Deck 7: Medications and Older Adults

Question 1

The home health nurse would be most concerned about self-medicating errors for the older adult living alone who is a type 1 diabetic and is

A) afflicted with early Parkinson disease.
B) visually impaired.
C) a rheumatoid arthritic with stiffened hands.
D) paralyzed from the waist down.

Answer 1

visually impaired.

Question 2

The patient complains that her medications stick in her throat. What would be an appropriate response of the nurse?

A) Suggesting that she take all the pills at one time with a mouthful of water.
B) Offering the patient one pill at a time.
C) Crushing all the pills and mixing them in the patient's breakfast cereal.
D) Offering a sip of water before and after each pill.

Answer 2

Offering a sip of water before and after each pill.

Question 3

When the medication nurse offers a pill to the older adult patient, the patient asks, "What is this and what is it for?" What is the best response by the nurse?

A) "I'm not at liberty to discuss your medication. You need to talk to your doctor."
B) "That's a 'feel good' pill that will make you feel better."
C) "It's a cephalosporin that has been ordered to treat your URI."
D) "It's an antibiotic for the infection in your urine."

Answer 3

"It's an antibiotic for the infection in your urine."

Question 4

What is a cause for increased rate of drug absorption in an older patient?

A) Change of the chemical composition of the drug
B) Increased gastric pH
C) Decreased strength of the drug
D) Decreased gastric motility

Question 5

What is a symptom of theophylline overdose?

A) Tachycardia
B) Confusion
C) Hypotension
D) Constipation

Question 6

The physician has written an order to convert an enteric-coated medication from the pill form to the liquid form. What would be the most appropriate response of the nurse?

A) Transcribe the order and change the medication administration record to show the liquid form.
B) Use up the rest of the tablets by crushing them and giving them dissolved in water.
C) Order the liquid form from the pharmacy as ordered.
D) Inquire if the physician wants the dose to be the same as the pill.

Question 7

What is a correct method of administering a transdermal medication patch?

A) Apply the patch at the same site every day and carry out documentation.
B) Fold and dispose of the used patch in the sharps container.
C) Warm the patch in his or her hands before application.
D) Cover the patch with tape to prevent dislodgement.

Question 8

Why does the nurse frequently assess an older adult who is on a psychotropic drug?

A) Older adults are less active.
B) The older adult has fewer cognitive capabilities.
C) Brain receptors have become hypersensitive.
D) Receptor sites have lower perfusion.

Question 9

What oral medication can be safely crushed?

A) Plain antihypertensive medication tablet
B) Sublingual tablet of nitroglycerin
C) Timed-release capsule for gastric reflux
D) Enteric-coated aspirin

Question 10

What age-related changes in the stomach can cause increased drug absorption and possibly drug toxicity?

A) Decreased gastric motility
B) Gastric reflux disease
C) Inability of gastric cells to transport the drug
D) Decreased peristalsis

Question 11

Why is drug testing done by pharmaceutical companies not always appropriate for the older adult?

A) The testing is not done long enough.
B) The testing does not require adequate follow-up.
C) The testing is not well regulated by the U.S. Food and Drug Administration.
D) The testing is usually conducted on healthy young persons.

Question 12

When the 80-year-old female patient refuses to take a medication because it burns her stomach, what action should be taken by the nurse?

A) Crush the pill and mix it with the dessert on her meal tray.
B) Insist that she take it "for her own good."
C) Circle and initial the dose time to show non-administration.
D) Document the reason for refusal and report the refusal to the charge nurse.

Question 13

What is the major risk of polypharmacy for the older adult?

A) Ignorance about his or her prescriptions
B) Taking over-the-counter preparations
C) Being treated by more than one physician
D) Taking old prescriptions rather than consulting a physician

Question 14

What is the purpose of the Beers criteria?

A) Identifies medications best avoided by the older adult.
B) Identifies diagnostic procedures that are considered inappropriate for a diagnosis.
C) Identifies penalties for extended-care facilities that allow administration of particular drugs.
D) Identifies assessments necessary before the prescription of particular drugs.

