TEST BANK FOR
LEHNE’S PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSES AND
nd
PHYSICIAN ASSISTANTS 2 EDITION ROSENTHAL| Chapter 1-92
[With Rational Answers]
Table Of Contents
Chapter 1 Prescriptive Authority
Chapter 2 Rational Drug Selection and Prescription Writing
Chapter 3 Promoting Positive Outcomes of Drug Therapy
Chapter 4 Pharmacokinetics, Pharmacodynamics, and Drug Interactions
Chapter 5 Adverse Drug Reactions and Medication Errors
Chapter 6 Individual Variation in Drug Responses
Chapter 7 Genetic and Genomic Considerations in Pharmacotherapeutics
Chapter 8 Drug Therapy During Pregnancy and Breast-Feeding
Chapter 9 Drug Therapy in Pediatric Patients
Chapter 10 Drug Therapy in Geriatric Patients
Chapter 11 Basic Principles of Neuropharmacology
Chapter 12 Physiology of the Peripheral Nervous System
Chapter 13 Muscarinic Agonists
Chapter 14 Muscarinic Antagonists
Chapter 15 Adrenergic Agonists
Chapter 16 Adrenergic Antagonists
Chapter 17 Indirect-Acting Antiadrenergic Agents
Chapter 18 Introduction to Central Nervous System Pharmacology
Chapter 19 Drugs for Parkinson Disease
Chapter 20 Drugs for Alzheimer Disease
Chapter 21 Drugs for Seizure Disorders
Chapter 22 Drugs for Muscle Spasm and Spasticity
Chapter 23 Local Anesthetics
Chapter 24 Opioid Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting Analgesics
Chapter 25 Drugs for Headache
Chapter 26 Antipsychotic Agents and Their Use in Schizophrenia
Chapter 27 Antidepressants
Chapter 28 Drugs for Bipolar Disorder
Chapter 29 Sedative-Hypnotic Drugs
Chapter 30 Management of Anxiety Disorders
Chapter 31 Central Nervous System Stimulants and Attention-Deficit/Hyperactivity Disorder
Chapter 32 Substance Use Disorders I: Basic Considerations
Chapter 33 Substance Use Disorders II: Alcohol
Chapter 34 Substance Use Disorders III: Nicotine and Smoking
Chapter 35 Substance Use Disorders IV: Major Drugs of Abuse Other Than Alcohol and Nicotine
Chapter 36 Review of Hemodynamics
Chapter 37. Diuretics
Chapter 38. Drugs Acting on the Renin-Angiotensin-Aldosterone System
Chapter 39 Calcium Channel Blockers
Chapter 40 Vasodilators
Chapter 41 Drugs for Hypertension
Chapter 42 Drugs for Heart Failure
Chapter 43 Antidysrhythmic Drugs
Chapter 44 Prophylaxis Atherosclerotic Cardiovascular Disease: Drugs Cholesterol TriglycerideLevels
Chapter 45 Drugs for Angina Pectoris
Chapter 46 Anticoagulant, Antiplatelet, and Thrombolytic Drugs
Chapter 47 Drugs for Deficiency Anemias
Chapter 48 Drugs for Diabetes Mellitus
Chapter 49 Drugs for Thyroid Disorders
Chapter 50 Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications
Chapter 51 Birth Control
Chapter 52 Androgens
,Chapter 53 Drugs for Erectile Dysfunction and Benign Prostatic Hyperplasia
Chapter 54 Review of the Immune System
Chapter 55 Childhood Immunization
Chapter 56 Antihistamines
Chapter 57 Cyclooxygenase Inhibitors: Nonsteroidal Anti-inflammatory Drugs and Acetaminophen
Chapter 58 Glucocorticoids in Nonendocrine Disorders
Chapter 59. Drug Therapy of Rheumatoid Arthritis
Chapter 60 Drug Therapy of Gout
Chapter 61. Drugs Affecting CalciumLevels and Bone Mineralization
Chapter 62 Drugs for Asthma and Chronic Obstructive Pulmonary Disease
Chapter 63 Drugs for Allergic Rhinitis, Cough, and Colds
Chapter 64 Drugs for Peptic Ulcer Disease
Chapter 65 Laxatives
Chapter 66 Other Gastrointestinal Drugs
Chapter 67 Vitamins
Chapter 68 Drugs for Weight Loss
Chapter 69 Complementary and Alternative Therapies
