Nurse practitioner prescriptive authority is regulated by:
1. The National Council of State Boards of Nursing
2. The U.S. Drug Enforcement Administration
3. The State Board of Nursing for each state
4. The State Board of Pharmacy - ANSWER 3. The State Board of Nursing for each state
2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) pre-
scriber include:
1. Nurses know more about Pharmacology than other prescribers because they take it both
in their basic nursing program and in their APRN program.
2. Nurses care for the patient from a holistic approach and include the patient in decision
making regarding their care.
3. APRNs are less likely to prescribe narcotics and other controlled substances.
4. APRNs are able to prescribe independently in all states, whereas a physician's assistant
needs to have a physician supervising their practice. - ANSWER 2. Nurses care for the pa-
tient from a holistic approach and include the patient in decision making regarding their
care.
3. Clinical judgment in prescribing includes:
1. Factoring in the cost to the patient of the medication prescribed
2. Always prescribing the newest medication available for the disease process
3. Handing out drug samples to poor patients
4. Prescribing all generic medications to cut costs - ANSWER 1. Factoring in the cost to
the patient of the medication prescribed
1
,4. Criteria for choosing an effective drug for a disorder include:
1. Asking the patient what drug they think would work best for them
2. Consulting nationally recognized guidelines for disease management
3. Prescribing medications that are available as samples before writing a prescription
4. Following U.S. Drug Enforcement Administration guidelines for prescribing - ANSWER
2. Consulting nationally recognized guidelines for disease management
5. Nurse practitioner practice may thrive under health-care reform because of:
1. The demonstrated ability of nurse practitioners to control costs and improve patient out-
comes
2. The fact that nurse practitioners will be able to practice independently
3. The fact that nurse practitioners will have full reimbursement under health-care reform
4. The ability to shift accountability for Medicaid to the state level - ANSWER 1. The
demonstrated ability of nurse practitioners to control costs and improve patient outcomes
1. A patient's nutritional intake and laboratory results reflect hypoalbuminemia. This is criti-
cal to prescribing because:
1. Distribution of drugs to target tissue may be affected.
2. The solubility of the drug will not match the site of absorption.
3. There will be less free drug available to generate an effect.
4. Drugs bound to albumin are readily excreted by the kidneys. - ANSWER 1. Distribution
of drugs to target tissue may be affected.
2. Drugs that have a significant first-pass effect:
1. Must be given by the enteral (oral) route only
2. Bypass the hepatic circulation
3. Are rapidly metabolized by the liver and may have little if any desired action
4. Are converted by the liver to more active and fat-soluble forms - ANSWER 3. Are rap-
idly metabolized by the liver and may have little if any desired action
2
,3. The route of excretion of a volatile drug will likely be the:
1. Kidneys
2. Lungs
3. Bile and feces
4. Skin - ANSWER 2. Lungs
4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a stor-
age reservoir of the drug. Storage reservoirs:
1. Assure that the drug will reach its intended target tissue
2. Are the reason for giving loading doses
3. Increase the length of time a drug is available and active
4. Are most common in collagen tissues - ANSWER 3. Increase the length of time a drug is
available and active
5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug's:
1. Propensity to go to the target receptor
2. Biological half-life
3. Pharmacodynamics
4. Safety and side effects - ANSWER 2. Biological half-life
6. Azithromycin dosing requires that the first day's dosage be twice those of the other 4 days
of the prescription. This is considered a loading dose. A loading dose:
1. Rapidly achieves drug levels in the therapeutic range
2. Requires four- to five-half-lives to attain
3. Is influenced by renal function
4. Is directly related to the drug circulating to the target tissues - ANSWER 1. Rapidly
achieves drug levels in the therapeutic range
3
, The point in time on the drug concentration curve that indicates the first sign of a therapeu-
tic effect is the:
1. Minimum adverse effect level
2. Peak of action
3. Onset of action
4. Therapeutic range - ANSWER 3. Onset of action
8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
1. When the drug has a wide therapeutic range
2. When the drug will be administered for a short time only
3. When there is a high correlation between the dose and saturation of receptor sites
4. To determine if a drug is in the therapeutic range - ANSWER 4. To determine if a drug is
in the therapeutic range
9. A laboratory result indicates that the peak level for a drug is above the minimum toxic
concentration. This means that the:
1. Concentration will produce therapeutic effects
2. Concentration will produce an adverse response
3. Time between doses must be shortened
4. Duration of action of the drug is too long - ANSWER 2. Concentration will produce an
adverse response
10. Drugs that are receptor agonists may demonstrate what property?
1. Irreversible binding to the drug receptor site
2. Upregulation with chronic use
3. Desensitization or downregulation with continuous use
4. Inverse relationship between drug concentration and drug action - ANSWER 3. Desen-
sitization or downregulation with continuous use
4
1. The National Council of State Boards of Nursing
2. The U.S. Drug Enforcement Administration
3. The State Board of Nursing for each state
4. The State Board of Pharmacy - ANSWER 3. The State Board of Nursing for each state
2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) pre-
scriber include:
1. Nurses know more about Pharmacology than other prescribers because they take it both
in their basic nursing program and in their APRN program.
