,HSC 204 Final Exam Principles of Pharmacology Questions And
Answers 2026/2027 Jersey College
Q1. An older adult has normal serum creatinine but substantially
reduced muscle mass. Why should renal drug clearance still be
assessed carefully?
A) Creatinine always rises sharply with aging
B) Low muscle mass can mask reduced renal function despite an apparently
normal creatinine
C) Aging prevents renal elimination of all medications
D) Serum creatinine directly measures hepatic metabolism
Correct Answer: B) Low muscle mass can mask reduced renal function
despite an apparently normal creatinine
Rationale: Reduced muscle mass can decrease creatinine production,
making serum creatinine appear normal even when renal filtration has
declined.
Q2. Which physiologic change can increase the duration of lipid-
soluble medications in many older adults?
A) Increased total body water
B) Increased hepatic blood flow
C) Increased skeletal muscle mass
D) Increased proportion of body fat
Correct Answer: D) Increased proportion of body fat
Rationale: Greater adipose tissue can increase distribution and prolong
elimination of lipid-soluble medications.
Q3. Which strategy best reduces medication-related risk in an older
adult taking medications from several prescribers?
A) Perform regular medication reconciliation including prescription, OTC, and
herbal products
B) Stop all medications older than one year
C) Use only brand-name medications
D) Avoid discussing supplements
Correct Answer: A) Perform regular medication reconciliation including
prescription, OTC, and herbal products
,Rationale: Comprehensive medication reconciliation helps identify
duplication, interactions, inappropriate therapy, and adherence problems.
Q4. Why are strongly anticholinergic medications often problematic
in older adults?
A) They improve cognition excessively
B) They increase renal filtration
C) They can contribute to confusion, constipation, urinary retention, and falls
D) They invariably cause hypoglycemia
Correct Answer: C) They can contribute to confusion, constipation, urinary
retention, and falls
Rationale: Older adults are particularly susceptible to central and peripheral
anticholinergic adverse effects.
Q5. Which principle is most appropriate when initiating certain
medications in frail older adults?
A) Start with the maximum dose
B) Use the lowest effective initial dose and titrate carefully when appropriate
C) Avoid monitoring because older adults respond predictably
D) Double the dose after the first missed dose
Correct Answer: B) Use the lowest effective initial dose and titrate carefully
when appropriate
Rationale: Age-related pharmacokinetic and pharmacodynamic changes
can increase sensitivity to medications and adverse effects.
Q6. An older adult taking several sedating medications develops
recurrent falls. Which action is most appropriate?
A) Review the medication regimen for additive CNS depression
B) Add another sedative at bedtime
C) Restrict all daytime activity
D) Increase every medication dose
Correct Answer: A) Review the medication regimen for additive CNS
depression
Rationale: Multiple CNS depressants can produce excessive sedation,
impaired balance, and increased fall risk.
, Q7. Which finding most strongly suggests medication-induced
orthostatic hypotension?
A) Hypertension while supine only
B) Increased appetite
C) Persistent fever
D) Dizziness and a substantial blood-pressure drop after standing
Correct Answer: D) Dizziness and a substantial blood-pressure drop after
standing
Rationale: Orthostatic hypotension causes reduced cerebral perfusion with
positional blood-pressure decline.
Q8. Why should renal function be reviewed before administering
many medications to older adults?
A) Aging increases kidney size in every patient
B) Older adults absorb no oral medications
C) Age-related reductions in renal clearance can increase medication
accumulation
D) Renal function affects only antibiotics
Correct Answer: C) Age-related reductions in renal clearance can increase
medication accumulation
Rationale: Declining renal filtration and secretion can prolong the half-life of
renally eliminated medications.
Q9. Which intervention best supports medication adherence in a
patient with a complex regimen?
A) Simplify the regimen when possible and use clear written schedules or
organizers
B) Change medication times every day
C) Avoid teaching family or caregivers
D) Use medical terminology exclusively
Correct Answer: A) Simplify the regimen when possible and use clear written
schedules or organizers
Rationale: Simplification and structured reminders can reduce confusion
and missed or duplicated doses.
Q10. Which finding in an older adult taking opioids warrants the
greatest concern?
