Practice Test Geeks(PSA) Prescribing Safety Assessment Practice Test
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Prescribing in Special Populations Flashcards

7 cards from real PSA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. An 80-year-old patient with CrCl 25 mL/min is prescribed gentamicin for a severe infection. What is the most important prescribing consideration?

    Answer: Reduce the dose and extend the dosing interval

    Aminoglycosides are renally cleared and nephrotoxic; dose reduction and extended dosing intervals are essential in renal impairment to avoid accumulation and toxicity.

  2. A 70-year-old woman with type 2 diabetes is prescribed metformin. Her eGFR is 30 mL/min/1.73m². What is the most appropriate action?

    Answer: Discontinue metformin due to risk of lactic acidosis

    Metformin is contraindicated when eGFR falls below 30 mL/min/1.73m² due to accumulation and risk of lactic acidosis.

  3. Which drug is MOST likely to require dose reduction in a patient with severe hepatic impairment?

    Answer: Morphine

    Morphine undergoes extensive hepatic metabolism; severe hepatic impairment reduces its clearance, leading to accumulation and increased risk of toxicity.

  4. An 85-year-old patient on warfarin is given a new prescription for ibuprofen. What is the most significant prescribing concern?

    Answer: Increased bleeding risk and potential renal impairment

    NSAIDs inhibit platelet function and increase GI bleeding risk while also potentially causing renal impairment, particularly dangerous in elderly patients on warfarin.

  5. A patient with CrCl 15 mL/min requires regular analgesia. Which opioid should be used with the most caution?

    Answer: Morphine

    Morphine's active metabolite morphine-6-glucuronide accumulates in renal failure, causing prolonged sedation and respiratory depression.

  6. An elderly patient is prescribed digoxin for atrial fibrillation. Which age-related factor most increases their risk of digoxin toxicity?

    Answer: Reduced renal clearance of digoxin

    Digoxin is primarily renally eliminated; age-related decline in renal function reduces its clearance and increases accumulation and toxicity risk.

  7. A 75-year-old on amlodipine and simvastatin is started on clarithromycin for a chest infection. What is the most important drug interaction concern?

    Answer: Clarithromycin inhibits CYP3A4, raising simvastatin levels and increasing risk of myopathy

    Clarithromycin is a potent CYP3A4 inhibitor and can markedly raise simvastatin plasma concentrations, increasing the risk of myopathy and rhabdomyolysis.