Which pharmacokinetic/pharmacodynamic parameter does the aging process least affect?
a. Absorption
b. Distribution
c. Metabolism
d. Excretion
Question 2An elderly man is brought to the geriatrics clinic by his wife because of his increasing confusion. As part of his medical workup, the nurse practitioner orders which of the following laboratory tests? (Select all that apply.)
a. Basic metabolic panel
b. Vitamin D level
c. Thyroid stimulating panel
d. Vitamin B12
e. Serum albumin level
Question 3Factors that affect the pharmacokinetics of lipophilic medications in older adults include:
a. greater adipose tissue ratio to body mass.
b. decreased total body water.
c. increased glomerular filtration rate.
d. increased creatinine clearance.
Question 4When a client asks, What could be causing my triglycerides to be so low; I'm really careful about my diet? the nurse responds by asking the client: (Select all that apply.)
a. Is your type 2 diabetes well managed?
b. Have you ever been diagnosed with renal failure?
c. Do you have a history of pancreatitis?
d. Are you on medication for hyperthyroid-ism?
e. Could you tell me how you are careful about your diet?
Question 5An older woman asks a nurse in the cardiology practice, What is the ideal number that my cho-lesterol levels should be? I am confused by all of the different numbers. The nurse formulates her response on the knowledge that:
a. recent guidelines from the American Heart Association state that there is no one size fits all recommendation and that recom-mendations must be individualized to each patient.
b. recent guidelines from the American Heart Association provide different recommen-dations for individuals age 65-74, 75-84, and over age 85.
c. recent guidelines from the American Heart Association recommend a total serum cholesterol level below 100.
d. recent guidelines from the American Heart Association recommend a total serum cholesterol level over 200.
Question 6An older resident of a long-term care facility diagnosed with dementia has in the last 48 hours become more confused than usual and while usually requiring help with toileting has been incon-tinent of urine.
The client's health care provider orders a complete blood count and serum electrolytes. When the laboratory tests are all within normal limits, the nurse initially:
a. attributes the changes in the resident's functioning to advancing dementia.
b. suggests that the resident be placed on broad-spectrum antibiotics to prevent in-fections.
c. speaks with the health care provider re-garding the changes in the client's func-tion and the possibility of obtaining a urine culture.
d. changes the plan of care to include blad-der training and implement a 24-hour cal-orie count.
Question 7A 78-year-old female patient was recently diagnosed with atrial fibrillation and started on Coumadin (warfarin) for stroke prophylaxis. A nurse provides extensive education on warfarin including the need for routine blood testing.
The woman states the following to a nurse: I understand all that you have taught me, but I do not know what a good number for the INR test is. The nurse bases her response on the knowledge that the recommended INR is:
a. 1.0-2.0.
b. 2.0-3.0.
c. 3.0-4.0.
d. 4.0-5.0.
Question 8A 69-year-old patient in the geriatric clinic has an annual physical examination and a complete blood count and serum electrolytes are drawn.
While the physical examination was uneventful, the laboratory results show an elevated blood urea nitrogen (BUN). The nurse will then:
a. ask that the test be rerun since the client showed no physical signs of renal failure.
b. review the client's medication list since BUN can be affected by many specific medications.
c. instruct the client on collecting a 24-hour urine specimen for a more detailed analy-sis.
d. assure the client that an elevated BUN is normal in older adults.
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