Deck 7: Geriatric Considerations

Question 1

An older patient takes ibuprofen for arthritis pain. The patient tells the nurse that the ibuprofen causes GI upset. Which action will the nurse take with this patient?

A) Ask the provider about having the patient take a different medication.
B) Instruct the patient to cut the ibuprofen dose in half to avoid GI upset.
C) Explain that all drugs have adverse effects.
D) Explore options to help decrease the drug side effects.

Answer 1

Explore options to help decrease the drug side effects.

Question 2

Which drug properties are potentially problematic for older patients? (Select all that apply.)

A) Drugs with anticholinergic effects
B) Drugs that are highly protein-bound
C) Drugs with a short half-life
D) Drugs that undergo hepatic conjugation
E) Drugs with a narrow therapeutic range

Answer 2

Drugs with anticholinergic effects
Drugs that are highly protein-bound
Drugs with a narrow therapeutic range

Question 3

The nurse is caring for an older patient who is taking 25 mg per day of hydrochlorothiazide. The nurse will closely monitor which lab value in this patient?

A) Coagulation studies
B) White blood count
C) LFTs
D) Serum potassium

Answer 3

Serum potassium

Question 4

The nurse is performing an admission assessment on an 80-year-old patient who has frequent hospital admissions. The patient appears more disoriented and confused than usual. Which action by the nurse is most appropriate at this time?

A) Asking about medications and doses
B) Asking for a neurologist consult
C) Requesting orders for LFTs
D) Suspecting impaired renal function

Question 5

A 75-year-old patient is readmitted to the hospital to treat recurrent pneumonia. The patient had been discharged home with a prescription for antibiotics 5 days prior. The nurse admitting this patient will take which initial action?

A) Ask the patient about OTC drug use.
B) Ask the patient how many doses of the antibiotic have been taken.
C) Discuss increasing the antibiotic dose with the provider.
D) Obtain an order for a creatinine clearance test.

Question 6

An older patient who reports a 2- to 3-year history of upper gastrointestinal (GI) symptoms will begin taking ranitidine (Zantac) to manage her symptoms. The patient has completed a health history form. The nurse notes that the patient answered "no" when asked if any medications were being taken. Which action will the nurse take next?

A) Ask whether the patient uses over-the-counter (OTC) medications.
B) Obtain a careful dietary history for the past two weeks.
C) Recommend that the patient take antacid tablets.
D) Suggest that the patient add high-potassium foods to the diet.

Question 7

The nurse is caring for an older adult patient who is receiving multiple medications. When monitoring this patient for potential drug toxicity, the nurse should review which lab values particularly closely given the patients advanced age?

A) Complete blood count and serum glucose levels
B) Pancreatic enzymes and urinalysis
C) Serum creatinine and liver function tests (LFTs)
D) Serum lipids and electrolytes

Question 8

The nurse is preparing an 80-year-old patient for discharge home from the hospital. The patient will receive several new medications. The patient lives alone but has several family members who stop by every day. The patient reports problems with manual dexterity and difficulty with childproof medication bottles. Which suggestions will the nurse make for this family? (Select all that apply.)

A) Ask the pharmacy for non-childproof medication bottles.
B) Ask the patient to record all medications and the times they are taken.
C) Consider placing the pills in an organizer container.
D) Provide the patient with the drug manufacturer information sheets.
E) Put water bottles near pills for convenience.

Question 9

To assist an older, confused patient to adhere to a multidrug regimen, the nurse will provide which recommendation?

A) Avoid the use of OTC medications.
B) Bring all medications to each clinic visit.
C) Review the manufacturer's information insert about each medication.
D) Save money by getting each drug at the pharmacy with the lowest price.

Question 10

The nurse is caring for a 78-year-old patient who lives independently. The patient will begin a new drug regimen that requires taking multiple drugs at various times per day. Which intervention is appropriate for the nurse to implement with this patient?

A) Ask the patient's family members to monitor the patient's drug regimen.
B) Develop a log and/or calendar to record the times each drug will be taken.
C) Reinforce the need to take the drugs as scheduled.
D) Write the medication administration times on each prescription label.

Question 11

An 80-year-old patient is being treated for an infection. An order for which type of antibiotic would cause concern for the nurse caring for this patient?

A) Aminoglycoside
B) Cephalosporin
C) Penicillin
D) Sulfonamide

Question 12

The nurse is caring for an 80-year-old patient who is taking warfarin (Coumadin). Which action does the nurse understand is important when caring for this patient?

A) Encouraging the patient to rise slowly from a sitting position
B) Initiating a fall-risk protocol
C) Maintaining strict intake and output measures
D) Monitoring blood pressure frequently

Question 13

A 75-year-old patient will be discharged home with a prescription for an opioid analgesic. To help the patient minimize adverse effects, what will the nurse recommend for this patient?

A) Sucking on lozenges to moisten oral mucosa
B) Taking an antacid with each dose
C) Taking the medication on an empty stomach
D) Using a stool softener

Question 14

The nurse is caring for an 82-year-old patient who takes digoxin to treat chronic atrial fibrillation. When caring for this patient, to monitor for drug side effects, what will the nurse carefully assess?

A) Blood pressure
B) Heart rate
C) Oxygen saturation
D) Respiratory rate