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An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy?
- A. Drug therapy will be based on the patient's weight.
- B. Drug therapy will be based on the patient's age.
- C. The patient will receive the maximum dose that is expected to reduce the blood pressure.
- D. The patient will receive the lowest possible dose at first, and then the dose will be increased as needed.
Correct Answer: D
Rationale: As a general rule, dosing for elderly patients should follow the principle of 'start low, and go slow,' meaning start with the lowest possible dose and increase slowly if needed, based on patient response. Dosing is not primarily based on weight or age, and maximum doses are not initially given.
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The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity?
- A. The lungs are immature.
- B. The kidneys are small.
- C. The liver is not fully developed.
- D. Excretion of the drug occurs quickly.
Correct Answer: C
Rationale: A neonate's liver is not fully developed and cannot detoxify many drugs, contributing most to drug toxicity. Immature lungs and small kidneys play lesser roles, and excretion is slow, not fast, due to organ immaturity.
The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age appropriate for this child?
- A. Give the injection without any advanced preparation.
- B. Give the injection, and then explain the reason for the procedure afterward.
- C. Offer a brief, concrete explanation of the procedure at the patient's level and with the parent or caregiver present.
- D. Prepare the child in advance with details about the procedure without the parent or caregiver present.
Correct Answer: C
Rationale: For a 4-year-old child, offering a brief, concrete explanation about a procedure just beforehand, with the parent or caregiver present, is appropriate. No preparation, explaining afterward, or preparing without a parent are not age-appropriate interventions.
The nurse recognizes that an elderly patient may experience a reduction in the stomach's ability to produce hydrochloric acid. This change may result in which effect?
- A. Delayed gastric emptying
- B. Increased gastric acidity
- C. Decreased gastrointestinal motility
- D. Altered absorption of some drugs
Correct Answer: D
Rationale: Reduction in the stomach's ability to produce hydrochloric acid is an aging-related change that results in a decrease in gastric acidity and may alter the absorption of some drugs. It does not directly cause delayed gastric emptying, increased gastric acidity, or decreased gastrointestinal motility.
For accurate medication administration to pediatric patients, the nurse must consider which of these factors?
- A. Organ maturity
- B. Renal output
- C. Body temperature
- D. Height
Correct Answer: A
Rationale: To administer medications to pediatric patients accurately, one must take into account organ maturity, body surface area, age, and weight. Renal output, body temperature, and height alone are not primary considerations for accurate medication administration.
When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations?
- A. West nomogram
- B. Clark rule
- C. Height-to-weight ratio
- D. Milligram per kilogram of body weight formula
Correct Answer: D
Rationale: The milligram per kilogram formula, based on body weight, is the most common method of calculating doses for pediatric patients. West nomogram and Clark rule are available but less commonly used, and height-to-weight ratio is not a standard method.