CCP Clinical Care in Long-Term Care 2

Question 1

A 78-year-old LTC resident with stage 3 chronic kidney disease has an eGFR of 28 mL/min. Which antibiotic requires the most significant dose reduction for a urinary tract infection?

Accepted Answer

Nitrofurantoin

Answer

Azithromycin

Answer

Ciprofloxacin

Answer

Doxycycline

Question 2

Which of the following is the MOST appropriate first-line pharmacological treatment for pain management in a non-verbal LTC resident with moderate osteoarthritis pain?

Accepted Answer

Scheduled low-dose acetaminophen

Answer

Ibuprofen 400 mg TID

Answer

Tramadol 50 mg PRN

Answer

Morphine IR 5 mg PRN

Question 3

A consultant pharmacist reviews a resident's medication list and notes she is receiving both warfarin and fluconazole. What is the primary pharmacokinetic concern?

Accepted Answer

Fluconazole inhibits CYP2C9, increasing warfarin levels

Answer

Fluconazole induces CYP2C9, decreasing warfarin levels

Answer

Fluconazole displaces warfarin from albumin, lowering efficacy

Answer

Fluconazole increases renal clearance of warfarin

Question 4

Under the CMS F-tag F758 regulations, which of the following constitutes an unnecessary antipsychotic use in a LTC setting?

Accepted Answer

Antipsychotic for behavioral symptoms of dementia without safety risk

Answer

Antipsychotic for diagnosed schizophrenia with documented benefit

Answer

Antipsychotic for Huntington's disease with documented benefit

Answer

Antipsychotic for Tourette's syndrome with physician documentation

Question 5

A LTC resident with heart failure is started on carvedilol. The consultant pharmacist should monitor for which electrolyte disturbance that is especially common in heart failure patients on diuretics?

Accepted Answer

Hypokalemia from loop diuretics

Answer

Hypernatremia

Answer

Hyperkalemia from carvedilol

Answer

Hypercalcemia from thiazides

Question 6

Which clinical tool is MOST appropriate for systematic fall risk stratification in a newly admitted LTC resident?

Accepted Answer

Morse Fall Scale

Answer

Mini-Mental State Examination (MMSE)

Answer

CAGE questionnaire

Answer

Braden Scale

Question 7

A consultant pharmacist identifies that a resident's bisphosphonate is being administered with the resident in a supine position due to limited mobility. What is the primary concern?

Accepted Answer

Esophageal irritation and risk of erosive esophagitis

Answer

Reduced absorption leading to treatment failure

Answer

Increased renal toxicity from prolonged contact

Answer

CNS toxicity from systemic absorption