Chapter 6-drug therapy older client

Question 1

oral medications with older clients there is

Answer 1

decreased peristalis due to decreased muscle tone, and intestinal movements slow

Question 2

To enhance drug absorption in providing drug therapy to older adult clients, when possible the nurse should:

Answer 2

administer liquid dosage forms.
Liquid dosage forms absorb better in the GI tract considering all the factors influencing drug absorption in the older adult

Question 3

The nurse understands which of the following is NOT associated with diminishing gastrointestinal absorption of drugs in the older adult client?

Answer 3

increased fluid consumption by the older adult client

Increased fluid consumption would improve blood supply and thus increase drug distribution, not absorption.

Question 4

When caring for older adults, the nurse understands that the characteristic of drug absorption, which is likely to occur with advancing age is:

Answer 4

loss of muscle tissue

There is an age-related reduction in muscle tissue because of atrophy

Question 5

When selecting an appropriate drug product for an older adult client, if possible, one should select a drug that is

Answer 5

not dependent on liver metabolism. Liver metabolism decreases with age, so when possible, the older adult should be prescribed medications that are not dependent on liver metabolism.

Question 6

Which of the following adverse drug reactions is more commonly seen in older adult clients?

Answer 6

orthostatic hypotension. Excessive sedation and orthostatic hypotension are adverse effects to drug therapy more common in the older adult

Question 7

When administering intramuscular injections to an older adult client, the most appropriate site of injection is the

Answer 7

vastus lateralis. The ventrogluteal site is the most appropriate in the older adult, especially, in an emaciated client, because of the size of the muscle in this site.

Question 8

The nurse is preparing a teaching plan for an older adult client about medications. The nurse understands that which factor is NOT true of older adult clients?

Answer 8

They tend to be as compliant in using their medications as younger adults.Noncompliance is an issue in the older adult resulting from a number of factors, including memory loss and lack of adequate finances

Question 9

Many older adults are prescribed eight or more medications per day. This is referred to as:

Answer 9

polypharmacy

Question 10

The nurse determines that which of the following is a priority nursing diagnosis for the client?

Answer 10

risk for injury related to drug interactions.

One of the major risks with polypharmacy is the risk for drug interactions.

Question 11

After the client begins taking the new medications, she develops periods of dizziness and confusion. The client’s daughter calls to ask the nurse what she should do. The nurse’s best response is:

Answer 11

“Notify the health care provider, since some adjustments might need to be made.”

Question 12

An 85-year-old male who was hospitalized for a fractured hip develops difficulty breathing. The client has been receiving IV therapy for 3 days. When the nurse assesses the client, moist respirations are auscultated, a full bounding pulse and pedal edema are palpated, and distended neck veins are noted. Based on the assessment, the nurse believes the most probable cause for the client’s symptoms is:

Answer 12

fluid overload. This is a risk when administering IV fluids to the older adult.

Question 13

An important function of nursing is teaching clients about their medications. When teaching an older adult, the nurse should use which of the following principles?

Answer 13

It is important to try to tie medication administration times to the person’s daily schedule.This action will increase learning for the older adult.

Question 14

Older adult clients are at risk for not getting prescriptions filled, largely because

Answer 14

they fear that after purchasing medications, they may not be able to tolerate them. This also ties into the financial aspect of the older adult’s situation.

Question 15

To encourage compliance with the medication regimen, the nurse may suggest:

Answer 15

providing samples of newly prescribed medications.

Question 16

Which of the following conditions places the older adult client most at risk for drug-drug interactions?

Answer 16

The client shares medications with friends or family. Sharing medications with others poses a risk of drug-drug interactions because medical professionals cannot oversee a client taking someone else’s medication.

Question 17

The nurse is preparing to administer oral medications to a client with visual impairment. The nurse should approach the client:

Answer 17

by announcing him- or herself in a normal tone while entering the client’s room.
The client is visually impaired, not hearing impaired. The nurse should announce him- or herself while entering the client’s room.

