Test Bank for Toward Healthy Aging,
11th Edition Chapter 11: Safe Medication
Use 11th Edition by Theris A. Touhy
1. What factors affect the pharmacokinetics of lipophilic medications in older adults?
a. Greater adipose tissue ratio to body mass
b. Decreased total body water
c. Increased glomerular filtration rate
d. Increased creatinine clearance - ANSANS: 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.
2. Which age-related change affects absorption?
a. Reduced saliva
b. Reduced body water
c. Increased adipose tissue
d. Reduced enzyme activity - ANSANS: A
Most medications are administered orally. This is potentially problematic due to an age-related
reduction in saliva. When combined with medication with strong anticholinergic properties,
swallowing sometimes very difficult. Reduced body water, increased adipose tissue, and
reduced enzyme activity are age-related changes that affect distribution.
3. What factor is an important contribution to polypharmacy in older adults?
a. Inadequate communication among medical care providers
b. Implementation of Medicare Part D prescription drug benefit
c. Use of generic medications
d. Increasing popularity of dietary and herbal supplements - ANSANS: A
When communication among patients, nurses, other health care providers, and caregivers
becomes fragmented, the risk for duplicative medications, inappropriate medications, potentially
unsafe dosages, and potentially preventable interactions is heightened. 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.
4. What area do nurses have the greatest effect on the safe, effective medication therapy of an
older client?
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. - ANSANS: 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).
5. When developing a teaching plan for an older, newly diagnosed diabetic client, the nurse best
ensures an understanding of oral hypoglycemic medications when providing what source of
teaching?
a. The package insert and assessing the client's reading skills
b. Website address for the American Diabetes Association
c. Oral explanations and sending the client home with a written copy
d. Copy of information in paragraph form as opposed to numbered line fashion - ANSANS: C
Providing memory aids, such as written information including charts, is effective in reinforcing
teaching. Package inserts are not always written in lay language that is 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 using a large-size font.
6. The nurse suspects that a client is experiencing tardive dyskinesia when observing that
behavior?
a. Involuntary moving
b. Involuntary twisting of facial muscles
c. Inability to voluntarily get up out of a chair.
d. Bilateral hand tremors - ANSANS;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.
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