Table of Contents
Unit 01 Introduction 1
Unit 02 Basic Principles of Pharmacology 6
TEST BANK Unit 03 Drug Therapy Across the Life Span 15
Lehne’s Pharmacotherapeutics for Advanced Practice Nurses Unit 04 Peripheral Nervous System Drugs 22
Unit 05 Central Nervous System Drugs 31
and Physician Assistants Unit 06 Drugs for Pain 38
Unit 07 Psychotherapeutic Drugs 43
Laura D. Rosenthal, and Jacqueline Rosenjack Burchum Unit 08 Substance Use Disorders 51
Unit 09 Drugs That Affect the Heart, Blood Vessels, Blood, and Blood Volume 59
2nd Edition 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
,Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021) Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021)
Unit 01: Introduction Patients taking metronidazole should be educated not to drink alcohol to prevent a
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Nurses and Physician disulfiram-like reaction. It would be concerning that the patient drinks wine daily. History
Assistants, 2nd Edition 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
MULTIPLE CHOICE patient’s ability to purchase medications; however, generic metronidazole is one of the less
expensive medications.
1. A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially? 4. The provider prepares a patient with newly diagnosed type 1 diabetes for hospital discharge.
a. Fax the renewal order to the pharmacy. Which action by the provider will best support the patient’s ability to effectively manage
b. Arrange to schedule an appointment with the patient. medication therapy?
c. Verify the patient’s adherence to the prescribed drug regimen. a. Asking the patient to demonstrate how to measure and administer insulin
d. Determine the patient’s current medication dosage and pain level. b. Discussing methods of storing insulin and discarding syringes
c. Giving information about how diet and exercise affect insulin requirements
ANS: B d. Teaching the patient about the long-term consequences of poor diabetes control
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 ANS: A
dosage of medication and pain level; however, this can be accomplished by scheduling an Because insulin must be given correctly to control symptoms and prevent an overdose, it is
appointment and evaluating the patient in person. 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
2. A metered-dose albuterol inhaler is prescribed for asthma management. The patient reports the teaching. The other teaching points are important as well, but they are not as critical.
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 5. A patient reports that a medication prescribed for recurrent migraine headaches is not
maximize medication effectiveness? working. Which action is the prescriber’s priority when addressing the patient's concern?
a. Ask the patient to demonstrate use of the inhaler and assess effectiveness. a. Ask the patient about the number and frequency of tablets taken.
b. Assess the patient’s exposure to first- and second-hand tobacco smoke. b. Assess the patient’s headache pain on a scale from 1 to 10.
c. Auscultate the patient's l u n W
gWsoWu.
ndTsBaS
ndMo.bW
taS
in other relevant vital signs. c. Prescribe a new medicationWfW
orWm.iTgrBaiSnMe .
mWanSagement.
d. Decrease the dosage to reduce side effects. d. Suggest biofeedback as an adjunct to drug therapy.
ANS: C ANS: A
Assessing and evaluating lung sounds as well as other vital signs helps determine the When evaluating the effectiveness of a drug, it is important to determine how often the
patient's physical response to the medication and allows comparison to the patient's baseline patient is using the drug. Asking the patient to identify how many tablets are taken and how
vital signs. Asking the patient to demonstrate inhaler use helps to evaluate the patient’s often helps the provider determine effective dosages and adherence to the medication
ability to administer the medication properly and is part of an effective evaluation, but is not regimen. The patient has already stated that the medication is not working; the actual level
a priority intervention based on the patient’s current report. Assessing tobacco smoke of pain may determine the degree to which it is not working, but it does not help the
exposure helps determine whether nondrug therapies, such as smoke avoidance, can be used provider to determine why it is not working. The assessment process should gather as much
as an adjunct to drug therapy, but does not relate to the patient’s current problem. Rewriting information about compliance, symptoms, and drug effectiveness as possible before
the prescription to decrease the dosage may address the degree of jitteriness experienced, enacting a change in treatment. Biofeedback may be an effective adjunct to treatment, but it
but does not address the patient’s concern that the drug is not always effective. should not be recommended without complete information about drug effectiveness.
3. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding 6. The drug manual states that older adult patients are at increased risk for hepatotoxicity.
would be most concerning to the provider? Which action is most important when prescribing this medication to an 80-year-old patient?
