Question 1

Emphasizing to a client to keep a diary of his or her adverse effects from prescribed medications is important.This nursing intervention may be crucial to the older adult client because of altered pharmacokinetics such as

A) increased gastric pH,resulting in more adverse effects.
B) decreased liver blood flow,altering metabolism of drugs.
C) increased renal excretion,leading to enhanced protein binding.
D) decreased adipose store,making drug distribution more stable.

Accepted Answer

The decreased liver blood flow in older adults alters the metabolism of drugs, which can result in an accumulation of drugs and increased adverse effects. Keeping a diary of adverse effects can help healthcare providers adjust the medication regimen accordingly. Increased gastric pH (A) can also affect drug absorption, but this is not directly related to altered pharmacokinetics in older adults. Increased renal excretion (C) and decreased adipose stores (D) are not factors that significantly affect pharmacokinetics in older adults.

Question 2

Probably one of the most important parts of the nursing process for the older adult client receiving drug therapy is the nurse's ability to&#10;A) suggest to the family that the client needs to be placed in a long-term care facility.&#10;B) devise a detailed plan for medication administration.&#10;C) communicate with patience,understanding,and dignity in all interactions.&#10;D) refer this client to several other health care nurses for alternate visits.&#10;

Accepted Answer

Communication is crucial when working with older adults receiving drug therapy. The nurse must be patient, understanding, and maintain the client's dignity in all interactions to ensure the best possible outcomes. Suggesting placement in a long-term care facility or referring the client to other healthcare nurses for alternate visits may not be necessary or appropriate for every client. A detailed plan for medication administration is important but not the most critical aspect of the nursing process.

Question 3

The nurse assesses that which of the following situations may result in medication misuse for the older adult?&#10;A) A drug regimen that is low cost and easily attainable&#10;B) The older adult follows a specific medication regimen&#10;C) The medication bottles have child-resistant caps&#10;D) The medication can be swallowed without difficulty&#10;

Accepted Answer

Child-resistant caps can be difficult for older adults to open due to conditions like arthritis or reduced hand strength, potentially leading to medication misuse or non-adherence.

Question 4

Which of the following is an accurate statement about the older adult's sensitivity to drugs?&#10;A) The blood-brain barrier is more resistant to fat-soluble drugs&#10;B) The baroreceptor response is increased&#10;C) Peripheral vascular tone is altered&#10;D) Abdominal adipose tissue is decreased&#10;

Accepted Answer

Peripheral vascular tone is altered in older adults, which can affect the distribution and action of drugs. Aging can lead to changes in the vascular system, including reduced elasticity and responsiveness of blood vessels, impacting how drugs are absorbed, distributed, and eliminated in the body.

Question 5

The nurse concludes that which of the following client manifestations caused by central nervous system changes may be the result of medication use?&#10;A) Decreased physical activity&#10;B) Increased number of falls&#10;C) Confusion&#10;D) Nausea&#10;

Accepted Answer

Central nervous system changes can include confusion, but this can also be a side effect of certain medications. Decreased physical activity may be a result of decreased mobility or general weakness, while increased number of falls may be due to environmental factors or impaired balance. Nausea may be a side effect of medication, but it can also be caused by other factors such as gastrointestinal issues or anxiety. Therefore, while all of these manifestations may be a result of central nervous system changes, medication use may specifically be linked to confusion.

Question 6

The nurse taking a medication history of an older adult client learns that the client takes diphenhydramine (Benadryl)two to three times weekly.The nurse should next assess the client to determine whether it causes which of the following adverse effects?

A) Confusion
B) Decreased blood pressure
C) Gastrointestinal upset
D) Inability to fall asleep

Accepted Answer

Diphenhydramine is an antihistamine that can cause sedation and confusion, particularly in older adults. It can also cause other adverse effects such as dry mouth, blurred vision, urinary retention, and constipation. However, confusion is the most concerning adverse effect as it can increase the risk of falls, accidents, and medication errors. The nurse should assess the client's cognitive function and monitor for signs of confusion or other adverse effects if diphenhydramine is continued or if the client is considering taking it more frequently.

Question 7

A frail older adult client has been taking mineral oil at home for self-treatment of constipation.Which of the following adverse effects would be of most concern in this client?&#10;A) Increased need for fat-soluble vitamins&#10;B) Risk for aspiration&#10;C) Generalized weakness&#10;D) Increased risk for falls&#10;

Accepted Answer

Mineral oil is a lubricant laxative that can cause aspiration (inhalation of liquid or food into the airways) if it enters the lungs. Aspiration can lead to serious respiratory problems or even death, particularly in frail older adults. Increased need for fat-soluble vitamins and generalized weakness can be side effects of long-term mineral oil use, but they are not as immediately concerning as the risk for aspiration. Increased risk for falls is not directly associated with mineral oil use.

Question 8

The nurse would place highest priority on assessing the client for hypotension and bradycardia if the client is receiving medications in which of the following drug categories?&#10;A) Analgesics&#10;B) Diuretics&#10;C) Antihypertensives&#10;D) Oral hypoglycemics&#10;

Accepted Answer

Antihypertensive medications can cause a decrease in blood pressure and heart rate, which can lead to hypotension and bradycardia. It is important for the nurse to closely monitor clients receiving antihypertensive medications for these potential adverse effects. Analgesics may cause sedation or respiratory depression, diuretics may cause electrolyte imbalances, and oral hypoglycemics may cause hypoglycemia, but these do not typically cause hypotension and bradycardia.

Question 9

Which nursing intervention will the nurse use to help an older adult client to swallow medication?&#10;A) Position the client flat&#10;B) Provide oral fluids after the medication is given&#10;C) Offer water before and after the oral medications are given&#10;D) Provide oral fluids before the medication is given&#10;

Accepted Answer

Offering water before and after oral medications helps to ensure that the medication is taken with enough fluid to aid in swallowing and prevent any residual medication from sticking in the throat. Providing fluids before giving the medication may cause the client to choke or cough, making it harder to swallow. Positioning the client flat is not an effective intervention for swallowing medication. Providing oral fluids after medication is given may not be effective in aiding the client to swallow the medication.

Question 10

An older adult client has begun reporting nausea,visual problems,and diarrhea.In obtaining a medication history,the nurse asks if the client is taking which of the following?&#10;A) Laxatives&#10;B) Vitamin C&#10;C) Digoxin&#10;D) Analgesics&#10;

Accepted Answer

Nausea, visual problems, and diarrhea are common side effects of digoxin, a medication used to treat heart failure and abnormal heart rhythms. Laxatives and vitamin C typically do not cause visual problems, and analgesics (pain relievers) may cause stomach upset but typically do not cause visual problems.

Deck 8: Drug Therapy for Older Adults