OLDER ADULT NCLEX CERTIFICATION
EVALUATION COMPLETE QUESTIONS AND
ANSWERS GRADED A+
●● Why are older adults more likely to experience adverse drug
reactions? (Select all that apply
)A) Because of the number of medications they take daily
B) Because of physiologic changes in metabolism and excretion
C) Because of higher percentage of body fluid
D) Because of cognitive changes
E) Because of interaction with foods, OTC preparations, and herbal
supplements
F) Because of decreased sense of taste
Answer: A) Because of the number of medications they take daily
B) Because of physiologic changes in metabolism and excretion
D) Because of cognitive changes
Factors that increase the risk for medication-related problems in older
adults include use of multiple medications, herbal and OTC medications,
physiologic changes related to aging, cognitive and sensory changes,
drug-testing methodology, knowledge deficits, and financial concerns.
●● What should you instruct the independent living older person to do?
,A) Take most medications with milk or antacids to avoid stomach upset
B) Avoid drinking alcohol if taking acetaminophen (Tylenol)
C) Keep daily medications in the kitchen cabinet near the sink
D) Save prescription drugs in case the care provider orders them again
Answer: B) Avoid drinking alcohol if taking acetaminophen
(Tylenol)Excessive use of acetaminophen (Tylenol) can damage the
kidneys, and if the patient uses alcohol heavily, it can also damage the
liver.
●● The nurse is caring for an elderly patient recently admitted to the
medical/surgical floor. With which written medication order would the
nurse feel comfortable complying?
A) MSO₄ 25 mg PO q4h PRN for pain
B) Acetaminophen 500 mg PO q4h PRN for pain
C) Levothyroxine 100 µg PO qDay for hypothyroidism
D) Digoxin 0.25 mg PO qDay, hold for HR<60 for dysrhythmia
Answer: B) Acetaminophen 500 mg PO q4h PRN for painThe nurse
should ensure each medication order has the full name of the medication
(not an abbreviation), the dose (without do-not-use abbreviations such as
µg), dosing interval (such as qDay and PRN) and any exclusions (such
as for heart rate less than [not "
●● The nurse works in a long term care facility that also employs
medication assistants. Which medications are appropriate to delegate to
the medication assistant? (Select all that apply)
,A) IV antibiotics to a patient with cellulitis of the lower leg
B) Albuterol nebulizer to the patient with chronic obstructive pulmonary
disease
C) PO furosemide (Lasix) to the patient in left-sided heart failure
D) Subcutaneous insulin injection to the patient with a sliding scale for
insulin administration
E) PO lactulose to the patient with hepatic encephalopathyF)
Transdermal fentanyl patch to the patient with Parkinson's disease
Answer: C) PO furosemide (Lasix) to the patient in left-sided heart
failure
E) PO lactulose to the patient with hepatic encephalopathy
The medication assistant can administer oral medications to stable
patients, which includes PO furosemide and lactulose. Although
medication assistants can administer some topical medications, fentanyl
is a controlled substance and requires a license to administer. The nurse
should plan to administer the IV antibiotics, albuterol nebulizer, insulin
injections, and the transdermal fentanyl patch.
●● The nurse caring for an older adult in the hospital must administer an
intramuscular injection. What is the best location for this injection?
A) Deltoid
B) Abdomen
C) Ventrogluteal
D) Anterior thigh
, Answer: C) Ventrogluteal
The ventrogluteal location is the best option for the older adult to receive
an intramuscular injection due to the size of the muscle. The abdomen is
used for subcutaneous injections. The deltoid muscle should be used
only rarely and for very small amounts of medication. The anterior thigh
is generally not an optimal injection location.R
●● Which age-related changes can alter the distribution of medications?