a. The patient had a recent yeast infection. a. Obtaining baseline liver function studies
b. There is a family history of cervical cancer. b. Ensuring that the drug is taken in the correct dose at the correct time
c. The patient drinks two glasses of wine every night. c. Discontinuing the order; the drug is contraindicated for this patient
d. The patient is unemployed. d. Giving the medication intravenously to avoid first pass metabolism
ANS: C ANS: A
1|Page 2|Page
,Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021) Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021)
Thefdrugfmanualfindicatesfthatfthisfdrugfincreasesfriskfoffhepatotoxicityfforfelderlyfpatients.fGet Thefpriorityfactionfisftofdiscontinuefthefmedicationftofpreventfafpotentialfworseningfoffthefpatie
tingfinformationfaboutfliverffunctionfbeforefgivingfthefdrugfestablishesfbaselinefdatafthatfcanfbef nt’sfsymptoms.fAfdifferentfprescriptionfmayfbefindicatedfdependingfonftheflengthfofftreatment.f
comparedfwithfposttreatmentfdataftofdeterminefwhetherfthefdrugfisfaffectingfthef liver.fTakingft Anfantihistaminefmayfbefadministeredfforfpruritis.fRashesfarefafcommonfsidefeffectfoffampicilli
hefcorrectfdosefatfthefcorrectfintervalfmayfminimizefrisk,fbutfwithoutfbaselinefinformation,fthefe n.fPruriticfmaculopapularfrashesfsuchfasfthefonefdescribedfoccurfinf5%ftof10%foffchildrenftakin
ffectsfcannotfbefdetermined.fDrugsfarefnotfroutinelyfcontraindicatedfforfanfincreasedfriskfoffadv gfampicillin,fespeciallyfinfthefpresencefoffviralfinfections.fTheyfdofnotfcontraindicateffuturefad
ersefeffects. ministrationfoffpenicillinfantibiotics.
7. Afpatientfwithfbipolarfdisorderfisfprescribedfdailyflithium.fWhichfactionfisfmostfimportantfforf 10. Whichfprescriberfactionfwillfhavefthefgreatestfimpactfonfthefpatient’sfcommitmentftofad
thefproviderftoftakefinforderftofdeterminefifftheftherapeuticflevelfisfmaintained? herenceftofanyftypefoffmedicationftherapy?
a. Evaluatefpreadministrationfbloodfwork. a. Prescribingfthefmedicationfinforalfformfwheneverfpossible
b. Prescribeftheflithiumftofbeftakenfatfregularfintervals. b. Schedulingfoncefafdayfadministration
c. Orderfperiodicflaboratoryftesting. c. Providingfmedicationfeducationfthatfthefpatientfcanfeasilyfunderstand
d. Assessfthefpatientfforfsignsfandfsymptomsfofflithiumftoxicity. d. Assuringfthatfthefmedicationfprescriptionfwillfbefcoveredfbyfthefpatient’sfins
urance
ANS:f f C
Therapeuticfserumflevelsfarefdeterminedfthroughfperiodicflaboratoryftesting.fPreadministratio ANS:f f C
nfbloodfworkfmayfbefnecessaryftofobtainfbaselinefstatusfpriorftofinitiatingftreatment,fbutfitfwillfn Nofotherfproviderfactionfassuresfthefpatient’sfcommitmentftofadhereftofafmedicationfplanfmoreft
otfdetermineftherapeuticflevels.fSchedulingfmedicationfadministrationfatfregularfintervalsfwillf hanfeffectivefmedicationfeducationfprovidedfinfafconcise,funderstandablefform.fItfisfnotfalwaysf
helpftofensurefmedicationfisfabsorbedfandfmetabolizedfpredictably,fbutfitfwillfnotfdeterminefthe possibleforfappropriateftofprescribefanforalfform.fWhilefmedicationfcostsfcanfpresentfafbarrierfto
rapeuticfbloodflevels.fAssessingfthefpatientfforfsignsfandfsymptomsfofftoxicityfwillfhelpftofdeter fcompliance,finsurancefcoveragefisfbutfoneffactorfaffectingfcosts.
minefifftheftherapeuticflevelfhasfbeenfexceeded,fnotfmaintained.
11. Whichfpatientfstatementfsuggestsftofthefproviderfthatfthefpatient’sfnonadherencefwithftheirfme
8. Whichffactorfbestfsupportsfanfincreasefforffullfprescriptivefauthorityfforfbothfadvancedfpra dicationfplanfisfrelatedftofdissatisfactionfwithftheftherapy?
cticefregisteredfnursesf(APRNs)fandfphysicianfassistantsf(PAs)? a. “Thisfmedicationfisftoofexpensive;fIfcan’tfaffordfitfanyflonger.”
a. Morefpatientsfwillfhavefaccessftofhealthfcare. b. “I’vefbeenftakingfthisfmedicationfforfwellfoverfafweekfandfIflostfonlyfafhalffafpou
b. EnrollmentfinfmedicalfschoWoW lsWis.pTreBdS
icM
te.
d WtoSdecrease. nd.”
c. EnrollmentfinfbothfAPRNfandfPAfprogramsfhasfincreased. c. “It’sftoofhardftofrememberfW toWtW
ak.eTthBeSpM
ill.eWvS
eryfotherfday;fso,fI’vefmissedfseveralfdo
d. Physicianfpracticesfhavefbecomefsoflarge,fqualityfcarefisfinfjeopardy. ses.”
d. “Ifhavefafveryfintense,ffastfpacedfjob;fit’sfhardftofmakeftimeftoftakefthefmedicationflikef
ANS:f f A Ifshould.”
