Geriatric Nursing Chapter 007 Medications and Older
Adults Exam TEST 2023/2024 VERIFIED
1. The nurse is aware that information derived from a pharmaceutical company's drug testing to
establish therapeutic dose ranges may not be appropriate for the older adult because testing:
a. is not done long enough.
b. does not require adequate follow-up.
c. is not well regulated by the U.S. Food and Drug Administration.
d. is usually tested on healthy young persons. correct answers ANS: D
Long and rigorously regulated drug testing procedures most often use healthy young adults as drug
testers.
2. The nurse assesses the older adult patient for evidence of the onset of the effectiveness of an oral
preparation because age-related changes in the concentration of gastric acid can:
a. change the chemical composition of the drug.
b. increase the distribution.
c. decrease the strength of the drug.
d. retard absorption. correct answers ANS: D
Decreased gastric acid can decrease the speed of absorption.
3. The nurse is aware that age-related changes in the stomach that can cause increased drug absorption
and possibly toxicity include:
a. decreased gastric motility.
b. gastric reflux disease.
c. inability of gastric cells to transport the drug.
d. decreased peristalsis. correct answers ANS: A
Decreased motility leaves the drug in contact with the gastric mucosa for a longer period of time, which
leads to increased absorption. Peristalsis is rhythmic movements of the bowels.
4. To help prevent lithium toxicity in the older adult, the nurse modifies the nursing care plan to include
interventions to:
a. increase fluid intake to 3500 mL daily.
b. have the patient ambulate for 10 minutes after the drug is administered.
c. prohibit citrus fruit in the diet.
d. administer a prescribed stool softener to ensure a daily bowel movement correct answers ANS: A
Increase of fluids will help allow water-soluble drugs such as lithium to be diluted in the bloodstream
more effectively and excreted more rapidly.
5. The nurse takes into consideration that as adipose tissue replaces muscle mass in the older adult, a
person taking a fat-soluble drug such as diazepam (Valium) several times a day would exhibit:
a. tachycardia.
, b. a hangover effect.
c. agitation.
d. hypertension. correct answers ANS: B
Fat-soluble drugs become trapped in the adipose tissue and are slowly released into the bloodstream,
increasing the drug's concentration.
6. The nurse cautions the older adult who is taking the protein-bound drug warfarin (Coumadin) that,
with age-related reduced plasma protein levels, the risk of an adverse reaction is high because:
a. unbound active drug molecules continue to circulate in the bloodstream.
b. the bleeding and clotting times will decrease, as evidenced by the PT and INR.
c. the drug becomes ineffective and does not deliver its intended therapeutic action.
d. renal damage can occur from the altered drug molecules. correct answers ANS: A
Unbound drug molecules will still be circulating, leading to excess drug in the bloodstream. In this
situation the bleeding and clotting times will be decreased.
7. The nurse frequently assesses the older adult who is on a psychotropic drug for an overdose because:
a. older adults are less active.
b. the older adult has fewer cognitive capabilities.
c. brain receptors have become hypersensitive.
d. receptor sites have lower perfusion. correct answers ANS: C
Brain receptors in the older adult become hypersensitive as age increases, resulting in an exaggerated
response to pharmacologic therapy.
8. The major risk of polypharmacy for the older adult is:
a. ignorance about his or her prescriptions.
b. taking over-the-counter preparations.
c. being treated by more than one physician.
d. taking old prescriptions rather than consulting a physician. correct answers ANS: C
Although all the options may offer an opportunity for polypharmacy, the major risk is that of the patient
being treated by more than one physician at the same time.
9. The home health nurse would be most concerned about self-medicating errors for the older adult
living alone who is a type 1 diabetic and is:
a. afflicted with early Parkinson disease.
b. visually impaired.
c. a rheumatoid arthritic with stiffened hands.
d. paralyzed from the waist down. correct answers ANS: B
The visually impaired diabetic is at the greatest risk for a medication error by incorrectly preparing an
insulin injection.
10. The medication nurse is aware that the most reliable method of patient identification for
administration of medications is:
a. a photograph of the patient.