Answers 2026/2027 Jersey College
Q1. An older adult has normal serum creatinine but substantially
reduced muscle mass. Why should renal drug clearance still be
assessed carefully?
A) Creatinine always rises sharply with aging
B) Low muscle mass can mask reduced renal function despite an apparently
normal creatinine
C) Aging prevents renal elimination of all medications
D) Serum creatinine directly measures hepatic metabolism
Correct Answer: B) Low muscle mass can mask reduced renal function
despite an apparently normal creatinine
Rationale: Reduced muscle mass can decrease creatinine production,
making serum creatinine appear normal even when renal filtration has
declined.
Q2. Which physiologic change can increase the duration of lipid-
soluble medications in many older adults?
A) Increased total body water
B) Increased hepatic blood flow
C) Increased skeletal muscle mass
D) Increased proportion of body fat
Correct Answer: D) Increased proportion of body fat
Rationale: Greater adipose tissue can increase distribution and prolong
elimination of lipid-soluble medications.
Q3. Which strategy best reduces medication-related risk in an older
adult taking medications from several prescribers?
A) Perform regular medication reconciliation including prescription, OTC, and
herbal products
B) Stop all medications older than one year
C) Use only brand-name medications
D) Avoid discussing supplements
Correct Answer: A) Perform regular medication reconciliation including
prescription, OTC, and herbal products
,Rationale: Comprehensive medication reconciliation helps identify
duplication, interactions, inappropriate therapy, and adherence problems.
Q4. Why are strongly anticholinergic medications often problematic
in older adults?
A) They improve cognition excessively
B) They increase renal filtration
C) They can contribute to confusion, constipation, urinary retention, and falls
D) They invariably cause hypoglycemia
Correct Answer: C) They can contribute to confusion, constipation, urinary
retention, and falls
Rationale: Older adults are particularly susceptible to central and peripheral
anticholinergic adverse effects.
Q5. Which principle is most appropriate when initiating certain
medications in frail older adults?
A) Start with the maximum dose
B) Use the lowest effective initial dose and titrate carefully when appropriate
C) Avoid monitoring because older adults respond predictably
D) Double the dose after the first missed dose
Correct Answer: B) Use the lowest effective initial dose and titrate carefully
when appropriate
Rationale: Age-related pharmacokinetic and pharmacodynamic changes
can increase sensitivity to medications and adverse effects.
Q6. An older adult taking several sedating medications develops
recurrent falls. Which action is most appropriate?
A) Review the medication regimen for additive CNS depression
B) Add another sedative at bedtime
C) Restrict all daytime activity
D) Increase every medication dose
Correct Answer: A) Review the medication regimen for additive CNS
depression
Rationale: Multiple CNS depressants can produce excessive sedation,
impaired balance, and increased fall risk.
, Q7. Which finding most strongly suggests medication-induced
orthostatic hypotension?
A) Hypertension while supine only
B) Increased appetite
C) Persistent fever
D) Dizziness and a substantial blood-pressure drop after standing
Correct Answer: D) Dizziness and a substantial blood-pressure drop after
standing
Rationale: Orthostatic hypotension causes reduced cerebral perfusion with
positional blood-pressure decline.
Q8. Why should renal function be reviewed before administering
many medications to older adults?
A) Aging increases kidney size in every patient
B) Older adults absorb no oral medications
C) Age-related reductions in renal clearance can increase medication
accumulation
D) Renal function affects only antibiotics
Correct Answer: C) Age-related reductions in renal clearance can increase
medication accumulation
Rationale: Declining renal filtration and secretion can prolong the half-life of
renally eliminated medications.
Q9. Which intervention best supports medication adherence in a
patient with a complex regimen?
A) Simplify the regimen when possible and use clear written schedules or
organizers
B) Change medication times every day
C) Avoid teaching family or caregivers
D) Use medical terminology exclusively
Correct Answer: A) Simplify the regimen when possible and use clear written
schedules or organizers
Rationale: Simplification and structured reminders can reduce confusion
and missed or duplicated doses.
Q10. Which finding in an older adult taking opioids warrants the
greatest concern?