ImplementationfoffthefAffordablefCarefActfhasfincreasedfthefnumberfoffindividualsfwithfhealt
hfcarefcoverage,fandfthusfthefnumberfwhofhavefaccessftofhealthfcarefservices.fThefincreasefinfth ANS:f f B
efnumberfoffpatientsfcreatesfthefneedfforfmorefprovidersfwithfprescriptivefauthority.fAPRNsfan Dissatisfactionfwithfdrugftherapyfcanftakefthefformfoffafpatient’sfunrealisticfexpectationfoffdesir
dfphysicalfassistantsfcanffillfthisfpracticefgap.fEnrollmentfinfmedicalfschoolfhasfincreasedfinfrec edfresultsfsuchfasfinfthefcasefoffsignificantfweightflossfinfafrelativelyfshortfperiodfofftime.fMedic
entfyearsfandfshowsfnofindicationfoffdecline.fWhilefsomefmedicalfpracticesfhavefincreasedfinfp ationfcosts,fforgetfulness,fandflackfoffplanningfarefsuggestedfbyfthefotherfoptions.
atientfvolume,ftherefisfnofreasonftofbelievefcarefhasfsuffered.fWhilefenrollmentfforfbothfAPRNf
andfPAfeducationfhasfincreased,fthatfisfnotfthefprimaryffactorfassociatedfwithfthefneedfforfincre
MULTIPLEfRESPONSE
asedfprescriptivefauthorityfforfthesefproviders.
1. Howfcanfthefprescriber’sfregularfcollaborationfwithfafpharmacistfimprovefpositivefoutcomesffor
9. Afpediatricfpatientfprescribedfampicillinfforfstreptococcalfpharyngitisfreportsfnewfonsetfoffafpru
fpatients? f(Selectfall fthatfapply.)
ritic,fdullfred,fmaculopapularfrashfonfthefchestfandfneck.fWhichfactionfisfmostfimportantfforfthef
a. Pharmacistsfcanfsuggestffoodsfthatfwillfhelpfwithfthefmedications'fabsorption.
providerftoftakeftofminimizefthisfpatient’sfriskfforfinjury?
b. Pharmacistsfhavefadditionalfinformationfonfdrugfinteractions.
a. Prescribefazithromycinftofreplacefthefampicillin.
c. Thefpharmacistfcanfsuggestfadequatefmedicationfdosing.
b. Discontinuefthefampicillin.
d. Pharmacistsfhaveffirsthandfknowledgefofftheffacilityfformulary.
c. Prescribefanfantihistaminefforfthefitching.
e. Pharmacyfcanfalterfprescriptionsfwhenfnecessaryftofpreventfpatientfharm.fA
d. Flagfallfmedicalfrecordsfwithfanf“AllergicftofPenicillin”fnotice.fA
NS:f B,fC,fD
NS:f B
3|Page 4|Page
, Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021) Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021)
Providersfshouldfcollaboratefwithfpharmacistsfbecauseftheyfwillflikelyfhavefadditionalfinforma Unit 02: Basic Principles of Pharmacology
f f f f f
tionfonfformulary,fdrugfinteractions,fandfsuggestionsfforfadequatefmedicationfdosing.fDietitian Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Nurses and Physician Ass
f f f f f f f f f
sfcanfmakeffoodfrecommendationsftoftreatfthefpatient’sfcondition.fThefpharmacistfcanfcontactft istants, 2nd Edition
f f
hefprescriberfaboutfquestionablefprescriptions,fbutfcannotfalterfthefprescriptionfwithoutfnotifica
tionfoffandfapprovalfbyfthefprovider.
MULTIPLEfCHOICE
2. Whichfstatementsfmadefbyfthefprescriberfdemonstratefanfunderstandingfoffeffectivefm
edicationfeducation?f(Selectfallfthatfapply.) 1. Whenfprescribingflovastatin,fwhatfwillfafproviderfadviseftofdecreasefthefriskfoffdevelopingfmu
a. “Thisfmedicationfneedsftofbefstoredfinfthefrefrigerator.” scleftoxicity?
b. “Takef3ftabletsfdaily:f1fwithfbreakfast,f1fwithflunch,fandfonefwithfdinner.” a. Avoidfexercisefforf2fhoursfafterfadministration.
c. “Youfneedftoftakefthefmedicationfasfwefdiscussedfuntilfallftheftabletsfarefgone.” b. Substitutefgrapefruitfjuicefwithforangefjuice.
d. “Callfthefofficefimmediatelyfiffyoufbeginfexperiencingfanyfitching,fheadache,forfdif c. Monitorfaspartatefaminotransferasef(AST)fandfalaninefaminotransferasef(ALT).
ficultyfbreathing.” d. TakefthefmedicationfwithfanfNSAIDforfotherfanti-inflammatoryfdrug.
e. “Whenfyoufcallfaboutfafmedicationfrefill,fbefsureftofletfthefpharmacistfknowfyoufaref
talkingfaboutfyourfheartfpill.” ANS:f f B
Grapefruitfjuicefcanfinhibitfthefmetabolismfoffcertainfdrugsfincludingfstatinsflikeflovastatin.fThefju
ANS:f f A,fB,fC,fD icefraisesfdrugflevelsfdecreasingfthefintestinalfmetabolismfoffthefdrugfresultingfinfincreasedfdrugfl
Therefarefbasicfcomponentsfthatfshouldfbefincludedfwhenfteachingfaboutfanyfnewfmedication.f evelsfwhichfincreasesfthefriskfforfadversefeffectsfsuchfasfmuscleftoxicity.
