Deck 21: Drugs for the Older Adult Patient

Question 1

Which of the following factors does NOT affect a drug's effect, metabolism, and toxicity?

A) Physiological alterations of advancing age
B) Genetic variations
C) Environmental factors
D) Generic versus brand-name form

Answer 1

Generic versus brand-name form

Question 2

Which of the following conditions is not much more serious for older adults than for younger adults?

A) Flu
B) Pneumonia
C) Fractures
D) Constipation

Answer 2

Constipation

Question 3

Which of the following terms describes the study of aging?

A) Cardiology
B) Nephrology
C) Dermatology
D) Gerontology

Answer 3

Gerontology

Question 4

Which of the following is NOT a change in the nervous system that is associated with decreased blood flow and oxygen supply to the brain?

A) Memory is affected.
B) The ability to make decisions is affected.
C) Confused thinking results.
D) May have difficulty understanding the meanings of words.

Question 5

Older adults make up the largest group of users of:

A) assistive devices.
B) physical therapy services.
C) pharmaceuticals.
D) corrective lenses.

Question 6

Older adults who are bedridden are at high risk for developing:

A) bruising.
B) wrinkles.
C) "spiders."
D) pressure sores.

Question 7

Which of the following is NOT a change that occurs in the respiratory system that is associated with aging?

A) The lungs have less of an ability to expand.
B) Breathing is shallower.
C) Respiration slows down to less than the normal 16 to 20 times per minute.
D) Not as much oxygen is supplied to the body.

Question 8

Which of the following is NOT a normal adjustment to aging?

A) Becoming less active
B) Taking up less strenuous sports
C) Reducing workload
D) Giving up all activity

Question 9

Which of the following is a change that occurs in the cardiovascular system associated with aging?

A) The heart pumps more forcefully and moves more blood with each beat.
B) The heart has more of an ability to gear up when the body is under stress.
C) Various parts of the heart and blood vessels lose elasticity.
D) There is more blood flow to all parts of the body.

Question 10

Which of the following statements is true about the population aged 65 years and older?

A) It is the slowest-growing segment of the population, increasing at 2 percent each year.
B) It is the fastest-growing segment of the population, increasing at 5 percent each year.
C) It is the slowest-growing segment of the population, increasing at 5 percent each year.
D) It is the fastest-growing segment of the population, increasing at 2 percent each year.

Question 11

Which of the following is one of the most important ways in which geriatric medicine differs from medical care delivered to younger patients?

A) Cost of procedures
B) Medication therapy
C) Compliance with medical advice
D) Availability of insurance coverage

Question 12

Because of changes the aging process has on the endocrine system, the body cannot react as quickly to:

A) stress.
B) changes in fluid balance.
C) changes in diet.
D) changes in light.

Question 13

Which of the following is NOT a change in the integumentary system associated with aging?

A) Skin becomes thinner.
B) Spots of color appear on the skin.
C) There is less blood flow to the skin.
D) More fat is laid down under the skin.

Question 14

For some people, which of the following is the first sign of aging?

A) Wrinkles
B) Loss of visual sharpness
C) Gray hair
D) Decreased tolerance to cold temperatures

Question 15

Which of the following occurs in the sensory system that is associated with aging?

A) Eyes easily adjust to light.
B) Ears do not hear the higher-pitched sounds.
C) Taste is heightened.
D) Sense of touch is increased.

Question 16

Which of the following statements accurately describes the aging process?

A) The body's ability to cope with stress increases.
B) Aging occurs at exactly the same rate in everyone.
C) Healing times are shorter but complications are more likely to develop.
D) Organs slow down and lose some functionality due to the loss of body cells.

Question 17

Which of the following terms is used to describe the study of the diseases of older adults?

A) Geriatrics
B) Pediatrics
C) Optometry
D) Orthopedics

Question 18

Older adults account for over _______ percent of all written prescriptions and over _______ percent of all over-the-counter drug and herbal remedies usage.

A) 15; 20
B) 25; 35
C) 30; 40
D) 45; 55

Question 19

Which of the following results from the interaction between sedatives and alcohol?

A) Hypertension
B) Hyperkalemia
C) Increased sedation
D) Decreased absorption of sedatives

Question 20

Which of the following substances settle in the lungs lessening their ability to expand?

A) Fatty layer
B) Oxygen
C) Fluid
D) Collagen

Question 21

Which of the following is NOT a change that occurs in the urinary system that is associated with aging?

A) Urgency may occur in female patients from a decrease in peritoneal muscle tone.
B) Stress incontinence may occur in female patients from a decrease in peritoneal muscle tone.
C) Urinary frequency may occur in male patients because of an enlarged prostate.
D) Stress incontinence may occur in male patients because of an enlarged prostate.

Question 22

Which of the following is NOT a change that occurs in the gastrointestinal system that is associated with aging?

