Question 1

The nurse is caring for a 4-month-old child who is on a water-soluble medication for seizures. The child's mother voices concern that the dosage seems "too much" for the child's age and would like the dosage verified. What actions will the nurse take? (Select all that apply.)

A) Verify dosage requirements in the PDR in mg/kg.
B) Compare the water composition requirements of adults and children.
C) Evaluate lean body mass and total fat content in adults and infants.
D) Chart "refused per mother" on the MAR and do not administer.
E) Compare transportation in the circulation of plasma-bound proteins between adults and children.

Verify dosage requirements in the PDR in mg/kg.
Compare the water composition requirements of adults and children.

Accepted Answer

Verify dosage requirements in the PDR in mg/kg.&#10;Compare the water composition requirements of adults and children.

Question 2

Which age-related change would most affect transdermal drug absorption in geriatric patients the most?&#10;A) Difficulty swallowing&#10;B) Diminished kidney function&#10;C) Changes in pigmentation&#10;D) Altered circulatory status

Accepted Answer

Altered circulatory status, such as reduced blood flow to the skin, can impair transdermal drug absorption in geriatric patients. This is because drugs delivered through the skin rely on blood flow to carry them to the systemic circulation. Age-related changes in the circulatory system, such as decreased cardiac output and peripheral vascular disease, can reduce blood flow to the skin and limit drug absorption. Difficulty swallowing may affect oral drug absorption, diminished kidney function may increase drug accumulation and toxicity, and changes in pigmentation may affect cosmetic appearance but are unlikely to affect drug absorption directly.

Question 3

Which factors in a patient would influence gastrointestinal absorption of medications? (Select all that apply.)&#10;A) Stomach pH&#10;B) Level of consciousness&#10;C) Fever&#10;D) Blood flow to gastric mucosa&#10;E) Weight&#10;F) Body surface area

Accepted Answer

Stomach pH and blood flow to gastric mucosa can both greatly affect gastrointestinal absorption of medications. A lower stomach pH can decrease absorption, while adequate blood flow to the gastric mucosa is necessary for efficient absorption. The other factors listed (level of consciousness, fever, weight, and body surface area) are not directly related to gastrointestinal absorption of medications.

Question 4

What time will the trough blood level need to be drawn if the nurse administers the intravenous medication dose at 9:00 AM?&#10;A) 6:30 AM&#10;B) 8:30 AM&#10;C) 9:30 AM&#10;D) 11:30 AM

Accepted Answer

Trough levels are typically drawn 30 minutes before the next dose of medication is due to ensure that the drug concentration in the blood is at its lowest point. If the medication is administered at 9:00 AM, the trough level should be drawn at 8:30 AM, just before the next dose.

Question 5

Which drugs cause birth defects?&#10;A) Teratogens&#10;B) Carcinogens&#10;C) Metabolites&#10;D) Placebos

Accepted Answer

Teratogens are substances or agents that can cause birth defects in unborn babies. These may include drugs such as thalidomide, valproic acid, and alcohol, among others. Carcinogens can cause cancer, metabolites are the products of metabolism in the body, and placebos are inactive substances used in clinical trials for comparison with active drugs.

Question 6

Why are elderly patients at increased risk for drug interactions and toxicity? (Select all that apply.)&#10;A) They have a higher incidence of malnourishment.&#10;B) Their renal function is enhanced.&#10;C) They have increased use of multiple medications.&#10;D) Hepatic function is reduced.&#10;E) There are often issues with swallowing.

Accepted Answer

Elderly patients often experience malnourishment, which can affect drug metabolism. They are more likely to use multiple medications, increasing the risk of interactions. Reduced hepatic function can impair drug metabolism, leading to toxicity.

Question 7

Which life-threatening illness may occur as a result of aspirin (salicylate) administration during viral illness to patients younger than 20 years of age?&#10;A) Anaphylactic shock&#10;B) Reye's syndrome&#10;C) Chickenpox&#10;D) Influenza A

Accepted Answer

Reye's syndrome is a rare but serious condition that can occur in children and teenagers who have recently had a viral illness, especially flu or chickenpox, and have been given aspirin. The use of aspirin during viral illness in children younger than 20 years of age has been associated with an increased risk of developing Reye's syndrome, which can be life-threatening. Anaphylactic shock is a severe allergic reaction, and chickenpox and influenza A are viral infections that can lead to Reye's syndrome with aspirin use.

