Gerontological Nurse Test Pharmacology in Older Adults 2 — Questions and Answers
Question 1: Polypharmacy in older adults is generally defined as the concurrent use of how many or more medications?
- 3 or more
- 5 or more (Correct answer)
- 8 or more
- 10 or more
Correct answer: 5 or more
Polypharmacy is typically defined as the concurrent use of five or more medications, which substantially increases the risk of adverse drug reactions and interactions.
Question 2: Which analgesic is considered potentially inappropriate for older adults and should generally be avoided due to hepatotoxicity risk with chronic use?
- Acetaminophen (exceeding 3g/day) (Correct answer)
- Ibuprofen
- Naproxen
- Celecoxib
Correct answer: Acetaminophen (exceeding 3g/day)
Acetaminophen exceeding 3 grams per day in older adults, especially those with liver disease or heavy alcohol use, poses a significant hepatotoxicity risk.
Question 3: A nurse notices an older adult patient is taking both warfarin and aspirin. The priority nursing action is to:
- Administer both medications as prescribed without concern
- Monitor for signs of bleeding and notify the provider of the potential interaction (Correct answer)
- Hold warfarin until aspirin therapy is complete
- Administer a vitamin K supplement immediately
Correct answer: Monitor for signs of bleeding and notify the provider of the potential interaction
Combining warfarin and aspirin significantly increases bleeding risk; the nurse must monitor for bleeding signs and communicate this high-risk interaction to the prescriber.
Question 4: Which age-related gastrointestinal change affects oral drug absorption in older adults?
- Increased gastric acid production
- Decreased splanchnic blood flow and delayed gastric emptying (Correct answer)
- Enhanced small intestinal absorption surface
- Increased intestinal motility
Correct answer: Decreased splanchnic blood flow and delayed gastric emptying
Reduced splanchnic blood flow and delayed gastric emptying slow the rate of drug absorption but generally do not significantly reduce total drug absorbed.
Question 5: A gerontological nurse is educating a patient about digoxin therapy. Which sign of digoxin toxicity should the patient report immediately?
- Mild constipation
- Visual disturbances such as yellow-green halos (Correct answer)
- Occasional headache
- Mild ankle swelling
Correct answer: Visual disturbances such as yellow-green halos
Yellow-green visual halos are a classic sign of digoxin toxicity, which is more common in older adults due to reduced renal clearance.
Question 6: When initiating a new medication in an older adult, which prescribing principle should guide dosing?
- 'Start low, go slow' to minimize adverse effects (Correct answer)
- 'Start high, taper down' to achieve faster therapeutic effect
- Use standard adult doses unless the patient weighs less than 60 kg
- Double the dose if no effect is seen within 24 hours
Correct answer: 'Start low, go slow' to minimize adverse effects
The 'start low, go slow' principle accounts for age-related pharmacokinetic changes, allowing clinicians to monitor for adverse effects before increasing the dose.
Gerontological Nurse Test Pharmacology in Older Adults 2
Polypharmacy in older adults is generally defined as the concurrent use of how many or more medications?