Pharmacological Aspects of Nursing Care 8Th Ed By Broyles Reiss Evans – Test Bank DRUG THERAPY FOR GERIATRIC CLIENTS

Pharmacological Aspects of Nursing Care 8Th Ed By Broyles Reiss Evans – Test Bank DRUG THERAPY FOR GERIATRIC CLIENTS Pharmacological Aspects of Nursing Care 8Th Ed By Broyles Reiss Evans – Test Bank DRUG THERAPY FOR GERIATRIC CLIENTS TRUE/FALSE ANSWERS The best way to determine if the client understands how to perform a self-care skill such as insulin administration is to have the client demonstrate the skill to the nurse. ANS: T PTS: 1 REF: p. 138, Box 6-2 OBJ: Cognitive Level: Evaluation Alcohol-drug interaction is rarely a problem for the elderly, because older adults do not use alcohol. ANS: F Feedback Correct Alcohol-drug interactions do occur because of alcohol use in the older adult. Incorrect PTS: 1 REF: p. 135 OBJ: Cognitive Level: Comprehension Health promotion activities are not necessary for residents of long-term care facilities, because the activities will not improve the well-being of the residents. ANS: F Feedback Correct Regardless of where they reside, elderly persons benefit from health promotion activities. Incorrect PTS: 1 REF: p. 136, Safe Nursing Practice 6-5 OBJ: Cognitive Level: Knowledge Elderly clients may suffer prolonged effects from sedative drugs. ANS: T PTS: 1 REF: p. 133 OBJ: Cognitive Level: Knowledge Elderly clients may have difficulty remembering specific instructions due to short-term memory loss. ANS: T PTS: 1 REF: p. 135 OBJ: Cognitive Level: Knowledge MULTIPLE CHOICE The nurse understands that when the elderly use oral medications there is: a. increased hydrochloric acid secretion in the stomach. b. shorter gastric emptying time. c. slower intestinal movement. d. greater gastric and intestinal blood flow. ANS: C Feedback A Incorrect: Hydrochloric acid production is decreased. B Incorrect: Gastric emptying time is increased. C Correct: Due to decreased muscle tone, intestinal movements (peristalsis) slows. D Incorrect: There is decreased gastric and intestinal blood flow. PTS: 1 REF: p. 133 OBJ: Cognitive Level: Comprehension To enhance drug absorption in providing drug therapy to elderly clients, when possible the nurse should: a. administer liquid dosage forms. b. administer sustained-release dosage forms. c. administer drugs in a suppository dosage form. d. use capsule instead of tablet dosage forms. ANS: A Feedback A Correct: Liquid dosage forms absorb better in the GI tract considering all the factors influencing drug absorption in the older adult. B Incorrect: Altered GI absorption negatively affects timed-released medication. C Incorrect: Loss of muscle tone and intestinal villi decreases the absorption of rectal medications. D Incorrect: Tablets and capsules absorption is similar. PTS: 1 REF: p. 133 | p. 137, Safe Nursing Practice 6-3 OBJ: Cognitive Level: Application The nurse understands which of the following is not associated with diminishing gastrointestinal absorption of drugs in the elderly? a. consumption of high fiber foods b. use of stimulant laxatives c. reduction in the absorptive area in the GI tract d. increased fluid consumption by the elderly ANS: D Feedback A Incorrect: High fiber foods can reduce the absorption of certain drugs. B Incorrect: The use of stimulant laxatives can reduce the absorption of medications. C Incorrect: This will diminish gastrointestinal absorption. D Correct: Increased fluid consumption would improve blood supply and thus increase drug distribution not absorption. PTS: 1 REF: p. 133 OBJ: Cognitive Level: Comprehension When caring for older adults, the nurse understands that the characteristic of drug absorption which is likely to occur with advancing age is: a. increase in water content of the body b. loss of muscle tissue c. loss of fat as a proportion of total body mass d. increased protein binding of drugs ANS: B Feedback A Incorrect: There is a decrease in water content in the body. B Correct: There is an age-related reduction in muscle tissue because of atrophy. C Incorrect: Fatty tissue increases with age. D Incorrect: There is a decreased protein-binding capacity with age. PTS: 1 REF: p. 133 OBJ: Cognitive Level: Comprehension When selecting an appropriate drug product for an elderly client, if possible, one should select a drug that is: a. not dependent on liver metabolism. c. bound to plasma proteins. b. not too water soluble. d. absorbed primarily in the stomach. ANS: A Feedback A Correct: Liver metabolism decreases with age, so, when possible, the older adult should be prescribed medications that are not dependent on liver metabolism. B Incorrect: Water-soluble drugs are the most appropriate for the older adult. C Incorrect: There is decreased protein-binding capacity in the older adult. D Incorrect: There is decreased gastric absorption ability in the older adult. PTS: 1 REF: p. 133 OBJ: Cognitive Level: Comprehension In determining an appropriate dose of a drug for an elderly client, which of the following should be considered? a. decreased creatinine clearance c. decreased platelet level b. increased liver metabolites d. increased hemoglobin level ANS: A Feedback A Correct: This increases the risk of cumulative and toxic effects of medications. B Incorrect: There is a decrease in liver metabolism resulting in decreased metabolites. C Incorrect: The platelet count usually does not affect how the appropriate dosage of a drug is determined. D Incorrect: The hemoglobin usually does not affect how the appropriate dosage of a drug is determined. PTS: 1 REF: p. 134 OBJ: Cognitive Level: Comprehension The nurse monitors an older adult for which of the following adverse drug reactions more commonly seen in elderly clients? a. anaphylactic shock c. orthostatic hypotension b. pseudomembranous enterocolitis d. discolored urine ANS: C Feedback A Incorrect: This is no more common in the older adult. B Incorrect: This is no more common in the older adult. C Correct: Excessive sedation and orthostatic hypotension are adverse effects to drug therapy more common in the older adult. D Incorrect: This is no more common in the older adult. PTS: 1 REF: p. 136 OBJ: Cognitive Level: Application When administering intramuscular injections to an elderly client, the nurse prepares to use which of the following injection sites: a. deltoid. c. rectus femoris. b. vastus lateralis. d. ventrogluteal. ANS: D Feedback A Incorrect: The deltoid muscle should not be used, because it has lost much of its mass. B Incorrect: The vastus lateralis muscle should not be used, because it has lost much of its mass. C Incorrect: This is not an appropriate IM site. D Correct: The ventrogluteal site is the most appropriate in the older adult especially, in an emaciated client, because of the size of the muscle in this site. PTS: 1 REF: p. 137, Safe Nursing Practice 6-3 OBJ: Cognitive Level: Application When preparing a teaching plan for elderly clients about their medications, the nurse understands that which factor is not true of elderly clients? a. About 95% live in the community and are not institutionalized. b. They have difficulty distinguishing blue and green. c. They tend to be as compliant in using their medications as younger adults. d. Many older adults experience short-term memory loss. ANS: C Feedback A Incorrect: This is a true statement. B Incorrect: This is a true statement. C Correct: Noncompliance is a issue in the older adult resulting from a number of factors including memory loss and lack of adequate finances. D Incorrect: This is a true statement. PTS: 1 REF: p. 138 OBJ: Cognitive Level: Comprehension Many elderly are prescribed eight or more medications per day. This is referred to as: a. overdosage. c. multiple treatments. b. polypharmacy. d. monotherapy. ANS: B Feedback A Incorrect: Although an overdose or drug interaction may occur, this is not the definition of overdosage. B Correct: This defines polypharmacy. C Incorrect: Polypharmacy usually occurs because of treatment for multiple conditions. D Incorrect: This is the use of one drug.