Chapter 06: Geriatric Considerations

Chapter 06: Geriatric Considerations

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. 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 closely?

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. 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.

 

DIF:    Cognitive Level: Understanding (Comprehension)               REF:    p. 53

TOP:    Nursing Process: Assessment

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. An older patient who reports a 2- to 3-year history of upper gastrointestinal (GI) symptoms will begin taking ranitidine (Zantac) to treat this disorder. 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 medications. 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.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 52

TOP:    Nursing Process: Assessment

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. 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 by the provider. Manufacturers’ inserts provide an overwhelming amount of information. Patients should be advised to use only one pharmacy.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 56

TOP:    Nursing Process: Nursing Intervention: Patient Teaching

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. 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.

 

DIF:    Cognitive Level: Understanding (Comprehension)               REF:    p. 53

TOP:    Nursing Process: Evaluation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

5. 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

Most of the digoxin is 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.

 

DIF:    Cognitive Level: Understanding (Comprehension)               REF:    p. 53

TOP:    Nursing Process: Evaluation

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies