Adult-Gerontology Primary Care Nurse Practitioner Exam Pharmacology & Medication Management in Aging Patients

Question 1

How does aging primarily affect drug distribution in older adults?

Accepted Answer

Increased body fat increases volume of distribution for lipid-soluble drugs

Answer

Increased total body water increases volume of distribution for water-soluble drugs

Answer

Decreased protein binding increases free fraction of albumin-bound drugs

Answer

Decreased renal blood flow reduces first-pass metabolism

Question 2

The Cockcroft-Gault formula is used by the AGPCNP to estimate:

Accepted Answer

Creatinine clearance as a surrogate for GFR to guide drug dosing

Answer

Liver function for drug metabolism

Answer

Body surface area for chemotherapy dosing

Answer

Nutritional status in older adults

Question 3

Which of the following benzodiazepines is considered relatively safer in older adults due to its lack of active metabolites?

Accepted Answer

Lorazepam

Answer

Diazepam

Answer

Chlordiazepoxide

Answer

Flurazepam

Question 4

The prescribing cascade occurs when:

Accepted Answer

A drug side effect is misinterpreted as a new condition and treated with another drug

Answer

Multiple providers prescribe the same medication

Answer

A patient takes medications at the wrong time

Answer

Generic substitution causes unexpected effects

Question 5

Which class of medications is listed on the Beers Criteria as potentially inappropriate in older adults due to anticholinergic effects?

Accepted Answer

First-generation antihistamines (e.g., diphenhydramine)

Answer

Selective serotonin reuptake inhibitors (SSRIs)

Answer

ACE inhibitors

Answer

Calcium channel blockers

Question 6

An AGPCNP conducts medication reconciliation at every visit. This process is most important for preventing:

Accepted Answer

Omission errors, duplication, and drug-drug interactions

Answer

Drug-food interactions

Answer

Medication non-adherence due to cost

Answer

Side effects from newly approved drugs