Question 1

A patient is receiving propranolol for hypertension.Which outcome demonstrates to the nurse that a priority goal related to medications has been met?

Accepted Answer

B

Question 2

When working with a patient suspected of substance abuse,the nurse is particularly interested in determining the cause of a patient's

Accepted Answer

Patients with substance abuse issues often have a history of falls due to impaired coordination and judgment, making it a key area of concern for nurses.

Question 3

When administering medications to older adults,the nurse shows an understanding of the effect of aging on drug distribution by monitoring which of the following most closely?

Accepted Answer

As individuals age, there is a natural decline in the production of plasma albumin, a protein that binds to drugs and affects their distribution throughout the body. Therefore, monitoring plasma albumin levels is especially important when administering medications to older adults as it can impact the efficacy and toxicity of drugs. Cardiac function, liver function, and red blood cell count can also be affected by aging, but they are not directly related to drug distribution.

Question 4

A 78-year-old man with a history of alcohol abuse is admitted to the acute care facility for reports of abdominal pain.Based on your understanding of alcohol withdrawal,the nurse knows that if patient is currently abusing alcohol,he will most likely

Accepted Answer

The most likely scenario for this patient is that he would develop withdrawal symptoms 48 to 72 hours after the last intake of alcohol. This is because this time frame aligns with the expected onset of symptoms for alcohol withdrawal syndrome, which can include abdominal pain, tremors, anxiety, and seizures. It is important for the healthcare team to monitor the patient closely for potential withdrawal symptoms and to provide appropriate interventions as needed, such as medication to manage symptoms or fluids to prevent dehydration. Option A is incorrect because delirium tremens may occur later, usually after 2-3 days of withdrawal. Option C and D are not appropriate interventions for alcohol withdrawal.

Question 5

To minimize the possible complications of polypharmacy among older adult patients,the nurse assesses this population for which of the following? (Select all that apply. )

Accepted Answer

The answer of To minimize the possible complications of polypharmacy...

Question 6

An older adult patient has been prescribed warfarin.The nurse's primary intervention involves daily assessment of which of the following?

Accepted Answer

Assessment of prothrombin time is crucial in patients on warfarin, as it is used to monitor the anticoagulant effect and determine appropriate dosing. Bruising, serum creatinine level, and reflex tone may also be important assessments but are not specific to warfarin therapy.

Question 7

A patient with diabetes and hypothyroidism is being admitted to an assisted living facility.During the admission assessment,the patient reports difficulty falling asleep.What question by the nurse is most appropriate?

Accepted Answer

The nurse should inquire about the patient's thyroid medication, as hypothyroidism can affect sleep patterns, and ensuring proper management of the condition is crucial.

Question 8

An older adult patient is currently undergoing detoxification for alcohol at a rehabilitation center.When assessing the patient using the Clinical Institute Withdrawal Assessment tool,the nurse determines the patient's current score to be 23.What action by the nurse is best?

Accepted Answer

A score of 23 on the Clinical Institute Withdrawal Assessment tool indicates severe withdrawal symptoms and requires prompt medical attention. The patient needs to be transferred to an acute care hospital where they can receive appropriate medical care and monitoring during detoxification. Seizure precautions should also be taken during transfer. Monitoring vital signs every 2 hours is not sufficient for a patient with severe withdrawal symptoms. Sharing with the patient that the detoxification process is almost complete is not appropriate at this time because the patient requires immediate medical attention for their severe symptoms.

Question 9

A newly-admitted older patient reports taking varenicline.What question by the nurse is most important?

Accepted Answer

The answer of A newly-admitted older patient reports taking varenicline.What...

Question 10

The nurse shows an understanding of medication-related risk factors common to older adults when asking which question?

Accepted Answer

The answer of The nurse shows an understanding of medication-related...

Question 11

An older adult patient shares with the admitting nurse that she drinks "one shot" of whiskey nightly to help her sleep.What intervention does the nurse add to this patient's care plan?

Accepted Answer

Alcohol can act as a depressant and affect sleep patterns. When an individual who is used to consuming alcohol regularly stops drinking, they may experience withdrawal symptoms, including agitation, anxiety, and in severe cases, seizures. The nurse should monitor for these signs to manage potential withdrawal safely.

Question 12

An older adult patient is being assessed for possible alcohol abuse.Which question by the nurse is best?

