NUR 209 EXAMINATION SCRIPT 2025/2026 QUESTIONS
AND ANSWERS GUARANTEE A+
✔✔What are some sociodemographic risk factors of frailty?
A) Multimorbidity, Chronic diseases, Obesity, Malnutrition, Impaired cognition,
Depressive symptoms, polypharmacy
B) Age, Female, Ethnicity, Education, Low socioeconomic position, Living alone,
Loneliness
C) physical inactivity, diet, smoking, alcohol
D) Immune function, Neuroendocrine function, Micronutrient deficiencies, Sarcopenia,
Energy imbalances/oxidative stress - ✔✔B
✔✔What are some clinical risk factors of frailty?
A) Multimorbidity, Chronic diseases, Obesity, Malnutrition, Impaired cognition,
Depressive symptoms, polypharmacy
B) Age, Female, Ethnicity, Education, Low socioeconomic position, Living alone,
Loneliness
C) physical inactivity, diet, smoking, alcohol
D) Immune function, Neuroendocrine function, Micronutrient deficiencies, Sarcopenia,
Energy imbalances/oxidative stress - ✔✔A) Multimorbidity, Chronic diseases, Obesity,
Malnutrition, Impaired cognition, Depressive symptoms, polypharmacy
✔✔What are some lifestyle risk factors of frailty?
A) Multimorbidity, Chronic diseases, Obesity, Malnutrition, Impaired cognition,
Depressive symptoms, polypharmacy
B) Age, Female, Ethnicity, Education, Low socioeconomic position, Living alone,
Loneliness
C) physical inactivity, diet, smoking, alcohol
D) Immune function, Neuroendocrine function, Micronutrient deficiencies, Sarcopenia,
Energy imbalances/oxidative stress - ✔✔C) physical inactivity, diet, smoking, alcohol
✔✔What are some biological risk factors of frailty?
A) Multimorbidity, Chronic diseases, Obesity, Malnutrition, Impaired cognition,
Depressive symptoms, polypharmacy
B) Age, Female, Ethnicity, Education, Low socioeconomic position, Living alone,
Loneliness
C) physical inactivity, diet, smoking, alcohol
D) Immune function, Neuroendocrine function, Micronutrient deficiencies, Sarcopenia,
Energy imbalances/oxidative stress - ✔✔D) Immune function, Neuroendocrine function,
Micronutrient deficiencies, Sarcopenia, Energy imbalances/oxidative stress
✔✔What is polypharmacy? - ✔✔5+ medications daily
✔✔Characteristics don't include:
A) The use of two medications with different mechanisms of action
,B) The use of more medications than are clinically indicated
C) Using two medications in combination that have been shown to be effective to treat a
medical condition
D) Using one medication to treat multiple condition
E) Treating many conditions with one drug - ✔✔E) Treating many conditions with one
drug
✔✔What is hyperpolypharmacy - ✔✔10+ medications a day
✔✔issue with polypharmacy - ✔✔highest at approximately 30% among 65-79yrs
✔✔Contributing factors to polypharmacy - ✔✔comorbidities, multiple providers, complex
or incomplete instructions about medications, use of non-perscribed drugs,
inappropriate perscribing
✔✔Pharmacokinetics - renal function - ✔✔Calculating creatinine clearance, either from
a urine collection or by using a mathematical equation such as the.
✔✔how to calculate creatine clearance - ✔✔Cockcroft-Gault formula to estimate kidney
function.
Creatinine clearance (ClCr) = urine creatinine X urine flow/serum creatinine
CICr (mL/min) = 1.2 (140 - age) (weight)serum creatin (umol/L)
In females multiply by 0.85
✔✔Significance medication related problems - ✔✔risk of clinically serious ADR is 4/100
prescriptions - 1/1000 will die
✔✔3D care (questions to ask) - ✔✔Drug the best
Dosage correct
Duration correct
Compliance
Adverse effects
Reactions
Expensive
✔✔what are some risks of anticholinergics
A) constipation, confusion, incontinence
B) dystonia, akathisia, and parkinsonism, falls
C) CHF, kidney failure
D) falls
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔A) constipation, confusion, incontinence
,✔✔what are some risks of psychotropics
A) dystonia, akathisia, and parkinsonism, falls
B) constipation, confusion, incontinence
C) falls
D) CHF, kidney failure
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔dystonia, akathisia, and parkinsonism, falls
✔✔what are some risks of NSAIDS
A) dystonia, akathisia, and parkinsonism, falls
B) constipation, confusion, incontinence
C) falls
D) CHF, kidney failure
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔D) CHF, kidney failure
✔✔what are some risks of hypoglycemics
A) dystonia, akathisia, and parkinsonism, falls
B) constipation, confusion, incontinence
C) falls
D) CHF, kidney failure
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔C) falls
✔✔what are some risks of diuretics
A) dystonia, akathisia, and parkinsonism, falls
B) constipation, confusion, incontinence
C) falls
D) CHF, kidney failure
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔E) falls, incontinence, SIADH, hyponatremia, potassium
imbalances
✔✔what are some risks of anticonvulsants
A) dystonia, akathisia, and parkinsonism, falls
B) constipation, confusion, incontinence
C) falls
D) CHF, kidney failure
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔F) sedation, falls, SIADH
✔✔Hypoglycemics - ✔✔Use long acting insulin and avoid sliding-scale insulin
The risk of hypoglycemia and its associated complications increases as the intensity of
glycemic control increases.
