CCP Clinical Care in Long-Term Care 3

Question 1

A 85-year-old LTC resident with type 2 diabetes has an HbA1c of 9.2%. The consultant pharmacist recommends a less stringent glycemic goal. What HbA1c target is generally appropriate for frail elderly LTC residents?

Accepted Answer

<8.0%

Answer

For frail elderly residents or those with limited life expectancy, ADA and geriatric guidelines recommend a relaxed HbA1c target of <8.0% to minimize hypoglycemia risk.

Question 2

Which medication class is considered most appropriate for short-term management of acute agitation in a LTC resident with no prior psychiatric history, according to current geriatric guidelines?

Accepted Answer

Low-dose haloperidol with close monitoring

Answer

Low-dose haloperidol may be used cautiously for acute agitation posing safety risks when non-pharmacological interventions fail, though risks must be documented and monitored closely.

Question 3

A resident on metformin 1000 mg BID is ordered for a contrast CT scan. The consultant pharmacist should recommend:

Accepted Answer

Hold metformin 48 hours before and 48 hours after contrast administration

Answer

Metformin should be held 48 hours before and after iodinated contrast in patients with renal impairment risk due to the rare but serious risk of contrast-induced nephropathy leading to metformin accumulation and lactic acidosis.

Question 4

Which of the following is a key component of a comprehensive medication review (CMR) conducted by a consultant pharmacist in a LTC facility under CMS guidelines?

Accepted Answer

Assessing all medications for appropriateness, efficacy, safety, and adherence

Answer

A comprehensive medication review evaluates the complete medication regimen for clinical indications, drug interactions, adverse effects, and opportunities for deprescribing in alignment with OBRA regulations.

Question 5

A LTC resident develops C. difficile infection (CDI) after a course of clindamycin. Which is the MOST appropriate first-line treatment for a non-severe initial episode?

Accepted Answer

Oral vancomycin 125 mg QID x 10 days

Answer

IDSA guidelines now recommend oral vancomycin 125 mg QID for 10 days as first-line for non-severe CDI, as it is superior to metronidazole in achieving clinical cure.

(CCP) Certified Consultant Pharmacist Practice Test

(CCP) Certified Consultant Pharmacist Practice Test

CCP Clinical Care in Long-Term Care 3