Accepted Answer

Question D is the best choice because it directly inquires about the patient's alcohol consumption in a quantifiable manner, allowing for an objective assessment of their drinking habits. This can help identify patterns that may indicate alcohol abuse.

Question 13

Your patient reports frequent constipation as a result of prescription medications and asks the nurse for advice about using a daily over-the-counter laxative.The most appropriate response by the nurse is to do which of the following?

Accepted Answer

It is important for the patient to consult with their healthcare provider before using any over-the-counter laxative, as it could potentially interact with other medications or medical conditions. Therefore, option A is the most appropriate response by the nurse. Option B may be helpful in educating the patient, but it doesn't address the possible interaction with other medications. Option C is not entirely accurate, as not all laxatives may interfere with prescription medications. Option D may be helpful for long term management, but it doesn't address the immediate need for relief from constipation.

Question 14

A 69-year-old patient was prescribed a benzodiazepine 3 years ago.The nurse should provide frequent patient assessment for which of the following? (Select all that apply. )

Accepted Answer

Benzodiazepines can cause drowsiness and sedation, which may lead to daytime sleepiness. They can also affect coordination and balance, leading to an unsteady gait. Additionally, benzodiazepines can cause forgetfulness or difficulty with memory recall. Shortness of breath and easy bleeding are not common side effects of benzodiazepines and would not typically require frequent assessment unless there was a pre-existing condition or indication of concern.

Question 15

An older adult diabetic patient is mildly hypertensive.The nurse prepares to educate the patient regarding angiotensin II-blocking agents.What information does the nurse include about these medications?

Accepted Answer

Angiotensin II-blocking agents, such as ACE inhibitors and ARBs, are known for their ability to protect the kidney's function in patients with diabetes and hypertension. They work by dilating blood vessels and reducing pressure within the kidneys, which can slow the progression of diabetic nephropathy. While these medications do have a therapeutic window, it is not necessarily well-defined. They are not necessarily more effective than other drugs in the same class, but they are preferred in patients with diabetes due to their protective effects on the kidneys. These medications should be used with caution in patients with compromised liver function.

Question 16

The nurse is assessing patients for impending alcohol withdrawal.The nurse assesses the patient with which of the following conditions as a priority?

Accepted Answer

The patient with a pulse of 118 beats/min and BP of 160/90 is exhibiting signs of autonomic hyperactivity, which is a hallmark of alcohol withdrawal. This patient is at high risk for seizures, delirium tremens, and death if not treated promptly. The other options may also be present in patients with alcohol withdrawal, but they are not as urgent as the patient with autonomic hyperactivity.

Question 17

The nurse is caring for an older adult who reports severe chronic pain.To best assess age-related physiologic changes that could influence plans for initiating an appropriate drug regimen,the nurse prepares the patient for which laboratory evaluation?

Accepted Answer

Since older adults have a decline in renal function, measuring the glomerular filtration rate (GFR) is important in determining the appropriate drug regimen for chronic pain. This is because the kidneys play a major role in excreting drugs, and changes in GFR can affect drug clearance and increase the risk for adverse effects. The other options (white blood count, serum complement level, electroencephalogram) do not provide information related to age-related physiologic changes that could influence plans for initiating appropriate drug therapy in chronic pain management.

Question 18

The nurse explains to ancillary staff that caffeine abuse is difficult to diagnose in the older adult patient because caffeine intoxication symptoms

Accepted Answer

The answer of The nurse explains to ancillary staff that...

Question 19

The nurse must be able to distinguish between alcohol intoxication and alcohol withdrawal to intervene appropriately.The nurse suspects alcohol intoxication when the patient does which of the following? (Select all that apply. )

Accepted Answer

Slurred speech, difficulty remembering information, and difficulty with coordination are all signs of alcohol intoxication. Seeing snakes in the room may be a sign of alcohol withdrawal delirium, and elevated blood pressure could be a result of a variety of causes or may not be related to alcohol intoxication.

Question 20

The nurse is preparing to apply a topical cream on the arm of a cognitively impaired,anorexic older adult patient in the terminal stage of lung cancer.The nurse carefully monitors the effectiveness of the medication because its effectiveness will be most negatively impacted by the patient's

Accepted Answer

The answer of The nurse is preparing to apply a...

Quiz 16: Drugs and Aging