Deck 3: Drug Therapy Across the Life Span

Question 1

An infant is prescribed a medication that has a narrow therapeutic range and is excreted by the kidneys. The provider will monitor closely for which effect?

A) Decreased drug effectiveness
B) Tachyphylaxis
C) Evidence of drug toxicity
D) Unusual CNS effects

Answer 1

Evidence of drug toxicity

Question 2

A pediatric provider is teaching nursing students to calculate medication doses for children using a formula based on body surface area. Which statement by a nursing student indicates understanding of the teaching?

A) "This formula helps approximate the first dose; other doses should be based on clinical observations."
B) "This formula accounts for pharmacokinetic factors that are different in children."
C) "Using this formula will prevent side effects of medications in children."
D) "This formula can determine medication dosing for a child of any age."

Answer 2

"This formula helps approximate the first dose; other doses should be based on clinical observations."

Question 3

A woman who breastfeeds her infant must take a prescription medication for 2 weeks. The medication is safe, but the patient wants to make sure her baby receives as little of the drug as possible. What instructions will the prescriber give the patient to best address her concerns?

A) "Give the baby formula as long as you are taking the medication."
B) "Take the medication immediately after breastfeeding your baby."
C) "Pump your breast milk and feed the baby by bottle."
D) "Take the medication 1 hour before breastfeeding."

Answer 3

"Take the medication immediately after breastfeeding your baby."

Question 4

An older adult patient with a history of forgetfulness will need to take multiple drugs after discharge from the hospital. What provider action will most successfully promote medication adherence in a forgetful patient?

A) Ask the patient to share the medication teaching with a neighbor or friend soon after discharge.
B) Give the patient detailed written information about each drug.
C) Schedule medications to be taken at the same times as much as possible.
D) Make sure the patient understands the actions and side effects of each drug.

Question 5

A medication prescribed for a neonate is eliminated primarily by hepatic metabolism. What action will the prescriber take to minimize risk to the infant?

A) Prescribe a dose that is relatively lower than an adult dose when adjusted for body surface area.
B) Prescribe a dose that is relatively higher than an adult dose when adjusted for body surface area.
C) Increase the frequency of medication dosing.
D) Discontinue the drug after one or two doses.

Question 6

A frail older adult patient is admitted to the hospital after several days of vomiting, diarrhea, poor intake of foods and fluids, and anuria for 8 hours. What laboratory studies will the provider order to help guide medication administration? (Select all that apply.)

A) Creatinine clearance
B) Gastric pH
C) Plasma drug levels
D) Serum albumin
E) Serum creatinine

Question 7

A provider is concerned about renal function in an 84-year-old patient who is taking several medications. What laboratory result will the provider order?

A) Creatinine clearance
B) Sodium levels
C) Potassium levels
D) Serum creatinine

Question 8

A provider obtains a drug history from an older adult who is a new patient. Of the multiple medications taken, which two, taken together, create a reason for concern?

A) Acetaminophen and oxycodone
B) Amitriptyline and diphenhydramine
C) Fexofenadine and an over-the-counter (OTC) laxative
D) Zolpidem and sertraline

Question 9

A 5-year-old has gray teeth. When taking a medication history, the provider will ask about previous use of which group of medications?

A) Glucocorticoids
B) Salicylates
C) Sulfonamides
D) Tetracyclines

Question 10

A child attending daycare is prescribed 750 mg of an antibiotic for 10 days. The drug may be dosed in several ways and is available in two concentrations. Which dosing regimen will the provider consider to best assure drug adherence?

A) 375 mg of a 250 mg/5 mL solution PO twice daily
B) 250 mg of a 250 mg/5 mL solution PO three times daily
C) 250 mg of a 500 mg/5 mL solution PO three times daily
D) 375 mg of a 500 mg/5 mL solution PO twice daily

Question 11

A pregnant patient asks her provider about the safe use of medications during the third trimester. What will the provider tell her about drugs taken at this stage?

A) "They may need to be given in higher doses if they undergo renal clearance."
B) "They require lower doses if they are metabolized by the liver."
C) "They are less likely to cross the placenta and affect the fetus."
D) "Drugs are more likely to cause anatomical defects if they are taken during the second trimester.

Question 12

An older adult patient is entering into the immediate postoperative period after a total hip replacement. The patient's son concerned about related pain asks meperidine be prescribed since, "I had it for severe pain when I injured when I was younger." What action will the provider take to reduce the patient's risk for injury while addressing the patient's pain?

A) Prescribe meperidine and request the initiation of the fall risk protocol.
B) Provide a PRN order for diphenhydramine for the expected side effect of itching.
C) Prescribe morphine and discuss the rationale with the patient's son.
D) Offer to prescribe diazepam to reduce the patient's anxiety and thus reduce the need for narcotics.

Question 13

Four older adult patients are taking multiple medications. For which patient is the provider most concerned about the risk for adverse drug effects?

A) An obese patient
B) A patient with decreased serum creatinine
C) A patient who experiences chronic diarrhea
D) An underweight patient with a chronically low appetite

Question 14

Which type of medication prescribed to a pregnant patient is more likely to have effects on her fetus?

A) Drugs that are highly polar
B) Ionized drugs
C) Lipid-soluble drugs
D) Protein-bound drugs

Question 15

The parents of a child with asthma ask the provider why their child cannot use oral corticosteroids more often, because they are so effective. The provider will base the discussion with the parents on what fact concerning oral corticosteroids?

A) Chronic glucocorticoid use can inhibit physical growth.
B) Frequent use of this drug may lead to a decreased response.
C) A hypersensitivity reaction to this drug may occur.
D) Systemic steroids are more toxic in children.

Question 16

An older adult patient is admitted to the hospital for treatment of an exacerbation of a chronic illness. Admission laboratory work reveals an extremely low serum drug level of the drug used to treat this condition. The patient's renal and hepatic function tests are normal. What might the provider suspect as a likely cause of this finding?

A) Nonadherence to the medical regimen
B) Chronic constipation
C) Increased tolerance to the drug's effects
D) Concurrent administration of two highly protein-bound drugs

Question 17

A provider speaking to a class or a group of pregnant patients correctly teaches that the highest risk of teratogen-induced gross malformations exists during which time period?

A) Immediately before conception
B) During the first trimester
C) During the second trimester
D) During the third trimester

Question 18

An infant developed a pruritic rash following exposure to an allergen. The infant's parents ask the provider about using a topical antihistamine. What information should the provider use to address the parents' question?

A) Antihistamines given by this route are not absorbed as well in children.
B) Applying an antihistamine to the skin can cause toxicity in this age group.
C) The child will also need oral medication to achieve effective results.
D) Topical medications have fewer side effects than those given by other routes.

Question 19

A pregnant woman asks why more is not known about the teratogenic effects of maternal medication ingestion during pregnancy. Which response will the provider offer to address the patient's concern?

A) "Clinical trials to determine teratogenic effects would put the fetus at risk."
B) "It is safer to recommend that pregnant women avoid medications while pregnant."
C) "Most women are reluctant to admit taking medications while they are pregnant."
D) "The relatively new MEPREP study will allow testing of medications during pregnancy in the future."

Question 20

A provider is reviewing an older adult patient's chart during a routine visit. Which patient information is of most concern regarding the renewing of medication prescriptions for highly protein-bound drugs?

A) Chronic constipation
B) Increased body fat
C) Low serum albumin
D) Low serum creatinine