Gerontological Nurse Test Pharmacology in Older Adults 1 — Questions and Answers
Question 1: Which pharmacokinetic change is most common in older adults that affects drug clearance?
- Increased renal clearance
- Decreased hepatic blood flow and renal function (Correct answer)
- Increased gastric acid secretion
- Enhanced protein binding
Correct answer: Decreased hepatic blood flow and renal function
Aging reduces hepatic blood flow and glomerular filtration rate, leading to decreased drug clearance and increased risk of toxicity.
Question 2: The Beers Criteria is a clinical tool used specifically to:
- Calculate safe medication doses for elderly patients
- Identify potentially inappropriate medications for adults aged 65 and older (Correct answer)
- Screen for medication allergies in nursing home residents
- Determine drug interactions in polypharmacy patients
Correct answer: Identify potentially inappropriate medications for adults aged 65 and older
The Beers Criteria, maintained by the American Geriatrics Society, lists medications considered potentially inappropriate for older adults due to higher risk of adverse effects.
Question 3: An 80-year-old patient is prescribed a new medication. Which age-related change most significantly increases the risk of drug accumulation?
- Decreased body fat percentage
- Reduced serum albumin levels
- Decreased creatinine clearance (Correct answer)
- Increased gastric motility
Correct answer: Decreased creatinine clearance
Decreased creatinine clearance in older adults slows renal excretion of drugs and their metabolites, leading to accumulation and potential toxicity.
Question 4: Which medication class listed in the Beers Criteria is most associated with causing falls in older adults?
- ACE inhibitors
- Benzodiazepines (Correct answer)
- Beta-blockers
- Statins
Correct answer: Benzodiazepines
Benzodiazepines cause sedation, cognitive impairment, and impaired balance in older adults, significantly increasing fall risk.
Question 5: A gerontological nurse is reviewing an older adult's medications and notes decreased serum albumin. What is the primary clinical concern?
- Reduced drug absorption from the GI tract
- Increased free (unbound) drug concentration leading to toxicity (Correct answer)
- Decreased drug distribution to target tissues
- Slower onset of drug action
Correct answer: Increased free (unbound) drug concentration leading to toxicity
Low serum albumin means fewer protein-binding sites, so more free drug circulates in the bloodstream, increasing the risk of adverse effects and toxicity.
Question 6: Which age-related change increases the volume of distribution for fat-soluble drugs in older adults?
- Decreased total body water
- Increased proportion of body fat relative to lean muscle mass (Correct answer)
- Reduced gastric pH
- Increased hepatic enzyme activity
Correct answer: Increased proportion of body fat relative to lean muscle mass
Because older adults have a higher ratio of body fat to lean mass, fat-soluble drugs distribute more widely, prolonging their duration of action.
Gerontological Nurse Test Pharmacology in Older Adults 1
Which pharmacokinetic change is most common in older adults that affects drug clearance?