Theyfaref(1)fmedicationfname,f(2)fpurpose,f(3)fdosingfregimen,f(4)fadministration,f(5)fadversef Takingfthefdrugfwithfanfanti-
effects,f(6)fanyfspecialfstoragefneeds,f(7)fassociatedflaboratoryftesting,f(8)ffoodforfdrugfinteracti inflammatoryfdrugfandfavoidingfexercisefafterfadministrationfarefnotfsupportedfbyfscience.fMo
ons,fandf(9)fdurationfofftherapy.fThefstatementfsuggestingfreferringftofthefmedicationfasf“yourfh nitoringfASTfandfALTfdetectsfliverftoxicity,fnotfmuscleftoxicity.
eartfpill”fisfinappropriatefsincefbeingffamiliarfwithfthefdrug’sfnamefisfimportantfinfavoidingfmed
icationferrors. 2. Whenfprescribingfdrugsfwithfafnarrowftherapeuticfindex,fwhatfinterventionfdoesfthefpr
oviderftakeftofdecreasefriskftofthefpatient?
3. Thefpatientfwhofhasfbeenfprescribedflithiumfforfafdiagnosisfoffbipolarfdisorderfasksfwhyfblo a. Schedulefdrugfadministrationfintervalsfthatfexceedfthefdrug’sfhalf-life.
odftestsfarefrequiredfonfafregularfbasis.fWhichfproviderfresponsesfdemonstratefanfunderstandi b. Orderfthefmedicationftofbefadministeredfbyfthefintravenousfroute.
ngfoffwhyfthefp a t i e W
n tWr W
e q.u T
i r eBsSaMv.a rWi eSt y fofflaboratoryftests?f(Selectfallfthatfapply.) c. Monitorf thef patient’sf plasmWaWdW
ru.gTleBvS
elM
sf .
a tWreSgular f intervals.
a. “Wefneedftofmonitorfhowfyourfthyroidfisffunctioning.” d. Teachfthefpatientfthatfoptimalfoutcomesfwillfrequirefadherenceftofthefmedicationfreg
b. “Wefneedftofmonitorfkidneyffunctionfwhilefyoufarefonfthisfdrug.” imen.
c. Thisfmedicationfcanfcausefyouftoflosefsodium,fsofwefneedftofmeasurefsodiumflev
els.” ANS:f f C
d. “Yourfliverfcanfbefdamagedfbyflithium;fregularftestingfhelpsfusfmonitorfforfthat.” Afdrugfwithfafnarrowftherapeuticfrangeforfindexfisfmorefdifficultftofadministerfsafely,fbecauseft
e. “Lithiumfcanfcausefyouftoflosefpotassium;fso,fwefregularlyfmonitorfyourfbloodfpot hefdifferencefbetweenfthefminimumfeffectivefconcentrationfandftheftoxicfconcentrationfisfsmall
assiumflevel.” .fPatientsftakingfthesefmedicationsfmustfhaveftheirfplasmafdrugflevelsfmonitoredfcloselyftofensu
refthatftheyfarefgettingfanfeffectivefdosefthatfisfnotftoxic.
ANS:f f A,fB,fC Administeringfmedicationsfatflongerfintervalsfrisksfincreasedfperiodsfoffsubtherapeuticflevels.f
Lithiumftherapyfcanfaffectfthyroidfandfrenalffunctionfasfwellfasfdepletefsodiumflevels.fRegularfl Drugsfthatfhavefafnarrowftherapeuticfrangefmayfbefgivenfbyfanyfroute;fintravenousfadministrati
aboratoryftestingfisfneededftofmonitorfsodiumflevelsfandfthyroidfandfrenalffunctionfandfsofallow onfisfnotfpreferablefandfinfmostfcasesfwillfnotfbeffeasible.fMedicationfregimenfadherencefisfnec
sfforfmodificationfofftheflithiumfdosefasfneeded.fLithiumfisfnotfassociatedfwithfalteredfliverffunc essary;fhowever,fdueftofindividualfvariation,fforfdrugsfwithfafnarrowftherapeuticfrange,fwhatfisf
tionforfpotassiumfdepletion. anfeffectivefdosefforfonefpatientfmayfbefaflethalfdosefforfanother.fForfthisfreason,fmonitoringfdru
gflevelsfremainsfthefprimaryfmethodfforfdecreasingfrisk.
