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WorksheetsChapter 5 Pharm Final Review
Total questions: 71
Worksheet time: 36mins
What age range defines an adult according to the document?
19 to 64 years
18 to 65 years
20 to 60 years
21 to 63 years
What is the term for the use of several drugs during the same period?
Monotherapy
Polypharmacy
Pharmacodynamics
Pharmacokinetics
Which of the following is a common age-related condition mentioned in the document?
Asthma
Pulmonary insufficiency
Migraine
Hypertension
What does the risk to benefit ratio refer to in the context of medication?
The cost of medication versus its effectiveness
The adverse effects of medications in relation to desired effects
The time taken for medication to work versus its side effects
The dosage of medication versus its potency
At what age is a person considered an older adult according to the document?
60 years or older
65 years or older
70 years or older
75 years or older
What is polypharmacy in older adults defined as?
The use of a single medication
The use of multiple medications
The use of herbal supplements
The use of alternative therapies
According to the Lau et al. (2010–2019) study, which condition was found in adults 80+?
Type 2 diabetes
Nonvalvular atrial fibrillation
Non–small cell lung cancer
Hypertension
What must nurses closely monitor in older adults according to the nursing implications?
Diet and exercise routines
Reactions to medications
Sleep patterns
Social interactions
What is the study of drug actions on target cells and resulting biochemical changes called?
Pharmacokinetics
Pharmacodynamics
Pharmacogenomics
Pharmacotherapy
How do age-related physiologic changes in older adults affect drug actions?
They enhance drug effectiveness.
They have no impact on drug actions.
They can alter how drugs act.
They make drugs act faster.
What is a consequence of fewer receptor sites or reduced receptor affinity in older adults?
Increased drug effectiveness
Reduced drug effectiveness
Faster drug metabolism
Enhanced drug clearance
What happens to the volume of distribution for fat-soluble drugs in older adults?
It decreases
It remains the same
It increases
It fluctuates randomly
What is the effect of decreased renal function on drug clearance in older adults?
Faster clearance of drugs
No change in drug clearance
Slower clearance of drugs
Enhanced drug metabolism
What is the number one cause of death in older adults?
Cancer
Cardiovascular disease
Respiratory disease
Diabetes
What percentage of older adults are affected by hypertension?
50-60%
60-70%
70-80%
80-90%
Which of the following is often not enough for treating hypertension in older adults?
Medication
Lifestyle changes
Surgery
Physical therapy
Which medication should be avoided as first-line therapy for systolic hypertension in older adults?
ACE inhibitors
Beta-blockers
Angiotensin II receptor blockers
Long-acting calcium channel blockers
For which conditions is Digoxin (Lanoxin) indicated in older adults?
Diabetes and hypertension
Heart disease and atrial fibrillation
Osteoporosis and arthritis
Asthma and COPD
What is the usual maximum dose per day for a patient with atrial fibrillation?
0.125 mg/day
0.25 mg/day
0.5 mg/day
1.0 mg/day
According to the Beers Criteria, which of the following is NOT a focus of the guidelines?
Medications to avoid
Dosage adjustments for chronic kidney disease
Drug-drug interactions
Medications for pediatric care
What is the loading dose for supraventricular tachydysrhythmia?
0.125 mg
0.25 mg
0.5 mg
1.0 mg
What percentage of medical admissions are accounted for by adverse drug events (ADEs)?
1%–3%
3%–10%
10%–15%
15%–20%
What is a key consideration when using opioids in end-of-life care?
They should be avoided entirely.
They require careful patient assessment.
They are always safe to use.
They should be used in high doses.
What does the Drug Burden Index (DBI) assess?
Cumulative exposure to medications with anticholinergic and sedative effects
The effectiveness of cardiac medications
The cost of medications for older adults
The nutritional value of medications
Which factor is NOT considered in the Drug Burden Index (DBI)?
Type of drug
Total number of medications
Daily dosing
Patient's age
What is a clinical impact of a high Drug Burden Index (DBI)?
Improved cognitive function
Increased fall risk in long-term care residents
Enhanced mobility
Reduced medication side effects
What percentage of ED visits related to psychiatric medication ADEs in adults ≥65 is Zolpidem responsible for?
10%
21%
35%
50%
Which of the following is a common adverse effect of anticholinergic medications in older adults?
Enhanced memory
Improved vision
Memory impairment
Increased energy
Which condition is associated with an increased risk of urinary retention in high-risk populations?
Diabetes
Benign prostatic hypertrophy (BPH)
Hypertension
Osteoporosis
Which cardiac medication is not appropriate as first-line therapy for atrial fibrillation?
Digoxin
Amiodarone
Methyldopa
Rivaroxaban
What risk is associated with the use of Digoxin (Lanoxin)?
Risk of digoxin toxicity
Increased blood pressure
Enhanced appetite
Improved sleep quality
What is a potential risk when Trimethoprim–Sulfamethoxazole is used with ACE inhibitors or ARBs?
Increased risk of hypokalemia
Increased risk of hyperkalemia
Increased risk of hypotension
Increased risk of hypertension
Which antidepressant is known to cause anticholinergic effects, sedation, and orthostatic hypotension?
Dextromethorphan/Quinidine
Amitriptyline hydrochloride
Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)
Cyclobenzaprine
What should be avoided in patients with fractures or at risk of falls?
Dextromethorphan/Quinidine
Amitriptyline hydrochloride
Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs)
Hydroxyzine hydrochloride
Which medication is associated with a risk of serotonin syndrome?
Cyclobenzaprine
Flurazepam hydrochloride
Methocarbamol
Diphenhydramine hydrochloride
What is a potential side effect of Diphenhydramine hydrochloride?
Increased alertness
Urinary retention
Hyperactivity
Sedation
What is a significant risk associated with the use of Ketorolac?