Question 15

An older adult is taking diazepam several times a day. What does the nurse specifically monitor for?

A) Tachycardia
B) A hangover effect
C) Agitation
D) Hypertension

Question 16

What site would be the best choice for an intramuscular injection to an emaciated 82-year-old patient?

A) Upper outer quadrant of the gluteus maximus
B) Gluteal
C) Deltoid
D) Ventrogluteal

Question 17

Which assessment finding in a 75-year-old man on a chlorpromazine (Thorazine) protocol should be immediately reported to the physician?

A) Cough
B) Headache
C) Drool
D) Nausea

Question 18

What should an older adult be encouraged to implement in order to prevent lithium toxicity?

A) Increase fluid intake to 3500 mL daily.
B) Have the patient ambulate for 10 minutes after the drug is administered.
C) Prohibit citrus fruit in the diet.
D) Administer a prescribed stool softener to ensure a daily bowel movement.

Question 19

Why would the nurse anticipate an adverse reaction in an older adult who is taking the protein-bound drug warfarin (Coumadin)?

A) Unbound active drug molecules continue to circulate in the bloodstream.
B) The bleeding and clotting times will decrease.
C) The drug becomes ineffective and does not deliver its intended therapeutic action.
D) Renal damage can occur from the altered drug molecules.

Question 20

What is the most reliable method of patient identification for administration of medications?

A) A photograph of the patient
B) An identification bracelet
C) Asking the patient to repeat his or her name
D) Use of the patient's room number

Question 21

Arrange the steps for preparing crushed medications to be given by feeding tube in order of priority.

A) Flush the tube to clear feeding.
B) Thoroughly crush the medication.
C) Administer each medication separately.
D) Dissolve each crushed medication in a medicine cup.
E) Flush the tube to clear the medication from the tube.
F) Reconnect the feeding tube.

Question 22

The nurse crushes a pill and disguises the dose in the mashed potatoes of a resident in a long-term care facility who previously refused the drug. It is then fed to the patient by the nursing assistant. This should be considered an error because it __________. (Select all that apply.)

A) violates the patient's right to refuse medication
B) involves delegation of medication administration to the nursing assistant
C) increases the amount of time for the drug administration pass
D) becomes impossible to confirm the patient received the entire dose
E) alters the food

Question 23

What factors increase the risk of medication-related problems in the older adult? (Select all that apply.)

A) Drug-testing methodology
B) Age-related changes
C) Polypharmacy
D) Cognitive and sensory changes
E) Lack of adequate medical follow-up

Question 24

The primary organ of drug metabolism is the __________.

Question 25

What information related to drug administration should be included in the nursing care plan? (Select all that apply.)

A) Schedule for drawing blood values
B) Patient's need for crushing medication
C) Patient's preference as to the use of medium in which to give crushed medicines
D) Schedule of medication and dose times
E) Parameters of pulse or blood pressure, if significant to administration

Question 26

What provisions should be included in the plan of care for a 70-year-old extended-care facility resident who will be self-administering his medications? (Select all that apply.)

A) Delivery of adequate supply of medication
B) Payment for medication
C) Locked medication storage at bedside
D) Medication administration record
E) Assessment of effectiveness of medication

Question 27

The nurse clarifies that the term __________ refers to the study of how persons respond to medicines.

Question 28

What measures may the older adult take to reduce the high cost of prescription drugs? (Select all that apply.)

A) Simply not fill a new prescription
B) Take less than prescribed to preserve their supply
C) Fill all prescriptions at once
D) Save old prescription drugs for later use
E) Share medications

Question 29

Why is self-medication with over-the-counter (OTC) drugs hazardous to the older adult? (Select all that apply.)

A) OTC drugs can increase the effect of a prescribed drug.
B) OTC drugs can interfere with the efficacy of a prescribed drug.
C) OTC drugs can mask significant symptoms of primary disease.
D) OTC drugs are easily obtained.
E) OTC drugs can lead to overdose because they are not considered to be "real drugs."

Question 30

The home health nurse periodically interviews patients relative to their use of _________ because it is the most commonly consumed and abused nonprescription drug used by adults.