Question 1

The GFRs for a 91-year-old woman who weighs 93 pounds and is 5'1" with a serum creatinine of 1.1, and for a 202-pound, 25-year-old male who is 5'9" with the same serum creatinine according to the Cockcroft Gault formula are:

Accepted Answer

A)   25ml/ min and 133 mL/min respectively
B)   25 mL/min and 103 mL/min respectively
C)   22 ml/min and 133 mL/min respectively
D)   22 ml/min and 103 mL/min respectivelyE) A) and B)
F) A) and C)

Question 2

Principles of prescribing for older adults include:

Accepted Answer

A)   Avoiding prescribing any newer high-cost medications
B)   Starting at a low dose and increasing the dose slowly
C)   Keeping the total dose at a lower therapeutic range
D)   All of the aboveE) C) and D)
F) All of the above

Question 3

Glen is an 82-year-old patient who needs to be prescribed a new drug. What changes in elimination should be taken into consideration when prescribing for Glen?

Accepted Answer

A)   Increased glomerular filtration rate (GFR)  will require higher doses of some renally excreted drugs.
B)   Decreased tubular secretion of medication will require dosage adjustments.
C)   Thin skin will cause increased elimination via sweat.
D)   Decreased lung capacity will lead to measurable decreases in lung excretion of drugs.E) A) and B)
F) None of the above

Question 4

In geriatric patients, the percentage of body fat is increased. What are the pharmacologic implications of this physiologic change?

Accepted Answer

A)   A lipid-soluble medication will be eliminated more quickly and not work as well.
B)   A lipid-soluble medication will accumulate in fat tissue and its duration of action may be prolonged.
C)   Absorption of lipid-soluble drugs is impaired in older adults.
D)   The bioavailability of the lipid-soluble drug will be increased in older adults.E) A) and C)
F) A) and B)

Question 5

When an elderly diabetic patient is constipated the best treatment options include:

Accepted Answer

A)   Mineral oil
B)   Bulk-forming laxatives such as psyllium
C)   Stimulant laxatives such as senna
D)   Stool softeners such as docusateE) B) and D)
F) A) and C)

Question 6

To improve positive outcomes when prescribing for the elderly the nurse practitioner should:

Accepted Answer

A)   Assess cognitive functioning in the elder
B)   Encourage the patient to take a weekly "drug holiday" to keep drug costs down
C)   Encourage the patient to cut drugs in half with a knife to lower costs
D)   All of the aboveE) A) and B)
F) None of the above

Question 7

Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie?

Accepted Answer

A)   Increased volume of distribution
B)   Decreased lipid solubility
C)   Decreased plasma proteins
D)   Increased muscle-to-fat ratioE) A) and D)
F) C) and D)

Question 8

Robert is a 72-year-old patient who has hypertension and angina. He is at risk for common medication practices seen in the elderly including:

Accepted Answer

A)   Use of another person's medications
B)   Hoarding medications
C)   Changing his medication regimen without telling his provider
D)   All of the aboveE) C) and D)
F) All of the above D

Question 9

Robert is complaining of poor sleep. Medications that may contribute to sleep problems in the elderly include:

Accepted Answer

A)   Diuretics
B)   Trazodone
C)   Clonazepam
D)   LevodopaE) B) and C)
F) A) and C)

Question 10

All of the following statements about the Beer's List are true except:

Accepted Answer

A)   It is a list of medications or medication classes that should generally be avoided in persons 65 years or older because they are either ineffective or they pose unnecessarily high risk for older persons and a safer alternative is available.
B)   It is derived from the expert opinion of one geriatrician and is not evidence-based.
C)   These criteria have been adopted by the Centers for Medicare and Medicaid Services for regulation of long-term care facilities.
D)   These criteria are directed at the general population of patients over 65 years of age and do not take disease states into consideration.E) All of the above
F) A) and C)

Question 11

A medication review of an elderly person's medications involves:

Accepted Answer

A)   Asking the patient to bring a list of current prescription medications to the visit
B)   Having the patient bring all of their prescription, over-the-counter, and herbal medications to the visit
C)   Asking what other providers are writing prescriptions for them
D)   All of the aboveE) All of the above
F) A) and B)

Question 12

You are reviewing the data from several meta-analyses that addressed the most common causes of adverse drug reactions in the older adult. Which of the following would you find to be decreased and the most common cause of these problems in older adults?

Accepted Answer

A)   Body fat content
B)   Liver function
C)   Renal function/clearance
D)   Plasma albumin levelsE) A) and B)
F) A) and C) C

Question 13

Which of the following is not consistent with the rules for geriatric prescribing:

Accepted Answer

A)   Half-life will be longer in older adults
B)   Steady state is reached more quickly in the older adult
C)   Reduce the number of drugs in the patient's regimen whenever possible
D)   Adverse drug responses present atypically in the older adultE) A) and B)
F) B) and C) B

Question 14

Delta is an 88-year-old patient who has mild low-back pain. What guidelines should be followed when prescribing pain management for Delta?