Chapter 70 Basic Principles of Antimicrobial Therapy
Chapter 71 Drugsthat Weaken the Bacterial Cell Wall I: Penicillins
Chapter 72 Drugsthat Weaken the Bacterial Cell Wall II: Other Drugs
Chapter 73 Bacteriostatic Inhibitors of Protein Synthesis
Chapter 74 Aminoglycosides: Bactericidal Inhibitors of Protein Synthesis
Chapter 75 Sulfonamides and Trimethoprim
Chapter 76 Drug Therapy of Urinary Tract Infections
Chapter 77 Drugs Therapy for Tuberculosis
Chapter 78 Miscellaneous Antibacterial Drugs
Chapter 79 Antifungal Agents
Chapter 80. Antiviral Agents I: Drugs for Non-HIV Viral Infections
Chapter 81 Antiviral Agents II: Drugs for HIV Infection and Related Opportunistic Infections
Chapter 82 Drug Therapy of Sexually Transmitted Diseases
Chapter 83 Anthelmintics, Antiprotozoal Drugs, and Ectoparasiticides
Chapter 84 Introduction to Immunomodulators
Chapter 85 Supportive Care of Patients Receiving Anticancer Drugs
Chapter 86 Drugs for Cancer Pain
Chapter 87 Drugs for the Eye
Chapter 88 Drugs for the Skin
Chapter 89 Drugs for the Ear
Chapter 90 Agents Affecting the Volume and Ion Content of Body Fluids
Chapter 91 Management of ST-Elevation Myocardial Infarction
Chapter 92 Additional Acute Care Drugs
Chapter 1: Prescriptive Authority
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, 2nd Ed
Multiple Choice
1. An APRN works in a urology clinic under the supervision of a physician who does not restrict
the types of medications the APRN is allowed to prescribe. State law does not require the
APRN to practice under physician supervision. How would the APRN‘s prescriptive authority
be described?
a. Full authority
b. Independent
c. Without limitation
d. Limited authority
ANS: B
The APRN has independent prescriptive authority because the regulating body does not
requirethat the APRN work under physician supervision. Full prescriptive authority gives the
provider the right to prescribe independently and without limitation. Limited authority places
restrictions on the types of drugsthat can be prescribed.DIF: CognitiveLevel:
ComprehensionREF: p. 1TOP: Nursing Process: IMSC:NCLEX Client Needs
,Category:Physiologic Integrity: Pharmacologic and Parenteral Therapies
2. Which factors increase the need for APRNs to have full prescriptive authority?
a. More patients will have access to health care.
b. Enrollment in medical schools is predicted to decrease.
c. Physician‘s assistants are being utilized less often.
d. APRN education is more complex than education for physicians.
ANS: A
Implementation of the Affordable Care Act has increased the number of individuals with health
care coverage, and thus the number who have access to health care services. The increase in the
number of patients creates the need for more providers with prescriptive authority. APRNs can fill
this practice gap.DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing Process:
Implementation MSC:NCLEX Client Needs Category:Physiologic Integrity: Pharmacologic
andParenteral Therapies
3. Which factors could be attributed to limited prescriptive authority for APRNs?
Select allthat apply.
a. Inaccessibility of patient care
b. Higher health care costs
c. Higher quality medical treatment
d. Improved collaborative care
e. Enhanced health literacy
ANS: A , B
Limiting prescriptive authority for APRNs can create barriers to quality, affordable, and accessible
patient care. It may also lead to poor collaboration among providers and higher health care costs.
