Test bank advanced practice nursing in the care of older adults 3rd edition kennedy-malone
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Advanced Practice Nursing in the Care of Older Adults /
Edition 2 TESTBANK_Kennedy-Malone TestBank
Drugs that use CYP 3A4 isoenzymes for metabolism may:
1. Induce the metabolism of another drug
2. Inhibit the metabolism of another drug
3. Both 1 and 2
4. Neither 1 nor 2 - ANSWER:3
Medication agreements or "Pain Medication Contracts" are recommended to be used:
1. Universally for all prescribing for chronic pain
2. For patients who have repeated requests for pain medication
3. When you suspect a patient is exhibiting drug-seeking behavior
4. For patients with pain associated with malignancy - ANSWER:1
Drugs that are prone to cause adverse drug effects include:
1. Diuretics
2. Inhaled anticholinergics
3. Insulins
4. Stimulants - ANSWER:3
The U.S. Food and Drug Administration MedWatch system is activated when:
1. There is an adverse event to a vaccine.
2. The patient has a severe reaction that is noted in the "Severe Reaction" section in the medication
label.
3. A lactating woman takes a medication that is potentially toxic to the breastfeeding infant.
4. An adverse event or serious problem occurs with a medication that is not already identified on the
label. - ANSWER:4
The Vaccine Adverse Events Reporting System is:
1. A mandatory reporting system for all health-care providers when they encounter an adverse
vaccine event
2. A voluntary reporting system that health-care providers or consumers may use to report vaccine
adverse events
3. Utilized to send out safety alerts regarding emerging vaccine safety issues
,4. Activated when a vaccine has been proven to cause significant adverse effects - ANSWER:2
A comprehensive assessment of a patient should be holistic when trying to determine competence in
drug administration. Which of the following factors would the NP omit from this type of assessment?
1. Financial status
2. Mobility
3. Social support
4. Sexual practices - ANSWER:4
Elena Vasquez's primary language is Spanish, and she speaks very limited English. Which technique
would be appropriate to use in teaching her about a new drug you have just prescribed?
1. Use correct medical terminology because Spanish has a Latin base.
2. Use a family member who speaks more English to act as an interpreter.
3. Use a professional interpreter or a reliable staff member who can act as an interpreter.
4. Use careful, detailed explanations. - ANSWER:3
Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he
understands teaching about his drug?
1. Stand facing him and speak slowly and clearly.
2. Speak in low tones or find a provider who has a lower voice.
3. Write down the instructions as well as speaking them.
4. If he reads lips, exaggerate lips movements when pronouncing the vowel sounds. - ANSWER:4
Which of the following factors may adversely affect a patient's adherence to a therapeutic drug
regimen?
1. Complexity of the drug regimen
2. Patient perception of the potential adverse effects of the drugs
3. Both 1 and 2
4. Neither 1 nor 2 - ANSWER:3
The health-care delivery system itself can create barriers to adherence to a treatment regimen. Which
of the following system variables creates such a barrier?
1. Increasing copayments for care
2. Unrestricted formularies for drugs, including brand names
3. Increasing the number of people who have access to care
4. Treating a wider range of disorders - ANSWER:1
,Ralph's blood pressure remains elevated despite increased doses of his drug. The NP is concerned
that he might not be adhering to his treatment regimen. Which of the following events would suggest
that he might not be adherent?
1. Ralph states that he always takes the drug "when I feel my pressure is going up."
2. Ralph contacts his NP to discuss the need to increase the dosage.
3. Ralph consistently keeps his follow-up appointments to check his blood pressure.
4. All of the above show that he is adherent to the drug regimen. - ANSWER:1
Nonadherence is especially common in drugs that treat asymptomatic conditions, such as
hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug
that:
1. Has a short half-life so that missing one dose has limited effect
2. Requires several dosage titrations so that missed doses can be replaced with lower doses to keep
costs down
3. Has a tolerability profile with fewer of the adverse effects that are considered "irritating," such as
nausea and dizziness
4. Must be taken no more than twice a day - ANSWER:3
Factors in chronic conditions that contribute to nonadherence include:
1. The complexity of the treatment regimen
2. The length of time over which it must be taken
3. Breaks in the usual daily routine, such as vacations and weekends
4. All of the above - ANSWER:4
While patient education about their drugs is important, information alone does not necessarily lead
to adherence to a drug regimen. Patients report greater adherence when:
1. The provider spent a lot of time discussing the drugs with them
2. Their concerns and specific area of knowledge deficit were addressed
3. They were given written material, such as pamphlets, about the drugs
4. The provider used appropriate medical and pharmacological terms - ANSWER:2
Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%.
To improve adherence in this population, prescribe drugs:
1. With a longer half-life so that missed doses produce a longer taper on the drug curve
2. In oral formulations that are more easily taken
3. That do not require frequent monitoring
, 4. Combined with patient education about the need to adhere even when symptoms are absent -
ANSWER:1
Many disorders require multiple drugs to treat them. The more complex the drug regimen, the less
likely the patient will adhere to it. Which of the following interventions will NOT improve adherence?
1. Have the patient purchase a pill container with compartments for daily or multiple times-per-day
dosing.
2. Match the clinic appointment to the next time the drug is to be refilled.
3. Write prescriptions for new drugs with shorter times between refills.
4. Give the patient a clear drug schedule that the provider devises to fit the characteristic of the drug.
- ANSWER:4
Pharmacologic interventions are costly. Patients for whom the cost/benefit variable is especially
important include:
1. Older adults and those on fixed incomes
2. Patients with chronic illnesses
3. Patients with copayments for drugs on their insurance
4. Patients on public assistance - ANSWER:1
Providers have a responsibility for determining the best plan of care, but patients also have
responsibilities. Patients the provider can be assured will carry through on these responsibilities
include those who:
1. Are well-educated and affluent
2. Have chronic conditions
3. Self-monitor drug effects on their symptoms
4. None of the above guarantee adherence - ANSWER:4
Monitoring adherence can take several forms, including:
1. Patient reports from data in a drug diary
2. Pill counts
3. Laboratory reports and other diagnostic markers
4. All of the above - ANSWER:4
Factors that explain and predict medication adherence include:
1. Social
2. Financial
3. Health system
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