Chapter 8 Nursing School Test Banks

 

1.

A nurse who is working with an older adult patient who takes eight medications a day wants to promote medication adherence. Which of the following nursing interventions would best promote medication adherence?

A)

Take prescribed medication as needed.

B)

Refill prescription medication when the last dose is taken.

C)

Place pills in a daily or weekly pillbox organized according to hours of the day or mealtimes.

D)

Ask for child-proof caps for all medication bottles.

2.

A nurse is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the nurse will also be careful to observe for:

A)

Possible drug toxicity

B)

Decreased therapeutic effects

C)

Altered drug absorption

D)

Increased drug metabolism

3.

A 72-year-old man who is unable to sleep since admission into the hospital is given a hypnotic medication at 9 PM. The nurse finds the patient drowsy and confused at 10 AM the next day. The nurse is aware that this behavior is most likely due to:

A)

Decreased hepatic function

B)

A toxic effect

C)

An allergic reaction

D)

Increased renal function

4.

A nurse is teaching an older adult patient about polypharmacy. Which of the following statements best describe that term?

A)

Taking more than one drug when the patient deems it necessary

B)

Taking several drugs simultaneously

C)

Increasing the dosage of a drug by the patient

D)

Taking one drug one day and another drug the next day

5.

A nurse is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system. Yet his current serum creatinine level is normal. The nurse will base her plan of care on the understanding that there is:

A)

An increase in drug excretion

B)

A decrease in the effectiveness of the prescribed drugs

C)

An increase in the production of creatinine

D)

A decrease in creatinine overall to be filtered

6.

A nurse is caring for an 81-year-old patient in a long-term care facility who takes nine different medications each day. The patient has a recent diagnosis of seizure disorder and has begun treatment with phenytoin (Dilantin), a highly protein-bound drug. After 1 month of Dilantin therapy, the patient is still extremely drowsy and sluggish. The nurse determines that the prolonged adverse effect is likely due to:

A)

An increase in creatinine to be filtered

B)

Polypharmacy decreasing the number of available protein-binding sites

C)

Increased efficiency of the bloodbrain barrier

D)

The normally low protein-binding properties of Dilantin

7.

A nurse is caring for a 92-year-old patient who is taking multiple drugs and displaying increased cognitive impairment and memory loss. The initial action of the nurse would be to:

A)

Try to distinguish between normal signs of aging and the adverse effects of drug therapy.

B)

Report adverse effects of drug therapy to the prescriber.

C)

Wait several days to see if the symptoms subside.

D)

Hold the patients medications until a doctor can see the patient.

8.

A 72-year-old man with peripheral vascular disease is being given a drug by the intramuscular route. His serum blood level concentrations have been erratic. The nurse suspects that this may be due to:

A)

Altered gastric pH levels

B)

Increased levels of plasma albumin

C)

Decreased blood flow to tissues and muscles which decreases absorption

D)

Decreased gastrointestinal motility

9.

A physician has determined that a 79-year-old patient is not having significant results from his drug therapy. Tests indicate that there may be a problem with absorption. The patient eats a lot of red meat, smokes regularly, and is frequently constipated. Recently, he also reported that he is experiencing sleeplessness. Based on this information, which of the following should the nurse specifically question him about?

A)

Dietary patterns

B)

Unreported health problems, if any

C)

Use of laxatives

D)

Lifestyle

10.

A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patients drug therapy?

A)

Vascular impairment

B)

Mild hypertension

C)

Dietary habits

D)

Chronic arthritis

Answer Key

1.

C

2.

A

3.

A

4.

B

5.

D

6.

B

7.

A

8.

C

9.

C

10.

A

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