It would not directly impact patient‘s health literacy.DIF: CognitiveLevel: ComprehensionREF:
p. 2TOP: Nursing Process: Implementation MSC:NCLEX Client Needs Category:Physiologic
Integrity: Pharmacologic and Parenteral Therapies
4. Which aspects support the APRN‘s provision for full prescriptive authority?
Select all that apply.
a. Clinical education includes prescription of medications and disease Processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN‘s ability to provide safecare.
d. Licensure ensures compliance with health care and safety standards.
e. Limiting provision can decrease health care affordability.
ANS: A , C , D
APRNs are educated to practice and prescribe independently without supervision. National
examinations validate the ability to provide safe and competent care. Licensure ensures
compliance with standards to promote public health and safety. Limited prescriptive authority
creates numerous barriers to quality, affordable, and accessible patient care.DIF: CognitiveLevel:
ComprehensionREF: pp. 1-2TOP: Nursing Process: ImplementationMSC:NCLEX Client Needs
Category:Physiologic Integrity: Pharmacologic andParenteral Therapies
5. Which aspects support the APRN‘s provision for full prescriptive authority?
Select allthat apply.
a. Clinical education includes prescription of medications and diseaseProcesses.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN‘s ability to provide safecare.
, d. Licensure ensures compliance with health care and safety standards.
ANS: A , C , D
APRNs are educated to practice and prescribe independently without supervision. National
examinations validate the ability to provide safe and competent care. Licensure ensures
compliance with standards to promote public health and safety. Limited prescriptive authority
creates numerous barriers to quality, affordable, and accessible patient care.DIF: CognitiveLevel:
ComprehensionREF: pp. 1-2TOP: Nursing P r o c e s s : ImplementationMSC:NCLEX
Client Needs Category:Physiologic Integrity: Pharmacologic andParenteral Therapies
6. A family nurse practitioner practicing in Maine is hired at a practice across state lines in
Virginia.Which aspect of practice may change for the APRN?
a. The APRN will have less prescriptive authority in the new position.
b. The APRN will have more prescriptive authority in the new position.
c. The APRN will have equal prescriptive authority in the newposition.
d. The APRN‘s authority will depend on federalregulations.
ANS: A
Virginia allows limited prescriptive authority, while Maine gives full authority to certified nurse
practitioners. The federal government does not regulate prescriptive authority.DIF:
CognitiveLevel: ComprehensionREF: p. 3TOP: NursingProcess: Implementation MSC:NCLEX
Client Needs Category:Physiologic Integrity: Pharmacologic and Parenteral Therapies
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, 2nd Ed.
Chapter 2: Rational Drug Selection and Prescription Writing
Test Bank
Multiple Choice
7. How can collaboration with a pharmacist improve positive outcomes for patients?
Select allthat apply.
a. Pharmacists can suggest foodsthat will help with the patient‘s condition.
b. Pharmacists have additional information on drug interactions.
c. The pharmacist can suggest adequate medication dosing.
d. Pharmacists have firsthand knowledge of the facility formulary.
e. Pharmacy can alter prescriptions when necessary to prevent patient harm.
ANS: B , C , D
Providers should collaborate with pharmacists because they will likely have additional information
on formulary, drug interactions, and suggestions for adequate medication dosing. Dietitians can
make foods recommendations to treat the patient‘s condition. The pharmacist can contact the
prescriber about questionable prescriptions, but cannot alter the prescription without notification
of and approval by the provider.DIF: CognitiveLevel: ComprehensionREF: p. 9TOP:
NursingProcess: DiagnosisMSC:NCLEXClient Needs Category:Physiologic Integrity: Reduction
ofRisk Potential
8. A patient presents with deliriumtremens requiring Ativan administration. The provider ofcare
is not in the facility.Which action by the nurse is most appropriate?
a. Obtain a telephone order.
b. Contact the on-call hospitalist.
c. Obtain an order from the chargenurse.
