Chapter 20: Pharmacologic Management

Chapter 20: Pharmacologic Management

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse is preparing to apply a topical cream on the arm of a cognitively impaired, anorexic older adult patient in the terminal stage of lung cancer. The nurse carefully monitors the effectiveness of the medication because its effectiveness will be most negatively impacted by the patient’s:

ANS:  A

Topical drugs face barriers to absorption because the aged skin has decreased water content, a relative decrease in lipid content, and a decrease in tissue perfusion. These changes may result in impaired absorption of some medications that are administered via lotions, creams, ointments, and patches. The other options are not related to medication effectiveness in this situation.

DIF:    Remembering (Knowledge)             REF:   Page 362        OBJ:   20-4

TOP:   Nursing Process: Assessment           MSC:  Health Promotion

2. When administering medications to older adults, the nurse shows an understanding of the effect of aging on drug distribution by monitoring the patient’s:

ANS:  D

With age, particularly for malnourished or frail adults, plasma albumin levels may drop and therefore should be monitored. As a result of decreased sites for protein binding, the activity of highly protein bound drugs, and any side effects caused by these drugs may be increased. The other options may be appropriate for specific drugs, but not in general.

DIF:    Remembering (Knowledge)             REF:   Page 362        OBJ:   20-4

TOP:   Nursing Process: Assessment           MSC:  Physiologic Integrity

3. An older adult patient has been prescribed warfarin (coumadin). The nurse’s primary intervention involves daily review of the patient’s:

ANS:  A

Warfarin therapy is monitored by the international normalized ratio (INR) or INR with prothrombin time.

DIF:    Remembering (Knowledge)             REF:   Page 363        OBJ:   20-4

TOP:   Nursing Process: Assessment           MSC:  Physiologic Integrity

4. A patient with diabetes and hypothyroidism is being admitted to an assisted living facility. During the admission assessment, the patient reports difficulty falling asleep. The nurse shows an understanding of sleep dysfunction and the older patient when asking:

ANS:  D

Insomnia and anxiety are problems that commonly plague older adults. Because insomnia and anxiety often occur secondary to medication side effects or secondary to medical conditions such as dementia, thyroid abnormalities, or depression, proper diagnosis and treatment of any underlying causes of insomnia or anxiety can help this condition. The other questions are appropriate for an intake interview, but not specifically related to the insomnia.

DIF:    Understanding (Comprehension)      REF:   Page 368        OBJ:   20-7

TOP:    Nursing Process: Assessment    MSC:   Physiologic Integrity