Accepted Answer

A)   Keep the dose of oxycodone low to prevent development of tolerance.
B)   Acetaminophen is the first-line drug of choice.
C)   Avoid prescribing NSAIDs.
D)   Add in a short-acting benzodiazepine for a synergistic effect on pain.E) A) and C)
F) C) and D)

Question 15

Steps to avoid polypharmacy include:

Accepted Answer

A)   Prescribing two or fewer drugs from each drug class
B)   Reviewing a complete drug history every 12 to 18 months
C)   Encouraging the elderly patient to coordinate their care with all of their providers
D)   Evaluating for duplications in drug therapy and discontinuing any duplicationsE) None of the above
F) C) and D)

Exam 51: Geriatric Patients

The GFRs for a 91-year-old woman who weighs 93 pounds and is 5'1" with a serum creatinine of 1.1, and for a 202-pound, 25-year-old male who is 5'9" with the same serum creatinine according to the Cockcroft Gault formula are:

Correct Answer
verified

Principles of prescribing for older adults include:

Correct Answer
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Glen is an 82-year-old patient who needs to be prescribed a new drug. What changes in elimination should be taken into consideration when prescribing for Glen?

Correct Answer
verified

In geriatric patients, the percentage of body fat is increased. What are the pharmacologic implications of this physiologic change?

Correct Answer
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When an elderly diabetic patient is constipated the best treatment options include:

Correct Answer
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To improve positive outcomes when prescribing for the elderly the nurse practitioner should:

Correct Answer
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Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie?

Correct Answer
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Robert is a 72-year-old patient who has hypertension and angina. He is at risk for common medication practices seen in the elderly including:

Correct Answer
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D

Robert is complaining of poor sleep. Medications that may contribute to sleep problems in the elderly include:

Correct Answer
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All of the following statements about the Beer's List are true except:

Correct Answer
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A medication review of an elderly person's medications involves:

Correct Answer
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You are reviewing the data from several meta-analyses that addressed the most common causes of adverse drug reactions in the older adult. Which of the following would you find to be decreased and the most common cause of these problems in older adults?

Correct Answer
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C

Which of the following is not consistent with the rules for geriatric prescribing:

Correct Answer
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B

Delta is an 88-year-old patient who has mild low-back pain. What guidelines should be followed when prescribing pain management for Delta?

Correct Answer
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Steps to avoid polypharmacy include:

Correct Answer
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Exam 51: Geriatric Patients

The GFRs for a 91-year-old woman who weighs 93 pounds and is 5'1" with a serum creatinine of 1.1, and for a 202-pound, 25-year-old male who is 5'9" with the same serum creatinine according to the Cockcroft Gault formula are:

Correct AnswerverifiedShow Answer

Principles of prescribing for older adults include:

Correct AnswerverifiedShow Answer

Glen is an 82-year-old patient who needs to be prescribed a new drug. What changes in elimination should be taken into consideration when prescribing for Glen?

Correct AnswerverifiedShow Answer

In geriatric patients, the percentage of body fat is increased. What are the pharmacologic implications of this physiologic change?

Correct AnswerverifiedShow Answer

When an elderly diabetic patient is constipated the best treatment options include:

Correct AnswerverifiedShow Answer

To improve positive outcomes when prescribing for the elderly the nurse practitioner should:

Correct AnswerverifiedShow Answer

Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie?

Correct AnswerverifiedShow Answer

Robert is a 72-year-old patient who has hypertension and angina. He is at risk for common medication practices seen in the elderly including:

Correct AnswerverifiedD

Robert is complaining of poor sleep. Medications that may contribute to sleep problems in the elderly include:

Correct AnswerverifiedShow Answer

All of the following statements about the Beer's List are true except:

Correct AnswerverifiedShow Answer

A medication review of an elderly person's medications involves:

Correct AnswerverifiedShow Answer

You are reviewing the data from several meta-analyses that addressed the most common causes of adverse drug reactions in the older adult. Which of the following would you find to be decreased and the most common cause of these problems in older adults?

Correct AnswerverifiedC

Which of the following is not consistent with the rules for geriatric prescribing:

Correct AnswerverifiedB

Delta is an 88-year-old patient who has mild low-back pain. What guidelines should be followed when prescribing pain management for Delta?

Correct AnswerverifiedShow Answer

Steps to avoid polypharmacy include:

Correct AnswerverifiedShow Answer

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D

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C

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B

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