Question 1

The health care provider has written an order to convert an enteric-coated medication from the pill form to the liquid form. What would be the most appropriate response of the nurse?

Accepted Answer

D

Question 2

An older adult is taking diazepam several times a day. What does the nurse specifically monitor for?

Accepted Answer

Diazepam is a benzodiazepine medication that can cause confusion and sedation in older adults. It can also lead to falls and cognitive impairment. Therefore, the nurse should closely monitor for any signs of confusion or cognitive changes in the patient taking diazepam. Monitoring for potential adverse side effects is crucial in promoting patient safety and preventing harm.

Question 3

What is the purpose of the Beers criteria?

Accepted Answer

The Beers criteria is a list of medications that are potentially inappropriate for use in older adults due to the high risk of adverse effects, such as falls, delirium, and other complications. The purpose is to help healthcare practitioners make more informed decisions when prescribing medications to older adults, with the goal of improving patient safety and reducing the risk of adverse outcomes.

Question 4

Why is drug testing done by pharmaceutical companies not always appropriate for the older adult?

Accepted Answer

Drug testing done by pharmaceutical companies is often conducted on healthy young individuals, and the results may not be applicable to older adults who may have multiple health conditions and may be taking multiple medications. Therefore, testing on older adults is essential to ensure safety and efficacy in this population.

Question 5

What is a symptom of theophylline overdose?

Accepted Answer

Tachycardia is a common symptom of theophylline overdose. Other symptoms may include seizures, restlessness, headache, nausea, vomiting, and hypotension. It is important to seek medical attention if an overdose is suspected.

Question 6

What should an older adult be encouraged to implement in order to prevent lithium toxicity?

Accepted Answer

Increasing fluid intake to 3500 mL daily helps to prevent lithium toxicity by increasing renal excretion of the medication. This is especially important in older adults who may have decreased renal function. Ambulating after drug administration or prohibiting citrus fruit in the diet are not directly related to preventing lithium toxicity. While a prescribed stool softener is important to prevent constipation, it does not directly relate to preventing lithium toxicity.

Question 7

The home health nurse would be most concerned about self-medicating errors for the older adult living alone who is a type 1 diabetic and is

Accepted Answer

Being visually impaired can hinder the individual's ability to properly read medication labels and accurately measure out their doses, leading to potential self-medicating errors. This is especially concerning for a type 1 diabetic, as improper dosages can have serious consequences. The other conditions may also affect the individual's ability to self-medicate, but not to the same extent as visual impairment.

Question 8

Which assessment finding in a 75-year-old man on a chlorpromazine protocol should be immediately reported to the physician?

Accepted Answer

Drooling is a possible side effect of chlorpromazine, and in a 75-year-old man, it may suggest the development of tardive dyskinesia, a serious neurological disorder associated with long-term use of antipsychotic medication. Drooling may also indicate an overdose or intolerance to chlorpromazine. Therefore, it should be immediately reported to the physician for further evaluation and management. Cough, headache, and nausea are common side effects of chlorpromazine and may not require immediate intervention unless they are severe or persistent.

Question 9

What oral medication can be safely crushed?

Accepted Answer

Plain antihypertensive medication tablets can generally be safely crushed because they do not have special coatings or formulations that are affected by crushing. Sublingual tablets, timed-release capsules, and enteric-coated medications should not be crushed as this can alter their absorption and effectiveness.

Question 10

What site would be the best choice for an intramuscular injection to an emaciated 82-year-old patient?

Accepted Answer

The ventrogluteal site is the best choice for an intramuscular injection in an emaciated 82-year-old patient because it is a safe and easily accessible site with a thick layer of muscle that can handle the medication. The gluteal site should be avoided as it can cause discomfort and injury to the sciatic nerve. The deltoid site is not recommended for an emaciated patient as it contains less muscle tissue and may result in inadequate absorption of the medication. The upper outer quadrant of the gluteus maximus is not a recognized injection site.

