Deck 20: Pharmacologic Management

Question 1

A patient is receiving propranolol (Inderal)for hypertension.Which outcome is the best indicator of goal success when considering the drug's potential effect on the patient's quality of life?

A)The patient verbalizes the importance of moderate exercise.
B)The patient experiences no injuries as a result of dizziness.
C)The patient's blood pressure stays within normal limits.
D)The patient describes symptoms indicative of an adverse drug reaction.

Answer 1

The patient experiences no injuries as a result of dizziness.

Question 2

When administering medications to older adults,the nurse shows an understanding of the effect of aging on drug distribution by monitoring the patient's:

A)cardiac function.
B)liver function.
C)red blood cell count.
D)plasma albumin levels.

Answer 2

plasma albumin levels.

Question 3

The nurse is assessing patients for impending alcohol withdrawal.The nurse assesses the patient with which of the following conditions as a priority?

A)Pulse,58 beats/min;and BP 100/60
B)Pulse,118 beats/min;and BP 160/90
C)Dozing off in chair and not recognizing staff
D)Reporting muscle aches and frequent stumbling

Answer 3

Pulse,118 beats/min;and BP 160/90

Question 4

When working with a patient suspected of substance abuse,the nurse is particularly interested in determining the cause of a patient's:

A)acute abdominal pain.
B)recurring insomnia.
C)extensive history of falls.
D)chlordiazepoxide (Librium)prescription.

Question 5

The nurse is preparing to apply a topical cream on the arm of a cognitively impaired,anorexic older adult patient in the terminal stage of lung cancer.The nurse carefully monitors the effectiveness of the medication because its effectiveness will be most negatively impacted by the patient's:

A)age.
B)cognitive limitations.
C)nutritional status.
D)cancer diagnosis.

Question 6

When initially planning care for the older adult patient who is prescribed clonidine patches as part of a smoking cessation program,the nurse:

A)assesses the patient for any skin disorders on the upper arms and back.
B)determines how many cigarettes or cigars the patient smokes per day.
C)asks if the patient is currently taking any antihypertensive medications.
D)educates the patient to the possible side effects of clonidine therapy.

Question 7

An older adult patient is currently undergoing detoxification for alcohol at a rehabilitation center.When assessing the patient using the Clinical Institute Withdrawal Assessment tool,the nurse determines the patient's current score to be 23.The nurse:

A)immediately institutes seizure precautions.
B)monitors the patient's vital signs every 2 hours.
C)arranges for the patient to be transferred to an acute care hospital.
D)shares with the patient that the detoxification process is almost complete.

Question 8

Your patient reports frequent constipation as a result of prescription medications and asks the nurse for advice about using a daily over-the-counter laxative.The most appropriate response by the nurse is to:

A)tell the patient to consult the health practitioner before using nonprescription drugs.
B)educate the patient about the side effects of regular laxative use.
C)tell the patient to avoid laxatives because they can interfere with medications already being taken.
D)tell the patient to consult a dietician about ways to correct chronic constipation.

Question 9

An older adult patient has been prescribed warfarin (coumadin).The nurse's primary intervention involves daily review of the patient's:

A)prothrombin time.
B)body for bruising.
C)serum creatinine level.
D)reflex tone.

Question 10

A patient with diabetes and hypothyroidism is being admitted to an assisted living facility.During the admission assessment,the patient reports difficulty falling asleep.The nurse shows an understanding of sleep dysfunction and the older patient when asking:

A)"Have you ever been prescribed a sleeping medication?"
B)"How do you feel about leaving your home to live here?"
C)"How long have you been a diabetic?"
D)"Are you taking medication for your thyroid problem?

Question 11

The nurse is caring for an older adult who reports severe chronic pain.To best assess age-related physiologic changes that could influence plans for initiating an appropriate drug regimen,the nurse prepares the patient for which laboratory evaluation?

A)White blood count
B)Glomerular filtration rate
C)Serum complement level
D)Electroencephalogram

Question 12

A 67-year-old woman presents at the emergency department with symptoms that suggest possible abuse of a narcotic analgesic.To best assure the patient's safe care,the nurse asks:

A)"When did you first start using the analgesic?"
B)"Have you experienced withdrawal symptoms before?"
C)"Why did you initially need an analgesic?"
D)"What prescribed drugs are you currently taking?"

