Geriatric Patient Assessment Flashcards
7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Geriatric Patient Assessment flashcards as text
A 79-year-old patient on digoxin for heart failure has serum digoxin levels within the therapeutic range of 0.8–2 ng/mL but develops nausea and visual disturbances. The consultant pharmacist should:
Answer: Recognize that elderly patients may develop toxicity at lower serum levels and recommend dose reduction
Elderly patients have reduced volume of distribution and renal clearance for digoxin; toxicity often occurs at levels below 2 ng/mL, and target levels of 0.5–0.9 ng/mL are preferred in heart failure.
When performing a medication reconciliation in a newly admitted nursing home resident, which source of information should the consultant pharmacist prioritize first?
Answer: Interviewing the patient and/or caregiver while reviewing medication bottles brought from home
Direct patient/caregiver interview combined with a brown-bag review of actual medication bottles provides the most accurate medication history, identifying discrepancies missed in written records.
Which of the following best describes the pharmacokinetic change most relevant to prescribing opioids in elderly patients?
Answer: Reduced hepatic first-pass metabolism and decreased renal clearance lead to increased drug exposure and prolonged effect
Age-related decline in hepatic blood flow and mass reduces first-pass metabolism, while decreased GFR slows renal clearance of opioid metabolites, necessitating lower doses and longer dosing intervals.
A consultant pharmacist reviews a 91-year-old patient on warfarin, aspirin 81 mg, and clopidogrel following a drug use evaluation. The most appropriate recommendation is to:
Answer: Evaluate the indication for triple antithrombotic therapy and recommend discontinuing aspirin if no clear indication exists
Triple antithrombotic therapy significantly increases major bleeding risk in elderly patients; guidelines recommend minimizing duration and eliminating aspirin when not clearly indicated.
The Short Physical Performance Battery (SPPB) assesses which three domains of physical function in older adults?
Answer: Standing balance, gait speed, and chair stand performance
SPPB evaluates static balance (side-by-side, semi-tandem, tandem stands), 4-meter walk gait speed, and repeated chair stands to predict disability and mortality risk.
Which of the following best explains why elderly patients are at increased risk for drug-induced delirium compared to younger patients?
Answer: Age-related reduction in brain cholinergic reserve and increased blood-brain barrier permeability create vulnerability to CNS-active drugs
Reduced cholinergic reserve, structural brain changes, and altered blood-brain barrier function make older adults disproportionately susceptible to delirium from anticholinergic drugs, opioids, and sedatives.
A consultant pharmacist recommends non-pharmacological interventions for an 80-year-old nursing home resident with chronic insomnia. Which intervention has the strongest evidence base as a first-line treatment?
Answer: Cognitive Behavioral Therapy for Insomnia (CBT-I)
CBT-I is recommended as first-line treatment for chronic insomnia by the American Academy of Sleep Medicine; sedating medications carry significant risks (falls, cognitive impairment, paradoxical agitation) in elderly patients.