Nokea
You are a home health nurse and one of your patients, Mrs. Cortes, has age-related macular degeneration and recently diagnosed type 2 diabetes. She speaks only a little English, and you cannot ascertain whether or not she knows how to take her medications because you do not speak Spanish. Which of the following represents the best intervention for addressing her educational need?
- A. Try to find a pharmacist in her neighborhood who speaks Spanish, can explain her medications to her, and will prepare the medication bottle labels in Spanish.
- B. Use a plastic weekly pill dispenser and fill it for her each week.
- C. Ask Mrs. Cortes who in her family can act as a translator and have that person present at the next visit, which is scheduled in 2 days. In the meantime, use a plastic pill dispenser and dispense her medications appropriately for the rest of today and the next.
- D. Try to reach a bilingual family member, but if that is not successful, teach her about the pills she should take by using universal symbols for daytime and nighttime or other symbols such as a clock that will indicate time of day.
Correct Answer: C
Rationale: Using a translator ensures clear communication for education, while a pill dispenser provides immediate medication management, addressing both short-term and long-term needs.
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Anticoagulant drugs (sometimes called 'blood thinners') are broken down (metabolized) in the liver. Which of the following might be an outcome if a patient has undiagnosed liver disease but is started on anticoagulants?
- A. There will be an increase in bleeding tendencies.
- B. The drugs will be ineffective, leading to an increase in clotting tendencies.
- C. The drugs will be excreted from the body unchanged.
- D. The drugs will cause more harm to the liver, possibly leading to liver failure.
Correct Answer: A
Rationale: Undiagnosed liver disease impairs anticoagulant metabolism, leading to drug accumulation and increased bleeding risk due to prolonged effects.
One reason polypharmacy occurs is because an older individual has several different health-care providers prescribing medications for him or her and each is unaware of what the other has prescribed.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Lack of coordination among providers contributes to polypharmacy, increasing drug interaction risks.
Older adults may have decreased sensation. Which of the following is an important intervention aimed at preventing complications from this physiological change?
- A. Check the bath water to make sure it is hot enough.
- B. Check the bath water to make sure it is not too hot.
- C. Make sure the patient wears at least socks when ambulating.
- D. Tell the patient to clip toenails regularly.
Correct Answer: B
Rationale: Checking bath water temperature prevents burns, as decreased sensation increases the risk of injury from hot water.
Which organs of the body are primarily responsible for metabolizing and eliminating medications from the body?
- A. Gastrointestinal tract and kidneys
- B. Pancreas and lungs
- C. Liver and gastrointestinal tract
- D. Liver and kidneys
Correct Answer: D
Rationale: The liver metabolizes medications, and the kidneys eliminate them, making these organs primarily responsible for drug processing in the body.
You care for a resident in a long-term facility. She receives a phone call informing her that her older sister has died. Which of the following interventions will be most helpful for her at this time?
- A. Give her the number of a support group.
- B. Contact the facility's chaplain.
- C. Sit quietly with her.
- D. Tell her that grieving is a process with several stages.
Correct Answer: C
Rationale: Sitting quietly provides immediate emotional support and presence, which is most helpful during acute grief.