A nurse is caring for an 81-year-old client in a long-term care facility who takes nine different
medications each day. The client 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 client is
still extremely drowsy and sluggish. The nurse determines that the prolonged adverse effect is likely due
to: - (answer)polypharmacy decreasing the number of available protein-binding sites.
A client will soon be discharged home from the hospital after a successful coronary artery bypass graft
(CABG). During client education about drug regimen, the nurse should prioritize teaching about: -
(answer)potential adverse effects of the drugs that the client will be taking.
A client has been diagnosed with cardiovascular disorder. The client is age 68; suffers from intermittent
joint pain and is under drug therapy; eats meat, salads, and fruits; prefers alternative herb medications
along with drug therapy; sometimes smokes; he lives alone and is looked after by a caregiver. Which
item of information has the greatest implication for planning his drug therapy? - (answer)prefers
alternative herb medications
An 82-year-old is suffering from acute anxiety and is prescribed alprazolam (Xanax) by the health care
provider. What steps can the provider take to ensure that the client will be at a decreased risk for
injury? - (answer)Prescribe a smaller dose
A 76-year-old client with congestive heart failure is being admitted to the hospital. The client states only
taking medications that the health care provider prescribes, but when the nurse assesses the
medications, three over-the-counter laxatives are in the client's bag of medications. What concerns does
the nurse have about this omission? - (answer)The laxatives can interact with and complicate prescribed
drug therapy.
Why is it important for the nurse to obtain baseline information from a client, such as a drug profile, an
accurate history of the client's usual abilities, and changes in abilities or health status? - (answer)To
determine any new signs and symptoms in the client that could be related to drug therapy
The elderly client is taking five prescription and over-the-counter medications. The nurse calculates the
client is at risk for two-drug combinations that could interact to produce an adverse effect. The number
of these two-drug combinations is: - (answer)10
The client is at risk for 10 two-drug combinations that could interact to produce an adverse effect. 1 2 3
4 5 1-----2x----3xx---4xxx--5xxxx- x indicates two-drug combination
, Nursing Foundations 2:
An older adult client has had two falls in the period of a week. The care provider's willingness to
consider discontinuation of the medication demonstrates a consideration of what safety-related action?
- (answer)risk-to-benefit ratio
What are the most common medical problems seen in older adults? (Select all that apply.)
Arthritis
Heart disease
Ventral hernia
Diabetes mellitus - (answer)Diabetes mellitus
Arthritis
Heart disease
The nurse should caution an older adult client against using diphenhydramine hydrochloride because of
what increased risk? - (answer)Confusion
A 79-year-old woman who takes several medications for a variety of chronic health problems has been
prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the
woman to take the pill at the same time of day that she takes some of her other medications. What is
the most likely rationale for the nurse's advice? - (answer)Integrating the new drug into the client's
existing schedule promotes adherence.
A nurse is conducting an assessment of a client who has recently had several changes made to the drug
regimen. What assessment question most directly addresses the safety implications of the client's drug
regimen? - (answer)"Do you take any herbal supplements or alternative medications?"
The nurse should be aware that many older adults take multiple prescribed and over-the-counter (OTC)
drugs. What is taking several drugs simultaneously known as? - (answer)Polypharmacy
When should the nurse assess all the client's prescribed medications? (Select all that apply.)
-when a medication is discontinued
-when the client orders medications from another country