3. Afpatientfreportsfthatfafmedicationfnoflongerfeffectivelyfalleviatesfsymptoms.fWhatfprocessfinf
ormsfthefprovider’sfresponseftofthefpatient’sfconcerns?
a. Endogenousfantagonistsfcompetefwithfthefdrugfforfreceptorfsites.
b. Decreasedfselectivityfforfreceptorsfresultsfinfafvarietyfoffeffects.
c. Desensitizationfoffreceptorfsitesfresultsffromfcontinualfexposureftofthefdrug.
d. Additionalfreceptorfsitesfarefsynthesizedfinfresponseftofthefmedication.fA
NS:f C
5|Page 6|Page
Unit 01 Introduction 1
Unit 02 Basic Principles of Pharmacology 6
TEST BANK Unit 03 Drug Therapy Across the Life Span 15
Lehne’s Pharmacotherapeutics for Advanced Practice Nurses Unit 04 Peripheral Nervous System Drugs 22
Unit 05 Central Nervous System Drugs 31
and Physician Assistants Unit 06 Drugs for Pain 38
Unit 07 Psychotherapeutic Drugs 43
Laura D. Rosenthal, and Jacqueline Rosenjack Burchum Unit 08 Substance Use Disorders 51
Unit 09 Drugs That Affect the Heart, Blood Vessels, Blood, and Blood Volume 59
2nd Edition 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
,Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021) Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021)
Unit 01: Introduction Patients taking metronidazole should be educated not to drink alcohol to prevent a
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Nurses and Physician disulfiram-like reaction. It would be concerning that the patient drinks wine daily. History
Assistants, 2nd Edition 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
MULTIPLE CHOICE patient’s ability to purchase medications; however, generic metronidazole is one of the less
expensive medications.
1. A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially? 4. The provider prepares a patient with newly diagnosed type 1 diabetes for hospital discharge.
a. Fax the renewal order to the pharmacy. Which action by the provider will best support the patient’s ability to effectively manage
b. Arrange to schedule an appointment with the patient. medication therapy?
c. Verify the patient’s adherence to the prescribed drug regimen. a. Asking the patient to demonstrate how to measure and administer insulin
d. Determine the patient’s current medication dosage and pain level. b. Discussing methods of storing insulin and discarding syringes
c. Giving information about how diet and exercise affect insulin requirements
ANS: B d. Teaching the patient about the long-term consequences of poor diabetes control
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 ANS: A
dosage of medication and pain level; however, this can be accomplished by scheduling an Because insulin must be given correctly to control symptoms and prevent an overdose, it is
appointment and evaluating the patient in person. 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
2. A metered-dose albuterol inhaler is prescribed for asthma management. The patient reports the teaching. The other teaching points are important as well, but they are not as critical.
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 5. A patient reports that a medication prescribed for recurrent migraine headaches is not
maximize medication effectiveness? working. Which action is the prescriber’s priority when addressing the patient's concern?
a. Ask the patient to demonstrate use of the inhaler and assess effectiveness. a. Ask the patient about the number and frequency of tablets taken.
b. Assess the patient’s exposure to first- and second-hand tobacco smoke. b. Assess the patient’s headache pain on a scale from 1 to 10.
c. Auscultate the patient's l u n W
gWsoWu.
ndTsBaS
ndMo.bW
taS
in other relevant vital signs. c. Prescribe a new medicationWfW
orWm.iTgrBaiSnMe .
mWanSagement.
d. Decrease the dosage to reduce side effects. d. Suggest biofeedback as an adjunct to drug therapy.
ANS: C ANS: A
Assessing and evaluating lung sounds as well as other vital signs helps determine the When evaluating the effectiveness of a drug, it is important to determine how often the
patient's physical response to the medication and allows comparison to the patient's baseline patient is using the drug. Asking the patient to identify how many tablets are taken and how
vital signs. Asking the patient to demonstrate inhaler use helps to evaluate the patient’s often helps the provider determine effective dosages and adherence to the medication
ability to administer the medication properly and is part of an effective evaluation, but is not regimen. The patient has already stated that the medication is not working; the actual level
a priority intervention based on the patient’s current report. Assessing tobacco smoke of pain may determine the degree to which it is not working, but it does not help the
exposure helps determine whether nondrug therapies, such as smoke avoidance, can be used provider to determine why it is not working. The assessment process should gather as much
as an adjunct to drug therapy, but does not relate to the patient’s current problem. Rewriting information about compliance, symptoms, and drug effectiveness as possible before
the prescription to decrease the dosage may address the degree of jitteriness experienced, enacting a change in treatment. Biofeedback may be an effective adjunct to treatment, but it
but does not address the patient’s concern that the drug is not always effective. should not be recommended without complete information about drug effectiveness.
3. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding 6. The drug manual states that older adult patients are at increased risk for hepatotoxicity.
would be most concerning to the provider? Which action is most important when prescribing this medication to an 80-year-old patient?
