Nokea
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.
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The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug?
- A. Laxatives
- B. Anticoagulants
- C. Sedatives
- D. Antidepressants
Correct Answer: C
Rationale: Sedatives and hypnotics often cause confusion, daytime sedation, ataxia, lethargy, forgetfulness, and increased risk for falls in the elderly. Laxatives, anticoagulants, and antidepressants may cause other adverse effects, but not the specific ones mentioned.
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.
The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?
- A. The patient is experiencing multiple illnesses.
- B. The patient uses one medication for an illness several times per day.
- C. The patient uses over-the-counter drugs for an illness.
- D. The patient uses multiple medications simultaneously.
Correct Answer: D
Rationale: Polypharmacy usually occurs when a patient has several illnesses and takes medications for each of them, possibly prescribed by different specialists who may be unaware of other treatments the patient is undergoing. It involves multiple medications, not just multiple illnesses, a single medication, or only over-the-counter drugs.
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.
An 83-year-old woman has been given a thiazide diuretic to treat heart failure. She and her caregiver should be told to watch for which problems?
- A. Constipation and anorexia
- B. Fatigue, leg cramps, and dehydration
- C. Daytime sedation and lethargy
- D. Edema, nausea, and blurred vision
Correct Answer: B
Rationale: Electrolyte imbalance, leg cramps, fatigue, and dehydration are common complications when thiazide diuretics are given to elderly patients. The other options do not describe typical complications associated with thiazide diuretics in the elderly.