Question 11

Why does the nurse frequently assess an older adult who is on a psychotropic drug?

Accepted Answer

As individuals age, their brain receptors become hypersensitive to certain drugs, including psychotropic drugs. This sensitivity means that these drugs can cause more pronounced and potentially harmful effects in older adults. Therefore, nurses need to assess older adults who are taking psychotropic drugs frequently to ensure that there are no adverse effects and to adjust the medication dosage as needed.

Question 12

What is a cause for increased rate of drug absorption in an older patient?

Accepted Answer

As a person ages, gastric motility can decrease, leading to a longer time for drugs to stay in the stomach and be absorbed. This can result in an increased rate of drug absorption.

Question 13

What is the most reliable method of patient identification for administration of medications?

Accepted Answer

An identification bracelet is the most reliable method of patient identification for administration of medications as it contains the patient's name, medical record number, and other important identifying information. A photograph of the patient may not be up-to-date or could be easily confusing for patients who look similar. Asking the patient to repeat their name could be unreliable if the patient is confused or unable to communicate effectively. Use of the patient's room number could also be unreliable as patients can be moved between rooms or there could be multiple patients with the same room number.

Question 14

What is the major risk of polypharmacy for the older adult?

Accepted Answer

Being treated by more than one physician can lead to multiple medications being prescribed that may interact with each other and cause adverse effects for the older adult. This can also lead to a lack of coordination of care and medication oversight.

Question 15

What age-related changes in the stomach can cause increased drug absorption and possibly drug toxicity?

Accepted Answer

Decreased gastric motility can lead to increased drug absorption because the drug remains in the stomach longer, allowing more time for absorption. This can potentially result in higher blood levels of the drug and increase the risk of toxicity.

Question 16

The patient complains that her medications stick in her throat. What would be an appropriate response of the nurse?

Accepted Answer

Offering a sip of water before and after each pill can help moisten the throat and facilitate the swallowing of medications. Crushing or altering medications can affect their efficacy and should only be done under the guidance of a healthcare provider. Offering all the pills at once may not be feasible or safe for some patients. Offering one pill at a time may be time-consuming and not practical in certain situations.

Question 17

When the medication nurse offers a pill to the older adult patient, the patient asks, "What is this and what is it for?" What is the best response by the nurse?

Accepted Answer

The nurse should provide the name of the medication and its intended purpose, as this information is important for informed consent and patient education. Option A is inappropriate, as it fails to address the patient's question and may be perceived as dismissive. Option B is unprofessional and vague. Option C may be technically accurate, but may not be helpful in terms of patient understanding. Option D is clear and concise, and provides relevant information to the patient.

Question 18

What provisions should be included in the plan of care for a 70-year-old extended-care facility resident who will be self-administering his medications? (Select all that apply.)

Accepted Answer

For a resident self-administering medications, it's important to ensure they have an adequate supply of medication (A), secure storage for their medication to prevent misuse or theft (C), a medication administration record to track dosages and times (D), and ongoing assessment of the medication's effectiveness to adjust treatment as necessary (E). Payment for medication (B) is a financial concern and does not directly relate to the safety and efficacy of self-administration practices.

Question 19

What is a correct method of administering a transdermal medication patch?

Accepted Answer

The answer of What is a correct method of administering...

Question 20

When the 80-year-old female patient refuses to take a medication because it burns her stomach, what action should be taken by the nurse?

Accepted Answer

Documenting the reason for refusal and reporting the refusal to the charge nurse is the proper action to take. It is important to respect the patient's wishes and concerns and document any refusals to ensure proper and accurate medication administration. Crushing the pill and mixing it with the dessert on her meal tray could alter the way the medication works and lead to an incorrect dosage. Insisting that she take it "for her own good" is not respectful of the patient's autonomy and could result in noncompliance in the future. Circling and initialing the dose time to show non-administration is not enough documentation and could lead to errors in medication reconciliation.

Quiz 7: Medications and Older Adults