2. Nurses care for the patient from a holistic approach and include the patient in decision
making regarding their care.
3. APRNs are less likely to prescribe narcotics and other controlled substances.
4. APRNs are able to prescribe independently in all states, whereas a physician's assistant
needs to have a physician supervising their practice. - ANSWER 2. Nurses care for the pa-
tient from a holistic approach and include the patient in decision making regarding their
care.
3. Clinical judgment in prescribing includes:
1. Factoring in the cost to the patient of the medication prescribed
2. Always prescribing the newest medication available for the disease process
3. Handing out drug samples to poor patients
4. Prescribing all generic medications to cut costs - ANSWER 1. Factoring in the cost to
the patient of the medication prescribed
1
,4. Criteria for choosing an effective drug for a disorder include:
1. Asking the patient what drug they think would work best for them
2. Consulting nationally recognized guidelines for disease management
3. Prescribing medications that are available as samples before writing a prescription
4. Following U.S. Drug Enforcement Administration guidelines for prescribing - ANSWER
2. Consulting nationally recognized guidelines for disease management
5. Nurse practitioner practice may thrive under health-care reform because of:
1. The demonstrated ability of nurse practitioners to control costs and improve patient out-
comes
2. The fact that nurse practitioners will be able to practice independently
3. The fact that nurse practitioners will have full reimbursement under health-care reform
4. The ability to shift accountability for Medicaid to the state level - ANSWER 1. The
demonstrated ability of nurse practitioners to control costs and improve patient outcomes
1. A patient's nutritional intake and laboratory results reflect hypoalbuminemia. This is criti-
cal to prescribing because:
1. Distribution of drugs to target tissue may be affected.
2. The solubility of the drug will not match the site of absorption.
3. There will be less free drug available to generate an effect.
4. Drugs bound to albumin are readily excreted by the kidneys. - ANSWER 1. Distribution
of drugs to target tissue may be affected.
2. Drugs that have a significant first-pass effect:
1. Must be given by the enteral (oral) route only
2. Bypass the hepatic circulation
3. Are rapidly metabolized by the liver and may have little if any desired action
4. Are converted by the liver to more active and fat-soluble forms - ANSWER 3. Are rap-
idly metabolized by the liver and may have little if any desired action
2
,3. The route of excretion of a volatile drug will likely be the:
1. Kidneys
2. Lungs
3. Bile and feces
4. Skin - ANSWER 2. Lungs
4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a stor-
age reservoir of the drug. Storage reservoirs:
1. Assure that the drug will reach its intended target tissue
2. Are the reason for giving loading doses
3. Increase the length of time a drug is available and active
4. Are most common in collagen tissues - ANSWER 3. Increase the length of time a drug is
available and active
5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug's:
1. Propensity to go to the target receptor
2. Biological half-life
3. Pharmacodynamics
4. Safety and side effects - ANSWER 2. Biological half-life
6. Azithromycin dosing requires that the first day's dosage be twice those of the other 4 days
of the prescription. This is considered a loading dose. A loading dose:
1. Rapidly achieves drug levels in the therapeutic range
2. Requires four- to five-half-lives to attain
3. Is influenced by renal function
4. Is directly related to the drug circulating to the target tissues - ANSWER 1. Rapidly
achieves drug levels in the therapeutic range
3
, The point in time on the drug concentration curve that indicates the first sign of a therapeu-
tic effect is the:
1. Minimum adverse effect level
2. Peak of action
3. Onset of action
4. Therapeutic range - ANSWER 3. Onset of action
8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
1. When the drug has a wide therapeutic range
2. When the drug will be administered for a short time only
3. When there is a high correlation between the dose and saturation of receptor sites
4. To determine if a drug is in the therapeutic range - ANSWER 4. To determine if a drug is
in the therapeutic range
9. A laboratory result indicates that the peak level for a drug is above the minimum toxic
concentration. This means that the:
1. Concentration will produce therapeutic effects
2. Concentration will produce an adverse response
3. Time between doses must be shortened
4. Duration of action of the drug is too long - ANSWER 2. Concentration will produce an
adverse response
10. Drugs that are receptor agonists may demonstrate what property?
1. Irreversible binding to the drug receptor site
2. Upregulation with chronic use
3. Desensitization or downregulation with continuous use
4. Inverse relationship between drug concentration and drug action - ANSWER 3. Desen-
sitization or downregulation with continuous use
4
