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1. JP is a 79-year-old woman with HFpEF, coronary artery disease, atrial fibrillation, T2DM, hypertension, GERD, osteoporosis, and major depressive disorder. Her current medications include extended-release metformin 1000 mg ER daily, furosemide 20 mg twice daily, spironolactone 25 mg daily, metoprolol succinate 100 mg daily, losartan 25 mg daily, digoxin 125 mcg daily, aspirin 81 mg daily, cholecalciferol 2000 units daily, citalopram 10 mg daily, and clonazepam 1 mg at bedtime as needed for sleep (she takes this less than once weekly). Her most recent serum creatinine is 1.25 mg/dL. She recently started experiencing headaches, dizziness, and mental disturbances. Which of the following medications is most likely causing her symptoms?

A. Metoprolol B. Clonazepam C. Digoxin D. Citalopram

2. SW is a 67-year-old African American malnrecently started on donepezil for Alzheimer's disease. Which of his current medications listed below has the highest potential to cause anticholinergic side effects?

A. Carvedilol B. Digoxin C. Fluoxetine D. Cyclobenzaprine

3. MC is a 72-year-old woman with past medical history significant for uncontrolled hypertension on multiple antihypertensives, hyperlipidemia, CHF, GERD with history of GI bleed, chronic kidney disease (creatinine clearance of 40 mL/min), osteoarthritis, and PTSD. Which of these medications is inappropriate to continue given MC's comorbidities?

A. Lisinopril B. Paroxetine C. Naproxen D. Rosuvastatin

4. JA is a 56-year-old white man. His medical history list includes hyperlipidemia, hypertension, GERD, major depressive disorder, and T2DM. Which of the following medications is inappropriate as first-line treatment for JA's listed conditions according to the STOPP criteria?

A. Atorvastatin B. Furosemide C. Citalopram D. Insulin

5. CM is an 85-year-old man with history of insomnia not related to mental health disorders. Which of the following medications is appropriate for him to take on an as-needed basis?

A. Trazodone B. Diphenhydramine C. Quetiapine D. Hydroxyzine

6. Which of the following interventions would be effective in the process of deprescribing?

A. Review medications at each office visit to ensure an accurate medication list B. Limit patients' medications to no more than 4 C. Advise the patient to stop taking any medication that they believe is causing an adverse effect D. All of the above

7. Older adults are more likely to be exposed to polypharmacy because of:

A. Concomitant substance use disorders B. Infections acquired during travel C. Changes in drug clearance D. Care provided by multiple physicians

8. In which of the following situations should you consider deprescribing a proton pump inhibitor following a 4-week treatment?

A. Barrett esophagus B. Mild-to-moderate gastroesophageal reflux disease or esophagitis C. Severe esophagitis D. Documented history of bleeding gastrointestinal ulcers

9. ML is a 77-year-old woman who takes temazepam, a benzodiazepine, for sleep. After reviewing the patient's chart and following a discussion with the patient and physician, you decide to recommend tapering of this drug. Which of the following should NOT be included in the deprescribing plan?

A. Tell the patient that insomnia and anxiety may occur B. Monitor the patient every 1–2 weeks for the duration of tapering C. Begin zolpidem if withdrawal symptoms occur D. Instruct the patient to avoid use of drugs that worsen insomnia, such as caffeine or alcohol

10. Deprescribing of an antipsychotic agent is appropriate in an older adult with

A. Schizophrenia B. Acute delirium C. Obsessive compulsive disorder D. Behavioral and psychological symptoms of dementia