Polypharmacy Challenges in Older Adults –
Complete Practice Assessment 150
Questions, Answers and Rationale 2025/2026
1. Which of the following is the most common consequence of
polypharmacy in older adults?
A. Improved adherence
B. Increased risk of drug-drug interactions
C. Reduced hospitalizations
D. Enhanced cognitive function
B. Increased risk of drug-drug interactions
Polypharmacy increases the likelihood of adverse drug reactions
and interactions due to multiple medications affecting the same
pathways.
2. Polypharmacy is generally defined as:
A. Use of 1–2 medications daily
B. Use of 3–4 medications daily
C. Use of 5 or more medications daily
D. Use of only prescription medications
C. Use of 5 or more medications daily
Five or more medications is the commonly accepted threshold for
polypharmacy in geriatric populations.
3. Which of the following is a risk factor for polypharmacy in older
adults?
A. Single chronic disease
B. Frequent healthcare visits
C. Living independently without caregivers
, D. Minimal prescription medications
B. Frequent healthcare visits
Multiple providers can increase the risk of redundant or
unnecessary prescriptions.
4. The Beers Criteria is used to:
A. Diagnose dementia
B. Identify potentially inappropriate medications in older adults
C. Screen for depression
D. Determine appropriate physical activity levels
B. Identify potentially inappropriate medications in older adults
The Beers Criteria provides guidelines on medications that may
be harmful in older adults due to age-related pharmacokinetic
and pharmacodynamic changes.
5. Which pharmacokinetic change is most relevant to polypharmacy
concerns in older adults?
A. Increased hepatic metabolism
B. Decreased renal clearance
C. Increased gastrointestinal absorption
D. Increased plasma protein levels
B. Decreased renal clearance
Renal function declines with age, increasing the risk of
accumulation and toxicity for renally-excreted drugs.
6. Which medication class is commonly implicated in falls among
older adults?
A. Antibiotics
B. Benzodiazepines
C. NSAIDs
D. Antihypertensives
B. Benzodiazepines
, Benzodiazepines can cause sedation, impaired balance, and
cognitive impairment, increasing fall risk.
7. A patient is taking 12 medications, many of which have
anticholinergic properties. The nurse should prioritize monitoring
for:
A. Hypertension
B. Constipation and confusion
C. Weight loss
D. Tachycardia
B. Constipation and confusion
Anticholinergic burden can cause delirium, cognitive impairment,
urinary retention, and constipation in older adults.
8. Deprescribing refers to:
A. Adding new medications to treat side effects
B. Gradually reducing or stopping medications that may be
harmful
C. Switching from generic to brand-name medications
D. Increasing medication doses for better efficacy
B. Gradually reducing or stopping medications that may be
harmful
Deprescribing helps minimize polypharmacy and reduce adverse
drug events.
9. Which strategy is most effective in preventing polypharmacy?
A. Prescribing medications without review
B. Using multiple pharmacies
C. Regular medication reconciliation
D. Self-medication with supplements
C. Regular medication reconciliation
, Reviewing all medications at each visit helps identify
unnecessary or harmful medications.
10. Older adults are at increased risk for digoxin toxicity
primarily due to:
A. Increased metabolism
B. Decreased renal clearance
C. Increased hepatic clearance
D. Increased gastrointestinal motility
B. Decreased renal clearance
Digoxin is renally excreted; impaired renal function increases the
risk of accumulation and toxicity.
11. Which symptom may indicate an adverse drug reaction in an
older adult?
A. Sudden confusion
B. Mild itching after showering
C. Stable vital signs
D. Normal appetite
A. Sudden confusion
Acute confusion or delirium is a common presentation of drug
toxicity in older adults.
12. Polypharmacy contributes to increased healthcare costs
primarily due to:
A. Reduced hospital admissions
B. Higher incidence of adverse drug events
C. Lower need for follow-up visits
D. Increased physical activity
B. Higher incidence of adverse drug events
More medications increase the risk of complications,
hospitalizations, and additional treatments.
