Question 1

Factors in chronic conditions that contribute to nonadherence include:

Accepted Answer

All of the listed factors can contribute to nonadherence in chronic conditions. A complex treatment regimen can be difficult for patients to follow, while extended timeframes can lead to patients forgetting or becoming tired of adhering to a medication schedule. Breaks from usual daily routines also can disrupt adherence patterns.

Question 2

Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:

Accepted Answer

Asymptomatic conditions often have no immediate tangible benefits to the patient, so patients are more likely to discontinue or skip dosages if they experience unpleasant side effects. A drug with fewer irritating side effects is more likely to be tolerated by the patient, resulting in better adherence.

Question 3

Monitoring adherence can take several forms, including:

Accepted Answer

Monitoring adherence to medication is a complex process that requires multiple methods. Patient reports from data in a drug diary can provide valuable insights into medication adherence. Pill counts can be used to determine the number of pills that a patient has taken over a given period. Laboratory reports and other diagnostic markers can highlight patient non-adherence to medication. A combination of these methods and others may provide the best approach to ensuring medication adherence by patients.

Question 4

Many disorders require multiple drugs to treat them. The more complex the drug regimen, the less likely the patient will adhere to it. Which of the following interventions will NOT improve adherence?

Accepted Answer

The answer of Many disorders require multiple drugs to treat...

Question 5

Pharmacologic interventions are costly. Patients for whom the cost/benefit variable is especially important include:

Accepted Answer

Older adults and those on fixed incomes often have limited financial resources, making the cost of medications a significant concern when considering the benefits of pharmacologic interventions.

Question 6

Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs:

Accepted Answer

A longer half-life allows the drug to remain in the system longer, reducing the impact of missed doses and potentially improving adherence.

Question 7

Ralph's blood pressure remains elevated despite increased doses of his drug. The NP is concerned that he might not be adhering to his treatment regimen. Which of the following events would suggest that he might not be adherent?

Accepted Answer

Ralph's statement that he only takes the drug when he feels his pressure is going up suggests that he is not following the prescribed dosing regimen. This could explain why his blood pressure remains elevated despite increased doses of the drug. Option B suggests that Ralph is being proactive about his treatment and seeking guidance from his NP, while option C suggests that he is making an effort to keep up with his follow-up appointments, both of which are positive signs of adherence. However, option A is the only one that suggests non-adherence.

Question 8

Elena Vasquez's primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed?

Accepted Answer

It is important to use a professional interpreter or a reliable staff member who can act as an interpreter to ensure accurate communication and understanding between the healthcare provider and the patient. Using a family member as an interpreter can lead to potential misinterpretation or inaccuracies in communication. Using medical terminology may also be confusing for a patient with limited English proficiency. Using careful, detailed explanations is also important, but having a professional interpreter is crucial in providing effective care for patients with limited English proficiency.

Question 9

Providers have a responsibility for determining the best plan of care, but patients also have responsibilities. Patients the provider can be assured will carry through on these responsibilities include those who:

Accepted Answer

Patients' adherence to a plan of care is not guaranteed by their education level, affluence, having chronic conditions, or self-monitoring drug effects. Adherence involves complex factors including but not limited to understanding, motivation, and the ability to follow through with the prescribed plan, which cannot be assured based solely on these characteristics.

Question 10

A comprehensive assessment of a patient should be holistic when trying to determine competence in drug administration. Which of the following factors would the NP omit from this type of assessment?

Accepted Answer

A comprehensive assessment should include factors that may impact a patient's ability to safely and effectively administer medications. Financial status, mobility, and social support can all play a role in this. However, sexual practices are not relevant to medication administration competence and should not be included in the assessment.

Question 11

Which of the following factors may adversely affect a patient's adherence to a therapeutic drug regimen?

Accepted Answer

Both the complexity of the drug regimen and the patient's perception of potential adverse effects of the drugs can decrease patient adherence to a therapeutic drug regimen. Patients may be more likely to miss or stop taking medications if they are difficult to understand or require numerous doses throughout the day. Additionally, if the patient perceives the drugs as having unfavorable side effects, they may be less likely to continue taking them.

Question 12

While patient education about their drugs is important, information alone does not necessarily lead to adherence to a drug regimen. Patients report greater adherence when:

Accepted Answer

While information is important, addressing the patient's individual concerns and knowledge deficits is crucial to promoting adherence. Patients are more likely to follow a drug regimen when they feel that their specific needs and concerns have been heard and addressed by the provider. Spending time discussing the drugs or using medical terminology may not be as impactful as addressing the patient's individual needs. While written material can be helpful, it is not as effective when used in isolation without addressing individual concerns.

Question 13

Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug?

Accepted Answer

Exaggerating lip movements can actually make it more difficult for someone who reads lips to understand what is being said. It distorts the natural patterns of speech, making lip reading less accurate.

Question 14

Factors that explain and predict medication adherence include:

Accepted Answer

All three factors (social, financial, and health system) are known to impact and predict medication adherence. Social factors may include support from family and friends, cultural beliefs, and access to transportation. Financial factors may include the cost of medication and insurance coverage. Health system factors may include the ease of obtaining prescriptions, communication with healthcare providers, and follow-up care.

Question 15

The health-care delivery system itself can create barriers to adherence to a treatment regimen. Which of the following system variables creates such a barrier?

Accepted Answer

Increasing copayments for care can create a financial barrier for patients to access and adhere to their treatment regimen. Research has shown that higher copayments are associated with lower adherence rates. Unrestricted formularies, increased access to care, and treating a wider range of disorders are not system variables that create barriers to adherence.

Quiz 6: Factors That Foster Positive Outcomes