Adults Exam TEST 2023/2024 VERIFIED
1. The nurse is aware that information derived from a pharmaceutical company's drug testing to
establish therapeutic dose ranges may not be appropriate for the older adult because testing:
a. is not done long enough.
b. does not require adequate follow-up.
c. is not well regulated by the U.S. Food and Drug Administration.
d. is usually tested on healthy young persons. correct answers ANS: D
Long and rigorously regulated drug testing procedures most often use healthy young adults as drug
testers.
2. The nurse assesses the older adult patient for evidence of the onset of the effectiveness of an oral
preparation because age-related changes in the concentration of gastric acid can:
a. change the chemical composition of the drug.
b. increase the distribution.
c. decrease the strength of the drug.
d. retard absorption. correct answers ANS: D
Decreased gastric acid can decrease the speed of absorption.
3. The nurse is aware that age-related changes in the stomach that can cause increased drug absorption
and possibly toxicity include:
a. decreased gastric motility.
b. gastric reflux disease.
c. inability of gastric cells to transport the drug.
d. decreased peristalsis. correct answers ANS: A
Decreased motility leaves the drug in contact with the gastric mucosa for a longer period of time, which
leads to increased absorption. Peristalsis is rhythmic movements of the bowels.
4. To help prevent lithium toxicity in the older adult, the nurse modifies the nursing care plan to include
interventions to:
a. increase fluid intake to 3500 mL daily.
b. have the patient ambulate for 10 minutes after the drug is administered.
c. prohibit citrus fruit in the diet.
d. administer a prescribed stool softener to ensure a daily bowel movement correct answers ANS: A
Increase of fluids will help allow water-soluble drugs such as lithium to be diluted in the bloodstream
more effectively and excreted more rapidly.
5. The nurse takes into consideration that as adipose tissue replaces muscle mass in the older adult, a
person taking a fat-soluble drug such as diazepam (Valium) several times a day would exhibit:
a. tachycardia.
, b. a hangover effect.
c. agitation.
d. hypertension. correct answers ANS: B
Fat-soluble drugs become trapped in the adipose tissue and are slowly released into the bloodstream,
increasing the drug's concentration.
6. The nurse cautions the older adult who is taking the protein-bound drug warfarin (Coumadin) that,
with age-related reduced plasma protein levels, the risk of an adverse reaction is high because:
a. unbound active drug molecules continue to circulate in the bloodstream.
b. the bleeding and clotting times will decrease, as evidenced by the PT and INR.
c. the drug becomes ineffective and does not deliver its intended therapeutic action.
d. renal damage can occur from the altered drug molecules. correct answers ANS: A
Unbound drug molecules will still be circulating, leading to excess drug in the bloodstream. In this
situation the bleeding and clotting times will be decreased.
7. The nurse frequently assesses the older adult who is on a psychotropic drug for an overdose because:
a. older adults are less active.
b. the older adult has fewer cognitive capabilities.
c. brain receptors have become hypersensitive.
d. receptor sites have lower perfusion. correct answers ANS: C
Brain receptors in the older adult become hypersensitive as age increases, resulting in an exaggerated
response to pharmacologic therapy.
8. The major risk of polypharmacy for the older adult is:
a. ignorance about his or her prescriptions.
b. taking over-the-counter preparations.
c. being treated by more than one physician.
d. taking old prescriptions rather than consulting a physician. correct answers ANS: C
Although all the options may offer an opportunity for polypharmacy, the major risk is that of the patient
being treated by more than one physician at the same time.
9. The home health nurse would be most concerned about self-medicating errors for the older adult
living alone who is a type 1 diabetic and is:
a. afflicted with early Parkinson disease.
b. visually impaired.
c. a rheumatoid arthritic with stiffened hands.
d. paralyzed from the waist down. correct answers ANS: B
The visually impaired diabetic is at the greatest risk for a medication error by incorrectly preparing an
insulin injection.
10. The medication nurse is aware that the most reliable method of patient identification for
administration of medications is:
a. a photograph of the patient.
