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How to Try This: Monitoring Medication Use in Older Adults

AJN The American Journal of Nursing: January 2009 - Volume 109 - Issue 1 - p 78–79
doi: 10.1097/01.NAJ.0000344051.28683.3f
CE TEST 2.6 HOURS Continuing Education
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CE 2.6 HOURS Continuing Education


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GENERAL PURPOSE: To instruct registered professional nurses in the use of the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults to evaluate risk warranting follow-up in older adults in various settings.

LEARNING OBJECTIVES: After reading this article and taking the test on the next page, you will be able to

  • discuss the need to screen older adults for inappropriate medication use.
  • outline the appropriate use of the Beers criteria.
  • summarize the development of the Beers criteria and outcomes associated with their use.


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1. The Beers criteria specify drugs and classes of drugs

a. that are appropriate for use by older adults.

b. that create dangerous interactions with each other.

c. whose use is unnecessary for the person screened.

d. whose associated risks might outweigh their benefits.

2. According to a national survey, what percentage of women ages 65 and older took 5 or more prescription drugs?

a. 12%

b. 19%

c. 23%

d. 31%

3. One reason why older adults metabolize drugs differently than younger people is that they tend to have

a. less blood flow to the kidneys.

b. more total body fluid.

c. increased lean body mass.

d. increased serum albumin levels.

4. Adults ages 65 and older have an incidence of adverse drug reactions requiring hospitalization that is how many times higher than that of adults younger than 65?

a. 4

b. 5

c. 6

d. 7

5. A recent study of Medicare- and Medicaid-eligible older adults in California indicated that they take a mean of how many drugs per day?

a. 7

c. 9

b. 8

d. 10

6. According to one evidence-based guideline, medication assessment should be done at least every

a. month.

b. 3 months.

c. 6 months.

d. year.

7. The usual method for compiling a list of an older adult's medications is to

a. consult with the patient's pharmacy.

b. have the patient bring in all medications used.

c. ask the patient's primary care provider.

d. interview the patient about medication use.

8. After compiling a list of all of the older adult's medications, the nurse should highlight the drugs listed in the Beers criteria plus

a. any drugs that aren't monitored by laboratory tests.

b. all other drugs the patient takes.

c. all over-the-counter drugs the patient takes.

d. any drugs that have an unclear indication for use.

9. The Beers criteria include all of the following except

a. consideration of the cost of medications.

b. generic and trade names of potentially inappropriate medications.

c. concerns regarding the possible adverse effects of the medications.

d. the severity of possible adverse events.

10. According to the American Medical Directors Association and the American Society of Consultant Pharmacists, the Beers criteria should not be used as

a. a first step in a nursing assessment of medication use.

b. a means of identifying off-label and alternative drug usage.

c. an aid to finding safer alternatives to high-risk drugs.

d. an absolute prohibition against prescribing certain medications.

11. Studies have shown that the greater the number of medications prescribed, the greater the

a. risk of adverse effects.

b. level of compliance.

c. patient's symptom control.

d. provider's involvement in care.

12. A review of the evidence supported designating most of the medications identified in the 1997 Beers criteria as

a. appropriate after screening for dosage safety.

b. inappropriate when goals are not met.

c. inappropriate for use in older adults.

d. appropriate when not combined with other cited drugs.

13. According to a study by Fick and colleagues, the prevalence of drug-related problems within 30 days of starting a new prescription in a group of older adults identified by the Beers criteria as receiving one or more potentially inappropriate medications was

a. 4.7%.

b. 14.3%.

c. 21.7%.

d. 28.3%.

14. A 2007 analysis of 19 studies using Beers I concluded that the only outcome that could be linked with the tool was

a. improved education.

b. fewer side effects.

c. hospitalization.

d. dosage reduction.

15. A type of drug listed in the Beers criteria that is noted to cause confusion, urinary retention, and other adverse effects in older adults is

a. anticholinergics.

b. antibiotics.

c. antiarrhythmics.

d. antitussives.

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