A) The secretions of the digestive tract slow down.
B) Food is harder to digest.
C) Diarrhea is a common problem.
D) Absorption of nutrients from the intestines is less effective.

Question 23

When obtaining a history from a patient, the healthcare worker must specifically question the patient about his or her use of:

A) OTC remedies.
B) drugs prescribed by different doctors.
C) herbal remedies.
D) all of the above.

Question 24

Which of the following terms describes why bones become lighter and more porous, and more apt to fracture easily?

A) Avitaminosis
B) Hypervitaminosis
C) Demineralization
D) Remineralization

Question 25

Which of the following terms describes a standard and comprehensive way of collecting information about a patient to be used by various members of the healthcare team?

A) Medical history
B) Diagnostic test results
C) Laboratory test results
D) Vital signs

Question 26

Which of the following affects absorption and distribution?

A) Slower blood circulation, slower absorption of medications through the intestines
B) Less blood flow to the kidneys, slower excretion of medications
C) Trouble swallowing oral medication because of missing teeth, constipation
D) Fewer stomach secretions, slowing down of muscular movements of the digestive tract

Question 27

Which of the following does NOT slow down the body's handling of drugs?

A) Diseased kidneys
B) Heart condition
C) Menopause
D) Hypertension

Question 28

Which of the following statements describes why wastes are excreted more slowly in the older adult?

A) The kidneys do not filter the blood as efficiently.
B) Eating is less pleasurable because taste and smell are dulled.
C) Older adults produce less stomach acid than normal.
D) Teeth are lost and eating becomes difficult.

Question 29

Which of the following statements about pharmacokinetics in the older adult is NOT true?

A) Absorption becomes slower.
B) Biotransformation becomes slower.
C) Excretion becomes slower.
D) Distribution becomes slower.

Question 30

Which of the following terms describes the use of a number of different drugs by a patient who may have several different health problems?

A) Pharmacokinetics
B) Cumulation
C) Polypharmacy
D) Polychemotherapy

Question 31

Which of the following can occur in the older adult as a result of the uneven distribution that occurs with aging?

A) Cumulative effect
B) Abnormal drug reactions
C) Tolerance
D) Synergism

Question 32

What are two other age-related factors that have an impact on the effect of a drug?

A) Disease and other drugs
B) Changes in muscle tone and skin elasticity
C) Gender and hormone secretion
D) Activity level and emotional state

Question 33

Which of the following is NOT a change that occurs in the musculoskeletal system that is associated with aging?

A) Muscles lose strength.
B) Body fat replaces muscle.
C) Ligaments and joints become thin and flabby.
D) Diseases of the bones, joints, and ligaments are more common.

Question 34

Which of the following guidelines should be followed when administering medications to older adults?

A) Give lower, more frequent doses.
B) Give lower, less frequent doses.
C) Give larger, less frequent doses.
D) Give larger, more frequent doses.

Question 35

Which of the following may occur in the older adult because drugs stay in effect longer and can build up in the body with repeated doses?

A) Synergism
B) Cumulative effect
C) Idiosyncratic effect
D) Tolerance

Question 36

Adjustments are made in the forms of medication given and their routes to aid in:

A) absorption.
B) distribution.
C) biotransformation.
D) excretion.

Question 37

Which of the following is NOT a change that occurs in the reproductive system that is associated with aging?

A) Sex hormone production decreases.
B) Sexual enjoyment ceases.
C) Females no longer menstruate.
D) Females are no longer able to conceive.

Question 38

Which of the following is NOT part of the medical history?

A) Demographics
B) Chief complaint
C) History of present illness
D) Diagnostic test results

Question 39

Which of the following can occur in the older adult as a result of changes in kidney function?

A) Cumulative effect
B) Abnormal drug reactions
C) Tolerance
D) Synergism

Question 40

Which of the following results from the combination of warfarin (Coumadin) and aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)?

A) Increased action of warfarin (Coumadin)
B) Decreased action of warfarin (Coumadin)
C) Increased action of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)
D) Decreased action of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 41

Respect each patient's customs and beliefs. Be ___________ to patients' cultural and ethnic beliefs in regard to drug therapy.

Question 42

Which of the following techniques allows an older adult patient to maintain his or her self-confidence and feeling of independence?

A) Stating his or her own name when asked
B) Taking an active role in his or her own care
C) Being respectful of his or her customs and beliefs
D) Helping him or her with eye drops

Question 43

One of the most important general rules for administering medications is:

A) crush tablets so they are easier to swallow.
B) explain what you are doing.
C) help a patient who has trouble swallowing pills.
D) help older patients with eyedrops.

Question 44

Which parts of the body demand and get more blood than the rest of the body?

A) Heart and kidneys
B) Brain and heart
C) Kidneys and brain
D) Liver and kidneys

Question 45

Why do drugs not reach the intestines as quickly in an older adult?

A) Enzymes lose effect with age.
B) There are fewer rugal folds.
C) Peristalsis is weaker.
D) Atherosclerosis blocks the arteries.

