NURS 1002 Chapter 3 Self-Study Module
Quiz: Life Span Considerations
A malnourished older adult patient experiences drug toxicity. Which factor does the nurse
assess to rule out drug distribution as a cause of the patient's toxicity?
A. Drug dosage
B. Drug half-life
C. Gastric acidity
D. Plasma proteins - correct answer-D. Plasma proteins
A malnourished older adult is likely to have a smaller percentage of lean muscle and lower
levels of circulating plasma proteins. The result is fewer protein-binding sites, increased
serum drug levels, and intensified drug effects. An error in drug dosage is a prescribing
error, the half-life is an issue of metabolism, and gastric acidity involves drug absorption.
At which gestational age does an embryo or fetus have the highest risk for drug-induced
developmental defects as a result of teratogenic exposure?
A. 4 weeks' gestation
B. 16 weeks' gestation
C. 29 weeks' gestation
D. 38 weeks' gestation - correct answer-A. 4 weeks' gestation
Drug-induced developmental defects are most likely during the embryonic period, the first
trimester of pregnancy. During the first 13 weeks, the basic shapes of internal organs and
other structures are being established.
The nurse checks the dosage calculation of a medication that acts on the central nervous
system (CNS) for accuracy before administering the drug to an infant. Why does the nurse
check the calculation?
A. Infants have slower drug metabolic rates.
B. Infants have adequate serum protein levels.
C. Infants have wide fluctuations in their weight.
D. Infants have immature blood-brain barriers. - correct answer-D. Infants have immature
blood-brain barriers.
The blood-brain barrier is not fully developed at birth; because of this, drugs enter the CNS
more easily, thereby rendering the infant especially sensitive to drugs that affect CNS
functions such as respiration. Because the nurse bases dosages on infant weight, the nurse
calculates the dosage at regular intervals to ensure the proper dosage of a given medication
for the infant's current weight. The metabolic rate of an infant is affected by many factors,
and it is not necessarily inadequate. Because of immature hepatic function, the levels of
plasma proteins produced by the liver are likely to be lower than they are in an adult. Finally,
an infant's weight may vary, and such variation can necessitate a significant change in
dosage; however, the weight variation is more likely to be a small one.
, The nurse plans care for an older adult male patient with a complex drug regimen. Which
action should the nurse implement to decrease the risk of patient nonadherence to therapy?
A. Instructing the patient to call for information about the drug therapy
B. Providing the patient with written instructions for all drugs prescribed
C. Encouraging the use of multiple alarms for drug reminders
D. Suggesting home remedies to counteract adverse effects - correct answer-B. Providing
the patient with written instructions for all drugs prescribed
To decrease the risk of patient nonadherence to a complicated drug regimen, the nurse
provides written instructions for all drugs that the patient takes and tries to simplify the
regimen. Written instructions provide the patient with a reliable reference and a reminder for
self-administration at home, and the regimen is simplified when the nurse compiles the
information into a single medication schedule. The nurse breaches the duty owed to the
patient by delegating proper instructions to the patient; telephone-based support or source of
reference is suitable once drug therapy instructions have been delivered properly by the
nurse. The use of multiple alarms increases the complexity, as well as the potential cost, of
an already complex situation. The nurse instructs the patient to avoid home remedies and
over-the-counter medications without the prior approval of the prescriber.
The nurse prepares medication for a 24-year-old patient who is 30 weeks' pregnant and has
hypoalbuminemia. Which factor related to drug safety in pregnancy is the nurse's priority to
reduce the risk of excessive drug exposure to the fetus when planning care for this patient?
A. Age of the patient
B. Distribution of the drug
C. Gestational age of the fetus
D. Serum sodium of the patient - correct answer-B. Distribution of the drug
For a pregnant patient with a low serum albumin level, the nurse's priority is the distribution
of the drug in the patient. If a patient with inadequate serum protein takes a drug that is
highly protein bound, more of the active ingredient of the drug will circulate in the pregnant
patient because the blood lacks protein to which the drug normally binds; thus, the fetus is
exposed to a higher-than-normal serum level of that drug.
The nurse prepares to administer a drug that is absorbed in the stomach to an older adult
patient. Drug absorption in this patient is likely to be what?
A. Increased as a result of diminished peristalsis
B. Increased by altered portal blood flow
C. Slowed as a result of excessive gastric acidity
D. Slowed as a result of delayed gastric emptying - correct answer-A. Increased as a result
of diminished peristalsis
Many factors can alter the absorption of drugs in older adults. The delayed gastric emptying
associated with diminished peristaltic action can increase absorption of a drug that is
absorbed in the stomach because the delay exposes the gastric mucosa to the drug for a
longer period. Altered portal blood flow affects drug distribution, and older adults tend to
have less gastric acid secretion.
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