Chapter 09: Geropharmacology
Touhy: Ebersole & Hess' Toward Healthy Aging, 9th Edition
MULTIPLE CHOICE
1. Factors that affect the pharmacokinetics of lipophilic medications in older adults include:
a. greater adipose tissue ratio to body mass.
b. decreased total body water.
c. increased glomerular filtration rate.
d. increased creatinine clearance.
ANS: A
Older adults have a higher ratio of adipose (fat) tissue where lipophilic (fat-soluble)
medications can be stored thus resulting in a potential for an accumulation of the medication
and potentially fatal overdoses. Older adults have a decrease in lean body mass and an
increase in fat. An increased body mass would not affect lipophilic medication absorption.
Older adults have a decreased glomerular filtration rate, which begins to decline as early as
age 25. Older adults have a decrease in overall kidney function.
m
er as
DIF: Cognitive Level: Remembering REF: p. 103
co
TOP: Integrated Process: Teaching/Learning
eH w
MSC: Client Needs: Health Promotion and Maintenance
o.
rs e
2. Which pharmacokinetic/pharmacodynamic parameter does the aging process least affect?
ou urc
a. Absorption
b. Distribution
c. Metabolism
d. Excretion
o
aC s
ANS: A
vi y re
There is no conclusive evidence that the absorptive process is changed appreciably in older
adults. Distribution, metabolism, and excretion are all affected significantly by aging.
DIF: Cognitive Level: Remembering REF: p. 107
ed d
TOP: Integrated Process: Teaching/Learning
ar stu
MSC: Client Needs: Health Promotion and Maintenance
3. What factor is an important contribution to polypharmacy in older adults?
a. Inadequate communication among medical care providers
is
b. Implementation of Medicare Part D prescription drug benefit
Th
c. Use of generic medications
d. Increasing popularity of dietary and herbal supplements
ANS: A
sh
Polypharmacy is often the result of inadequate communication among specialists or between
specialists and primary care providers. Medicare Part D prescription drug benefits influence
the financing of medication but are not directly related to polypharmacy. Generic medications
are a way to keep medication costs down. The use of herbal supplements is an important
factor when examining drug interactions or adverse reactions but is not a direct factor related
to polypharmacy.
This study source was downloaded by 100000822778155 from CourseHero.com on 04-20-2021 08:41:36 GMT -05:00
https://www.coursehero.com/file/14903581/c9/
, DIF: Cognitive Level: Remembering REF: p. 104
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
4. The area in which nurses have the greatest effect on the safe, effective medication therapy of
an older client is:
a. educating the client to all aspects of the medication.
b. assessing for adverse reactions to the medication.
c. monitoring overall health of the client as it is affected by the medication.
d. evaluating the outcomes resulting from the medication.
ANS: A
Nurses have the greatest opportunity to impact medication use and improve treatment
outcomes through patient education. Assessing for reactions, monitoring effects, and
evaluation of outcomes all depend on the client’s understanding and compliance with the
medication therapy (i.e., are affected by client education).
DIF: Cognitive Level: Analyzing REF: p. 110
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
m
er as
5. When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse best
co
eH w
ensures an understanding of oral hypoglycemic medications when providing:
a. the package insert and assessing the client’s reading skills.
o.
b. the client with the website address for the American Diabetes Association.
c. rs e
oral explanations and sending the client home with a written copy.
ou urc
d. the information in paragraph form as opposed to numbered line fashion.
ANS: C
o
Providing memory aids, such as written information including charts, is effective in
aC s
reinforcing teaching. Package inserts are not always written in lay language that is
vi y re
understandable and appropriate to the reading level of the older adult. The font size of the
print may be too small for aging eyes. Not all older adults are computer literate or comfortable
with the use of the computer. This method may be more effective for younger clients. A more
effective manner in which to provide written information to older adults is in the form of lists
ed d
using a large-size font.
ar stu
DIF: Cognitive Level: Applying REF: pp. 110–112
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
is
6. The nurse suspects that a client is experiencing tardive dyskinesia when observing that:
Th
a. the client can’t seem to stop moving.
b. the client’s facial muscles are twisting involuntarily.
c. the client not able to get up out of a chair.
sh
d. the client’s hand tremors so much that drinking from a cup is difficult.
ANS: B
Facial movements and involuntary twisting of the limbs, trunk, neck, and face is the definition
of tardive dyskinesia. A compulsion to be in motion is the definition of akathisia. An inability
to move is the definition of akinesia. A bilateral tremor and rigidity reflects Parkinsonian
symptoms.
