LEHNE’S PHARMACOTHERAPEUTICS FOR ADVANCED
PRACTICE NURSES AND PHYSICIAN ASSISTANTS
3RD Edition By Laura Rosenthal:
, Table of Contents
Unit 01 Introduction 1
Unit 02 Basic Principles of Pharmacology 6
Unit 03 Drug Therapy Across the Life Span 15
Unit 04 Peripheral Nervous System Drugs 22
Unit 05 Central Nervous System Drugs 31
Unit 06 Drugs for Pain 38
Unit 07 Psychotherapeutic Drugs 43
Unit 08 Substance Use Disorders 51
Unit 09 Drugs That Affect the Heart, Blood Vessels, Blood, and Blood Volume 59
Unit 10 Drugs for Endocrine Disorders 68
Unit 11 Women’s Health 73
Unit 12 Men’s Health 78
Unit 13 Antiinflammatory, Antiallergic, and Immunologic Drugs 83
Unit 14 Drugs for Bone and Joint Disorders 91
Unit 15 Respiratory Tract Drugs 97
Unit 16 Gastrointestinal Drugs 102
Unit 17 Nutrition and Complimentary Therapies 110
Unit 18 Therapy of Infectious and Parasitic Diseases 116
Unit 19 Cancer Therapy 140
Unit 20 Drugs for Eyes, Ears, and Skin 145
Unit 21 Drugs Therapy in Acute Care 152
,Unit 01: Introduction
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants,
3rd Edition
MULTIPLE CHOICE
1. A patient diagnosed with chronic pain calls to request an oxycodone
(Oxycontin) refill. Which action should the prescriber take initially?
a. Fax the renewal order to the pharmacy.
b. Arrange to schedule an appointment with the patient.
c. Verify the patient’s adherence to the prescribed drug regimen.
d. Determine the patient’s current medication dosage and pain level.
ANSWER: B
Schedule II medications are not eligible for refills, and prescriptions must be handwritten. It is
important to verify the patient’s adherence to the drug regimen and determine the current
dosage of medication and pain level; however, this can be accomplished by scheduling an
appointment and evaluating the patient in person.
2. A metered-dose albuterol inhaler is prescribed for asthma management. The
patient reports feeling jittery sometimes when taking the medication, and does
not feel that the medication is always effective. Which action will the
provider take to best minimize patient risks and maximize medication
effectiveness?
a. Ask the patient to demonstrate use of the inhaler and assess effectiveness.
b. Assess the patient’s exposure to first- and second-hand tobacco smoke.
c. Auscultate the patient's l un W
gWsoWu.ndTsBaSndMo.bW
taS
in other relevant vital signs.
d. Decrease the dosage to reduce side effects.
ANSWER: C
Assessing and evaluating lung sounds as well as other vital signs helps determine the
patient's physical response to the medication and allows comparison to the patient's
baseline vital signs. Asking the patient to demonstrate inhaler use helps to evaluate the
patient’s ability to administer the medication properly and is part of an effective evaluation,
but is not a priority intervention based on the patient’s current report. Assessing tobacco
smoke exposure helps determine whether nondrug therapies, such as smoke avoidance,
can be used as an adjunct to drug therapy, but does not relate to the patient’s current
problem. Rewriting the prescription to decrease the dosage may address the degree of
jitteriness experienced, but does not address the patient’s concern that the drug is not
always effective.
3. A patient is prescribed metronidazole for bacterial vaginosis. Which patient
history finding would be most concerning to the provider?
a. The patient had a recent yeast infection.
b. There is a family history of cervical cancer.
c. The patient drinks two glasses of wine every night.
d. The patient is unemployed.
ANSWER: C
, Patients taking metronidazole should be educated not to drink alcohol to prevent a
disulfiram- like reaction. It would be concerning that the patient drinks wine daily. History
of a yeast infection may indicate increased risk for recurrence with administration of an
antimicrobial. A family history of cervical cancer is not related to administration of
metronidazole.
Unemployment can indicate lack of insurance coverage, which may limit the patient’s
ability to purchase medications; however, generic metronidazole is one of the less
expensive medications.