Question 18

The nurse is preparing to administer a medication to a 65-year-old client. The nurse’s concern about the client’s ability to metabolize the medication is based on:

Answer 18

the blood flow in the liver decreasing approximately 1% per year after age 25. the blood flow in the liver decreasing approximately 1% per year after age 25.

Question 19

The nurse is concerned about the multiple medications prescribed for an older client, because the more medications the client is taking:

Answer 19

the greater the risk for medication errors. As the number of drugs taken increases, medication errors increase.

Question 20

When preparing to administer oral medications to a hospitalized older adult client, the nurse’s first action should be to:

Answer 20

position the client in an upright position. This position will facilitate the movement of the medications into the stomach by gravity and decrease the risk of aspiration.

Question 21

The older adult client refuses to take a newly prescribed medication. In response, the nurse responds:

Answer 21

“Could you tell me your reason for not wanting to take the medication?”

Question 22

When the nurse is preparing to draw up medication for a subcutaneous injection for an older adult client, the choice is:

Answer 22

a 1 mL syringe with a 5/8-inch, 25-gauge needle. A maximum of 1 mL can be injected into subcutaneous tissue. A 1/2- to 5/8-inch needle with a 25- to 28-gauge needle is appropriate for a subcutaneous injection.

Question 23

The nurse confirms the client’s prescription for ampicillin 500 mg po q.i.d. The po addresses which of the seven rights?

Answer 23

right route, The abbreviation po means “by mouth” (the route).

Question 24

The nurse charts that the medication for Mr. Jones was administered at 0900. The nurse’s action addresses which right?

Answer 24

The nurse’s action results in right documentation.

Question 25

The nurse is preparing to administer an IM injection to her older adult client. The nurse places the palm of her hand on the greater trochanter, points her index finger toward the anterior superior iliac spine, and points her middle finger toward the iliac crest to locate which IM site?

Answer 25

ventrogluteal, The nurse has identified the ventrogluteal IM site.

Question 26

Prescribed is carvedilol 3.125 mg po twice a day. The pharmacy supplies 6.25 mg scored carvedilol tablets. The nurse will administer:

Answer 26

1/2 tablet

Divide 3.125 mg by 6.25 mg = 0.5. X tablet = 1/2 tablet.

Question 27

The nurse is writing a client goal for the new admission, who is an older adult client. The nurse is using which part of the nursing process?

Answer 27

planning, Planning is the identifying of goals and outcome criteria to measure the goal.

Question 28

The nurse determines that the client has sustained no injury from self-administration of medications. This describes which part of the nursing process?

Answer 28

evaluation

Question 29

Which of the following would NOT be a nonpharmacological therapy that might be substituted for some client’s medications?

Answer 29

OTC ASA, Although ASA is obtained OTC, it is a pharmacological approach to therapy.

Question 30

Many older adults have physiological changes affecting responses to medication. Of the following factors, which one would not place the older adult client at a higher risk for drug-related problems?

Answer 30

loss of smell, making it difficult to take unpleasant-tasting medication. Loss of smell decreases the sense of taste, so an unpleasant taste of the medication might not be as noticeable.

Question 31

When caring for the older adult, the nurse needs to remember that physiological changes associated with aging result in which of the following?

Answer 31

an increase in fatty tissue

and a decrease in liver drug metabolism

Question 32

The nurse considers which of the following when counseling an older adult client about medication use? Select all that apply

Answer 32

potential alcohol use, proper medication storage, visual capability to read labels properly, and economic concerns for purchase of medications

Question 33

Which of the following would be an appropriate response by the nurse for the older adult client who states he or she is having difficulty sleeping? Select all that apply.

Answer 33

Avoid spicy evening meals,Take prescription diuretics in the morning if possible.
and Do not consume fluids within 2 hours of bedtime.

Question 34

Prescribed is oxycodone 5 mg/acetaminophen (APAP) 325 mg combined tablets, one every 4 hours as needed for pain. The pharmacy sends oxycodone 5 mg/APAP 325 mg tablets. The nurse can administer a maximum of ____________________ tablets in a 24-hour period.

Answer 34

six

Question 35

The nurse is taking an older adult client’s medication history. The nurse is using the ____________________ phase of the nursing process

Answer 35

assessment