Deck 27: Drugs and Older Adults

Question 1

Janelle,64 years of age,is thrilled about the effects tolterodine on her incontinence and finds that she has returned to an active social life.What potential gastrointestinal side effect is associated with tolterodine?

A)diarrhea
B)rapid transit time
C)constipation
D)increased motility

Answer 1

constipation

Question 2

Alice,67 years of age,is experiencing insomnia and recalls that a number of years ago,she took a benzodiazepine to help her fall asleep.She knows that benzodiazepines are associated with increased falls and wonders whether a nonbenzodiazepine such as Ambien would eliminate that risk.Is this the case?

A)Yes.Nonbenzodiazepine hypnotics are extremely safe.
B)Possibly,but it would depend on what other medications she is taking
C)No.Nonbenzodiazepine hypnotics are also associated with syncope and falls.
D)Probably,but only if she does not have other health problems

Answer 2

No.Nonbenzodiazepine hypnotics are also associated with syncope and falls.

Question 3

Randy,82 years of age,has relative achlorhydria.What process will this affect?

A)excretion
B)absorption
C)metabolism
D)distribution

Answer 3

absorption

Question 4

Charis,age 89,has impaired circulation.What process might this affect?

A)metabolism
B)distribution
C)excretion
D)absorption

Question 5

Jadon,67 years of age,has impaired exchange of gasses in his lungs.What process might this affect?

A)metabolism
B)excretion
C)distribution
D)absorption

Question 6

Clifton,77 years of age,takes phenytoin to control his seizures.What age-related change may alter distribution and necessitate changing his dose?

A)poor gas exchange in the lungs
B)decreased production of albumin
C)slowed GI motility
D)renal dysfunction

Question 7

Ernest,72 years of age,has less muscle and more fat than he had when younger.What process will that affect?

A)absorption
B)distribution
C)excretion
D)metabolism

Question 8

Deann,79 years of age,simply doesn't drink as much water or other fluids as she used to when younger.What process might this affect?

A)excretion
B)distribution
C)metabolism
D)absorption

Question 9

Cristobal,age 79,has early renal failure.What type of medication is especially dangerous to him because of its nephrotoxic effects?

A)OTC antacids
B)aminoglycosides
C)benzodiazepines
D)OTC antitussives

Question 10

Gregory has taken antacids much of his adult life and now,at age 68,continues to take them nearly daily.What risk is associated with frequent use of antacids by elderly individuals?

A)spending money on remedies that do not work
B)paradoxical hypersecretion of acid
C)masking signs of a GI bleed or GI cancer
D)physical dependence

Question 11

Chad is concerned about all of the medications his grandfather takes and after his grandfather is involved in a serious motor vehicle accident,decides to do some research.He finds that risk of cognitive impairment,delirium,falls,fractures,and motor vehicle accidents is elevated in older individuals who take .

A)oral antiadiabetics
B)antibiotics
C)antihyperteisives
D)benzodiazepines

Question 12

Hudson,73 years of age,has severe arthritis and takes an NSAID.What is especially concerning about the use of NSAIDs in elderly individuals?

A)Elderly patients may become psychologically dependent on NSAIDs.
B)Even fatal bleeds may not be preceded by any warning signs or symptoms.
C)Elderly patients become tolerant to NSAIDs and need ever-increasing doses.
D)Because of their side effects,medication adherence is poor for elderly individuals taking NSAIDs.

Question 13

Hudson,73 years of age,has severe arthritis and takes an NSAID.What should he know about minimizing his risk of adverse effects from long-term use?

A)He can reduce his risk of GI bleed by taking the NSAID with a glass of red wine for the protective effects of resveratrol.
B)He may wish to explore the possibility of substituting acetaminophen for pain,if possible,at least part of the time.
C)He should take over-the-counter antacids when he takes the NSAID and if he should experience GI distress.
D)He can double his doses if the pain worsens,but not for more than three consecutive days.

Question 14

Lachlan,87 years of age,has routine blood work that indicates liver impairment.What process is importantly affected by liver function?

A)excretion
B)absorption
C)metabolism
D)distribution

Question 15

Layla,62 years of age,has had success with the antipsychotic olanzapine for a number of years and is highly motivated to continue the medication.Are there any potential issues with this drug as she ages?

A)Probably,as long as she is physically healthy
B)Yes.It is associated with orthostatic hypotension and may increase her risk of falls and syncope.
C)Possibly,but it largely depends on what other medications she is taking
D)No.It is one of the safest antipsychotics for elderly individuals.

Question 16

Gia,85 years of age,is in a specialized nursing home for patients with dementia.Recently,she has been frighteningly aggressive and the staff is exploring pharmacological management using antipsychotics.What risk is elevated in elderly patients with dementia who are given antipsychotics?

A)hypersexuality
B)death
C)blindness
D)COPD

Question 17

Mandatory retirement at age 72 has left Devon in a prolonged depression,and his doctor suggests an antidepressant.Would imipramine be a good choice for him?

A)No.Imipramine has significant anticholinergic action and is inappropriate.
B)Possibly,but it depends on what other medications Devon is taking.
C)Yes.Imipramine is safe and effective for elderly individuals.
D)Yes,but only if psychotherapy does not help Devon.

Question 18

Lela works in a nursing home and notices copies of The Beers List at nursing stations and in medication rooms.What does The Beers List list?

A)potentially inappropriate medications
B)Medicare formulary medications
C)first line medication choices
D)generally safe medications

Question 19

Cristobal,79 years of age,has early renal failure.What process might this affect?

A)absorption
B)metabolism
C)excretion
D)distribution

Question 20

Lynn,93 years of age,has very thin,atrophic skin.How might this affect medication administered via a transdermal patch?

A)Thin skin is associated with more rapid absorption of the medication.
B)Reduced blood flow to the skin may slow absorption.
C)The effect depends on what medication is administered.
D)The real issue is muscle mass;therefore,atrophied skin should not have an impact.

Question 21

While in a meeting with nursing home staff about your grandfather's health,the head nurse raises the issue of polypharmacy.Polypharmacy refers to the use of .

A)inappropriate medications
B)multiple medications
C)excessive medications
D)dangerous medications

Question 22

It is Aileen's first day working at the nursing home as an RN.While reviewing patient charts,she notices that one patient with restless leg syndrome is receiving dangerously high doses of a dopamine agonist.What should she do?

A)Call the patient's family and let them know.
B)Nothing - she is new and should not cause trouble.
C)Cancel the medication order.
D)Talk to the appropriate authority.

Question 23

In the United States,how many deaths are caused annually by medication-related problems?

A)200,000
B)75,000
C)150,000
D)100,000

Question 24

According to a recent study,what percentage of Americans over the age of 65 are unnecessarily exposed to potentially hazardous prescribing in the course of a year?

A)33%
B)25%
C)20%
D)10%

Question 25

In the United States,what percentage of people over the age of 60 take at least five medications?

A)30%
B)60%
C)40%
D)50%