Question 8

Which patients require special considerations for medication administration? (Select all that apply.)&#10;A) 29-year-old pregnant woman&#10;B) 2-month-old baby&#10;C) 18-year-old college student&#10;D) 45-year-old farmer&#10;E) 82-year-old retired nurse

Accepted Answer

Pregnant women, infants, and the elderly require special considerations for medication administration due to physiological changes, developmental differences, and age-related factors that can affect drug metabolism, distribution, and elimination.

Question 9

The nurse is teaching an elderly patient with difficulty swallowing about his medications. Which explanation by the nurse is most helpful?&#10;A) &#34;Enteric-coated tablets can be crushed and taken with applesauce.&#34;&#10;B) &#34;Tablets that are scored can be broken in half.&#34;&#10;C) &#34;Medications labeled 'SR' can be crushed.&#34;&#10;D) &#34;Avoid taking medications in liquid form.&#34;

Accepted Answer

Breaking tablets that are scored in half can make them easier to swallow for someone with difficulty swallowing.

Question 10

What will the nurse expect the health care provider's order to be when starting an older adult patient on thyroid hormone replacement therapy?&#10;A) Administer a loading dose of the drug&#10;B) Directions on how to taper the drug&#10;C) A dosage that is one third to one half of the regular dosage&#10;D) A dosage that is double the regular dosage

Accepted Answer

Older adults are more sensitive to thyroid hormone replacement therapy and therefore require a lower starting dose, usually one third to one half of the regular dosage, to avoid adverse effects such as cardiac arrhythmias or bone loss. Administering a loading dose or doubling the regular dosage can also increase the risk of adverse effects. Tapering may be appropriate when discontinuing the medication, but it is not typically necessary when starting it.

Question 11

After giving instructions to an expectant mother about taking medications during pregnancy, which patient statement indicates the need for further teaching?&#10;A) &#34;I will not take herbal medicines during pregnancy.&#34;&#10;B) &#34;For morning sickness, I will try crackers instead of taking a drug.&#34;&#10;C) &#34;If I get a cold, I will avoid taking nonprescription medications until I check with my physician.&#34;&#10;D) &#34;I will limit my alcohol intake to only one glass of wine weekly.&#34;

Accepted Answer

The answer of After giving instructions to an expectant mother...

Question 12

Which classification of medications commonly causes allergic reactions in children?&#10;A) Antacids&#10;B) Analgesics&#10;C) Antibiotics&#10;D) Anticonvulsants

Accepted Answer

The answer of Which classification of medications commonly causes allergic...

Question 13

Which would be considered to reduce accumulation of a drug in a patient who has decreased liver function?&#10;A) Decreasing the time interval between dosages&#10;B) Reducing the dosage&#10;C) Administering the medication intravenously&#10;D) Changing the drug to one that has a longer half-life

Accepted Answer

The answer of Which would be considered to reduce accumulation...

Question 14

When is the ideal time for a nursing mother to take her own medications?&#10;A) Before the infant latches on to begin to breast-feed&#10;B) As soon as the mother wakes up in the morning&#10;C) Right before the mother goes to sleep at night&#10;D) As soon as the infant finishes breast-feeding

Accepted Answer

The answer of When is the ideal time for a...

Question 15

One of the prescribed medications for a 36-week-gestational-age baby girl is a topical water-soluble medication to be applied to the perineum daily to treat an inflammatory rash. What considerations is the nurse aware of before medication administration? (Select all that apply.)

A) Age of the client
B) Location of topical application
C) Increased intestinal transit rate
D) Condition of the skin
E) Gastric pH of 8

Accepted Answer

The answer of One of the prescribed medications for a...

Question 16

The nurse is administering an antibiotic intravenously. Which blood level determines the lowest amount of medication present in the patient?&#10;A) Peak&#10;B) Serum&#10;C) Therapeutic&#10;D) Trough

Accepted Answer

The answer of The nurse is administering an antibiotic intravenously....

Question 17

Which patient would the nurse identify as having the lowest rate of absorption of enteral medications?&#10;A) 5-year-old boy&#10;B) 18-year-old woman&#10;C) 55-year-old man&#10;D) 85-year-old woman

Accepted Answer

The answer of Which patient would the nurse identify as...

Deck 3: Drug Action Across the Life Span