Long-Term Care Pharmacy Services 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 Long-Term Care Pharmacy Services flashcards as text
A consultant pharmacist notices that a nursing facility has been consistently administering 'as needed' (PRN) benzodiazepines to the same resident daily for 30 days. The appropriate action is to:
Answer: Recommend the prescriber reassess the ongoing need and consider a scheduled taper or discontinuation plan
Daily PRN benzodiazepine use de facto becomes scheduled use, requiring reassessment for dependence, appropriateness, and possible tapering per LTC guidelines.
Which of the following is the most appropriate pain management alternative to meperidine (Demerol) in elderly LTC residents?
Answer: Scheduled low-dose opioids with bowel regimen (e.g., oxycodone or morphine)
Meperidine is on the Beers Criteria as potentially inappropriate in older adults due to normeperidine accumulation causing CNS toxicity; safer opioids with bowel prophylaxis are preferred.
A nursing facility must report a significant medication error to its state agency. Which best describes the consultant pharmacist's responsibility in this process?
Answer: Assist in root cause analysis and recommend system-level changes to prevent recurrence
The consultant pharmacist contributes clinical expertise to root cause analysis and quality improvement efforts following a significant medication error.
What is the recommended approach for managing opioid-induced constipation (OIC) in LTC residents receiving chronic opioid therapy?
Answer: Initiate a stimulant laxative prophylactically when opioids are started
Stimulant laxatives (e.g., senna) should be initiated prophylactically when chronic opioid therapy begins because OIC does not resolve with tolerance, unlike other opioid side effects.
Which of the following is a key indicator that an LTC pharmacy's drug distribution system is functioning appropriately?
Answer: Low medication error rates and accurate cycle fill reconciliation
Low error rates and accurate cycle fill reconciliation indicate that the pharmacy's dispensing and verification processes are effective and safe.
A geriatric resident newly admitted to an LTC facility has a serum creatinine of 0.6 mg/dL. The consultant pharmacist should recognize this as:
Answer: Potentially misleading due to reduced muscle mass in elderly patients, requiring CrCl calculation using Cockcroft-Gault
In elderly patients with reduced muscle mass, serum creatinine may appear normal despite significantly reduced renal function; Cockcroft-Gault or CKD-EPI equations should be used for accurate GFR estimation.
An LTC facility asks the consultant pharmacist to help develop a fall prevention protocol. Which medication class review is MOST critical to include?
Answer: Psychotropics, antihypertensives, and sedative-hypnotics
Psychotropics, antihypertensives, and sedative-hypnotics are the leading medication contributors to falls in elderly LTC residents and must be reviewed in any fall prevention initiative.