Complete Practice Assessment 150
Questions, Answers and Rationale 2025/2026
1. Which of the following is the most common consequence of
polypharmacy in older adults?
A. Improved adherence
B. Increased risk of drug-drug interactions
C. Reduced hospitalizations
D. Enhanced cognitive function
B. Increased risk of drug-drug interactions
Polypharmacy increases the likelihood of adverse drug reactions
and interactions due to multiple medications affecting the same
pathways.
2. Polypharmacy is generally defined as:
A. Use of 1–2 medications daily
B. Use of 3–4 medications daily
C. Use of 5 or more medications daily
D. Use of only prescription medications
C. Use of 5 or more medications daily
Five or more medications is the commonly accepted threshold for
polypharmacy in geriatric populations.
3. Which of the following is a risk factor for polypharmacy in older
adults?
A. Single chronic disease
B. Frequent healthcare visits
C. Living independently without caregivers
, D. Minimal prescription medications
B. Frequent healthcare visits
Multiple providers can increase the risk of redundant or
unnecessary prescriptions.
4. The Beers Criteria is used to:
A. Diagnose dementia
B. Identify potentially inappropriate medications in older adults
C. Screen for depression
D. Determine appropriate physical activity levels
B. Identify potentially inappropriate medications in older adults
The Beers Criteria provides guidelines on medications that may
be harmful in older adults due to age-related pharmacokinetic
and pharmacodynamic changes.
5. Which pharmacokinetic change is most relevant to polypharmacy
concerns in older adults?
A. Increased hepatic metabolism
B. Decreased renal clearance
C. Increased gastrointestinal absorption
D. Increased plasma protein levels
B. Decreased renal clearance
Renal function declines with age, increasing the risk of
accumulation and toxicity for renally-excreted drugs.
6. Which medication class is commonly implicated in falls among
older adults?
A. Antibiotics
B. Benzodiazepines
C. NSAIDs
D. Antihypertensives
B. Benzodiazepines
, Benzodiazepines can cause sedation, impaired balance, and
cognitive impairment, increasing fall risk.
7. A patient is taking 12 medications, many of which have
anticholinergic properties. The nurse should prioritize monitoring
for:
A. Hypertension
B. Constipation and confusion
C. Weight loss
D. Tachycardia
B. Constipation and confusion
Anticholinergic burden can cause delirium, cognitive impairment,
urinary retention, and constipation in older adults.
8. Deprescribing refers to:
A. Adding new medications to treat side effects
B. Gradually reducing or stopping medications that may be
harmful
C. Switching from generic to brand-name medications
D. Increasing medication doses for better efficacy
B. Gradually reducing or stopping medications that may be
harmful
Deprescribing helps minimize polypharmacy and reduce adverse
drug events.
9. Which strategy is most effective in preventing polypharmacy?
A. Prescribing medications without review
B. Using multiple pharmacies
C. Regular medication reconciliation
D. Self-medication with supplements
C. Regular medication reconciliation
, Reviewing all medications at each visit helps identify
unnecessary or harmful medications.
10. Older adults are at increased risk for digoxin toxicity
primarily due to:
A. Increased metabolism
B. Decreased renal clearance
C. Increased hepatic clearance
D. Increased gastrointestinal motility
B. Decreased renal clearance
Digoxin is renally excreted; impaired renal function increases the
risk of accumulation and toxicity.
11. Which symptom may indicate an adverse drug reaction in an
older adult?
A. Sudden confusion
B. Mild itching after showering
C. Stable vital signs
D. Normal appetite
A. Sudden confusion
Acute confusion or delirium is a common presentation of drug
toxicity in older adults.
12. Polypharmacy contributes to increased healthcare costs
primarily due to:
A. Reduced hospital admissions
B. Higher incidence of adverse drug events
C. Lower need for follow-up visits
D. Increased physical activity
B. Higher incidence of adverse drug events
More medications increase the risk of complications,
hospitalizations, and additional treatments.
