Adult-Gerontology Primary Care Nurse Practitioner Exam Pharmacology & Medication Management in Aging Patients

Question 1

How does aging primarily affect drug distribution in older adults?

Accepted Answer

Increased body fat increases volume of distribution for lipid-soluble drugs

Answer

With aging, body fat increases relative to lean mass, increasing the volume of distribution and prolonging the half-life of lipophilic drugs such as benzodiazepines.

Question 2

The Cockcroft-Gault formula is used by the AGPCNP to estimate:

Accepted Answer

Creatinine clearance as a surrogate for GFR to guide drug dosing

Answer

The Cockcroft-Gault equation estimates creatinine clearance using age, weight, sex, and serum creatinine, guiding renally-cleared drug dosing in older adults.

Question 3

Which of the following benzodiazepines is considered relatively safer in older adults due to its lack of active metabolites?

Accepted Answer

Lorazepam

Answer

Lorazepam is preferred when a benzodiazepine is necessary in older adults because it has no active metabolites and a shorter half-life, reducing accumulation risk.

Question 4

The prescribing cascade occurs when:

Accepted Answer

A drug side effect is misinterpreted as a new condition and treated with another drug

Answer

The prescribing cascade is the process whereby an adverse drug effect is mistaken for a new medical condition, leading to additional prescriptions and compounding harm.

Question 5

Which class of medications is listed on the Beers Criteria as potentially inappropriate in older adults due to anticholinergic effects?

Accepted Answer

First-generation antihistamines (e.g., diphenhydramine)

Answer

First-generation antihistamines like diphenhydramine have strong anticholinergic activity, causing confusion, urinary retention, constipation, and falls in older adults.

Adult-Gerontology Primary Care Nurse Practitioner Exam Practice Test

Adult-Gerontology Primary Care Nurse Practitioner Exam Practice Test

Adult-Gerontology Primary Care Nurse Practitioner Exam Pharmacology & Medication Management in Aging Patients