, Older patients with an A1c less than 7% are at an increased risk for falls.
Severe episodes associated with an increased risk for the development of dementia
associated with more episodes of cardiac ischemia than are hyper- or normoglycemic
states
✔✔Sulfonylureas - mechanism of action - ✔✔binds to the ATP sensitive K channel in
pancreatic beta cells triggering insulin release
✔✔Sulfonylureas - Example - ✔✔glipzide, glimepiride, glyburide
✔✔Sulfonylureas - major advantages - ✔✔inexpensive
✔✔Sulfonylureas - contraindicatioons - ✔✔glyburide is contraindicated in CKD
✔✔Common side effects and important toxicities of Sulfonylureas - ✔✔weight gain and
hypoglycemia
✔✔Proton pump inhibitors - risk for - ✔✔low vit B12, bone fractures, pneumonia,
intestinal infections
✔✔NSAIDS -risks - ✔✔Gastric or duodenal ulcers/UGI bleed
Prohypertensive effect: inhibition of COX-2 in the kidneys: associated with reduced
prostaglandin I2 (PGI2 or prostacyclin a potent inhibitor of platelet aggregation and a
powerful vasodilator)
Worsening of HF: decrease in renal blood flow and compensatory retention of sodium
and water
Aspirin-induced asthma (AIA) or nonsteroidal anti-inflammatory drug (NSAID)-
exacerbated respiratory disease (NERD) is defined as hypersensitivity to
aspirin/NSAIDs, causing respiratory-related symptoms such as bronchospasms, acute
asthma exacerbation (lower airway), and severe asthma morbidity.
Platelet dysfunction: inhibit platelet aggregation through inhibition of COX-1 and the
thromboxane A2 (TXA2) pathway.
Acute renal failure: NSAIDs block the production of prostaglandins resulting in
unopposed vasoconstriction
Acute interstitial nephritis (from a direct toxicity of the drug on the renal parenchyma).
Elevation of liver enzymes
AND ANSWERS GUARANTEE A+
✔✔What are some sociodemographic risk factors of frailty?
A) Multimorbidity, Chronic diseases, Obesity, Malnutrition, Impaired cognition,
Depressive symptoms, polypharmacy
B) Age, Female, Ethnicity, Education, Low socioeconomic position, Living alone,
Loneliness
C) physical inactivity, diet, smoking, alcohol
D) Immune function, Neuroendocrine function, Micronutrient deficiencies, Sarcopenia,
Energy imbalances/oxidative stress - ✔✔B
✔✔What are some clinical risk factors of frailty?
A) Multimorbidity, Chronic diseases, Obesity, Malnutrition, Impaired cognition,
Depressive symptoms, polypharmacy
B) Age, Female, Ethnicity, Education, Low socioeconomic position, Living alone,
Loneliness
C) physical inactivity, diet, smoking, alcohol
D) Immune function, Neuroendocrine function, Micronutrient deficiencies, Sarcopenia,
Energy imbalances/oxidative stress - ✔✔A) Multimorbidity, Chronic diseases, Obesity,
Malnutrition, Impaired cognition, Depressive symptoms, polypharmacy
✔✔What are some lifestyle risk factors of frailty?
A) Multimorbidity, Chronic diseases, Obesity, Malnutrition, Impaired cognition,
Depressive symptoms, polypharmacy
B) Age, Female, Ethnicity, Education, Low socioeconomic position, Living alone,
Loneliness
C) physical inactivity, diet, smoking, alcohol
D) Immune function, Neuroendocrine function, Micronutrient deficiencies, Sarcopenia,
Energy imbalances/oxidative stress - ✔✔C) physical inactivity, diet, smoking, alcohol
✔✔What are some biological risk factors of frailty?