(Select all that apply)
A) Decreased liver mass
B) Increased total body fat
C) Increased total body water
D) Decreased lean body mass
E) Decreased total body mass
F) Decreased vascularization of intestinal villi
Answer: A) Decreased liver mass
C) Increased total body water
D) Decreased lean body massDistribution of drugs is altered by an
increase in total body fat, decreased total body water, decreased lean
body mass, and decreased total body mass. Decreased liver mass affects
drug metabolism. Decreased vascularization of intestinal villi would
affect the absorption of medication
EVALUATION COMPLETE QUESTIONS AND
ANSWERS GRADED A+
●● Why are older adults more likely to experience adverse drug
reactions? (Select all that apply
)A) Because of the number of medications they take daily
B) Because of physiologic changes in metabolism and excretion
C) Because of higher percentage of body fluid
D) Because of cognitive changes
E) Because of interaction with foods, OTC preparations, and herbal
supplements
F) Because of decreased sense of taste
Answer: A) Because of the number of medications they take daily
B) Because of physiologic changes in metabolism and excretion
D) Because of cognitive changes
Factors that increase the risk for medication-related problems in older
adults include use of multiple medications, herbal and OTC medications,
physiologic changes related to aging, cognitive and sensory changes,
drug-testing methodology, knowledge deficits, and financial concerns.
●● What should you instruct the independent living older person to do?
,A) Take most medications with milk or antacids to avoid stomach upset
B) Avoid drinking alcohol if taking acetaminophen (Tylenol)
C) Keep daily medications in the kitchen cabinet near the sink
D) Save prescription drugs in case the care provider orders them again
Answer: B) Avoid drinking alcohol if taking acetaminophen
(Tylenol)Excessive use of acetaminophen (Tylenol) can damage the
kidneys, and if the patient uses alcohol heavily, it can also damage the
liver.
●● The nurse is caring for an elderly patient recently admitted to the
medical/surgical floor. With which written medication order would the
nurse feel comfortable complying?
A) MSO₄ 25 mg PO q4h PRN for pain
B) Acetaminophen 500 mg PO q4h PRN for pain
C) Levothyroxine 100 µg PO qDay for hypothyroidism
D) Digoxin 0.25 mg PO qDay, hold for HR<60 for dysrhythmia
Answer: B) Acetaminophen 500 mg PO q4h PRN for painThe nurse
should ensure each medication order has the full name of the medication
(not an abbreviation), the dose (without do-not-use abbreviations such as
µg), dosing interval (such as qDay and PRN) and any exclusions (such
as for heart rate less than [not "
●● The nurse works in a long term care facility that also employs
medication assistants. Which medications are appropriate to delegate to
the medication assistant? (Select all that apply)
,A) IV antibiotics to a patient with cellulitis of the lower leg
B) Albuterol nebulizer to the patient with chronic obstructive pulmonary
disease
C) PO furosemide (Lasix) to the patient in left-sided heart failure
D) Subcutaneous insulin injection to the patient with a sliding scale for
insulin administration
E) PO lactulose to the patient with hepatic encephalopathyF)
Transdermal fentanyl patch to the patient with Parkinson's disease
Answer: C) PO furosemide (Lasix) to the patient in left-sided heart
failure
E) PO lactulose to the patient with hepatic encephalopathy
The medication assistant can administer oral medications to stable
patients, which includes PO furosemide and lactulose. Although
medication assistants can administer some topical medications, fentanyl
is a controlled substance and requires a license to administer. The nurse
should plan to administer the IV antibiotics, albuterol nebulizer, insulin
injections, and the transdermal fentanyl patch.
●● The nurse caring for an older adult in the hospital must administer an
intramuscular injection. What is the best location for this injection?
A) Deltoid
B) Abdomen
C) Ventrogluteal
D) Anterior thigh
, Answer: C) Ventrogluteal
The ventrogluteal location is the best option for the older adult to receive
an intramuscular injection due to the size of the muscle. The abdomen is
used for subcutaneous injections. The deltoid muscle should be used
only rarely and for very small amounts of medication. The anterior thigh
is generally not an optimal injection location.R
●● Which age-related changes can alter the distribution of medications?
(Select all that apply)
A) Decreased liver mass
B) Increased total body fat
C) Increased total body water
D) Decreased lean body mass
E) Decreased total body mass
F) Decreased vascularization of intestinal villi
Answer: A) Decreased liver mass
C) Increased total body water
D) Decreased lean body massDistribution of drugs is altered by an
increase in total body fat, decreased total body water, decreased lean
body mass, and decreased total body mass. Decreased liver mass affects
drug metabolism. Decreased vascularization of intestinal villi would
affect the absorption of medication
