Adult-Gerontology CNS Test Advanced Pharmacology & Therapeutics

Question 1

Which class of medications is first-line for reducing mortality in patients with HFrEF?

Accepted Answer

ACE inhibitors or ARBs, beta-blockers, and mineralocorticoid receptor antagonists

Answer

Loop diuretics and digoxin

Answer

Calcium channel blockers and nitrates

Answer

Hydralazine alone

Question 2

The Beers Criteria is used by CNS practitioners to:

Accepted Answer

Identify medications potentially inappropriate for use in older adults

Answer

Calculate antibiotic dosing in renal failure

Answer

Determine opioid equivalency conversions

Answer

Screen for drug interactions in all age groups

Question 3

Polypharmacy in older adults most significantly increases risk of:

Accepted Answer

Adverse drug reactions, drug-drug interactions, and medication non-adherence

Answer

Antibiotic resistance

Answer

Vitamin toxicity

Answer

Renal calculi formation

Question 4

Direct oral anticoagulants (DOACs) are preferred over warfarin in non-valvular atrial fibrillation primarily because:

Accepted Answer

They have predictable pharmacokinetics, require no routine INR monitoring, and have comparable or superior efficacy with lower intracranial bleeding risk

Answer

They are less expensive and have no dietary restrictions

Answer

They can be reversed more easily than warfarin

Answer

They are safer in severe renal impairment

Question 5

Metered-dose inhaler (MDI) technique in older adults is frequently suboptimal because:

Accepted Answer

Coordination difficulties, arthritis, and cognitive impairment reduce proper actuation-inhalation synchrony

Answer

Older adults have increased lung compliance reducing drug deposition

Answer

MDIs deliver too high a drug concentration for older lungs

Answer

Older patients metabolize inhaled drugs faster

Question 6

Which opioid is considered safest for pain management in older adults with renal impairment?

Accepted Answer

Oxycodone with careful dose titration

Answer

Morphine

Answer

Codeine

Answer

Hydromorphone