Adult-Gerontology CNS Test Advanced Pharmacology & Therapeutics 3

Question 1

The pharmacokinetic change most responsible for increased drug levels in older adults is:

Accepted Answer

Decreased hepatic and renal clearance leading to drug accumulation

Answer

Aging reduces hepatic blood flow and enzyme activity (phase I metabolism) and decreases glomerular filtration rate, impairing drug elimination and increasing steady-state levels.

Question 2

Triple whammy combination causing acute kidney injury in older adults consists of:

Accepted Answer

ACE inhibitor/ARB + NSAID + diuretic

Answer

Combining ACE inhibitor/ARB (reduce GFR), NSAIDs (constrict afferent arteriole), and diuretics (reduce volume) creates additive hemodynamic AKI risk particularly in older adults.

Question 3

Medication reconciliation is critical at care transitions in older adults primarily to prevent:

Accepted Answer

Medication discrepancies, omission errors, and adverse drug events during handoffs

Answer

Care transitions are high-risk periods where medications are frequently omitted, duplicated, or incorrectly transcribed, leading to preventable adverse drug events.

Question 4

When initiating beta-blockers for a patient with newly diagnosed HFrEF, the CNS should:

Accepted Answer

Start at a very low dose and uptitrate slowly over weeks to months as tolerated

Answer

Beta-blockers must be started low and titrated slowly in HFrEF because a failing heart is dependent on sympathetic tone — abrupt high doses can precipitate acute decompensation.

Question 5

Azithromycin should be used with caution in older adults with cardiovascular disease because it:

Accepted Answer

Prolongs the QTc interval, increasing risk of torsades de pointes

Answer

Azithromycin prolongs cardiac repolarization (QTc prolongation), particularly dangerous in older adults with structural heart disease or those on other QT-prolonging agents.

Adult-Gerontology CNS Test Practice Test

Adult-Gerontology CNS Test Practice Test

Adult-Gerontology CNS Test Advanced Pharmacology & Therapeutics 3