Certified Medication Aide (CMA) — All Questions

Amlodipine is a calcium channel blocker. Which side effect is listed for this group?

• a.Black, tarry stools and bleeding gums
• b.Swelling of the hands, feet, ankles or lower legs✓
• c.A dry, persistent cough
• d.Painful white patches inside the mouth or on the tongue

Calcium channel blockers such as amlodipine can cause swelling of the hands, feet, ankles or lower legs, and dizziness. Black stools, a dry cough and mouth thrush point to other causes.

A resident has reduced kidney function. Why does this matter for medications?

• a.The resident will need higher doses of most drugs
• b.Drugs removed by the kidneys can build up in the body✓
• c.Oral medications will work only if they are crushed
• d.Drugs will no longer be absorbed from the intestines

If the kidneys or liver work less well, a drug can build up, which is why the prescriber may adjust doses and why the aide watches for signs of too much drug.

Which organ does most of the work of metabolizing (changing) drugs in the body?

• a.The stomach
• b.The liver✓
• c.The lungs
• d.The kidneys

Metabolism happens mainly in the liver, which changes drugs into forms that are easier to remove. The kidneys handle most excretion.

A resident receives a scheduled laxative. Which finding should the medication aide report?

• a.Diarrhea, abdominal pain or no bowel movement✓
• b.A soft, formed bowel movement the next morning
• c.A normal appetite at both lunch and dinner today
• d.Sleeping through the whole night without waking

For laxatives and stool softeners, bowel movements are recorded as the facility requires, and diarrhea, abdominal pain or no bowel movement is reported. A soft, formed stool shows the medication working.

A drug name ends in "-lol," as in carvedilol. Which drug class does this usually indicate?

• a.ACE inhibitor
• b.Proton pump inhibitor
• c.Beta blocker✓
• d.Cholesterol-lowering statin

Beta blocker names usually end in -lol (metoprolol, carvedilol). ACE inhibitors end in -pril, statins in -statin and proton pump inhibitors in -prazole.

A resident who takes risperidone has new movements of the lips and tongue that she cannot control. What may this be?

• a.A sign of low blood glucose that needs juice
• b.A normal part of aging that needs no report
• c.A possible sign of tardive dyskinesia that should be reported✓
• d.A sign that the medication is working better

The FDA label describes uncontrolled movements of the face, lips or tongue as possible signs of tardive dyskinesia, which are reported. A change like this is never assumed to be normal aging.

Why must prednisone not be stopped or skipped unless the prescriber orders it?

• a.It is a blood thinner, and missing a dose causes clots
• b.Stopping it suddenly can leave the body short of its own steroids✓
• c.It is a Schedule II drug, so skipped doses must be counted
• d.It is an antibiotic, so the full course must be finished on schedule

MedlinePlus warns that stopping prednisone suddenly can leave the body short of its own steroids. Prednisone is a corticosteroid that reduces inflammation, not an antibiotic, anticoagulant or controlled substance.

A resident has just started zolpidem for sleep. What is the main safety concern the medication aide watches for?

• a.Swelling of the ankles and feet after several days of use
• b.Drowsiness, confusion and unsteadiness that raise fall risk✓
• c.A faster heartbeat and a higher blood pressure in the morning
• d.Low blood glucose with heavy sweating in the middle of the night

Sedatives and sleep medications can cause drowsiness, confusion and unsteadiness, which raise the risk of falls in older adults. Morning drowsiness or unsteadiness is reported.

Which side effects are most common with sublingual nitroglycerin, according to the FDA label?

• a.Constipation and drowsiness
• b.Headache and dizziness✓
• c.Dry cough and hoarseness
• d.Muscle pain and weakness

Headache and dizziness are the most common side effects on the FDA label, and MedlinePlus says the person will probably be told to sit down before taking a dose.

Which drink is acceptable to take with alendronate?

• a.Orange juice
• b.Mineral water
• c.Plain water✓
• d.Milk

MedlinePlus says alendronate is taken only with plain water, never milk, juice or mineral water, which can interfere with it.

A resident takes naproxen, an NSAID. Which finding should be reported?

• a.Black, tarry stools or stomach pain✓
• b.Walking farther than usual without pain
• c.Taking the dose with food or milk
• d.Less joint stiffness than last week

NSAIDs can cause ulcers and bleeding in the stomach or intestine without warning. Black or tarry stools, stomach pain, or vomit that is bloody or looks like coffee grounds are reported. Less pain shows the drug working.

Aspirin and clopidogrel are antiplatelet medications. What should the medication aide watch for and report?

• a.Swelling in the ankles at the end of the day
• b.A dry cough that keeps the resident awake
• c.Signs of bleeding such as bruising, nosebleeds or black stools✓
• d.Low blood glucose with shakiness and sweating

Antiplatelets raise bleeding risk, so the same bleeding signs as for anticoagulants are reported: unusual bruising, bleeding gums, nosebleeds, blood in urine, and black or tarry stools.

When is levothyroxine generally taken?

• a.At bedtime with a small snack and a glass of milk
• b.On an empty stomach, 30 minutes to 1 hour before breakfast✓
• c.Together with an antacid to protect the stomach
• d.With breakfast and a calcium supplement, at the same time each day

Levothyroxine is taken on an empty stomach, 30 minutes to 1 hour before breakfast, and separated from calcium, iron and antacids. Follow the times on the MAR.

Which complaint from a resident who takes furosemide should be reported to the nurse?

• a.Feeling rested and eating a full breakfast
• b.Passing more urine in the hours after the morning dose
• c.Thirst, weakness and muscle cramps✓
• d.Sleeping well through the night without waking

MedlinePlus tells people taking furosemide to report dry mouth, thirst, weakness, muscle pain or cramps, confusion, or a rapid or pounding heartbeat. Increased urine output is the intended effect of a diuretic.