This study source was downloaded by 100000822778155 from CourseHero.com on 04-20-2021 08:41:36 GMT -05:00
https://www.coursehero.com/file/14903581/c9/
Touhy: Ebersole & Hess' Toward Healthy Aging, 9th Edition
MULTIPLE CHOICE
1. Factors that affect the pharmacokinetics of lipophilic medications in older adults include:
a. greater adipose tissue ratio to body mass.
b. decreased total body water.
c. increased glomerular filtration rate.
d. increased creatinine clearance.
ANS: A
Older adults have a higher ratio of adipose (fat) tissue where lipophilic (fat-soluble)
medications can be stored thus resulting in a potential for an accumulation of the medication
and potentially fatal overdoses. Older adults have a decrease in lean body mass and an
increase in fat. An increased body mass would not affect lipophilic medication absorption.
Older adults have a decreased glomerular filtration rate, which begins to decline as early as
age 25. Older adults have a decrease in overall kidney function.
m
er as
DIF: Cognitive Level: Remembering REF: p. 103
co
TOP: Integrated Process: Teaching/Learning
eH w
MSC: Client Needs: Health Promotion and Maintenance
o.
rs e
2. Which pharmacokinetic/pharmacodynamic parameter does the aging process least affect?
ou urc
a. Absorption
b. Distribution
c. Metabolism
d. Excretion
o
aC s
ANS: A
vi y re
There is no conclusive evidence that the absorptive process is changed appreciably in older
adults. Distribution, metabolism, and excretion are all affected significantly by aging.
DIF: Cognitive Level: Remembering REF: p. 107
ed d
TOP: Integrated Process: Teaching/Learning
ar stu
MSC: Client Needs: Health Promotion and Maintenance
3. What factor is an important contribution to polypharmacy in older adults?
a. Inadequate communication among medical care providers
is
b. Implementation of Medicare Part D prescription drug benefit
Th
c. Use of generic medications
d. Increasing popularity of dietary and herbal supplements
ANS: A
sh
Polypharmacy is often the result of inadequate communication among specialists or between
specialists and primary care providers. Medicare Part D prescription drug benefits influence
the financing of medication but are not directly related to polypharmacy. Generic medications
are a way to keep medication costs down. The use of herbal supplements is an important
factor when examining drug interactions or adverse reactions but is not a direct factor related
to polypharmacy.
This study source was downloaded by 100000822778155 from CourseHero.com on 04-20-2021 08:41:36 GMT -05:00
https://www.coursehero.com/file/14903581/c9/
, DIF: Cognitive Level: Remembering REF: p. 104
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
4. The area in which nurses have the greatest effect on the safe, effective medication therapy of
an older client is:
a. educating the client to all aspects of the medication.
b. assessing for adverse reactions to the medication.
c. monitoring overall health of the client as it is affected by the medication.
d. evaluating the outcomes resulting from the medication.
ANS: A
Nurses have the greatest opportunity to impact medication use and improve treatment
outcomes through patient education. Assessing for reactions, monitoring effects, and
evaluation of outcomes all depend on the client’s understanding and compliance with the
medication therapy (i.e., are affected by client education).
DIF: Cognitive Level: Analyzing REF: p. 110
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
m
er as
5. When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse best
co
eH w
ensures an understanding of oral hypoglycemic medications when providing:
a. the package insert and assessing the client’s reading skills.
o.
b. the client with the website address for the American Diabetes Association.
c. rs e
oral explanations and sending the client home with a written copy.
ou urc
d. the information in paragraph form as opposed to numbered line fashion.
ANS: C
o
Providing memory aids, such as written information including charts, is effective in
aC s
reinforcing teaching. Package inserts are not always written in lay language that is
vi y re
understandable and appropriate to the reading level of the older adult. The font size of the
print may be too small for aging eyes. Not all older adults are computer literate or comfortable
with the use of the computer. This method may be more effective for younger clients. A more
effective manner in which to provide written information to older adults is in the form of lists
ed d
using a large-size font.
ar stu
DIF: Cognitive Level: Applying REF: pp. 110–112
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
is
6. The nurse suspects that a client is experiencing tardive dyskinesia when observing that:
Th
a. the client can’t seem to stop moving.
b. the client’s facial muscles are twisting involuntarily.
c. the client not able to get up out of a chair.
sh
d. the client’s hand tremors so much that drinking from a cup is difficult.
ANS: B
Facial movements and involuntary twisting of the limbs, trunk, neck, and face is the definition
of tardive dyskinesia. A compulsion to be in motion is the definition of akathisia. An inability
to move is the definition of akinesia. A bilateral tremor and rigidity reflects Parkinsonian
symptoms.
This study source was downloaded by 100000822778155 from CourseHero.com on 04-20-2021 08:41:36 GMT -05:00
https://www.coursehero.com/file/14903581/c9/