A) Multimorbidity, Chronic diseases, Obesity, Malnutrition, Impaired cognition,
Depressive symptoms, polypharmacy
B) Age, Female, Ethnicity, Education, Low socioeconomic position, Living alone,
Loneliness
C) physical inactivity, diet, smoking, alcohol
D) Immune function, Neuroendocrine function, Micronutrient deficiencies, Sarcopenia,
Energy imbalances/oxidative stress - ✔✔D) Immune function, Neuroendocrine function,
Micronutrient deficiencies, Sarcopenia, Energy imbalances/oxidative stress
✔✔What is polypharmacy? - ✔✔5+ medications daily
✔✔Characteristics don't include:
A) The use of two medications with different mechanisms of action
,B) The use of more medications than are clinically indicated
C) Using two medications in combination that have been shown to be effective to treat a
medical condition
D) Using one medication to treat multiple condition
E) Treating many conditions with one drug - ✔✔E) Treating many conditions with one
drug
✔✔What is hyperpolypharmacy - ✔✔10+ medications a day
✔✔issue with polypharmacy - ✔✔highest at approximately 30% among 65-79yrs
✔✔Contributing factors to polypharmacy - ✔✔comorbidities, multiple providers, complex
or incomplete instructions about medications, use of non-perscribed drugs,
inappropriate perscribing
✔✔Pharmacokinetics - renal function - ✔✔Calculating creatinine clearance, either from
a urine collection or by using a mathematical equation such as the.
✔✔how to calculate creatine clearance - ✔✔Cockcroft-Gault formula to estimate kidney
function.
Creatinine clearance (ClCr) = urine creatinine X urine flow/serum creatinine
CICr (mL/min) = 1.2 (140 - age) (weight)serum creatin (umol/L)
In females multiply by 0.85
✔✔Significance medication related problems - ✔✔risk of clinically serious ADR is 4/100
prescriptions - 1/1000 will die
✔✔3D care (questions to ask) - ✔✔Drug the best
Dosage correct
Duration correct
Compliance
Adverse effects
Reactions
Expensive
✔✔what are some risks of anticholinergics
A) constipation, confusion, incontinence
B) dystonia, akathisia, and parkinsonism, falls
C) CHF, kidney failure
D) falls
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔A) constipation, confusion, incontinence
,✔✔what are some risks of psychotropics
A) dystonia, akathisia, and parkinsonism, falls
B) constipation, confusion, incontinence
C) falls
D) CHF, kidney failure
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔dystonia, akathisia, and parkinsonism, falls
✔✔what are some risks of NSAIDS
A) dystonia, akathisia, and parkinsonism, falls
B) constipation, confusion, incontinence
C) falls
D) CHF, kidney failure
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔D) CHF, kidney failure
✔✔what are some risks of hypoglycemics
A) dystonia, akathisia, and parkinsonism, falls
B) constipation, confusion, incontinence
C) falls
D) CHF, kidney failure
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔C) falls
✔✔what are some risks of diuretics
A) dystonia, akathisia, and parkinsonism, falls
B) constipation, confusion, incontinence
C) falls
D) CHF, kidney failure
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔E) falls, incontinence, SIADH, hyponatremia, potassium
imbalances
✔✔what are some risks of anticonvulsants
A) dystonia, akathisia, and parkinsonism, falls
B) constipation, confusion, incontinence
C) falls
D) CHF, kidney failure
E) falls, incontinence, SIADH, hyponatremia, potassium imbalances
F) sedation, falls, SIADH - ✔✔F) sedation, falls, SIADH
✔✔Hypoglycemics - ✔✔Use long acting insulin and avoid sliding-scale insulin
The risk of hypoglycemia and its associated complications increases as the intensity of
glycemic control increases.
, Older patients with an A1c less than 7% are at an increased risk for falls.
Severe episodes associated with an increased risk for the development of dementia
associated with more episodes of cardiac ischemia than are hyper- or normoglycemic
states
✔✔Sulfonylureas - mechanism of action - ✔✔binds to the ATP sensitive K channel in
pancreatic beta cells triggering insulin release
✔✔Sulfonylureas - Example - ✔✔glipzide, glimepiride, glyburide
✔✔Sulfonylureas - major advantages - ✔✔inexpensive
✔✔Sulfonylureas - contraindicatioons - ✔✔glyburide is contraindicated in CKD
✔✔Common side effects and important toxicities of Sulfonylureas - ✔✔weight gain and
hypoglycemia
✔✔Proton pump inhibitors - risk for - ✔✔low vit B12, bone fractures, pneumonia,
intestinal infections
✔✔NSAIDS -risks - ✔✔Gastric or duodenal ulcers/UGI bleed
Prohypertensive effect: inhibition of COX-2 in the kidneys: associated with reduced
prostaglandin I2 (PGI2 or prostacyclin a potent inhibitor of platelet aggregation and a
powerful vasodilator)
Worsening of HF: decrease in renal blood flow and compensatory retention of sodium
and water
Aspirin-induced asthma (AIA) or nonsteroidal anti-inflammatory drug (NSAID)-
exacerbated respiratory disease (NERD) is defined as hypersensitivity to
aspirin/NSAIDs, causing respiratory-related symptoms such as bronchospasms, acute
asthma exacerbation (lower airway), and severe asthma morbidity.
Platelet dysfunction: inhibit platelet aggregation through inhibition of COX-1 and the
thromboxane A2 (TXA2) pathway.
Acute renal failure: NSAIDs block the production of prostaglandins resulting in
unopposed vasoconstriction
Acute interstitial nephritis (from a direct toxicity of the drug on the renal parenchyma).
Elevation of liver enzymes
