Exam 4|NSG 3180 Exam 4 (Adult Health):Questions & Answers:Updated A+ Guide Solution

1. Which age-related pharmacokinetic change most increases the older adult’s risk for drug toxicity? A. Faster hepatic metabolism B. Slower elimination and absorption C. Increased total body water D. Higher serum albumin Correct answer: B Rationale: Older adults have slower metabolism, slower absorption, and reduced renal clearance, causing drugs to remain longer and accumulate— raising toxicity risk. Faster metabolism (A) would lower risk. Increased total body water (C) is typically decreased with age. Higher albumin (D) is often reduced, which actually increases free drug levels. 2. A nurse assessing medication adherence in an elder should ask which priority question to reduce adverse outcomes? A. “What color are your pills?” B. “How do you take your medication—walk me through your routine.” C. “Do you prefer brand or generic medications?” D. “Do you want a 90-day supply?” Correct answer: B Rationale: Having the elder describe exactly how and when they take meds reveals memory lapses, misunderstanding, and polypharmacy risks. Pill color (A) and brand preference (C) don’t address adherence. Supply size (D) is logistical and may worsen errors if routine is poor. 3. To decrease conflicting prescriptions from multiple clinicians, the nurse should recommend: A. Using different pharmacies for price shopping B. One primary provider and one supplier pharmacy C. Storing old prescriptions for future use D. Alternating providers every visit Correct answer: B Rationale: Consolidating care with the same provider and pharmacy improves reconciliation and interaction checks. Multiple pharmacies (A) increase error risk. Saving old prescriptions (C) risks inappropriate reuse. Alternating providers (D) fragments care. 4. An older adult asks about using an herbal tea for sleep. The nurse’s best advice is to: A. Start immediately since herbs are natural B. Double the tea strength for effect C. Check with the doctor first D. Use herbs instead of prescribed meds Correct answer: C Rationale: Herb–drug interactions are common; provider review is essential. “Natural” does not mean safe (A), stronger tea (B) increases risk, and replacing prescribed meds (D) can be dangerous. 5. Which statement best defines ageism? A. A government policy for retirees B. Discriminatory behavior based on age C. Positive bias toward the young and old D. A normal stage of psychosocial development Correct answer: B Rationale: Ageism is discrimination due to age, often seen in workplaces and healthcare. The other options mischaracterize it as policy (A), positive bias (C), or developmental stage (D). 6. What is the nurse’s number one responsibility when elder abuse is suspected? A. Call the family first B. Report to Adult Protective Services or immediate supervisor C. Confront the suspected abuser D. Discharge the patient to home with instructions Correct answer: B Rationale: Nurses are mandated reporters—notify APS or follow institutional chain of command. Calling family (A) or confronting (C) can escalate danger, and discharge (D) jeopardizes safety. 7. Which cluster most suggests possible elder abuse? A. Uniform bruise pattern and rapid discharge desire B. Multiple bruises in various healing stages and controlling caregiver C. Single shin bruise from a fall with independent historian D. Neatly documented home meds and accurate history Correct answer: B Rationale: Red flags include bruises at different stages, caregiver answering for the patient, reluctance to discharge, and suspicious injuries (e.g., spiral fractures, burns). A single plausible bruise (C) is less concerning; (A) and (D) lack key warning signs. 8. To evaluate if organs are handling a nephrotoxic drug, the priority tests are: A. AST/ALT only B. BUN and creatinine ± liver panel C. Troponin and CK-MB D. Amylase and lipase Correct answer: B Rationale: Renal function (BUN/creatinine) is key for nephrotoxic risk; liver panel may be needed for hepatotoxic agents. Cardiac enzymes (C) and pancreatic enzymes (D) are not first-line for this purpose. 9. Which taste/thirst change in aging requires safety teaching? A. Increased thirst leading to overhydration B. More intense taste of sweets C. Decreased thirst—encourage fluids even if not thirsty D. Heightened salt sensitivity preventing excess intake Correct answer: C Rationale: Older adults often have decreased thirst and blunted taste, gravitating to bland/salty foods; they need reminders to drink adequately.