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.

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is A

Explanation

The correct answer is A.

“I will use a walker until I can walk without pain.” This statement indicates a need for further teaching because the client should use a walker or other assistive device until they have regained their balance, flexibility and strength, not just until the pain subsides.Using a walker too long or too little can affect the healing process and the stability of the new hip joint.

Choice B is correct because the client should avoid crossing their legs or bending their hip more than 90 degrees to prevent dislocating the new hip joint.

Choice C is correct because the client should sleep on their back with a pillow between their legs to keep the hip in a neutral position and prevent excessive internal or external rotation.

Choice D is correct because the client should apply ice to their hip if it becomes swollen or inflamed to reduce pain and inflammation.The client should also elevate their leg and notify their healthcare provider if they notice any signs of infection, such as fever, chills, redness, warmth or drainage from the incision site.

Normal ranges for hip replacement surgery recovery vary depending on the individual and the type of surgery, but some general guidelines are:.

• The client should be able to walk with a cane or crutches within 2 to 4 weeks after surgery.

• The client should be able to resume most daily activities within 6 to 12 weeks after surgery.

• The client should avoid high-impact activities, such as running, jumping or contact sports, for at least 6 months after surgery.

• The client should have regular follow-up visits with their healthcare provider and physical therapist to monitor their progress and adjust their treatment plan as needed.

A. Promote physical activity and exercise to maintain muscle strength, joint mobility, balance and coordination. B. Encourage adequate nutrition and hydration to prevent malnutrition, dehydration and electrolyte imbalance. C. Manage chronic diseases and medications to prevent complications, adverse effects and polypharmacy. D. Provide assistive devices and adaptive equipment to enhance mobility, safety and independence E. Modify the environment to reduce hazards, improve accessibility and facilitate self-care.

Correct Answer is ["A","B","C","E"]

Explanation

The correct answer isA, B, C and E.These interventions are consistent with the best practices for optimizing functional status in the elderly.

Some explanations for the choices are:.

• Choice A is correct because physical activity and exercise can help maintain muscle strength, joint mobility, balance and coordination, which are essential for functional independence and quality of life.

• Choice B is correct because adequate nutrition and hydration can prevent malnutrition, dehydration and electrolyte imbalance, which can impair physical and cognitive function and increase the risk of complications.

• Choice C is correct because managing chronic diseases and medications can prevent complications, adverse effects and polypharmacy, which can affect functional status and increase the need for health care services.

• Choice D is wrong because providing assistive devices and adaptive equipment is not an intervention to improve functional status, but rather to enhance mobility, safety and independence for patients who already have functional limitations.

The question asks for interventions to improve functional status, not to compensate for it.

• Choice E is correct because modifying the environment can reduce hazards, improve accessibility and facilitate self-care, which can promote functional independence and prevent injuries or falls.

The normal ranges for blood glucose and blood pressure for older adults with diabetes and hypertension are:.

• Blood glucose: 80-130 mg/dL before meals and less than 180 mg/dL after meals.

• Blood pressure: less than 140/90 mmHg or individualized based on comorbidities and risk factors.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge instructions to an older adult client who had a hip replacement surgery. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is A

Explanation

A nurse is implementing interventions to improve the functional status of an older adult client who has diabetes and hypertension. Which of the following interventions should the nurse include? (Select all that apply.).

Correct Answer is ["A","B","C","E"]

Explanation

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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?