PRESCRIBING STRATEGIES FOR OLDER ADULTS Self-Assessment Answers and Rationales
1. The correct answer is b. Rationale: Most references cite 65 years of age as the threshold for significant age-related changes to be impactful. 2. The correct answer is c. Rationale: Renal function declines with advancing age and is more impactful to the safety and efficacy of many medications than are the other choices. 3. The correct answer is b. Rationale: Medications that treat the same condition may not be appropriate for all patients or clinical situations. Alternatively, some medications would be preferable to others based on patient-specific factors or the drug’s mechanism of action that is favorable based on a patient’s comorbidity.
4. The correct answer is d. Rationale: Deprescribing focuses on removing those medications from a patient’s regimen that pose more risk than benefit or that are no longer clinically indicated. 5. The correct answer is d. Rationale: Brand loyalty is not an element of a comprehensive medication review. 6. The correct answer is a. Rationale: Acetaminophen has a broad safety profile and lacks any significant safety concerns when used at recommended doses.
PRESCRIBING STRATEGIES FOR OLDER ADULTS Final Examination Questions Select the best answer for each question and mark your answers on the Final Examination Answer Sheet found on page 123, or complete your test online at EliteLearning.com/Book 66. Which of the following lacks guidance on rational medication use in elderly patients? a. Beers criteria. b. Harriet Lane Handbook. 71. With regard to the medical care of elderly patients, what does the acronym PIM mean? a. Prolonged interval medication.
b. Pharmacologically inactive medication. c. Potentially inappropriate medication. d. Possibly interacting medication. 72. Which of the following is a good example of a prescribing cascade? a. Adding a beta blocker to an ACE inhibitor for uncontrolled hypertension. b. Changing antidepressants from nortriptyline to sertraline due to lack of response. c. Adding diphenhydramine to treat metoclopramide- induced dystonic reactions. d. Starting senna at the same time as an opioid to avoid constipation. 73. The stated goals of the AGS Beers criteria encompass all of the following EXCEPT: a. Reduce the out-of-pocket medication expenses of older patients. b. Educate clinicians and patients. c. Establish a framework for quality improvement initiatives in elderly medication management. d. Reduce exposure of elderly patients to certain medications through improved medication selection. 74. Medication reconciliation should be performed: a. At each primary care provider’s visit with a patient. b. When a patient is transferred between an ICU and a general inpatient bed. c. Upon discharge from the hospital. d. In all of the above situations. 75. A notable difference between the AGS Beers criteria and the STOPP/START criteria is that: a. Only the AGS Beers criteria suggest medications that should be avoided. b. There are more START criteria than AGS Beers criteria. c. The AGS Beers criteria list is updated every other year versus every five years for STOPP/START. d. The START criteria guides medications that should be employed/added for a given clinical situation.
c. STOPP/START. d. Package insert. 67. A 76-year-old widow in your clinic reports difficulty sleeping at night. Which of the following sequential interventions provides the safest approach? a. Zolpidem, melatonin, warm milk. b. Turn off the TV 1 hour before bedtime, chamomile tea, alprazolam. c. Read a book instead of watching TV in bed, white noise, melatonin. d. Warm milk, turn off the TV at 10 PM, eszopiclone. 68. Your 81-year-old otherwise healthy patient was recently admitted to the hospital after sustaining motor vehicle accident–related injuries. Now at the preadmission baseline, which medication initiated during hospitalization would be appropriate to continue beyond discharge? a. Omeprazole for stress ulcer prophylaxis. b. Haloperidol for agitation/delirium. c. Enoxaparin for deep vein thrombosis(DVT) prophylaxis. d. Acetaminophen for pain. 69. Which of the following statements best describes natural supplements’ safety and/or efficacy? a. They are natural, so they are much safer than synthetic pharmaceuticals. b. Natural supplements are not consistently subject to the same quality, scientific rigor, and health benefit claims as commercial pharmaceuticals are. c. Natural supplements are less likely to have inert ingredients or impurities in their formulation. d. Natural supplements do not interact with commercially manufactured medications. 70. What is the relationship between aging, serum creatinine values, and renal function? a. Renal function slowly declines with advancing age, and serum creatinine may not be a consistently reliable indicator of current renal function. b. Renal dosing adjustments for medication use in older adults are unnecessary as long as serum creatine values remain below 1.0 mg/dL. c. Serum creatinine values falsely increase with age-related muscle loss increases. d. Serum creatinine values falsely increase with age-related muscle loss decreases.
Course Code: RPTTX03PA
Page 90
Book Code: RPTTX2024
EliteLearning.com/Pharmacy-Technician
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