior to client transfer.

Question 22

An older client who is repeatedly admitted to the hospital tells the nurse it is because of the inability to purchase prescribed medications. What should the nurse respond to the client?
1) "Medical insurance covers these costs. Do you need help getting coverage?"
2) "I'm not surprised that you can't afford them. You are on a lot of medications."
3) "There are ways to reduce the cost of medications, such as using Medicare Part D."
4) "I will contact our social services department for resources to obtain medications."

Question 23

The nurse is instructing an older client about medication management. What information should the nurse include? Select all that apply.
1) Obtain all of your medications from the same pharmacy.
2) Request that medications be placed in childproof packages and caps.
3) Develop a method for remembering if medications have been taken, such as moving it to a different place.
4) Schedule medications at mealtimes or in conjunction with other specific activities unless contraindicated.
5) Establish a routine for taking medications, such as preparing medication for each day in different containers.

Question 24

The nurse has completed an educational program for residents of a retirement community regarding unsafe medication practices. Which statement made by a resident best indicates effective teaching?
1) "Over-the-counter medications are good for up to two years."
2) "I will buy all of my medication from the same pharmacy."
3) "My roommate and I can share any medications that are the same, if needed."
4) "Medication can be obtained that is inexpensive from an internet pharmacy."

Question 25

The home care nurse is reviewing the medications that an older client is currently taking. Which guidelines should the nurse follow when conducting this review? Select all that apply.
1) Review the client's allergies.
2) Review the drug for number of refills.
3) Review the drugs for duplicate therapy.
4) Review the client's medical conditions.
5) Review each drug for interactions with other drugs.