CCP Geriatric Patient Assessment 5

Question 1

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:

Accepted Answer

Recognize that elderly patients may develop toxicity at lower serum levels and recommend dose reduction

Answer

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.

Question 2

When performing a medication reconciliation in a newly admitted nursing home resident, which source of information should the consultant pharmacist prioritize first?

Accepted Answer

Interviewing the patient and/or caregiver while reviewing medication bottles brought from home

Answer

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.

Question 3

Which of the following best describes the pharmacokinetic change most relevant to prescribing opioids in elderly patients?

Accepted Answer

Reduced hepatic first-pass metabolism and decreased renal clearance lead to increased drug exposure and prolonged effect

Answer

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.

Question 4

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:

Accepted Answer

Evaluate the indication for triple antithrombotic therapy and recommend discontinuing aspirin if no clear indication exists

Answer

Triple antithrombotic therapy significantly increases major bleeding risk in elderly patients; guidelines recommend minimizing duration and eliminating aspirin when not clearly indicated.

Question 5

The Short Physical Performance Battery (SPPB) assesses which three domains of physical function in older adults?

Accepted Answer

Standing balance, gait speed, and chair stand performance

Answer

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.

(CCP) Certified Consultant Pharmacist Practice Test

(CCP) Certified Consultant Pharmacist Practice Test

CCP Geriatric Patient Assessment 5