STUVIA 2024/2025
Chapter 7: Geriatric Considerations
The nurse is caring for an older adult patient who is receiving multiple medications. When monitoring
this patient for potential drug toxicity, the nurse should review which lab values particularly closely
given the patients advanced age?
a. Complete blood count and serum glucose levels
b. Pancreatic enzymes and urinalysis
c. Serum creatinine and liver function tests (LFTs)
d. Serum lipids and electrolytes - ✔✔ANS: C
With liver and kidney dysfunction, the efficacy of drugs is generally increased and may cause toxicity
due to decreased drug clearance. The nurse should review serum creatinine levels to monitor renal
function and LFTs to monitor hepatic function. The other lab tests may be ordered for specific drugs if
they affect those body systems.
An older patient who reports a 2- to 3-year history of upper gastrointestinal (GI) symptoms will begin
taking ranitidine (Zantac) to manage her symptoms. The patient has completed a health history form.
The nurse notes that the patient answered "no" when asked if any medications were being taken.
Which action will the nurse take next?
a. Ask whether the patient uses over-the-counter (OTC) medications.
%
b. Obtain a careful dietary history for the past two weeks.
c. Recommend that the patient take antacid tablets.
d. Suggest that the patient add high-potassium foods to the diet. - ✔✔ANS: A
Many patients do not think of OTC products as medications and often do not list them when asked
about medication use. A patient who takes ranitidine along with an OTC antacid could be duplicating
therapy. A dietary history is important as well but would not be the most important action in this case.
The nurse should not recommend antacid tablets or high-potassium foods before gathering additional
information.
To assist an older, confused patient to adhere to a multidrug regimen, the nurse will provide which
recommendation?
a. Avoid the use of OTC medications.
b. Bring all medications to each clinic visit.
c. Review the manufacturer's information insert about each medication.
d. Save money by getting each drug at the pharmacy with the lowest price. - ✔✔ANS: B
Patients who take multiple medications should be advised to bring medications to each clinic visit.
Patients may take OTC medications as long as those are included in the list of medications reviewed
stuvia
, STUVIA 2024/2025
by the provider. Manufacturers' inserts provide an overwhelming amount of information. Patients
should be advised to use only one pharmacy.
The nurse is caring for an older patient who is taking 25 mg per day of hydrochlorothiazide. The nurse
will closely monitor which lab value in this patient?
a. Coagulation studies
b. White blood count
c. LFTs
d. Serum potassium - ✔✔ANS: D
Older patients who take doses of hydrochlorothiazide between 25 and 50 mg/day have increased risk
of electrolyte imbalances, so potassium should be monitored closely.
The nurse is caring for an 82-year-old patient who takes digoxin to treat chronic atrial fibrillation.
When caring for this patient, to monitor for drug side effects, what will the nurse carefully assess?
a. Blood pressure
b. Heart rate
c. Oxygen saturation
d. Respiratory rate - ✔✔ANS: B
%
Digoxin is primarily eliminated by the kidneys, so a decline in kidney function can cause digoxin
accumulation, which can cause bradycardia. Digoxin should not be given to any patient with a pulse
less than 60 beats per minute.
The nurse is caring for an 80-year-old patient who is taking warfarin (Coumadin). Which action does
the nurse understand is important when caring for this patient?
a. Encouraging the patient to rise slowly from a sitting position
b. Initiating a fall-risk protocol
c. Maintaining strict intake and output measures
d. Monitoring blood pressure frequently - ✔✔ANS: B
Patients who take anticoagulants have an increased risk of hemorrhage. Older patients have an
increased risk of falls that can lead to bleeding complications. Initiating a fall-risk protocol is important.
Warfarin does not affect blood pressure and would not cause orthostatic hypotension. Warfarin does
not alter urine output.