LEHNE’S PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSES AND
nd
PHYSICIAN ASSISTANTS 2 EDITION ROSENTHAL| Chapter 1-92
[With Rational Answers]
Table Of Contents
Chapter 1 Prescriptive Authority
Chapter 2 Rational Drug Selection and Prescription Writing
Chapter 3 Promoting Positive Outcomes of Drug Therapy
Chapter 4 Pharmacokinetics, Pharmacodynamics, and Drug Interactions
Chapter 5 Adverse Drug Reactions and Medication Errors
Chapter 6 Individual Variation in Drug Responses
Chapter 7 Genetic and Genomic Considerations in Pharmacotherapeutics
Chapter 8 Drug Therapy During Pregnancy and Breast-Feeding
Chapter 9 Drug Therapy in Pediatric Patients
Chapter 10 Drug Therapy in Geriatric Patients
Chapter 11 Basic Principles of Neuropharmacology
Chapter 12 Physiology of the Peripheral Nervous System
Chapter 13 Muscarinic Agonists
Chapter 14 Muscarinic Antagonists
Chapter 15 Adrenergic Agonists
Chapter 16 Adrenergic Antagonists
Chapter 17 Indirect-Acting Antiadrenergic Agents
Chapter 18 Introduction to Central Nervous System Pharmacology
Chapter 19 Drugs for Parkinson Disease
Chapter 20 Drugs for Alzheimer Disease
Chapter 21 Drugs for Seizure Disorders
Chapter 22 Drugs for Muscle Spasm and Spasticity
Chapter 23 Local Anesthetics
Chapter 24 Opioid Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting Analgesics
Chapter 25 Drugs for Headache
Chapter 26 Antipsychotic Agents and Their Use in Schizophrenia
Chapter 27 Antidepressants
Chapter 28 Drugs for Bipolar Disorder
Chapter 29 Sedative-Hypnotic Drugs
Chapter 30 Management of Anxiety Disorders
Chapter 31 Central Nervous System Stimulants and Attention-Deficit/Hyperactivity Disorder
Chapter 32 Substance Use Disorders I: Basic Considerations
Chapter 33 Substance Use Disorders II: Alcohol
Chapter 34 Substance Use Disorders III: Nicotine and Smoking
Chapter 35 Substance Use Disorders IV: Major Drugs of Abuse Other Than Alcohol and Nicotine
Chapter 36 Review of Hemodynamics
Chapter 37. Diuretics
Chapter 38. Drugs Acting on the Renin-Angiotensin-Aldosterone System
Chapter 39 Calcium Channel Blockers
Chapter 40 Vasodilators
Chapter 41 Drugs for Hypertension
Chapter 42 Drugs for Heart Failure
Chapter 43 Antidysrhythmic Drugs
Chapter 44 Prophylaxis Atherosclerotic Cardiovascular Disease: Drugs Cholesterol TriglycerideLevels
Chapter 45 Drugs for Angina Pectoris
Chapter 46 Anticoagulant, Antiplatelet, and Thrombolytic Drugs
Chapter 47 Drugs for Deficiency Anemias
Chapter 48 Drugs for Diabetes Mellitus
Chapter 49 Drugs for Thyroid Disorders
Chapter 50 Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications
Chapter 51 Birth Control
Chapter 52 Androgens
,Chapter 53 Drugs for Erectile Dysfunction and Benign Prostatic Hyperplasia
Chapter 54 Review of the Immune System
Chapter 55 Childhood Immunization
Chapter 56 Antihistamines
Chapter 57 Cyclooxygenase Inhibitors: Nonsteroidal Anti-inflammatory Drugs and Acetaminophen
Chapter 58 Glucocorticoids in Nonendocrine Disorders
Chapter 59. Drug Therapy of Rheumatoid Arthritis
Chapter 60 Drug Therapy of Gout
Chapter 61. Drugs Affecting CalciumLevels and Bone Mineralization
Chapter 62 Drugs for Asthma and Chronic Obstructive Pulmonary Disease
Chapter 63 Drugs for Allergic Rhinitis, Cough, and Colds
Chapter 64 Drugs for Peptic Ulcer Disease
Chapter 65 Laxatives
Chapter 66 Other Gastrointestinal Drugs
Chapter 67 Vitamins
Chapter 68 Drugs for Weight Loss
Chapter 69 Complementary and Alternative Therapies
