Adult-Gerontology CNS Test Pharmacology and Therapeutics 2 — Questions and Answers
Question 1: Which antihypertensive class is recommended as first-line therapy for older adults with both diabetes and hypertension?
- Beta-blockers
- ACE inhibitors or ARBs (Correct answer)
- Alpha-blockers
- Centrally acting agents
Correct answer: ACE inhibitors or ARBs
ACE inhibitors and ARBs provide renal protection in diabetic patients and are recommended first-line for hypertension with diabetes.
Question 2: A CNS is caring for an 82-year-old on long-term corticosteroids. Which prophylactic medication is most important to add?
- Antifungal
- Proton pump inhibitor
- Bisphosphonate (Correct answer)
- Anticoagulant
Correct answer: Bisphosphonate
Long-term corticosteroids cause bone loss; bisphosphonates are recommended to prevent glucocorticoid-induced osteoporosis.
Question 3: Which benzodiazepine property makes it particularly risky in older adults compared to short-acting alternatives?
- Short half-life
- Long half-life with active metabolites (Correct answer)
- Renal elimination
- High protein binding
Correct answer: Long half-life with active metabolites
Long-acting benzodiazepines have active metabolites that accumulate in older adults, increasing fall and cognitive impairment risk.
Question 4: A CNS selects an antibiotic for a UTI in an 85-year-old woman with a penicillin allergy. Which is the best oral choice for an uncomplicated UTI?
- Amoxicillin-clavulanate
- Trimethoprim-sulfamethoxazole (Correct answer)
- Nitrofurantoin
- Ciprofloxacin
Correct answer: Trimethoprim-sulfamethoxazole
TMP-SMX is appropriate for uncomplicated UTI when local resistance patterns support its use and penicillins are contraindicated.
Question 5: Which medication is the preferred first-line treatment for Clostridioides difficile infection in older adults per current guidelines?
- Metronidazole
- Oral vancomycin (Correct answer)
- Fidaxomicin
- Rifaximin
Correct answer: Oral vancomycin
Oral vancomycin is now the preferred first-line treatment for C. difficile infection, achieving higher cure rates than metronidazole.
Question 6: What is polypharmacy defined as in most clinical guidelines for older adults?
- Taking 2 or more medications
- Taking 5 or more medications (Correct answer)
- Taking 10 or more medications
- Taking any OTC medication daily
Correct answer: Taking 5 or more medications
Polypharmacy is broadly defined as the concurrent use of five or more medications, a common and high-risk condition in older adults.
Adult-Gerontology CNS Test Pharmacology and Therapeutics 2
Which antihypertensive class is recommended as first-line therapy for older adults with both diabetes and hypertension?