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?

Accepted Answer

Adjusting the timing of medication administration to fit the client's daily schedule can help improve adherence by minimizing inconvenience, such as frequent urination interrupting activities. This approach respects the client's lifestyle while maintaining the therapeutic regimen.

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.

Accepted Answer

A person can overdose on medications containing acetaminophen, as it is a common ingredient in many OTC drugs and can lead to liver damage if taken in excess. Health insurance typically does not cover OTC medications, as they are not prescribed. There is a risk of increased drug interactions between prescribed and OTC medications, which can affect the efficacy and safety of treatment.

Question 3

The nurse is preparing an educational program regarding adverse drug reactions (ADR). What information should the nurse include? Select all that apply.

Accepted Answer

Adverse drug reactions (ADRs) are more common in older adults due to physiological changes and polypharmacy. Serious side effects are indeed considered ADRs. Anticoagulants and antidiabetics are among the drugs most often associated with ADRs due to their narrow therapeutic index and significant impact on physiological processes. Reactions can also occur from drug-drug interactions and polypharmacy, which is the use of multiple medications by a patient, often seen in older populations.

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?

Accepted Answer

The medication for sleep causing excessive sedation is indicated by the client's low respiratory rate and inability to be aroused. Sedatives can depress the central nervous system, leading to reduced respiratory rates and excessive sedation, especially in older clients who may be more sensitive to these medications.

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?

Accepted Answer

Older clients may have different ways of managing their medications, and understanding their routine can help identify any issues with adherence or administration that might affect the medication's effectiveness.

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.

Accepted Answer

The answer of It has been determined that nonpharmacological approaches...

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?

Accepted Answer

The answer of After completing a medication history, the nurse...

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?

Accepted Answer

Assessing intake, output, and dietary intake of protein is appropriate because poor appetite can lead to decreased protein intake, which can affect BUN levels. Additionally, understanding the client's fluid balance and nutritional status can help in addressing the elevated BUN level, especially when the creatinine clearance is normal, indicating that the kidneys are still filtering blood at a normal rate.

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.

Accepted Answer

Drinking water helps ensure the medication passes through the esophagus. Taking sips of water before medication can help lubricate the esophagus. Sitting up helps prevent reflux and irritation.

Question 10

The nurse teaches the client about measures to prevent constipation. What does the nurse teach the client? Select all that apply.

Accepted Answer

The answer of The nurse teaches the client about measures...

Question 11

An older client has taken a nonsteroidal anti-inflammatory drug (NSAID) medication for general muscle aches. Which finding is most concerning?

Accepted Answer

Dark emesis is most concerning because it may indicate gastrointestinal bleeding, a serious potential side effect of NSAID use.

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?

Accepted Answer

Medications for high blood pressure can sometimes cause side effects such as dizziness or orthostatic hypotension, which can increase the risk of falls, especially in older clients. This is why the precaution was put in place after starting the medication.

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.

Accepted Answer

The answer of An older client is experiencing a change...

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?

Accepted Answer

The use of psychotropic drugs, including sedatives, in older clients, especially those with dementia, can be excessive and potentially harmful. It's important to balance the need to manage symptoms like agitation with the risk of adverse effects from these medications. Lowering the dose can be a strategy to minimize harm while still providing necessary care.

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.

Accepted Answer

The answer of The nurse is providing a psychotropic medication...

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?

Accepted Answer

Antipsychotic medications should be used judiciously in older clients, and efforts to discontinue or taper these medications should be made when appropriate to minimize potential side effects and ensure that their use is truly necessary. Fidgeting and impaired memory are not appropriate primary indications for antipsychotic use, and these medications can sometimes be misused as chemical restraints, which is unethical and against best practice guidelines.

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.

Accepted Answer

Some herbal remedies can interact with medications, potentially causing adverse effects. It's important to discuss the use of herbal remedies with a healthcare provider to ensure safety. The FDA does not regulate herbal remedies, meaning their safety and efficacy are not guaranteed. Additionally, many herbal remedies lack scientific evidence supporting their 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?

Accepted Answer

Older clients often require lower doses of medications due to changes in metabolism and drug sensitivity. Administering Restoril (temazepam) at a lower dose of 15 mg instead of the usual adult dose of 30 mg is appropriate for an older client to minimize potential side effects and ensure safety.

Question 19

An older client who takes digoxin has not eaten in 2 days. Which finding most concerns the nurse?

Accepted Answer

Weakness and visual disturbances in a client taking digoxin are indicative of digoxin toxicity, which is a serious concern, especially if the client has not eaten in 2 days, potentially altering electrolyte balance and enhancing the drug's effects.

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?

Accepted Answer

The correct statement indicating an understanding of the nurse's role in medication management for older adults is D, which suggests encouraging the person with heartburn to sit up after medications and meals. This advice is based on the principle of non-pharmacological interventions first and recognizes the importance of posture in managing heartburn, a common issue in older adults. Choices A and B suggest interventions that could potentially lead to adverse effects in older adults, such as dependence on laxatives or benzodiazepines. Choice C, while important for managing acute pain, does not specifically address the unique considerations necessary for medication management in older adults.

Quiz 6: Pharmacology and Older Adults