a. The patient had a recent yeast infection. a. Obtaining baseline liver function studies
b. There is a family history of cervical cancer. b. Ensuring that the drug is taken in the correct dose at the correct time
c. The patient drinks two glasses of wine every night. c. Discontinuing the order; the drug is contraindicated for this patient
d. The patient is unemployed. d. Giving the medication intravenously to avoid first pass metabolism
ANS: C ANS: A
1|Page 2|Page
,Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021) Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021)
Thefdrugfmanualfindicatesfthatfthisfdrugfincreasesfriskfoffhepatotoxicityfforfelderlyfpatients.fGet Thefpriorityfactionfisftofdiscontinuefthefmedicationftofpreventfafpotentialfworseningfoffthefpatie
tingfinformationfaboutfliverffunctionfbeforefgivingfthefdrugfestablishesfbaselinefdatafthatfcanfbef nt’sfsymptoms.fAfdifferentfprescriptionfmayfbefindicatedfdependingfonftheflengthfofftreatment.f
comparedfwithfposttreatmentfdataftofdeterminefwhetherfthefdrugfisfaffectingfthef liver.fTakingft Anfantihistaminefmayfbefadministeredfforfpruritis.fRashesfarefafcommonfsidefeffectfoffampicilli
hefcorrectfdosefatfthefcorrectfintervalfmayfminimizefrisk,fbutfwithoutfbaselinefinformation,fthefe n.fPruriticfmaculopapularfrashesfsuchfasfthefonefdescribedfoccurfinf5%ftof10%foffchildrenftakin
ffectsfcannotfbefdetermined.fDrugsfarefnotfroutinelyfcontraindicatedfforfanfincreasedfriskfoffadv gfampicillin,fespeciallyfinfthefpresencefoffviralfinfections.fTheyfdofnotfcontraindicateffuturefad
ersefeffects. ministrationfoffpenicillinfantibiotics.
7. Afpatientfwithfbipolarfdisorderfisfprescribedfdailyflithium.fWhichfactionfisfmostfimportantfforf 10. Whichfprescriberfactionfwillfhavefthefgreatestfimpactfonfthefpatient’sfcommitmentftofad
thefproviderftoftakefinforderftofdeterminefifftheftherapeuticflevelfisfmaintained? herenceftofanyftypefoffmedicationftherapy?
a. Evaluatefpreadministrationfbloodfwork. a. Prescribingfthefmedicationfinforalfformfwheneverfpossible
b. Prescribeftheflithiumftofbeftakenfatfregularfintervals. b. Schedulingfoncefafdayfadministration
c. Orderfperiodicflaboratoryftesting. c. Providingfmedicationfeducationfthatfthefpatientfcanfeasilyfunderstand
d. Assessfthefpatientfforfsignsfandfsymptomsfofflithiumftoxicity. d. Assuringfthatfthefmedicationfprescriptionfwillfbefcoveredfbyfthefpatient’sfins
urance
ANS:f f C
Therapeuticfserumflevelsfarefdeterminedfthroughfperiodicflaboratoryftesting.fPreadministratio ANS:f f C
nfbloodfworkfmayfbefnecessaryftofobtainfbaselinefstatusfpriorftofinitiatingftreatment,fbutfitfwillfn Nofotherfproviderfactionfassuresfthefpatient’sfcommitmentftofadhereftofafmedicationfplanfmoreft
otfdetermineftherapeuticflevels.fSchedulingfmedicationfadministrationfatfregularfintervalsfwillf hanfeffectivefmedicationfeducationfprovidedfinfafconcise,funderstandablefform.fItfisfnotfalwaysf
helpftofensurefmedicationfisfabsorbedfandfmetabolizedfpredictably,fbutfitfwillfnotfdeterminefthe possibleforfappropriateftofprescribefanforalfform.fWhilefmedicationfcostsfcanfpresentfafbarrierfto
rapeuticfbloodflevels.fAssessingfthefpatientfforfsignsfandfsymptomsfofftoxicityfwillfhelpftofdeter fcompliance,finsurancefcoveragefisfbutfoneffactorfaffectingfcosts.
minefifftheftherapeuticflevelfhasfbeenfexceeded,fnotfmaintained.
11. Whichfpatientfstatementfsuggestsftofthefproviderfthatfthefpatient’sfnonadherencefwithftheirfme
8. Whichffactorfbestfsupportsfanfincreasefforffullfprescriptivefauthorityfforfbothfadvancedfpra dicationfplanfisfrelatedftofdissatisfactionfwithftheftherapy?
cticefregisteredfnursesf(APRNs)fandfphysicianfassistantsf(PAs)? a. “Thisfmedicationfisftoofexpensive;fIfcan’tfaffordfitfanyflonger.”
a. Morefpatientsfwillfhavefaccessftofhealthfcare. b. “I’vefbeenftakingfthisfmedicationfforfwellfoverfafweekfandfIflostfonlyfafhalffafpou
b. EnrollmentfinfmedicalfschoWoW lsWis.pTreBdS
icM
te.
d WtoSdecrease. nd.”
c. EnrollmentfinfbothfAPRNfandfPAfprogramsfhasfincreased. c. “It’sftoofhardftofrememberfW toWtW
ak.eTthBeSpM
ill.eWvS
eryfotherfday;fso,fI’vefmissedfseveralfdo
d. Physicianfpracticesfhavefbecomefsoflarge,fqualityfcarefisfinfjeopardy. ses.”
d. “Ifhavefafveryfintense,ffastfpacedfjob;fit’sfhardftofmakeftimeftoftakefthefmedicationflikef
ANS:f f A Ifshould.”