Question 46

Never administer medication to a patient who:

A) cannot verbally state his or her name.
B) does not have a caregiver present.
C) does not have an identification bracelet.
D) does not respond to his or her name.

Question 47

The patient's chief complaint, history of present illness, and past health history are examples of ________________ data.

A) subjective
B) objective
C) adjective
D) demographic

Question 48

Which of the following can occur in an older adult as a result in changes in the liver function?

A) Cumulative effect
B) Tolerance
C) Synergism
D) Idiosyncratic reactions

Question 49

Which of the following is the reason the patient came to the healthcare facility?

A) Family history
B) Past health history
C) History of present illness
D) Chief complaint

Question 50

Adapt to hearing and vision problems. Stand _____________ the patient when you speak, so that he or she can read your lips.

Question 51

Which of the following is NOT a guideline to follow when administering medication to older adult patients?

A) Allow the patient to lie down when administering medications.
B) Give one tablet at a time to swallow.
C) Allow time between tablets for the patient to rest.
D) Explain what the drugs are for.

Question 52

Which of the following is NOT a technique to practice when helping a patient who has trouble swallowing pills?

A) Ask the physician to substitute a liquid medication if possible.
B) Have the patient take a few sips of water to moisten the mouth.
C) Raise the head of the bed or have the patient sit up.
D) Crush the pill or place it in applesauce.

Question 53

Sometimes what seems like mental confusion is merely a sign that a patient cannot __________ or __________ what you are doing or saying.

Question 54

When taking a patient's history, which of the following components would reveal information about such illnesses as cancer or heart disease?

A) History of present illness
B) Chief complaint
C) Past health history
D) Family history

Question 55

Which of the following is NOT a skill used to perform the review of systems?

A) Inspection
B) Palpation
C) Auscultation
D) Collection

Question 56

Which of the following are older adults more likely to experience than younger patients when administered medications?

A) Allergies
B) Resistance
C) Adverse reactions
D) Tolerance

Question 57

The information gathered from the review of systems and the taking of vital signs are examples of ________________ data.

A) subjective
B) objective
C) adjective
D) demographic

Question 58

The combination of a corticosteroid and digitalis in an older adult can result in which of the following conditions?

A) Edema
B) Dyspnea
C) Hypotension
D) Cardiac arrhythmias

Question 59

When a patient appears confused, assess the reason. Confusion and other mental status changes are frequent _______________ of a number of medications.

Question 60

Always stay with an older patient until you are sure an oral medication has been ____________.

Question 61

Tetracycline combined with dairy products leads to the _____________ absorption of the drug.

Question 62

Make sure you chart prn medications immediately. It is easy to _____________ patients accidentally by forgetting to chart their prn medication.

Question 63

To help older adult patients remember to take their medications, arrange for them to take the medications at certain _______ each day, such as before meals.

Question 64

The action of warfarin (Coumadin) is increased when combined with __________ or nonsteroidal anti-inflammatory drugs (NSAIDs).

Question 65

When you give medications to older adults, it is important to remember that they can and should take a(n) ____________ part in their medication therapy. They should be encouraged to take their own medications under your supervision.

Question 66

_______________ is a protein that makes up fibers in connective tissue and builds up in the lungs during aging, thus decreasing lung elasticity.

Question 67

The use of a number of different drugs by a patient who may have several different health problems is termed __________________.

Question 68

The branch of medicine pertaining to the diseases and disorders of people 65 years of age or older is called ____________________.

Question 69

If special instructions go along with the medications, explain them clearly and simply, but also ___________ them down.

Question 70

Use caution with prn medications. When a prn order has a safe range of doses, try giving the ____________ dose first. This dose is often enough to bring about the desired effect.

Question 71

___________________ is the study of aging.

Question 72

Current research suggests that older adults who take aspirin and other anti-inflammatory drugs such as ibuprofen for at least two years have a significantly lower incidence of _____________ disease than do older adults who do not take these drugs.

Question 73

Keep medications ____________. Never leave the medicine room or cart unlocked. Never leave the medication cart unattended.

Question 74

The population aged 65 years and older is the ______________-growing segment of the population, ___________ by approximately 2 percent each year.

Question 75

The combination of alcohol and sedatives can result in ___________.

Question 76

Physicians who are trained in all aspects of caring, including quality-of-life issues, for people 65 years of age or older are called _______________.

Question 77

Never ____________ a patient to take a medication.

Question 78

The care of older adult patients includes concern for their _____________ health. This depends on you letting them care for themselves when they are willing and able to do so.

Question 79

Explain the need for medication to __________________ patients. A patient who has no obvious symptoms may refuse medications. Explain to patients why they need to continue to take some medications (e.g., those for hypertension and infection) even after the symptoms are under control.

Question 80

Chart medications _______________. Do your charting as soon as you finish giving the medication.