Chapter 70 Basic Principles of Antimicrobial Therapy
Chapter 71 Drugsthat Weaken the Bacterial Cell Wall I: Penicillins
Chapter 72 Drugsthat Weaken the Bacterial Cell Wall II: Other Drugs
Chapter 73 Bacteriostatic Inhibitors of Protein Synthesis
Chapter 74 Aminoglycosides: Bactericidal Inhibitors of Protein Synthesis
Chapter 75 Sulfonamides and Trimethoprim
Chapter 76 Drug Therapy of Urinary Tract Infections
Chapter 77 Drugs Therapy for Tuberculosis
Chapter 78 Miscellaneous Antibacterial Drugs
Chapter 79 Antifungal Agents
Chapter 80. Antiviral Agents I: Drugs for Non-HIV Viral Infections
Chapter 81 Antiviral Agents II: Drugs for HIV Infection and Related Opportunistic Infections
Chapter 82 Drug Therapy of Sexually Transmitted Diseases
Chapter 83 Anthelmintics, Antiprotozoal Drugs, and Ectoparasiticides
Chapter 84 Introduction to Immunomodulators
Chapter 85 Supportive Care of Patients Receiving Anticancer Drugs
Chapter 86 Drugs for Cancer Pain
Chapter 87 Drugs for the Eye
Chapter 88 Drugs for the Skin
Chapter 89 Drugs for the Ear
Chapter 90 Agents Affecting the Volume and Ion Content of Body Fluids
Chapter 91 Management of ST-Elevation Myocardial Infarction
Chapter 92 Additional Acute Care Drugs
Chapter 1: Prescriptive Authority
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, 2nd Ed
Multiple Choice
1. An APRN works in a urology clinic under the supervision of a physician who does not restrict
the types of medications the APRN is allowed to prescribe. State law does not require the
APRN to practice under physician supervision. How would the APRN‘s prescriptive authority
be described?
a. Full authority
b. Independent
c. Without limitation
d. Limited authority
ANS: B
The APRN has independent prescriptive authority because the regulating body does not
requirethat the APRN work under physician supervision. Full prescriptive authority gives the
provider the right to prescribe independently and without limitation. Limited authority places
restrictions on the types of drugsthat can be prescribed.DIF: CognitiveLevel:
ComprehensionREF: p. 1TOP: Nursing Process: IMSC:NCLEX Client Needs
,Category:Physiologic Integrity: Pharmacologic and Parenteral Therapies
2. Which factors increase the need for APRNs to have full prescriptive authority?
a. More patients will have access to health care.
b. Enrollment in medical schools is predicted to decrease.
c. Physician‘s assistants are being utilized less often.
d. APRN education is more complex than education for physicians.
ANS: A
Implementation of the Affordable Care Act has increased the number of individuals with health
care coverage, and thus the number who have access to health care services. The increase in the
number of patients creates the need for more providers with prescriptive authority. APRNs can fill
this practice gap.DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing Process:
Implementation MSC:NCLEX Client Needs Category:Physiologic Integrity: Pharmacologic
andParenteral Therapies
3. Which factors could be attributed to limited prescriptive authority for APRNs?
Select allthat apply.
a. Inaccessibility of patient care
b. Higher health care costs
c. Higher quality medical treatment
d. Improved collaborative care
e. Enhanced health literacy
ANS: A , B
Limiting prescriptive authority for APRNs can create barriers to quality, affordable, and accessible
patient care. It may also lead to poor collaboration among providers and higher health care costs.