ImplementationfoffthefAffordablefCarefActfhasfincreasedfthefnumberfoffindividualsfwithfhealt
hfcarefcoverage,fandfthusfthefnumberfwhofhavefaccessftofhealthfcarefservices.fThefincreasefinfth ANS:f f B
efnumberfoffpatientsfcreatesfthefneedfforfmorefprovidersfwithfprescriptivefauthority.fAPRNsfan Dissatisfactionfwithfdrugftherapyfcanftakefthefformfoffafpatient’sfunrealisticfexpectationfoffdesir
dfphysicalfassistantsfcanffillfthisfpracticefgap.fEnrollmentfinfmedicalfschoolfhasfincreasedfinfrec edfresultsfsuchfasfinfthefcasefoffsignificantfweightflossfinfafrelativelyfshortfperiodfofftime.fMedic
entfyearsfandfshowsfnofindicationfoffdecline.fWhilefsomefmedicalfpracticesfhavefincreasedfinfp ationfcosts,fforgetfulness,fandflackfoffplanningfarefsuggestedfbyfthefotherfoptions.
atientfvolume,ftherefisfnofreasonftofbelievefcarefhasfsuffered.fWhilefenrollmentfforfbothfAPRNf
andfPAfeducationfhasfincreased,fthatfisfnotfthefprimaryffactorfassociatedfwithfthefneedfforfincre
MULTIPLEfRESPONSE
asedfprescriptivefauthorityfforfthesefproviders.
1. Howfcanfthefprescriber’sfregularfcollaborationfwithfafpharmacistfimprovefpositivefoutcomesffor
9. Afpediatricfpatientfprescribedfampicillinfforfstreptococcalfpharyngitisfreportsfnewfonsetfoffafpru
fpatients? f(Selectfall fthatfapply.)
ritic,fdullfred,fmaculopapularfrashfonfthefchestfandfneck.fWhichfactionfisfmostfimportantfforfthef
a. Pharmacistsfcanfsuggestffoodsfthatfwillfhelpfwithfthefmedications'fabsorption.
providerftoftakeftofminimizefthisfpatient’sfriskfforfinjury?
b. Pharmacistsfhavefadditionalfinformationfonfdrugfinteractions.
a. Prescribefazithromycinftofreplacefthefampicillin.
c. Thefpharmacistfcanfsuggestfadequatefmedicationfdosing.
b. Discontinuefthefampicillin.
d. Pharmacistsfhaveffirsthandfknowledgefofftheffacilityfformulary.
c. Prescribefanfantihistaminefforfthefitching.
e. Pharmacyfcanfalterfprescriptionsfwhenfnecessaryftofpreventfpatientfharm.fA
d. Flagfallfmedicalfrecordsfwithfanf“AllergicftofPenicillin”fnotice.fA
NS:f B,fC,fD
NS:f B
3|Page 4|Page
, Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021) Test Bank - Lehne’s Pharmacotherapeutics for Advanced Practice Nurses & Physician Assistants, 2e (Rosenthal, 2021)
Providersfshouldfcollaboratefwithfpharmacistsfbecauseftheyfwillflikelyfhavefadditionalfinforma Unit 02: Basic Principles of Pharmacology
f f f f f
tionfonfformulary,fdrugfinteractions,fandfsuggestionsfforfadequatefmedicationfdosing.fDietitian Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Nurses and Physician Ass
f f f f f f f f f
sfcanfmakeffoodfrecommendationsftoftreatfthefpatient’sfcondition.fThefpharmacistfcanfcontactft istants, 2nd Edition
f f
hefprescriberfaboutfquestionablefprescriptions,fbutfcannotfalterfthefprescriptionfwithoutfnotifica
tionfoffandfapprovalfbyfthefprovider.
MULTIPLEfCHOICE
2. Whichfstatementsfmadefbyfthefprescriberfdemonstratefanfunderstandingfoffeffectivefm
edicationfeducation?f(Selectfallfthatfapply.) 1. Whenfprescribingflovastatin,fwhatfwillfafproviderfadviseftofdecreasefthefriskfoffdevelopingfmu
a. “Thisfmedicationfneedsftofbefstoredfinfthefrefrigerator.” scleftoxicity?
b. “Takef3ftabletsfdaily:f1fwithfbreakfast,f1fwithflunch,fandfonefwithfdinner.” a. Avoidfexercisefforf2fhoursfafterfadministration.
c. “Youfneedftoftakefthefmedicationfasfwefdiscussedfuntilfallftheftabletsfarefgone.” b. Substitutefgrapefruitfjuicefwithforangefjuice.
d. “Callfthefofficefimmediatelyfiffyoufbeginfexperiencingfanyfitching,fheadache,forfdif c. Monitorfaspartatefaminotransferasef(AST)fandfalaninefaminotransferasef(ALT).
ficultyfbreathing.” d. TakefthefmedicationfwithfanfNSAIDforfotherfanti-inflammatoryfdrug.
e. “Whenfyoufcallfaboutfafmedicationfrefill,fbefsureftofletfthefpharmacistfknowfyoufaref
talkingfaboutfyourfheartfpill.” ANS:f f B
Grapefruitfjuicefcanfinhibitfthefmetabolismfoffcertainfdrugsfincludingfstatinsflikeflovastatin.fThefju
ANS:f f A,fB,fC,fD icefraisesfdrugflevelsfdecreasingfthefintestinalfmetabolismfoffthefdrugfresultingfinfincreasedfdrugfl
Therefarefbasicfcomponentsfthatfshouldfbefincludedfwhenfteachingfaboutfanyfnewfmedication.f evelsfwhichfincreasesfthefriskfforfadversefeffectsfsuchfasfmuscleftoxicity.