An 80-year-old patient is being treated for an infection. An order for which type of antibiotic would
cause concern for the nurse caring for this patient?
a. Aminoglycoside
b. Cephalosporin
stuvia
Chapter 7: Geriatric Considerations
The nurse is caring for an older adult patient who is receiving multiple medications. When monitoring
this patient for potential drug toxicity, the nurse should review which lab values particularly closely
given the patients advanced age?
a. Complete blood count and serum glucose levels
b. Pancreatic enzymes and urinalysis
c. Serum creatinine and liver function tests (LFTs)
d. Serum lipids and electrolytes - ✔✔ANS: C
With liver and kidney dysfunction, the efficacy of drugs is generally increased and may cause toxicity
due to decreased drug clearance. The nurse should review serum creatinine levels to monitor renal
function and LFTs to monitor hepatic function. The other lab tests may be ordered for specific drugs if
they affect those body systems.
An older patient who reports a 2- to 3-year history of upper gastrointestinal (GI) symptoms will begin
taking ranitidine (Zantac) to manage her symptoms. The patient has completed a health history form.
The nurse notes that the patient answered "no" when asked if any medications were being taken.
Which action will the nurse take next?
a. Ask whether the patient uses over-the-counter (OTC) medications.
%
b. Obtain a careful dietary history for the past two weeks.
c. Recommend that the patient take antacid tablets.
d. Suggest that the patient add high-potassium foods to the diet. - ✔✔ANS: A
Many patients do not think of OTC products as medications and often do not list them when asked
about medication use. A patient who takes ranitidine along with an OTC antacid could be duplicating
therapy. A dietary history is important as well but would not be the most important action in this case.
The nurse should not recommend antacid tablets or high-potassium foods before gathering additional
information.
To assist an older, confused patient to adhere to a multidrug regimen, the nurse will provide which
recommendation?
a. Avoid the use of OTC medications.
b. Bring all medications to each clinic visit.
c. Review the manufacturer's information insert about each medication.
d. Save money by getting each drug at the pharmacy with the lowest price. - ✔✔ANS: B
Patients who take multiple medications should be advised to bring medications to each clinic visit.
Patients may take OTC medications as long as those are included in the list of medications reviewed
stuvia
, STUVIA 2024/2025
by the provider. Manufacturers' inserts provide an overwhelming amount of information. Patients
should be advised to use only one pharmacy.
The nurse is caring for an older patient who is taking 25 mg per day of hydrochlorothiazide. The nurse
will closely monitor which lab value in this patient?
a. Coagulation studies
b. White blood count
c. LFTs
d. Serum potassium - ✔✔ANS: D
Older patients who take doses of hydrochlorothiazide between 25 and 50 mg/day have increased risk
of electrolyte imbalances, so potassium should be monitored closely.
The nurse is caring for an 82-year-old patient who takes digoxin to treat chronic atrial fibrillation.
When caring for this patient, to monitor for drug side effects, what will the nurse carefully assess?
a. Blood pressure
b. Heart rate
c. Oxygen saturation
d. Respiratory rate - ✔✔ANS: B
%
Digoxin is primarily eliminated by the kidneys, so a decline in kidney function can cause digoxin
accumulation, which can cause bradycardia. Digoxin should not be given to any patient with a pulse
less than 60 beats per minute.
The nurse is caring for an 80-year-old patient who is taking warfarin (Coumadin). Which action does
the nurse understand is important when caring for this patient?
a. Encouraging the patient to rise slowly from a sitting position
b. Initiating a fall-risk protocol
c. Maintaining strict intake and output measures
d. Monitoring blood pressure frequently - ✔✔ANS: B
Patients who take anticoagulants have an increased risk of hemorrhage. Older patients have an
increased risk of falls that can lead to bleeding complications. Initiating a fall-risk protocol is important.
Warfarin does not affect blood pressure and would not cause orthostatic hypotension. Warfarin does
not alter urine output.
An 80-year-old patient is being treated for an infection. An order for which type of antibiotic would
cause concern for the nurse caring for this patient?
a. Aminoglycoside
b. Cephalosporin
stuvia
