id
int64 1
104
| question
stringlengths 54
358
| op_a
stringlengths 3
106
⌀ | op_b
stringlengths 4
101
| op_c
stringlengths 4
112
| op_d
stringlengths 3
98
| op_e
stringclasses 4
values | op_f
stringclasses 1
value | cop/0
stringclasses 4
values | cop/1
stringclasses 3
values | cop/2
stringclasses 2
values | choice_type
stringclasses 2
values | exp
stringlengths 54
719
| subject_name
stringclasses 1
value | topic_name
stringclasses 6
values |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
101 | The nurse is performing an admission assessment on an 80-year-old patient who has frequent hospital admissions. The patient appears more disoriented and confused than usual. Which action by the nurse is correct? | Asking about medication doses | Asking for a neurologist consult | Requesting orders for liver function tests | Suspecting impaired renal function | null | null | op_a | null | null | single | An initial sign of drug toxicity in elderly patients may be confusion or changes in behavior. The nurse should ask about drug doses and notify the provider of the behaviors. The provider may order further evaluation based on examination of the patient. | Pharmacology | Geriatric Considerations |
101 | An older patient takes ibuprofen for arthritis pain. The patient tells the nurse that the ibuprofen causes gastrointestinal (GI) upset. Which action will the nurse take with this patient? | Ask the provider about having the patient take a different medication. | Instruct the patient to cut the ibuprofen dose in half to avoid GI upset. | Explain that all drugs have adverse effects. | Explore options to help decrease the drug side effects. | null | null | op_d | null | null | single | Older adults are more likely to experience drug side effects, and nurses should be aware of measures that may decrease these side effects and thus improve adherence. | Pharmacology | Geriatric Considerations |
102 | The nurse is caring for a 78-year-old patient who lives independently. The patient will begin a new drug regimen that requires taking multiple drugs at various times per day. Which intervention is appropriate for the nurse to implement with this patient? | Ask the patient's family members to monitor the patient's drug regimen. | Develop a log to record the times each drug will be taken. | Reinforce the need to take the drugs as scheduled. | Write the medication administration times on each prescription label. | null | null | op_b | null | null | single | The patient should be advised to keep a medication record of drugs and when they will be taken. The patient is independent, and this helps maintain independence. Family member support is essential when older patients are confused. Reinforcing information without providing a means to keep track of the medications does not necessarily improve compliance. Writing medication times on prescription labels does not help to organize the medication schedule. | Pharmacology | Geriatric Considerations |
103 | The nurse is preparing an 80-year-old patient for discharge home from the hospital. The patient will receive several new medications. The patient lives alone but has several family members who stop by every day. Which suggestions will the nurse make for this family? (Select all that apply.) | Ask the pharmacy for non-childproof medication bottles. | Ask the patient to record all medications and the times they are taken. | Place the pills in an organizer container. | Provide the patient with the drug manufacturer information sheets. | Put water bottles near pills for convenience. | null | op_a | op_c | op_e | multiple | To help older patients with compliance, medications should be convenient and easy to open. Asking the pharmacist for non-childproof containers will help make medications easier to get. Using an organizer container helps patients remember which drugs should be taken at what time. Placing water bottles nearby eliminates a step in the process and increases the likelihood that a medication will be taken on time. | Pharmacology | Geriatric Considerations |
104 | Which drug properties are problematic for older patients? (Select all that apply.) | Drugs with anticholinergic effects | Drugs that are highly protein-bound | Drugs with a short half-life | Drugs that undergo hepatic conjugation | Drugs with a narrow therapeutic range | null | op_a | op_b | op_e | multiple | Older patients are more susceptible to drug side effects, especially those that cause anticholinergic effects. Older patients have a loss of protein-binder sites for drugs, so those that are highly protein-bound will have higher than usual serum levels and can cause toxicity. Drugs with a narrow therapeutic range require closer monitoring in all patients, but especially in older patients. Drugs with a short half-life are preferred because older patients have a decreased ability to metabolize and excrete drugs. Hepatic conjugation is usually not influenced by older age, liver diseases, or drug interaction. | Pharmacology | Geriatric Considerations |