,NR565 – Advanced Pharmacology Fundamentals
Exam Study Guide – Midterm Exam
Exam Format: Non-Cumulative exam
Question Type: Multiple Choice
Number of Questions: 100
Time Allotted: 120 minutes (1.2 minutes per question)
Testing Timeframe: The midterm exam will be available starting on Wednesday week #4
at 12:01 am MT until Saturday week #4 at 11:59 pm MT.
1. Exam Coverage
Content Areas:
● Week 1: Foundations in Pharmacology
● Week 2: Pharmacotherapy for Cardiovascular Conditions
● Week 3: Pharmacotherapy for Pain
● Week 4: Pharmacotherapy for Musculoskeletal and Rheumatologic Conditions
2. Key Concepts to Study
Week 1: Chapters 1–10 – Foundations in Pharmacology
● Prescriptive authority
○ Defined by state law and nurse practice acts
○ Determines:
■ Which drugs can be prescribed
■ Level of autonomy (independent vs collaborative)
○ APRNs are accountable for:
■ Safe, ethical prescribing
■ Practicing within legal scope
○ Prescribing outside scope = legal and ethical violation
● Prescription writing
○ A valid prescription must include:
■ Patient name and identifiers
■ Drug name (generic preferred)
■ Dose, route, frequency
■ Quantity and refills
■ Prescriber name, credentials, signature
○ Types of prescriptions:
■ Written
■ Electronic
■ Verbal (limited use)
● Prescribing considerations
○ Prescribing must consider:
, ○ Diagnosis and indication
○ Patient age, weight, comorbidities
○ Renal and hepatic function
○ Pregnancy and lactation status
○ Genetic variability
○ Cost and adherence
● Medication education
○ Patient education includes:
■ Purpose of medication
■ How and when to take it
■ Expected benefits
■ Common adverse effects
■ When to seek medical attention
■ Importance of adherence
○ Education improves outcomes and reduces errors.
● Drug absorption
○ Entry of drug into bloodstream
○ Influenced by:
■ Route of administration
■ Blood flow
■ GI motility and pH
○ First-pass metabolism reduces oral bioavailability
■ How First-Pass Metabolism Reduces Bioavailability
● Bioavailability = the fraction of administered drug that reaches
systemic circulation unchanged.
● If a large portion of the drug is metabolized in the liver
● Less active drug is available to produce therapeutic effects
● Exam wording: Extensive first-pass metabolism = low oral
bioavailability
■ First-pass metabolism does NOT:
● Increase drug effect
● Occur with IV drugs
● Affect distribution directly
● Drug distribution
○ Movement from blood to tissues
○ Influenced by:
■ Plasma protein binding
■ Tissue perfusion
■ Body fat and water
○ Only unbound drug is active
● Drug metabolism
Exam Study Guide – Midterm Exam
Exam Format: Non-Cumulative exam
Question Type: Multiple Choice
Number of Questions: 100
Time Allotted: 120 minutes (1.2 minutes per question)
Testing Timeframe: The midterm exam will be available starting on Wednesday week #4
at 12:01 am MT until Saturday week #4 at 11:59 pm MT.
1. Exam Coverage
Content Areas:
● Week 1: Foundations in Pharmacology
● Week 2: Pharmacotherapy for Cardiovascular Conditions
● Week 3: Pharmacotherapy for Pain
● Week 4: Pharmacotherapy for Musculoskeletal and Rheumatologic Conditions
2. Key Concepts to Study
Week 1: Chapters 1–10 – Foundations in Pharmacology
● Prescriptive authority
○ Defined by state law and nurse practice acts
○ Determines:
■ Which drugs can be prescribed
■ Level of autonomy (independent vs collaborative)
○ APRNs are accountable for:
■ Safe, ethical prescribing
■ Practicing within legal scope
○ Prescribing outside scope = legal and ethical violation
● Prescription writing
○ A valid prescription must include:
■ Patient name and identifiers
■ Drug name (generic preferred)
■ Dose, route, frequency
■ Quantity and refills
■ Prescriber name, credentials, signature
○ Types of prescriptions:
■ Written
■ Electronic
■ Verbal (limited use)
● Prescribing considerations
○ Prescribing must consider:
, ○ Diagnosis and indication
○ Patient age, weight, comorbidities
○ Renal and hepatic function
○ Pregnancy and lactation status
○ Genetic variability
○ Cost and adherence
● Medication education
○ Patient education includes:
■ Purpose of medication
■ How and when to take it
■ Expected benefits
■ Common adverse effects
■ When to seek medical attention
■ Importance of adherence
○ Education improves outcomes and reduces errors.
● Drug absorption
○ Entry of drug into bloodstream
○ Influenced by:
■ Route of administration
■ Blood flow
■ GI motility and pH
○ First-pass metabolism reduces oral bioavailability
■ How First-Pass Metabolism Reduces Bioavailability
● Bioavailability = the fraction of administered drug that reaches
systemic circulation unchanged.
● If a large portion of the drug is metabolized in the liver
● Less active drug is available to produce therapeutic effects
● Exam wording: Extensive first-pass metabolism = low oral
bioavailability
■ First-pass metabolism does NOT:
● Increase drug effect
● Occur with IV drugs
● Affect distribution directly
● Drug distribution
○ Movement from blood to tissues
○ Influenced by:
■ Plasma protein binding
■ Tissue perfusion
■ Body fat and water
○ Only unbound drug is active
● Drug metabolism
