Drug Therapy in Geriatric Patients –
Nursing Pharmacology – Examination
Practice Questions with Answers
Introduction:
This document covers drug therapy principles in geriatric
patients, focusing on pharmacokinetics, pharmacodynamics,
polypharmacy, adverse drug reactions, and age-related
changes in absorption, distribution, metabolism, and
excretion. It consists of practice questions with detailed
answers commonly used for nursing pharmacology exams and
clinical decision-making in elderly care.
Exam Questions and Answers:
Based on changes in hepatic function in older adult patients,
which adjustment should the nurse expect for oral medications
that undergo extensive first pass metabolism?
a. A higher dose should be used with the same time schedule.
b. The interval between doses should be increased.
c. No change is necessary; metabolism will not be affected.
d. The interval between doses should be reduced. -Answer:- B
,The interval between doses of the medication should be
increased in older adult patients, because drugs that undergo
the first pass effect may not be broken down as well as in an
individual with full liver function. A higher dose of the
medication is not indicated, because toxic effects could occur.
A change in administration may be indicated in older adults,
because their metabolism is affected. The interval between
doses should not be reduced but increased.
A thin older adult woman is admitted to the hospital after
several days of vomiting, diarrhea, and poor intake of foods
and fluids. She has not voided since admission. In preparing to
care for this patient, the nurse will look for what laboratory
values to help guide medication administration?
Select all that apply.
a. Creatinine clearance
b. Gastric pH
c. Plasma drug levels
d. Serum albumin
e. Serum creatinine -Answer:- A,C,D
Creatinine clearance is the best way to evaluate renal function
in the older adult. Plasma drug levels are important for
determining if the patient has toxic or subtherapeutic drug
levels. Serum albumin may be decreased, especially in patients
, who are thin, are chronically undernourished, or have been
vomiting, and the decreased level may result in higher levels
of drugs that normally bind to proteins. Gastric pH is not
important; most GI changes result in lowered absorption and
less free drug. Serum creatinine levels are related to the
amount of lean muscle mass, which may be low in older adult
patients, and do not reflect renal function.
A nurse is reviewing an older adult patient's chart before
giving medications. Which patient information is of most
concern?
a. Chronic constipation
b. Increased body fat
c. Low serum albumin
d. Low serum creatinine -Answer:- C
Low serum albumin reduces protein binding of drugs and can
cause levels of free drug to rise, increasing the risk of toxicity.
Altered gastrointestinal (GI) absorption is not a major factor in
drug sensitivity in the older adult, although delayed gastric
emptying can delay drug responses. Increased body fat can
alter drug distribution, causing reduced responses in lipid-
soluble drugs, however, it is not the finding of greatest
concern to the nurse. Low serum creatinine is a function of
Nursing Pharmacology – Examination
Practice Questions with Answers
Introduction:
This document covers drug therapy principles in geriatric
patients, focusing on pharmacokinetics, pharmacodynamics,
polypharmacy, adverse drug reactions, and age-related
changes in absorption, distribution, metabolism, and
excretion. It consists of practice questions with detailed
answers commonly used for nursing pharmacology exams and
clinical decision-making in elderly care.
Exam Questions and Answers:
Based on changes in hepatic function in older adult patients,
which adjustment should the nurse expect for oral medications
that undergo extensive first pass metabolism?
a. A higher dose should be used with the same time schedule.
b. The interval between doses should be increased.
c. No change is necessary; metabolism will not be affected.
d. The interval between doses should be reduced. -Answer:- B
,The interval between doses of the medication should be
increased in older adult patients, because drugs that undergo
the first pass effect may not be broken down as well as in an
individual with full liver function. A higher dose of the
medication is not indicated, because toxic effects could occur.
A change in administration may be indicated in older adults,
because their metabolism is affected. The interval between
doses should not be reduced but increased.
A thin older adult woman is admitted to the hospital after
several days of vomiting, diarrhea, and poor intake of foods
and fluids. She has not voided since admission. In preparing to
care for this patient, the nurse will look for what laboratory
values to help guide medication administration?
Select all that apply.
a. Creatinine clearance
b. Gastric pH
c. Plasma drug levels
d. Serum albumin
e. Serum creatinine -Answer:- A,C,D
Creatinine clearance is the best way to evaluate renal function
in the older adult. Plasma drug levels are important for
determining if the patient has toxic or subtherapeutic drug
levels. Serum albumin may be decreased, especially in patients
, who are thin, are chronically undernourished, or have been
vomiting, and the decreased level may result in higher levels
of drugs that normally bind to proteins. Gastric pH is not
important; most GI changes result in lowered absorption and
less free drug. Serum creatinine levels are related to the
amount of lean muscle mass, which may be low in older adult
patients, and do not reflect renal function.
A nurse is reviewing an older adult patient's chart before
giving medications. Which patient information is of most
concern?
a. Chronic constipation
b. Increased body fat
c. Low serum albumin
d. Low serum creatinine -Answer:- C
Low serum albumin reduces protein binding of drugs and can
cause levels of free drug to rise, increasing the risk of toxicity.
Altered gastrointestinal (GI) absorption is not a major factor in
drug sensitivity in the older adult, although delayed gastric
emptying can delay drug responses. Increased body fat can
alter drug distribution, causing reduced responses in lipid-
soluble drugs, however, it is not the finding of greatest
concern to the nurse. Low serum creatinine is a function of
