# An 82-year-old client with multiple chronic conditions is prescribed several new medications. Which nursing action is the MOST important priority when administering medications to this older adult client? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=541814 > language: ko > subject: Growth & Development ## 문제 An 82-year-old client with multiple chronic conditions is prescribed several new medications. Which nursing action is the MOST important priority when administering medications to this older adult client? ## 보기 1. Assess for potential drug interactions and contraindications before administration **✔ 정답** 2. Ensure the client can swallow pills without difficulty 3. Verify the client's insurance coverage for the new medications 4. Schedule medications at convenient times for the client **정답: 1** ## 해설 Assessing for drug interactions and contraindications is the highest priority due to age-related physiological changes and polypharmacy risks in older adults. Other options address important but secondary concerns like swallowing ability or scheduling. ## 심화 해설 Clinical Context & Priority Setting When administering medications to an 82-year-old client with multiple chronic conditions, the nurse must recognize that polypharmacy is not simply a high pill count—it is a clinically significant risk factor for adverse drug events. The literature consistently identifies older adults with multimorbidity as a population with a heightened risk of adverse drug reactions due to the complexity of their medication regimens [3]. In this context, the foundational step of the nursing process (assessment) must focus on safety. Before any medication is administered, the nurse must determine whether the prescribed agent is safe for that specific client at that specific time. This makes assessing for potential drug interactions and contraindications the most critical priority. Why Assessment of Interactions and Contraindications is the Priority The rationale for prioritizing this assessment over the other listed actions is rooted in the concept of direct physiological harm prevention. Polypharmacy carries the potential for increased risk and severity of adverse reactions, which can lead to hospitalizations [1]. A new medication added to an existing complex regimen can precipitate a dangerous interaction, such as a pharmacodynamic interaction causing profound hypotension or a pharmacokinetic interaction leading to drug toxicity. An evidence-based nursing approach to reducing polypharmacy risks emphasizes the critical role of the nurse in monitoring for these dangers [4]. While ensuring the client can swallow (option 2) is a component of safe administration, it does not address the systemic, potentially life-threatening risk posed by a drug-drug or drug-disease interaction. The nurse’s role as a medication expert involves contributing to the appropriate use of medications, which begins with a thorough pre-administration safety assessment [1]. Analysis of Other Options - Option 2: Ensure the client can swallow pills without difficulty. This is a standard safety check before administration but is a secondary physical assessment. A client could have a safe swallow yet still experience a severe adverse drug reaction from an interaction that was not assessed. The systemic risk of a drug interaction poses a greater threat to physiological integrity. - Option 3: Verify the client's insurance coverage for the new medications. This action addresses a psychosocial and financial barrier to adherence, which is an important long-term concern. However, it does not address the immediate physiological safety of the client during the medication administration process. The immediate priority is preventing harm from the medication itself. - Option 4: Schedule medications at convenient times for the client. Scheduling for convenience is a strategy to improve adherence and reduce the burden of a complex regimen, which is a recognized challenge in deprescribing and medication management . However, this is a care-coordination task that follows, not precedes, the determination that the medications are safe to take together. Safety must be established before convenience can be considered. Integration of Evidence into Nursing Practice The challenges of deprescribing and safe prescribing in older adults highlight why the nurse's pre-administration assessment is so vital. Clinical decision support systems are being developed to help identify potentially inappropriate medications in geriatric patients because the risk of adverse drug events is so high [3]. In the absence of such a system at the bedside, the nurse’s critical thinking becomes the primary safety net. An evidence-based nursing intervention model for older surgical patients with polypharmacy demonstrated that a structured nursing process, which includes rigorous medication review, can effectively reduce medication errors and adverse reactions [4]. This review is not a passive acceptance of a prescription but an active, critical assessment for contraindications and interactions. The nurse acts as a crucial final checkpoint in the therapeutic process, ensuring that each medication administered is appropriate and safe for the older adult’s unique physiological and pharmacological profile [1].References (research sources) - [1]Deprescribing: Reducing Harm, Enhancing Care.Research articleMatos C, Pinheiro C. (2026) · DOI: 10.5041/rmmj.10575 - [3]A comparative evaluation of two clinical decision support systems for safer prescribing in older adults: an exploratory single-patient case study.Research articleBobrova V, Desselle S, Heinämäki J, Volmer D. (2026) · DOI: 10.3389/fphar.2026.1830248 - [4]Evidence-based nursing to reduce polypharmacy risks in older cholecystectomy patients.Research articleDeng YH, Zeng CF, Zhou J. (2025) · DOI: 10.4240/wjgs.v17.i12.113860 ## 임상 시나리오 Medication Safety in Older Adults with PolypharmacyPrioritizing Assessment to Prevent Adverse Drug Events For an older adult with polypharmacy, the nurse's priority before administration is to assess for drug interactions and contraindications. This step directly prevents the most immediate and severe physiological harm, such as drug toxicity or profound hypotension. A thorough assessment involves checking each new medication against the client's full profile, including prescription drugs, over-the-counter agents, and supplements. Use a current, evidence-based drug reference to screen for pharmacokinetic and pharmacodynamic interactions. CautionDo not confuse a stable, long-term medication list with safety. The risk of an adverse drug event spikes with each newly added agent. Always re-assess the entire regimen, not just the new prescription, for cumulative anticholinergic burden, CNS depression, or nephrotoxic effects. ## 핵심 개념 - **Polypharmacy** — The concurrent use of multiple medications, often defined as five or more, which significantly increases the risk of adverse drug events, interactions, and geriatric syndromes. - **Contraindication** — A specific situation or condition where a particular drug, procedure, or treatment should not be used because it may be harmful to the patient. - **Pharmacodynamic interaction** — An interaction where one drug alters the effect of another at its site of action, leading to additive, synergistic, or antagonistic effects. - **Pharmacokinetic interaction** — An interaction where one drug alters the absorption, distribution, metabolism, or excretion of another, changing its concentration in the body. ## 같은 주제 문제 - [A 78-year-old client with heart failure and diabetes is taking 12 different medications. T…](https://mymerci.kr/pages/nclex_q.php?qn_id=541815) - [An 82-year-old client with multiple chronic conditions is taking 12 different medications.…](https://mymerci.kr/pages/nclex_q.php?qn_id=541816) - [An 82-year-old client with multiple chronic conditions is prescribed several new medicatio…](https://mymerci.kr/pages/nclex_q.php?qn_id=541817) --- More free questions: [기출문제](https://mymerci.kr/) _학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._