Question 1

The Beers Criteria recommend which muscle relaxant for use in the elderly?&#10;A) Methocarbamol (Robaxin)&#10;B) Carisoprodol (Soma)&#10;C) Cyclobenzaprine (Flexeril)&#10;D) None of the above

Accepted Answer

The Beers Criteria recommend avoiding the use of all muscle relaxants in the elderly due to increased risks of adverse effects such as sedation, confusion, falls, and fractures.

Question 2

The most common prescribing error in long-term care facilities is:&#10;A) The wrong drug is prescribed&#10;B) The wrong dose of medication is prescribed&#10;C) Medications are administered at the wrong time&#10;D) Drugs with known interaction are prescribed

Accepted Answer

Studies have shown that the most common prescribing error in long-term care facilities is the wrong dose of medication being prescribed. This can be due to a variety of factors, such as incorrect dosage calculations, prescribing errors, or failure to adjust for changes in a patient's condition or kidney function. It is important for healthcare providers to regularly review medication orders and consult with pharmacists to ensure the appropriate dose is being prescribed for each patient.

Question 3

Patients with chronic illness may struggle with adherence to their treatment regimen.Intelligent non-adherence occurs when the patient:&#10;A) May not understand the specifics of his or her medication regimen&#10;B) Cannot afford to pay for all the medications in his or her regimen&#10;C) Occasionally misses doses of medications due to forgetfulness&#10;D) Chooses to discontinue or alter his or her medication regimen

Accepted Answer

Intelligent non-adherence is when the patient intentionally chooses to discontinue or alter their medication regimen. This may be due to a variety of reasons such as fear of side effects or a belief that the medication is not effective. It is important for healthcare providers to understand the reasons for the patient's non-adherence and work with them to address any concerns and find a solution that works for both the patient and their medical needs.

Question 4

The Beers Criteria is used to:&#10;A) Determine appropriate prescribing in the elderly&#10;B) Set guidelines for prescribing sedatives for the elderly&#10;C) Assess potentially inappropriate medications in the elderly&#10;D) Provide regulation in the prescribing of potentially dangerous medications

Accepted Answer

The Beers Criteria is a list of medications that should be avoided or used with caution in elderly patients due to their potential to cause harm or have limited benefits in this population. It helps healthcare providers assess potentially inappropriate medications in the elderly population.

Question 5

According to the Beers Criteria list,the elderly should be cautiously prescribed fluoxetine (Prozac)due to:&#10;A) Excessive drowsiness&#10;B) Long half-life&#10;C) Dry mouth and constipation&#10;D) Decreased renal excretion

Accepted Answer

The Beers Criteria lists fluoxetine (Prozac) as potentially inappropriate for use in the elderly due to its long half-life. This means that the drug stays in the body for a longer period of time, increasing the risk of adverse effects or drug interactions. Therefore, caution should be taken when prescribing fluoxetine to the elderly.

Question 6

Many elderly patients use diphenhydramine (Benadryl)as a sleep aid.The Beers Criteria recommends against the use of diphenhydramine in the elderly due to:&#10;A) Lack of efficacy in the elderly&#10;B) It may cause confusion&#10;C) It may induce depression&#10;D) Orthostatic hypotension

Accepted Answer

Diphenhydramine is an anticholinergic drug, and in elderly patients, it can cause confusion, sedation, and an increased risk of falls. The Beers Criteria advises against its use in older adults due to these potential adverse effects.

Question 7

Steps the provider can take to improve medication adherence in the chronically ill patient include:&#10;A) Tell the patient to take the medications as prescribed for optimum health&#10;B) Assess adherence either through self-report or laboratory values&#10;C) Encourage the patient to take the medications regularly&#10;D) If noncompliant with the medication regimen,ask if the patient values good health

Accepted Answer

Assessing adherence through self-report or laboratory values allows the provider to understand the patient's current adherence level and identify any barriers to adherence, which is crucial for developing effective strategies to improve it.

Question 8

The Beers Criteria states mineral oil is not recommended to be used in the elderly due to:&#10;A) Lack of efficacy in this age group&#10;B) Concern for oil leakage from the anus&#10;C) Potential for aspiration of oil&#10;D) Concern for CNS and extrapyramidal effects

Accepted Answer

Mineral oil can potentially be aspirated and cause lipid pneumonia, which can be life-threatening in elderly patients with compromised lung function. Therefore, it is not recommended for use in this population.

Deck 52: Chronic Illness and Long-Term Care