Toward Healthy Aging: 9, 10, 14, 19, 31
Questions With Complete Solutions
1. Factors that affect the pharmacokinetics of lipophilic
medications in older adults include:
a. greater adipose tissue ratio to body mass.
b. decreased total body water.
c. increased glomerular filtration rate.
d. increased creatinine clearance. Correct Answers a.
greater adipose tissue ratio to body mass.
10. The nurse's first response when told by a client during an
assessment interview that he "can't take furosemide (Lasix)" is
to ask:
a. "Is your health care provider aware that you are allergic to
Lasix?"
b. "Can you describe what happened when you took Lasix?"
c. "When was the last time you took Lasix?"
d. "Have you any questions regarding your reaction to Lasix?"
Correct Answers ANS: B
It is important to document the type of allergic reaction, when
the patient had it, how long it lasted, and how it was treated.
Determining whether the health care provider is aware of the
allergic reaction or when the medication was last taken does not
have precedence over assessing the client's reaction to the
medication since neither has a direct bearing on the management
of a similar reaction. Evaluating the client's understanding of the
reaction is appropriate but not as an initial response.
,11. An 81-year-old patient is being discharged from the hospital
to home. She is on seven different medications, which are to be
taken at four different times during the day. What would be most
useful in helping this patient manage her medications?
a. The package inserts from all of the medications for the client
to read
b. A pillbox with compartments for each day and each of the
doses
c. A written list of all the client's medications and administration
routine
d. A suggestion that the client's daughter administer the
medications Correct Answers ANS: B
Providing a pillbox is an effective method to reinforce exactly
which medications are to be given at what times. It also serves
as an effective method to remind patients when they have
missed a dose. Package inserts are often written in language that
is not easy for patients to understand. Another consideration is
that the size of the print in package inserts may be too small for
aging eyes. Although providing a written list of the medications
is appropriate, it does not make as much of an impact on the
overall management of this patient's medications as other
options. There is no indication that this patient cannot self-
administer the medications.
12. A 77-year-old Hispanic Catholic nun (retired) who
immigrated to the United States 15 years ago lives alone but in
an apartment complex where her biological sister lives as well.
She is being discharged home after a hospitalization for
congestive heart failure with prescriptions for eight different
medications. She is considered at risk for noncompliance due to
contributing factors that include: (Select all that apply.)
, a. language barrier.
b. living alone.
c. large number of medications.
d. ethnic background.
e. religious background. Correct Answers ANS: A, B, C
Language barriers, living alone, and a large number of
medications are all factors that have been shown to contribute to
noncompliance in older adults. There is no evidence that ethnic
or religious background contributes to noncompliance.
13. An older client prescribed a transdermal morphine patch for
severe chronic pain is being educated on the appropriate
administration of the medication. The nurse shows an
understanding of essential information regarding this route of
drug administration when stating: (Select all that apply.)
a. "This is an effective route for delivering small doses of
medication over long periods of time."
b. "Since you have problems with digestion, this is a good way
to take your medication."
c. "Please show me how you would apply your patch."
d. "Be careful to put the patch only on your chest but change
locations with each application."
e. "Be sure to avoid placing the patch on injured skin." Correct
Answers ANS: A, B, C, E
Aging does increase the risk of developing an allergic reaction
due to its effect on the immune system and decreased gastric
motility. Transdermal medications bypass the gastrointestinal
tract and so do not cause digestion problems, and their
effectiveness is not affected by digestive problems.
Demonstrating the application process is an excellent way to
evaluate the client's understanding and technique. Transdermal
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