A 70-year-old patient has just received a drug that can cause sedation.
What would be the priority nursing diagnosis for this patient?
Deficient Knowledge, unfamiliar with drug therapy.
Ineffective health maintenance, need for medication.
Risk for injury, related to adverse effect of the drug.
Noncompliance, cost of the drug.
The Correct Answer is C
Choice A rationale
This choice is incorrect. Although knowledge about drug therapy is important, it is not the most immediate concern in this scenario. The priority nursing diagnosis should address the potential risks associated with the drug’s side effects, such as sedation, which can impair the patient’s ability to function safely.
Choice B rationale
This choice is incorrect. While effective health maintenance and medication adherence are crucial, they do not directly address the immediate risk posed by the drug’s sedative effects. The priority should be to prevent harm and ensure the patient’s safety, which involves mitigating the risk of injury related to sedation.
Choice C rationale
This choice is correct. The primary concern with sedative drugs, especially in elderly patients, is the increased risk of falls and injuries due to impaired coordination and alertness. The nursing diagnosis “Risk for injury, related to adverse effect of the drug” directly addresses this critical issue, making it the priority in this situation.
Choice D rationale
This choice is incorrect. Noncompliance due to the cost of the drug is an important consideration, but it does not address the immediate safety risk posed by sedation. The priority should be to ensure the patient’s safety by managing the side effects that could lead to injury. Cost-related concerns can be addressed after ensuring that the patient is not at immediate risk of harm. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Generic medications are equivalents to brand name drugs and are not typically a priority query unless there's an issue of consistency in medication use.
Choice B rationale
Over-the-counter (OTC) medications can interact with prescription medications or have side effects, so it’s crucial to know if a patient is taking any.
Choice C rationale
This question is important for women who are pregnant but is not the primary concern when assessing general medication use.
Choice D rationale
Orphan drugs are used to treat rare conditions and are less likely to be encountered in a general assessment.
Correct Answer is C
Explanation
Choice A rationale
Exhibiting the ability to provide self-care may not be realistic for a patient with advanced Alzheimer’s disease. Cognitive decline may impair their ability to perform daily activities independently, necessitating assistance from caregivers.
Choice B rationale
Improving memory for recent events is unlikely in advanced Alzheimer’s disease, as the condition typically involves progressive memory loss and cognitive decline. New medications may help manage symptoms, but reversing memory loss is not a realistic goal.
Choice C rationale
Receiving appropriate assistance for care needs is a realistic and achievable goal for patients with advanced Alzheimer’s disease. As the disease progresses, patients will require increasing levels of support to ensure their safety and well-being.
Choice D rationale
Demonstrating improved cognitive function is unlikely in advanced Alzheimer’s disease. While medications may help manage symptoms, the progressive nature of the disease means that cognitive decline will continue, and improvement is not a realistic expectation.
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