Question 13

An older adult diabetic patient is mildly hypertensive.The nurse prepares to educate the patient regarding angiotensin II-blocking agents.These drugs are especially useful in older adults because they:

A)protect the kidney's function.
B)have a well-defined therapeutic window.
C)are more effective than other drugs in the same class.
D)can be given when liver function is compromised.

Question 14

An older adult patient is having difficulty remembering when to take several of the prescribed medications.To improve the patient's compliance with the medication regimen,the nurse:

A)asks the patient's spouse to consistently administer the drugs.
B)checks the drug guide to see if decreasing the frequency if the drugs is possible.
C)informs the patient's physician about the drug noncompliance.
D)teaches the patient to administer daily pills with a pill dispenser.

Question 15

The nurse shows an understanding of medication-related risk factors common to older adults when asking:

A)"Are you aware of the possible side effects of your medications?"
B)"Do you regularly take any dietary supplements?"
C)"How do you keep track of when your medications are due?"
D)"How many different physicians are prescribing medications for you?"

Question 16

An older adult patient shares with the admitting nurse that she drinks "one shot" of whiskey nightly to help her sleep.The nurse documents the need to:

A)assess the patient for slurred speech,lack of coordination,and nystagmus.
B)address the effects of alcohol abuse with the patient.
C)provide the patient with an alcohol substitute.
D)assess the patient for signs of agitation,as well as anxiety and seizures.

Question 17

The nurse explains to ancillary staff that caffeine abuse is difficult to diagnose in the older adult patient because caffeine intoxication symptoms:

A)can be confused with normal effects of aging.
B)often mimic those of some cardiac disorders.
C)produce fewer symptoms in older adults than in younger adults.
D)resemble the side effects of several antihypertensive drugs.

Question 18

The nurse responsible for administering medications to the residents of a long-term care facility shows an understanding of the risk of injury this population experiences when:

A)confirming the patient's identity prior to providing the medication.
B)assessing the patient for a history of drug-related allergies.
C)implementing the 5 rights of medication administration routinely.
D)educating patients about the purpose and side efforts of their medications.

Question 19

An older adult patient is being assessed for possible alcohol abuse.To best assess the patient's risk potential,the nurse asks:

A)"Have you ever experienced a memory loss as a result of consuming alcohol?"
B)"Would you drink to relax after a particularly stressful day?"
C)"Do you ever drink when you are alone?"
D)"How many alcoholic drinks do you consume each week?"

Question 20

A 68-year-old man with a history of alcohol abuse is admitted to the acute care facility for reports of abdominal pain.Based on your understanding of alcohol withdrawal,the nurse knows that if patient is currently abusing alcohol,he will most likely:

A)experience delirium tremors within 4 hours of hospitalization.
B)develop withdrawal symptoms 48 to 72 hours after the last intake of alcohol.
C)receive 1 ounce of alcohol every 4 hours while awake.
D)be prescribed oxazepam (Serax).

Question 21

The nurse must be able to distinguish between alcohol intoxication and alcohol withdrawal to intervene appropriately.The nurse suspects alcohol intoxication when the patient does which of the following? (Select all that apply. )

A)Slurs his speech when answering questions
B)Has difficulty remembering his address
C)Reports seeing snakes in the corner of the room
D)Documents his blood pressure as 168/90
E)Experiences difficulty when walking to the bathroom

Question 22

A 69-year-old was prescribed a benzodiazepine 3 years ago.This medication regimen increases the patient's risk for injury related to drug abuse and requires frequent patient assessment for which of the following? (Select all that apply. )

A)Daytime sleepiness
B)Unsteady gait
C)Shortness of breath
D)Easy bleeding
E)Forgetfulness

Question 23

To minimize the possible complications of polypharmacy among older adult patients,the nurse assesses this population for which of the following? (Select all that apply. )

A)Number of physicians providing medical care
B)Location of pharmacies where prescriptions are filled
C)Presence of chronic illnesses
D)Tendency to borrow medication from family or friend
E)Use of over-the-counter medication to self-medicate