Geriatric Medication Precautions Nursing

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Geriatric Medication Precautions

Question 1:

Some reasons why it is difficult for older adults to have safe and efficacious drug experiences include all of the following except:

A) Seniors use more drugs.

B) Older adults are more likely to suffer from chronic disease.

C) Aging may change pharmacokinetics and/or pharmacodynamics of drugs.

D) Older persons are not interested in taking their medication.

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Geriatric Medication Precautions

Question 2:

What are some physical changes an elderly person may experience that may prevent them from taking their medication properly.

A) Older adults may have trouble swallowing.

B) Older people struggle with reduced hearing.

C) Seniors experience deteriorating eyesight.

D) All of the above

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Geriatric Medication Precautions

Question 3:

An elderly patient that may experience a decline in short term memory can miss a dose from his medication, take less dose than prescribed, or double a dose from his medication.

A) True

B) False

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Geriatric Medication Precautions

Question 4:

Some of the potential drug-related problems an older patient can experience are listed below. Which one of those listed involves a drug therapeutic response.

A) Drug-drug interactions

B) Drug-disease interactions

C) Drug ineffectiveness

D) Drug specific adverse events

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Geriatric Medication Precautions

Question 5:

Prescribing cascade is said to describe what occurs when an initial drug is prescribed to a patient which produces negative signs and symptoms (adverse effects) that are mistaken to be indications of a new condition and then the doctor prescribes a new drug for these symptoms.

A) True

B) False

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Geriatric Medication Precautions

Question 6:

Inappropriate prescribing can involve which of the following:

A) Inappropriate drug

B) Wrong dose

C) Incorrect duration of therapy

D) All of the above

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Geriatric Medication Precautions

Question 7:

Under prescribing refers to a drug a patient has an indication for, does not have any contraindications for but is not receiving because it has not been prescribed. This is similar to which one of the concepts listed below.

A) Drug omission

B) Polypharmacy

C) Prescribing Cascade

D) Potential Inappropriate Medication

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Geriatric Medication Precautions

Question 8:

The drugs that are typically under prescribed in older adults include which of the following:

A) Opioids

B) Anticoagulants

C) Beta Blockers

D) All of the above

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Geriatric Medication Precautions

Question 9:

IGRIMUP is a group of global medical professionals that are bringing focus to reducing polypharmacy and inappropriate prescribing for older adults. What does IGRIMUP stand for?

A) International Grounding to Resolve Independent Medication Under Prescribing

B) International Group for Reducing Inappropriate Medication Use and Polypharmacy

C) Intercontinental Global Effort to Reduce Inappropriate Medication Under Prescribing

D) None of the above

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Geriatric Medication Precautions

Question 10:

Some recommendations from the IGRIMUP include all the ones listed below except:

A) Review for deprescribing

B) Include all drugs in the review

C) Perform a physical assessment

D) None of the above

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Geriatric Medication Precautions

Question 11:

There are several tools that are used to help decrease inappropriate medication prescribing and polypharmacy some of these include:

A) Beers Criteria

B) STOPP/START

C) Medication Appropriateness Index

D) All of the above

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Geriatric Medication Precautions

Question 12:

The Beers Criteria focus is on five different elements. Which of the statements listed below is not one of the elements?

A) Preferred drugs by the elderly

B) Drugs to avoid in the elderly with a pre-existing disease state

C) Drug interactions of special interest for older adults

D) Drug dosing alterations due to reduced kidney function

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Geriatric Medication Precautions

Question 13:

Some of the types of drugs listed in the Beers Criteria as Potentially Inappropriate Medications for older persons include:

A) Antispasmodics like Belladonna alkaloids because of anticholinergic properties.

B) Vitamin supplements

C) Anti-itch creams

D) None of the above

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Geriatric Medication Precautions

Question 14:

The Beers List suggests not combining certain drugs together because of drug-drug interactions. One of their recommendations states to avoid using in older persons two drugs with anticholinergic properties at the same time because there is an increased risk of cognitive decline.

A) True

B) False

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Geriatric Medication Precautions

Question 15:

According to the Beers List, it is not recommended to combine opioids with benzodiazepines because there is higher risk for what?

A) Nervousness

B) Addictive behavior

C) Potential overdose

D) None of the above

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Geriatric Medication Precautions

Question 16:

As per the Beers Criteria on drug-disease interactions, Cilostazol is expected to potentially increase the incidence of mortality if used in older patients with heart failure.