4. The provider prepares a patient with newly diagnosed type 1 diabetes for
hospital discharge. Which action by the provider will best support the patient’s
ability to effectively manage medication therapy?
a. Asking the patient to demonstrate how to measure and administer insulin
b. Discussing methods of storing insulin and discarding syringes
c. Giving information about how diet and exercise affect insulin requirements
d. Teaching the patient about the long-term consequences of poor diabetes control
ANSWER: A
Because insulin must be given correctly to control symptoms and prevent an overdose, it is
most important for the patient to know how to measure and administer it. Asking for a
demonstration of technique is the best way to determine whether the patient has understood
the teaching. The other teaching points are important as well, but they are not as critical.
5. A patient reports that a medication prescribed for recurrent migraine
headaches is not working. Which action is the prescriber’s priority when
addressing the patient's concern?
a. Ask the patient about the number and frequency of tablets taken.
b. Assess the patient’s headache pain on a scale from 1 to 10.
c. PrescribeanewmedicationWfW orWm.iT
g rBaiSnM
e .mW
anSagement.
d. Suggest biofeedback as an adjunct to drug therapy.
ANSWER: A
When evaluating the effectiveness of a drug, it is important to determine how often the
patient is using the drug. Asking the patient to identify how many tablets are taken and
how often helps the provider determine effective dosages and adherence to the medication
regimen. The patient has already stated that the medication is not working; the actual level
of pain may determine the degree to which it is not working, but it does not help the
provider to determine why it is not working. The assessment process should gather as
much information about compliance, symptoms, and drug effectiveness as possible before
enacting a change in treatment. Biofeedback may be an effective adjunct to treatment, but it
should not be recommended without complete information about drug effectiveness.
6. The drug manual states that older adult patients are at increased risk for
hepatotoxicity. Which action is most important when prescribing this
medication to an 80-year-old patient?
a. Obtaining baseline liver function studies
b. Ensuring that the drug is taken in the correct dose at the correct time
c. Discontinuing the order; the drug is contraindicated for this patient
d. Giving the medication intravenously to avoid first pass metabolism
ANSWER: A
PRACTICE NURSES AND PHYSICIAN ASSISTANTS
3RD Edition By Laura Rosenthal:
, Table of Contents
Unit 01 Introduction 1
Unit 02 Basic Principles of Pharmacology 6
Unit 03 Drug Therapy Across the Life Span 15
Unit 04 Peripheral Nervous System Drugs 22
Unit 05 Central Nervous System Drugs 31
Unit 06 Drugs for Pain 38
Unit 07 Psychotherapeutic Drugs 43
Unit 08 Substance Use Disorders 51
Unit 09 Drugs That Affect the Heart, Blood Vessels, Blood, and Blood Volume 59
Unit 10 Drugs for Endocrine Disorders 68
Unit 11 Women’s Health 73
Unit 12 Men’s Health 78
Unit 13 Antiinflammatory, Antiallergic, and Immunologic Drugs 83
Unit 14 Drugs for Bone and Joint Disorders 91
Unit 15 Respiratory Tract Drugs 97
Unit 16 Gastrointestinal Drugs 102
Unit 17 Nutrition and Complimentary Therapies 110
Unit 18 Therapy of Infectious and Parasitic Diseases 116
Unit 19 Cancer Therapy 140
Unit 20 Drugs for Eyes, Ears, and Skin 145
Unit 21 Drugs Therapy in Acute Care 152
,Unit 01: Introduction
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants,
3rd Edition
MULTIPLE CHOICE
1. A patient diagnosed with chronic pain calls to request an oxycodone
(Oxycontin) refill. Which action should the prescriber take initially?
a. Fax the renewal order to the pharmacy.
b. Arrange to schedule an appointment with the patient.
c. Verify the patient’s adherence to the prescribed drug regimen.
d. Determine the patient’s current medication dosage and pain level.
ANSWER: B
Schedule II medications are not eligible for refills, and prescriptions must be handwritten. It is
important to verify the patient’s adherence to the drug regimen and determine the current
dosage of medication and pain level; however, this can be accomplished by scheduling an
appointment and evaluating the patient in person.