High risk of GI bleeding
Can cause confusion
Pulmonary toxicity
Decreased absorption
Which of the following is a potential side effect of Meperidine hydrochloride (Demerol)?
High risk of GI bleeding
Can cause confusion
Renal toxicity
Decreased distribution
What are the risks associated with the antibiotic Nitrofurantoin (Macrodantin)?
Pulmonary, renal, and hepatic toxicity
High risk of GI bleeding
Confusion and dizziness
Decreased absorption and distribution
Which of the following is NOT a part of the assessment for preventing adverse drug reactions (ADRs)?
Review all meds: Rx, OTC, herbals
Check renal function: BUN and creatinine clearance
Monitor blood pressure
Evaluate med adherence
What age-related physiological changes affect pharmacokinetics in older adults?
Increased metabolism
Decreased organ function affecting absorption and distribution
Enhanced renal clearance
Improved liver function
What is the Anticholinergic Drug Scale (ADS) used to assess?
Risk of cardiovascular disease
Cognitive impairment risk
Metabolic rate
Physical activity level
Which of the following conditions is commonly treated with anticholinergic drugs?
Diabetes
Hypertension
Parkinson disease
Asthma
At what age may adverse effects of anticholinergic drugs begin?
45
55
65
75
Which of the following is a common over-the-counter anticholinergic drug to avoid?
Ibuprofen
Diphenhydramine (Benadryl)
Acetaminophen
Aspirin
What is a potential risk associated with high ADS scores?
Increased metabolism
Enhanced physical strength
Falls and confusion
Improved memory
What effect does decreased gastric acidity have on drug absorption in older adults?
Increases absorption of drugs needing low pH
Leads to delayed or impaired absorption of drugs needing low pH
Enhances the efficiency of drug absorption
Reduces the risk of nausea and vomiting
How does reduced GI blood flow and surface area affect drug absorption in older adults?
Increases the efficiency of drug absorption
Has no effect on drug absorption
Reduces the efficiency of drug absorption
Enhances gastric emptying
What is a clinical impact of slower absorption rates in older adults?
Decreases peak serum drug levels
Alters peak serum drug levels
Increases drug circulation
Reduces the need for higher doses
What happens to lipid-soluble drugs in older adults?
They are stored longer in muscle tissue
They are stored longer in fat tissue
They are rapidly eliminated
They have no change in distribution
What is a consequence of decreased serum albumin in older adults?
Increased protein binding
Decreased free drug
Increased free drug
Decreased drug effects
How does aging affect liver metabolism in older adults?
Increases liver size and mass
Increases hepatic blood flow
Slows metabolism of drugs
Increases enzyme activity
What is a clinical implication of age-related liver changes in older adults?
Decreased risk of drug accumulation
Increased risk of drug accumulation and toxicity
No need for dose adjustment
Faster drug metabolism
What does pharmacogenomics use to guide drug therapy?
Patient's age
Patient's genetic makeup
Patient's diet
Patient's race
Which of the following is a change in kidney function related to aging?
Increased kidney blood flow
Increased functioning nephrons
Decreased glomerular filtration rate (GFR)
Increased tubular secretion
What is the best indicator of kidney function, although complex to measure directly?
Serum creatinine
Creatinine clearance (CrCl)
Tubular secretion
Blood pressure
Which formula is commonly used to estimate creatinine clearance for drug dosing?
Henderson-Hasselbalch equation
Cockcroft-Gault formula
Michaelis-Menten equation
Hill equation
Why might serum creatinine appear normal despite decreased kidney function?
Increased muscle mass
Decreased muscle mass
Increased dietary protein
Increased tubular secretion
What is a clinical implication of reduced kidney function in older adults?
Increased drug excretion
Decreased risk of drug accumulation
Increased risk of drug accumulation and toxicity
Increased dosages of drugs with long half-lives
What are some age-related infection risks in older adults?
Increased cytokine production
Enhanced immunity
Physiologic changes in integumentary, pulmonary, GI systems
Decreased risk of chronic diseases
Which symptom is most commonly associated with urinary tract infections (UTI) in older adults?
Decreased urination
Acute dysuria
Increased appetite
Weight gain
Why is it important to monitor drug levels during antibiotic therapy in older adults?
To increase the dosage
To prevent nephrotoxicity and ototoxicity
To ensure faster recovery
To reduce the cost of treatment
What is a potential risk of long-term antiretroviral therapy in older adults with HIV?
Improved bone density
Enhanced liver function
Kidney injury
Increased immunity
What is a common challenge faced by older adults using multiple medications?
Enhanced memory
Improved vision
Altered mental status
Increased energy levels
Why is vaccination critical for older adults in communal settings?
To increase appetite
To reduce morbidity and mortality
To enhance physical strength
To improve social skills
What is a strategy to improve medication adherence in older adults?
Prescribe high doses immediately
Use only brand-name medications
Start with small doses and increase slowly
Avoid educating patients about medications
What is a barrier to medication adherence in older adults?
Feeling symptomatic
Experiencing adverse effects
Having a strong support system
Access to free medications
What is one way to keep care affordable according to the nursing and provider roles?
Use brand-name medications
Use generics
Increase pill burden
Complicate dosing schedules
What reading level is "The Basics" patient education material designed for?
1st-2nd grade
3rd-4th grade
5th-6th grade
7th-8th grade
According to Pariseault et al. (2021), what is one key theme identified in managing polypharmacy in older adults?
Financial management
Defining polypharmacy
Dietary restrictions
Exercise routines
What is the focus of the study by Pariseault et al. (2021) regarding nurse practitioners?
Enhancing surgical techniques
Improving medication management
Developing new medications
Increasing hospital admissions