It would not directly impact patient‘s health literacy.DIF: CognitiveLevel: ComprehensionREF:
p. 2TOP: Nursing Process: Implementation MSC:NCLEX Client Needs Category:Physiologic
Integrity: Pharmacologic and Parenteral Therapies
4. Which aspects support the APRN‘s provision for full prescriptive authority?
Select all that apply.
a. Clinical education includes prescription of medications and disease Processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN‘s ability to provide safecare.
d. Licensure ensures compliance with health care and safety standards.
e. Limiting provision can decrease health care affordability.
ANS: A , C , D
APRNs are educated to practice and prescribe independently without supervision. National
examinations validate the ability to provide safe and competent care. Licensure ensures
compliance with standards to promote public health and safety. Limited prescriptive authority
creates numerous barriers to quality, affordable, and accessible patient care.DIF: CognitiveLevel:
ComprehensionREF: pp. 1-2TOP: Nursing Process: ImplementationMSC:NCLEX Client Needs
Category:Physiologic Integrity: Pharmacologic andParenteral Therapies
5. Which aspects support the APRN‘s provision for full prescriptive authority?
Select allthat apply.
a. Clinical education includes prescription of medications and diseaseProcesses.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN‘s ability to provide safecare.
, d. Licensure ensures compliance with health care and safety standards.
ANS: A , C , D
APRNs are educated to practice and prescribe independently without supervision. National
examinations validate the ability to provide safe and competent care. Licensure ensures
compliance with standards to promote public health and safety. Limited prescriptive authority
creates numerous barriers to quality, affordable, and accessible patient care.DIF: CognitiveLevel:
ComprehensionREF: pp. 1-2TOP: Nursing P r o c e s s : ImplementationMSC:NCLEX
Client Needs Category:Physiologic Integrity: Pharmacologic andParenteral Therapies
6. A family nurse practitioner practicing in Maine is hired at a practice across state lines in
Virginia.Which aspect of practice may change for the APRN?
a. The APRN will have less prescriptive authority in the new position.
b. The APRN will have more prescriptive authority in the new position.
c. The APRN will have equal prescriptive authority in the newposition.
d. The APRN‘s authority will depend on federalregulations.
ANS: A
Virginia allows limited prescriptive authority, while Maine gives full authority to certified nurse
practitioners. The federal government does not regulate prescriptive authority.DIF:
CognitiveLevel: ComprehensionREF: p. 3TOP: NursingProcess: Implementation MSC:NCLEX
Client Needs Category:Physiologic Integrity: Pharmacologic and Parenteral Therapies
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, 2nd Ed.
Chapter 2: Rational Drug Selection and Prescription Writing
Test Bank
Multiple Choice
7. How can collaboration with a pharmacist improve positive outcomes for patients?
Select allthat apply.
a. Pharmacists can suggest foodsthat will help with the patient‘s condition.
b. Pharmacists have additional information on drug interactions.
c. The pharmacist can suggest adequate medication dosing.
d. Pharmacists have firsthand knowledge of the facility formulary.
e. Pharmacy can alter prescriptions when necessary to prevent patient harm.
ANS: B , C , D
Providers should collaborate with pharmacists because they will likely have additional information
on formulary, drug interactions, and suggestions for adequate medication dosing. Dietitians can
make foods recommendations to treat the patient‘s condition. The pharmacist can contact the
prescriber about questionable prescriptions, but cannot alter the prescription without notification
of and approval by the provider.DIF: CognitiveLevel: ComprehensionREF: p. 9TOP:
NursingProcess: DiagnosisMSC:NCLEXClient Needs Category:Physiologic Integrity: Reduction
ofRisk Potential
8. A patient presents with deliriumtremens requiring Ativan administration. The provider ofcare
is not in the facility.Which action by the nurse is most appropriate?
a. Obtain a telephone order.
b. Contact the on-call hospitalist.
c. Obtain an order from the chargenurse.