2. A metered-dose albuterol inhaler is prescribed for asthma management. The
patient reports feeling jittery sometimes when taking the medication, and does
not feel that the medication is always effective. Which action will the
provider take to best minimize patient risks and maximize medication
effectiveness?
a. Ask the patient to demonstrate use of the inhaler and assess effectiveness.
b. Assess the patient’s exposure to first- and second-hand tobacco smoke.
c. Auscultate the patient's l un W
gWsoWu.ndTsBaSndMo.bW
taS
in other relevant vital signs.
d. Decrease the dosage to reduce side effects.
ANSWER: C
Assessing and evaluating lung sounds as well as other vital signs helps determine the
patient's physical response to the medication and allows comparison to the patient's
baseline vital signs. Asking the patient to demonstrate inhaler use helps to evaluate the
patient’s ability to administer the medication properly and is part of an effective evaluation,
but is not a priority intervention based on the patient’s current report. Assessing tobacco
smoke exposure helps determine whether nondrug therapies, such as smoke avoidance,
can be used as an adjunct to drug therapy, but does not relate to the patient’s current
problem. Rewriting the prescription to decrease the dosage may address the degree of
jitteriness experienced, but does not address the patient’s concern that the drug is not
always effective.
3. A patient is prescribed metronidazole for bacterial vaginosis. Which patient
history finding would be most concerning to the provider?
a. The patient had a recent yeast infection.
b. There is a family history of cervical cancer.
c. The patient drinks two glasses of wine every night.
d. The patient is unemployed.
ANSWER: C
, Patients taking metronidazole should be educated not to drink alcohol to prevent a
disulfiram- like reaction. It would be concerning that the patient drinks wine daily. History
of a yeast infection may indicate increased risk for recurrence with administration of an
antimicrobial. A family history of cervical cancer is not related to administration of
metronidazole.
Unemployment can indicate lack of insurance coverage, which may limit the patient’s
ability to purchase medications; however, generic metronidazole is one of the less
expensive medications.
4. The provider prepares a patient with newly diagnosed type 1 diabetes for
hospital discharge. Which action by the provider will best support the patient’s
ability to effectively manage medication therapy?
a. Asking the patient to demonstrate how to measure and administer insulin
b. Discussing methods of storing insulin and discarding syringes
c. Giving information about how diet and exercise affect insulin requirements
d. Teaching the patient about the long-term consequences of poor diabetes control
ANSWER: A
Because insulin must be given correctly to control symptoms and prevent an overdose, it is
most important for the patient to know how to measure and administer it. Asking for a
demonstration of technique is the best way to determine whether the patient has understood
the teaching. The other teaching points are important as well, but they are not as critical.
5. A patient reports that a medication prescribed for recurrent migraine
headaches is not working. Which action is the prescriber’s priority when
addressing the patient's concern?
a. Ask the patient about the number and frequency of tablets taken.
b. Assess the patient’s headache pain on a scale from 1 to 10.
c. PrescribeanewmedicationWfW orWm.iT
g rBaiSnM
e .mW
anSagement.
d. Suggest biofeedback as an adjunct to drug therapy.
ANSWER: A
When evaluating the effectiveness of a drug, it is important to determine how often the
patient is using the drug. Asking the patient to identify how many tablets are taken and
how often helps the provider determine effective dosages and adherence to the medication
regimen. The patient has already stated that the medication is not working; the actual level
of pain may determine the degree to which it is not working, but it does not help the
provider to determine why it is not working. The assessment process should gather as
much information about compliance, symptoms, and drug effectiveness as possible before
enacting a change in treatment. Biofeedback may be an effective adjunct to treatment, but it
should not be recommended without complete information about drug effectiveness.
6. The drug manual states that older adult patients are at increased risk for
hepatotoxicity. Which action is most important when prescribing this
medication to an 80-year-old patient?
a. Obtaining baseline liver function studies
b. Ensuring that the drug is taken in the correct dose at the correct time
c. Discontinuing the order; the drug is contraindicated for this patient
d. Giving the medication intravenously to avoid first pass metabolism
ANSWER: A