A) True

B) False

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Geriatric Medication Precautions

Question 17:

The drug Apixaban, according to the Beers Criteria, is not recommended for use in elderly patients with which of the following conditions:

A) Older patients with atrial fibrilation

B) Those with a CrCl of less than 25 ml/min

C) Older individuals who have a history of stroke

D) Elderly persons with migraines

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Geriatric Medication Precautions

Question 18:

Prasugrel is a drug that demonstrates benefit in older persons with diabetes or myocardial infarction. It should be used with caution in patients older than 75 years old because of the increased risk of what?

A) Heart palpitations

B) Tremors

C) Bleeding

D) Dizziness

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Geriatric Medication Precautions

Question 19:

As per the Beers Criteria on drug-disease interactions, Benzodiazepines are not recommended for the elderly patients with seizures.

A) True

B) False

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Geriatric Medication Precautions

Question 20:

The STOPP/START criteria is a tool created to address polypharmacy and inappropriate prescribing. What does STOPP stand for?

A) Screening Tool of Older Person’s Prescriptions

B) Steady Tool to Order Practical Prescriptions

C) Study to Organize People’s Prescriptions

D) None of the above

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Geriatric Medication Precautions

Question 21:

What are the main objectives of prescribing in the STOPP/START method?

A) Prescribing should be intended to improve medication appropriateness.

B) Prescribing should be practical and help reduce drug costs.

C) Prescribing should make every effort to decrease adverse drug events in the elderly.

D) All of the above

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Geriatric Medication Precautions

Question 22:

All prescribing tools suggest the following: The intent of providing the accurate, evidence-based information is strictly as a tool to facilitate appropriate decision making for prescribers. Ultimately, the final drug selection rests on the prescribing clinician.

A) True

B) False

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Geriatric Medication Precautions

Question 23:

Deprescribing is the actual procedure used to reduce the dose of a medication or remove it from the patient’s drug regimen all together if it is no longer needed. Which of the following scenarios best matches the action of deprescribing?

A) Pharmacist recommends the discontinuation of simvastatin because patient is on rosuvastatin.

B) Doctor reduces the dose of Donepezil from 10mg to 5mg due to severe nausea.

C) Older patient decides not to take his medication because he feels dizzy.

D) A and B only

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Geriatric Medication Precautions

Question 24:

All of the following are questions used to determine the Medication Appropriateness Index except:

A) Does the drug have an indication?

B) Are the directions correct?

C) Have the patient missed doses on a regular basis?

D) Are there clinically significant drug-drug interactions?

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Geriatric Medication Precautions

Question 25:

The ARMOR tool is another strategic tool that can help tackle polypharmacy, prescribing cascade, and potentially inappropriate medications. What does ARMOR stand for?

A) Assess, Review, Minimize, Optimize and Reassess

B) Align, Review, Method, Organization, Research

C) Access, Receive, Manage, Organize, and Review

D) None of the above

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Geriatric Medication Precautions

Question 26:

Other supportive prescribing tools include:

A) Good Palliative Geriatric Practice Algorithm

B) FORTA (Fit For The Aged)

C) Geriatric Risk Assessment MedGuide (GRAM)

D) All of the above

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Geriatric Medication Precautions

Question 27:

CV is a 75 -year-old male that mainly gets his medications from the VA. He comes to your pharmacy to fill his prescription for a 21-day supply of prednisone. He wants to know where he can find a bottle of Naproxen over the counter which he uses for knee pain. He will go get it while he waits for his prescription. How should you proceed?

A) Point him in the direction of the over-the-counter pain relievers and fill his prednisone quickly so he does not wait long.

B) Tell him he needs to take his prednisone with food because it may aggravate his stomach.

C) Advise patient it is not recommended that he take the OTC Naproxen with Prednisone because it increases the risk of gastrointestinal bleed.

D) B and C only

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Geriatric Medication Precautions

Question 28:

According to the Beers Criteria, in the drug-disease interactions, older patients should avoid which of the following drugs when they have Delirium/Cognitive impairment/Dementia.

A) Drugs with Anticholinergic effects

B) Antipsychotics

C) Corticosteroids

D) All of the above

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Geriatric Medication Precautions

Question 29:

A Comprehensive Medication Review is one of the best ways to perform a drug review that can identify polypharmacy, drug duplication, potentially inappropriate drugs, drug-drug interactions, and drug-disease interactions.

A) True

B) False

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Geriatric Medication Precautions

Question 30:

Which of the following are suggestions you can give to your elderly patient to help them use their medication safely and effectively.

A) Patient should be familiar with all their medications, name and what it is for.

B) The patient should carry a current list of all their medications.

C) Reminders such as sticky notes, written schedules or pillboxes should be used to remember to take medication.

D) All of the above

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