Theyfaref(1)fmedicationfname,f(2)fpurpose,f(3)fdosingfregimen,f(4)fadministration,f(5)fadversef Takingfthefdrugfwithfanfanti-
effects,f(6)fanyfspecialfstoragefneeds,f(7)fassociatedflaboratoryftesting,f(8)ffoodforfdrugfinteracti inflammatoryfdrugfandfavoidingfexercisefafterfadministrationfarefnotfsupportedfbyfscience.fMo
ons,fandf(9)fdurationfofftherapy.fThefstatementfsuggestingfreferringftofthefmedicationfasf“yourfh nitoringfASTfandfALTfdetectsfliverftoxicity,fnotfmuscleftoxicity.
eartfpill”fisfinappropriatefsincefbeingffamiliarfwithfthefdrug’sfnamefisfimportantfinfavoidingfmed
icationferrors. 2. Whenfprescribingfdrugsfwithfafnarrowftherapeuticfindex,fwhatfinterventionfdoesfthefpr
oviderftakeftofdecreasefriskftofthefpatient?
3. Thefpatientfwhofhasfbeenfprescribedflithiumfforfafdiagnosisfoffbipolarfdisorderfasksfwhyfblo a. Schedulefdrugfadministrationfintervalsfthatfexceedfthefdrug’sfhalf-life.
odftestsfarefrequiredfonfafregularfbasis.fWhichfproviderfresponsesfdemonstratefanfunderstandi b. Orderfthefmedicationftofbefadministeredfbyfthefintravenousfroute.
ngfoffwhyfthefp a t i e W
n tWr W
e q.u T
i r eBsSaMv.a rWi eSt y fofflaboratoryftests?f(Selectfallfthatfapply.) c. Monitorf thef patient’sf plasmWaWdW
ru.gTleBvS
elM
sf .
a tWreSgular f intervals.
a. “Wefneedftofmonitorfhowfyourfthyroidfisffunctioning.” d. Teachfthefpatientfthatfoptimalfoutcomesfwillfrequirefadherenceftofthefmedicationfreg
b. “Wefneedftofmonitorfkidneyffunctionfwhilefyoufarefonfthisfdrug.” imen.
c. Thisfmedicationfcanfcausefyouftoflosefsodium,fsofwefneedftofmeasurefsodiumflev
els.” ANS:f f C
d. “Yourfliverfcanfbefdamagedfbyflithium;fregularftestingfhelpsfusfmonitorfforfthat.” Afdrugfwithfafnarrowftherapeuticfrangeforfindexfisfmorefdifficultftofadministerfsafely,fbecauseft
e. “Lithiumfcanfcausefyouftoflosefpotassium;fso,fwefregularlyfmonitorfyourfbloodfpot hefdifferencefbetweenfthefminimumfeffectivefconcentrationfandftheftoxicfconcentrationfisfsmall
assiumflevel.” .fPatientsftakingfthesefmedicationsfmustfhaveftheirfplasmafdrugflevelsfmonitoredfcloselyftofensu
refthatftheyfarefgettingfanfeffectivefdosefthatfisfnotftoxic.
ANS:f f A,fB,fC Administeringfmedicationsfatflongerfintervalsfrisksfincreasedfperiodsfoffsubtherapeuticflevels.f
Lithiumftherapyfcanfaffectfthyroidfandfrenalffunctionfasfwellfasfdepletefsodiumflevels.fRegularfl Drugsfthatfhavefafnarrowftherapeuticfrangefmayfbefgivenfbyfanyfroute;fintravenousfadministrati
aboratoryftestingfisfneededftofmonitorfsodiumflevelsfandfthyroidfandfrenalffunctionfandfsofallow onfisfnotfpreferablefandfinfmostfcasesfwillfnotfbeffeasible.fMedicationfregimenfadherencefisfnec
sfforfmodificationfofftheflithiumfdosefasfneeded.fLithiumfisfnotfassociatedfwithfalteredfliverffunc essary;fhowever,fdueftofindividualfvariation,fforfdrugsfwithfafnarrowftherapeuticfrange,fwhatfisf
tionforfpotassiumfdepletion. anfeffectivefdosefforfonefpatientfmayfbefaflethalfdosefforfanother.fForfthisfreason,fmonitoringfdru
gflevelsfremainsfthefprimaryfmethodfforfdecreasingfrisk.
3. Afpatientfreportsfthatfafmedicationfnoflongerfeffectivelyfalleviatesfsymptoms.fWhatfprocessfinf
ormsfthefprovider’sfresponseftofthefpatient’sfconcerns?
a. Endogenousfantagonistsfcompetefwithfthefdrugfforfreceptorfsites.
b. Decreasedfselectivityfforfreceptorsfresultsfinfafvarietyfoffeffects.
c. Desensitizationfoffreceptorfsitesfresultsffromfcontinualfexposureftofthefdrug.
d. Additionalfreceptorfsitesfarefsynthesizedfinfresponseftofthefmedication.fA
NS:f C
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