Which of the following drugs would most likely be on the Beer's List? (Select All that Apply.)

Ibuprofen

Diazepam

Warfarin

Digoxin

Metformin

Answer and Explanation

Correct Answer : A,B,D

A. Ibuprofen: NSAIDs such as ibuprofen are on the Beers List due to the risk of gastrointestinal bleeding, renal impairment, and hypertension in older adults. Safer alternatives are recommended when possible.

B. Diazepam: Long-acting benzodiazepines like diazepam are included because they increase the risk of sedation, confusion, and falls in older adults. Shorter-acting agents or nonpharmacologic approaches are preferred.

C. Warfarin: Warfarin is not broadly listed as inappropriate but requires careful monitoring of INR and diet. It is often necessary for anticoagulation and is not automatically contraindicated for older adults.

D. Digoxin: Digoxin is on the Beers List at doses greater than 0.125 mg/day due to the risk of toxicity, particularly with reduced renal clearance in older adults. Lower doses or alternatives are often considered safer.

E. Metformin: Metformin is not on the Beers List and is commonly used safely in older adults, except in cases of severe renal impairment where lactic acidosis risk is increased. It is generally a preferred first-line therapy for type 2 diabetes.

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Correct Answer is C

Explanation

A. Speaking to the client sternly and instructing the client to open their mouth and cooperate immediately: A stern approach often increases anxiety and resistance in dementia patients. Such communication can escalate uncooperative behavior rather than promote cooperation.

B. Quickly performing oral hygiene without explanation since the client is uncooperative: Rushing through oral care without engaging the client disregards their dignity and may increase agitation. This method can also compromise safety, as the client may resist.

C. Involving the client in the process of oral hygiene, such as using the hand-over-hand technique to brush the client’s teeth: This approach engages the client, promotes cooperation, and respects autonomy. The hand-over-hand technique allows the caregiver to guide movements while giving the client a sense of participation and control.

D. Having another nurse aide assist in holding the client’s mouth open with a tongue depressor: Forcing the mouth open with a tongue depressor can cause injury and distress. It is considered unsafe, undignified, and should not be used as a strategy for routine oral care in dementia patients

A. Salmeterol B. Metoprolol C. Misoprostol D. Albuterol

Correct Answer is D

Explanation

A. Salmeterol: Salmeterol is a long-acting beta agonist (LABA) used for maintenance therapy in COPD and asthma. It is not suitable for acute symptom relief because its onset of action is too slow for emergency situations.

B. Metoprolol: Metoprolol is a beta-blocker used primarily for hypertension, arrhythmias, and heart failure. It would worsen bronchoconstriction in COPD patients by blocking beta-2 receptors in the lungs.

C. Misoprostol: Misoprostol is a prostaglandin analog used for preventing gastric ulcers and for cervical ripening in obstetrics. It has no role in the management of acute respiratory distress or COPD exacerbations.

D. Albuterol: Albuterol is a short-acting beta agonist (SABA) with rapid onset of action. It is the drug of choice for acute bronchospasm and COPD exacerbations, as it quickly relaxes bronchial smooth muscle and relieves shortness of breath.

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Which of the following drugs would most likely be on the Beer's List? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In a long-term care facility, a nurse is having a discussion with the nurse aides about ways to deal with dementia clients who are uncooperative with mouth care. Appropriate methods to use include which of the following?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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