CCP Geriatric Patient Assessment 3 — Questions and Answers
Question 1: Which Beers Criteria medication class is associated with the highest risk of falls and hip fractures in older adults?
- Benzodiazepines and sedative-hypnotics (Correct answer)
- ACE inhibitors
- Beta-blockers
- Statins
Correct answer: Benzodiazepines and sedative-hypnotics
Benzodiazepines and sedative-hypnotics are explicitly listed in the Beers Criteria as high-risk for older adults due to their association with sedation, cognitive impairment, and falls.
Question 2: A consultant pharmacist conducting a comprehensive medication review in a skilled nursing facility should routinely assess which parameter related to swallowing in elderly patients?
- Dysphagia and ability to swallow whole tablets (Correct answer)
- Renal tubular secretion capacity
- Hepatic microsomal enzyme activity
- Blood-brain barrier permeability
Correct answer: Dysphagia and ability to swallow whole tablets
Dysphagia is common in elderly patients and affects medication delivery; pharmacists must assess swallowing ability and recommend appropriate formulations when indicated.
Question 3: Which pain assessment tool is most appropriate for an elderly patient with moderate-to-severe dementia who cannot self-report pain?
- PAINAD (Pain Assessment in Advanced Dementia) (Correct answer)
- Numeric Rating Scale (NRS)
- Visual Analog Scale (VAS)
- McGill Pain Questionnaire
Correct answer: PAINAD (Pain Assessment in Advanced Dementia)
PAINAD uses behavioral observations (breathing, vocalization, facial expression, body language, consolability) to assess pain in non-verbal dementia patients.
Question 4: What is the primary reason anticholinergic medications are of particular concern in geriatric patients?
- Age-related decline in cholinergic neurons increases vulnerability to anticholinergic adverse effects (Correct answer)
- Elderly patients have faster renal clearance of these drugs
- Anticholinergic drugs become less potent with age
- Older patients have higher baseline acetylcholine levels
Correct answer: Age-related decline in cholinergic neurons increases vulnerability to anticholinergic adverse effects
Age-related loss of cholinergic neurons and reduced acetylcholine synthesis make elderly patients more susceptible to anticholinergic adverse effects such as confusion, urinary retention, and constipation.
Question 5: Which laboratory value is the most reliable indicator of long-term nutritional status and correlates with clinical outcomes in geriatric patients?
- Serum albumin (Correct answer)
- Serum prealbumin
- Total lymphocyte count
- Serum transferrin
Correct answer: Serum albumin
Serum albumin (half-life ~20 days) reflects chronic nutritional status and is a strong predictor of morbidity, mortality, and length of hospital stay in elderly patients.
Question 6: A 76-year-old patient is started on a new SSRI for depression. Which adverse effect should the consultant pharmacist specifically monitor for in this geriatric patient?
- Hyponatremia (Correct answer)
- Hyperkalemia
- Metabolic alkalosis
- Hypercalcemia
Correct answer: Hyponatremia
SSRIs are a leading cause of drug-induced SIADH and hyponatremia in elderly patients, which can cause confusion, falls, and seizures.
Question 7: The Timed Up and Go (TUG) test in elderly patients measures which of the following?
- Mobility and fall risk based on time to rise, walk 3 meters, turn, and return to sitting (Correct answer)
- Cognitive processing speed
- Cardiopulmonary exercise tolerance
- Fine motor coordination of the upper extremities
Correct answer: Mobility and fall risk based on time to rise, walk 3 meters, turn, and return to sitting
TUG measures the time for a patient to stand from a chair, walk 3 meters, turn around, walk back, and sit down; >12 seconds indicates fall risk.
CCP Geriatric Patient Assessment 3
Which Beers Criteria medication class is associated with the highest risk of falls and hip fractures in older adults?