Deck 6: Factors That Foster Positive Outcomes

Question 1

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?

A) Financial status
B) Mobility
C) Social support
D) Sexual practices

Answer 1

Sexual practices

Question 2

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

A) Stand facing him and speak slowly and clearly
B) Speak in low tones or find a provider who has a lower voice
C) Write down the instructions as well as speaking them
D) If he reads lips,exaggerate lips movements when pronouncing the vowel sounds

Answer 2

If he reads lips,exaggerate lips movements when pronouncing the vowel sounds

Question 3

Elena Vasquez' 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?

A) Use correct medical terminology since Spanish has a Latin base
B) Use a family member who speaks more English to act as interpreter
C) Use a professional interpreter or a reliable staff member who can interpret
D) Use careful,detailed explanations

Answer 3

Use a professional interpreter or a reliable staff member who can interpret

Question 4

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

A) Older adults and those on fixed incomes
B) Patients with chronic illnesses
C) Patients with copayments for drugs on their insurance
D) Patients on public assistance

Question 5

Factors in chronic conditions that contribute to non-adherence include:

A) The complexity of the treatment regimen
B) The length of time over which it must be taken
C) Breaks in the usual daily routine,such as vacations and weekends
D) All of the above

Question 6

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:

A) Are well-educated and affluent
B) Have chronic conditions
C) Self-monitor drug effects on their symptoms
D) None of the above guarantee adherence

Question 7

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

A) Complexity of the drug regimen
B) Patient perception of the potential adverse effects of the drugs
C) Both A and B
D) Neither A nor B

Question 8

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?

A) Ralph states that he always takes the drug "when I feel my pressure is going up."
B) Ralph contacts his NP to discuss the need to increase the dose.
C) Ralph consistently keeps his follow-up appointments to check his blood pressure.
D) All of the above show that he is adherent to the drug regimen.

Question 9

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?

A) Have the patient purchase a pill container with compartments for daily or multiple times per day dosing.
B) Match the clinic appointment to the next time the drug is to be refilled.
C) Write prescriptions for new drugs with shorter times between refills.
D) Give the patient a clear drug schedule that the provider devises to fit the characteristic of the drug.

Question 10

Adverse drug reactions and patients' perceptions of them are likely to produce non-adherence.Which of the following ADRs are least likely to produce non-adherence?

A) Severe hypotension and anaphylaxis
B) Constipation and diarrhea
C) Headache and dizziness
D) Nausea and vomiting

Question 11

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

A) Has a short half-life so that missing one dose has limited effect
B) Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down.
C) Has a tolerability profile with less of the adverse effects that are considered "irritating," such as nausea and dizziness.
D) Must be taken no more than twice a day.

Question 12

Monitoring adherence can take several forms,including:

A) Patient reports from data in a drug diary
B) Pill counts
C) Lab reports and other diagnostic markers
D) All of the above

Question 13

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:

A) The provider spent a lot of time discussing the drugs with them
B) Their concerns and specific area of knowledge deficit were addressed
C) They were given written material,such as pamphlets,about the drugs
D) The provider used appropriate medical and pharmacologic terms

Question 14

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

A) With a longer half-life so that missed doses produce a longer taper on the drug curve
B) In oral formulations that are more easily taken
C) That do not require frequent monitoring
D) Combined with patient education about the need to adhere even when symptoms are absent

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?

A) Increasing copayments for care
B) Unrestricted formularies for drugs including brand names
C) Increasing the number of people who have access to care
D) Treating a wider range of disorders