A nurse is reviewing the medication list of an older adult client who takes several medications for different health problems.
The nurse recognizes that polypharmacy in older adults can increase the risk of which of the following?
Adverse drug reactions.
Medication adherence
Drug-drug interactions.
Therapeutic effects.
The Correct Answer is A
The correct answer is A.
Adverse drug reactions.
Polypharmacy, which refers to the effects of taking multiple medications concurrently to manage coexisting health problems, is common among older adults.
It is defined as the regular use of at least five medications.
Polypharmacy can lead to an increase in geriatric syndromes, decrease in functional outcomes, and increased mortality.
One of the major risks of polypharmacy is adverse drug reactions, which are harmful or unintended effects of a medication that occur at normal doses.
Adverse drug reactions can result from drug-drug interactions, drug-disease interactions, drug-age interactions, or inappropriate prescribing.
Adverse drug reactions can cause symptoms such as confusion, dizziness, falls, bleeding, or organ damage.
They can also lead to hospitalizations, increased health care costs, and reduced quality of life.
Choice B is wrong because medication adherence, which is the extent to which patients take medications as prescribed by their health care providers, can actually decrease with polypharmacy.
This is because taking multiple medications can be complex, costly, and burdensome for older adults, especially if they have cognitive impairment or low health literacy.
Medication adherence can also be influenced by patients’ beliefs, preferences, and expectations about their medications.
Choice C is wrong because drug-drug interactions are not a risk of polypharmacy per se, but rather a cause of adverse drug reactions.
Drug-drug interactions occur when two or more drugs affect each other’s pharmacokinetics (absorption, distribution, metabolism, excretion) or pharmacodynamics (mechanism of action, efficacy, toxicity).
Drug-drug interactions can alter the therapeutic effects or safety of a medication.
Choice D is wrong because therapeutic effects are the intended or desired effects of a medication that benefit the patient’s health condition.
Therapeutic effects can decrease with polypharmacy due to drug-drug interactions that reduce the efficacy of a medication.
Therapeutic effects can also be diminished by prescribing cascade, which is a phenomenon where a new medication is prescribed to treat a symptom that is actually an adverse drug reaction of another medication.
Normal ranges for blood pressure are.
≤120/80.
mmHg for normal,.
120−129/80.
mmHg for elevated,.
130−139/80−89.
mmHg for stage 1 hypertension, and.
≥140/90.
mmHg for stage 2 hypertension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is B.
Diphenhydramine.Diphenhydramine is an antihistamine and sedative medication that can causedeliriumin older adults, especially when used in high doses or for a long time.Delirium is a serious change in mental abilities that results in confused thinking and reduced awareness of the surroundings.It can be caused by various factors, such as infections, medications, surgery, or alcohol or drug use or withdrawal.Delirium can have serious consequences, such as increased risk of falls, complications, and death.
Choice A is wrong because acetaminophen is a pain reliever and fever reducer that does not usually cause delirium in older adults.
However, acetaminophen overdose can cause liver damage and altered mental status.
Choice C is wrong because metformin is an oral medication that lowers blood sugar levels in people with type 2 diabetes.
Metformin does not typically cause delirium in older adults.
However, metformin can cause a rare but serious condition called lactic acidosis, which can cause confusion and other symptoms.
Choice D is wrong because lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure and prevents heart failure.
Lisinopril does not usually cause delirium in older adults.
However, lisinopril can cause a rare but serious condition called angioedema, which can cause swelling of the face, tongue, or throat and difficulty breathing.
Normal ranges for some relevant laboratory tests are:.
• Albumin: 3.5-5.0 g/dL.
• Potassium: 3.5-5.0 mEq/L.
• Total cholesterol: <200 mg/dL.
• Hemoglobin: 13.5-17.5 g/dL for men; 12.0-15.5 g/dL for women.
Correct Answer is A
Explanation
The correct answer is A.
Decreased metabolic rate.This is because the metabolic rate is the amount of energy that the body uses to maintain its functions, and it tends to decline with age due to various factors, such as loss of muscle mass, reduced activity, hormonal changes, and decreased thyroid function.
A lower metabolic rate means that the body produces less heat and therefore feels colder more easily.
Choice B is wrong because increased blood pressure is not a normal physiological change with aging, but rather a risk factor for cardiovascular diseases that can be influenced by lifestyle, genetics, and other factors.
Choice C is wrong because increased sweat gland activity is not a normal physiological change with aging, but rather a sign of hyperhidrosis, which is a condition that causes excessive sweating due to overactive sweat glands.Sweat glands actually decrease in number and function with age, which can impair thermoregulation and increase the risk of heat-related illnesses.
Choice D is wrong because decreased body fat is not a normal physiological change with aging, but rather a result of malnutrition, illness, or other causes.Body fat actually tends to increase with age, especially in the abdominal region, due to hormonal changes, reduced physical activity, and lower metabolic rate.
Body fat can act as an insulator and help maintain body temperature.
Normal ranges for metabolic rate vary depending on age, sex, body size, activity level, and other factors.
A general estimate for resting metabolic rate (RMR) is 10 calories per kilogram of body weight per day for men and 9 calories per kilogram of body weight per day for women.
However, this may not reflect the actual metabolic rate of an individual, as it does not account for the effects of food intake, exercise, or environmental factors.
Therefore, it is better to measure metabolic rate using indirect calorimetry or other methods that can capture these variables.
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