Test Bank for Pharmacotherapeutics for Advanced Practice, 3rd Edition, Virginia Poole Arcangelo

Chapter 6. Principles of Pharmacotherapy in Elderly Patients

 

MULTIPLE CHOICE

 

1. Principles of prescribing for older adults include:

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

 

 

ANS:   B                    PTS:   1

 

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

A.	Increased volume of distribution
B.	Decreased lipid solubility
C.	Decreased plasma proteins
D.	Increased muscle to fat ratio

 

 

ANS:   C                    PTS:   1

 

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

A.	Increased 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

 

 

ANS:   B                    PTS:   1

 

4. A medication review of an elderly person’s medications involves:

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 medication to the visit
C.	Asking what other providers are writing prescriptions for them
D.	All of the above

 

 

ANS:   D                   PTS:   1

 

5. Steps to avoid polypharmacy include:

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 duplications

 

 

ANS:   D                   PTS:   1

 

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

A.	Use of another person’s medications
B.	Hoarding medications
C.	Changing his medication regimen without telling his provider
D.	All of the above

 

 

ANS:   D                   PTS:   1

 

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

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 above

 

 

ANS:   A                    PTS:   1

 

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

A.	Mineral oil
B.	Bulk-forming laxatives such as psyllium
C.	Stimulant laxatives such as senna
D.	Stool softeners such as docusate

 

 

ANS:   D                   PTS:   1

 

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

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

 

 

ANS:   B                    PTS:   1

 

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

A.	Diuretics
B.	Trazodone
C.	Clonazepam
D.	Levodopa

 

 

ANS:   A                    PTS:   1