Board Certified Geriatric Pharmacist (BCGP)
Practice Exam Verified Questions, Correct
Answers, and Detailed Explanations for
Science Students||Already Graded A+
1. Which physiological change most significantly affects drug
distribution in older adults?
A. Increased total body water
B. Increased hepatic blood flow
C. Increased body fat percentage
D. Increased serum albumin
Answer: C
Increased body fat prolongs the half-life of lipophilic drugs such as
benzodiazepines.
2. Which medication is listed in the Beers Criteria as potentially
inappropriate due to anticholinergic effects?
A. Sertraline
B. Diphenhydramine
C. Metformin
D. Acetaminophen
Answer: B
Diphenhydramine has strong anticholinergic effects that increase
confusion and fall risk.
3. An elderly patient with chronic kidney disease requires dose
adjustment based on which parameter?
,A. Serum creatinine alone
B. Blood urea nitrogen
C. Creatinine clearance
D. Urine output
Answer: C
Creatinine clearance better reflects renal function in older adults than
serum creatinine alone.
4. Which adverse drug effect is most associated with antipsychotic
use in dementia patients?
A. Bradycardia
B. Hypoglycemia
C. Increased mortality
D. Constipation
Answer: C
Antipsychotics carry a boxed warning for increased mortality in
elderly patients with dementia-related psychosis.
5. Which antihypertensive is preferred in older adults with isolated
systolic hypertension?
A. ACE inhibitor
B. Beta-blocker
C. Thiazide diuretic
D. Alpha-blocker
Answer: C
Low-dose thiazide diuretics are effective and well tolerated in
isolated systolic hypertension.
,6. Which medication increases fall risk most significantly in older
adults?
A. Lisinopril
B. Metformin
C. Benzodiazepines
D. Aspirin
Answer: C
Benzodiazepines cause sedation, impaired balance, and cognitive
impairment.
7. Which tool is commonly used to assess potentially inappropriate
medications in geriatrics?
A. CHA₂DS₂-VASc
B. APGAR score
C. Beers Criteria
D. FRAX score
Answer: C
The Beers Criteria identifies medications that may pose more risk
than benefit in older adults.
8. Which vaccine is recommended annually for adults aged ≥65
years?
A. Zoster vaccine
B. Influenza vaccine
C. Tdap
D. Hepatitis B
Answer: B
Annual influenza vaccination is strongly recommended for older
adults.
, 9. Which opioid is preferred in older adults with renal impairment?
A. Morphine
B. Codeine
C. Hydromorphone
D. Meperidine
Answer: C
Hydromorphone has fewer active metabolites compared to
morphine.
10. Which laboratory value is most affected by dehydration in
elderly patients?
A. Hemoglobin
B. BUN/creatinine ratio
C. ALT
D. Platelet count
Answer: B
Dehydration causes a disproportionate rise in BUN relative to
creatinine.
11. Which antidepressant is safest in older adults?
A. Amitriptyline
B. Paroxetine
C. Sertraline
D. Imipramine
Answer: C
Sertraline has minimal anticholinergic effects and fewer drug
interactions.
Practice Exam Verified Questions, Correct
Answers, and Detailed Explanations for
Science Students||Already Graded A+
1. Which physiological change most significantly affects drug
distribution in older adults?
A. Increased total body water
B. Increased hepatic blood flow
C. Increased body fat percentage
D. Increased serum albumin
Answer: C
Increased body fat prolongs the half-life of lipophilic drugs such as
benzodiazepines.
2. Which medication is listed in the Beers Criteria as potentially
inappropriate due to anticholinergic effects?
A. Sertraline
B. Diphenhydramine
C. Metformin
D. Acetaminophen
Answer: B
Diphenhydramine has strong anticholinergic effects that increase
confusion and fall risk.
3. An elderly patient with chronic kidney disease requires dose
adjustment based on which parameter?
,A. Serum creatinine alone
B. Blood urea nitrogen
C. Creatinine clearance
D. Urine output
Answer: C
Creatinine clearance better reflects renal function in older adults than
serum creatinine alone.
4. Which adverse drug effect is most associated with antipsychotic
use in dementia patients?
A. Bradycardia
B. Hypoglycemia
C. Increased mortality
D. Constipation
Answer: C
Antipsychotics carry a boxed warning for increased mortality in
elderly patients with dementia-related psychosis.
5. Which antihypertensive is preferred in older adults with isolated
systolic hypertension?
A. ACE inhibitor
B. Beta-blocker
C. Thiazide diuretic
D. Alpha-blocker
Answer: C
Low-dose thiazide diuretics are effective and well tolerated in
isolated systolic hypertension.
,6. Which medication increases fall risk most significantly in older
adults?
A. Lisinopril
B. Metformin
C. Benzodiazepines
D. Aspirin
Answer: C
Benzodiazepines cause sedation, impaired balance, and cognitive
impairment.
7. Which tool is commonly used to assess potentially inappropriate
medications in geriatrics?
A. CHA₂DS₂-VASc
B. APGAR score
C. Beers Criteria
D. FRAX score
Answer: C
The Beers Criteria identifies medications that may pose more risk
than benefit in older adults.
8. Which vaccine is recommended annually for adults aged ≥65
years?
A. Zoster vaccine
B. Influenza vaccine
C. Tdap
D. Hepatitis B
Answer: B
Annual influenza vaccination is strongly recommended for older
adults.
, 9. Which opioid is preferred in older adults with renal impairment?
A. Morphine
B. Codeine
C. Hydromorphone
D. Meperidine
Answer: C
Hydromorphone has fewer active metabolites compared to
morphine.
10. Which laboratory value is most affected by dehydration in
elderly patients?
A. Hemoglobin
B. BUN/creatinine ratio
C. ALT
D. Platelet count
Answer: B
Dehydration causes a disproportionate rise in BUN relative to
creatinine.
11. Which antidepressant is safest in older adults?
A. Amitriptyline
B. Paroxetine
C. Sertraline
D. Imipramine
Answer: C
Sertraline has minimal anticholinergic effects and fewer drug
interactions.
