Geriatric Polypharmacy (NCLEX) Risk Assessment Quiz

1. An 81-year-old on metoprolol and verapamil develops bradycardia. What is the likely cause?

Synergistic cardiac depression

Increased thyroid activity

Reduced potassium levels

Medication allergy

2. True or False: Older adults require higher doses of medications due to slower metabolism.

True

False

3. An 83-year-old on multiple medications reports constipation and urinary retention. Which drug is most likely responsible?

Anticholinergic medication

Statin

ACE inhibitor

Antibiotic

4. Which age-related physiologic change most impacts drug metabolism in polypharmacy?

Decreased renal function and liver metabolism

Increased stomach acid

Enhanced drug absorption

Faster metabolism

5. Which laboratory value must be monitored when an elderly patient takes both NSAIDs and ACE inhibitors?

Serum creatinine and potassium

Glucose levels

Hemoglobin A1C

Lipid panel

6. An 78-year-old patient takes warfarin, aspirin, and ibuprofen daily. Which action should the nurse take first?

Assess for signs of bleeding

Discontinue all NSAIDs immediately

Increase warfarin dose

Document current medications

7. Polypharmacy-related cognitive impairment is most commonly caused by which drug class?

Benzodiazepines and anticholinergics

Antihypertensives

Antibiotics

Antihistamines only

8. Which strategy best reduces polypharmacy risks in geriatric patients?

Increase medication doses

Medication reconciliation and deprescribing

Add more preventive drugs

Change medications monthly

9. An 80-year-old on digoxin, furosemide, and lisinopril develops nausea and weakness. What is the priority assessment?

Serum potassium level

Digoxin toxicity level

Liver function tests

Thyroid function

10. Beers Criteria is used to identify which in older adults?

Potentially inappropriate medications

Drug dosage amounts

Medication brand names

Insurance coverage options

11. A 75-year-old takes omeprazole, iron supplements, and calcium. Which interaction is most concerning?

Omeprazole reduces iron absorption

Iron increases calcium levels

Calcium reduces omeprazole efficacy

No significant interactions

12. Which medication class commonly causes anticholinergic side effects in elderly patients?

ACE inhibitors

Tricyclic antidepressants

Beta-blockers

Statins

13. Polypharmacy in older adults increases risk for which of the following?

Improved medication efficacy

Adverse drug interactions and falls

Better disease management

Reduced hospital admissions

14. A 76-year-old takes cimetidine and warfarin. Which effect is expected?

Decreased warfarin levels

Increased warfarin levels and bleeding risk

No interaction

Increased cimetidine absorption

15. Grapefruit juice interacts with which medication class commonly used in older adults?

Statins and calcium channel blockers

ACE inhibitors

Diuretics

Antibiotics

16. A 79-year-old on fluoxetine and tramadol develops confusion and agitation. What is the priority concern?

Serotonin syndrome

Medication allergy

Dehydration

Hypertension

17. An 82-year-old on metformin, lisinopril, and atorvastatin reports dizziness. What should be evaluated first?

Blood glucose levels

Renal function and drug clearance

Lipid panel results

Dietary sodium intake

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Polypharmacy Quiz: Can You Spot the Risk?