Pharm 578
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? - answer Independent
Which factors increase the need for APRNs to have full prescriptive authority? -
answerMore patients will have access to health care.
Which factors could be attributed to limited prescriptive authority for APRNs? SATA -
answerInaccessibility of patient care
Higher health care costs
Which aspects support the APRN's provision for full prescriptive authority? SATA -
answer-Clinical education includes prescription of medications and disease processes
-National examinations provide validation of the APRN's ability to provide safecare
-Licensure ensures compliance with health care and safety standards.
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? - answerThe APRN will
have less prescriptive authority in the new position.
How can collaboration with a pharmacist improve positive outcomes for patients? Select
all that apply - answer-Pharmacists have additional information on drug interactions.
- The pharmacist can suggest adequate medication dosing.
- Pharmacists have firsthand knowledge of the facility formulary
A patient presents with deliriumtremens requiring Ativan administration. The provider of
care is not in the facility. Which action by the nurse is most appropriate? - answerobtain
a telephone order
A patient with chronic pain calls the provider's office to request a refill on their oxycontin.
Which action is most appropriate? - answerSchedule an appointment with the patient.
A patient prescribed amoxicillin for streptococcal pharyngitis reports new onset of a flat,
itchy red rash on the chest and neck. Which action is most important? -
answerdiscontinue the medication
A patient taking three medications for hypertension is diagnosed with COPD. Which
action should be taken prior to prescribing medications to treat COPD? - answerObtain
a complete medication history.
,A patient with diabetes reports losing their job and an inability to purchase required
medications. Which action is most appropriate? - answerContact a different pharmacy
A patient recently prescribed hydrocodone calls to report they are unable to fill the
prescription. Which factors could contribute to the inability to fill the prescription? Select
all that apply. - answera. DEA number missing from prescription
b. Prescription sent via electronic messenger
d. Prescriber license number not included
A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action should be taken first? - answerAsk the patient about the number
and frequency of tablets taken
A patient is prescribed metronidazole for bacterial vaginosis. Which patient history
finding would be most concerning? - answerDrinks two glasses of wine every night
A patient is using a metered-dose inhaler containing albuterol for asthma. The
medication label instructs the patient to administer "two puffs every 4 hours as needed
for coughing or wheezing." The patient reports feeling jittery sometimes when taking the
medication, and she doesn't feel that the medication is always effective. Which action is
most appropriate? - answerAuscultating lung sounds and obtaining vital signs
A patient newly diagnosed with diabetes is to be discharged from the hospital. Which
action should be taken first during medication education? - answerAsking the patient to
demonstrate how to measure and administer insulin
The drug manual states that older adult patients are at increased risk for hepatic side
effects. Which action is most important when prescribing this medication to an 80-year-
old patient? - answerObtain pretreatment laboratory work.
A patient recently diagnosed with HIV is prescribed several medications to treat the
condition. Which factors could impact the patient's adherence to the treatment regimen?
Select all that apply - answera. The patient is uninsured
b. The patient works three part-time jobs
c. The medication regimen includes six different pills
e. Medication regimen requires medication be taken at regular 4-hour intervals.
A patient diagnosed with bipolar disorder is prescribed daily lithium. Which action is
most important to determine if the therapeutic level is maintained? - answerEnsure
periodic laboratory testing is completed
The nurse administers naloxone [Narcan] to a patient who has received a toxic dose of
morphine sulfate. The nurse understands that the naloxone is effective because of
which action? - answerPreventing activation of opioid receptors through antagonist
actions
, A patient is taking drug X and receives a new prescription for drug Y, which is listed as
an inducing agent. The nurse caring for this patient understands that this patient may
require doses of drug ? - answerhigher; X
The nurse is preparing to administer penicillin G intramuscularly to a child. The child's
parents ask why the drug cannot be given in an oral liquid form. What is the nurse's
reply? - answerThis drug would be inactivated by enzymes in the stomach
Which statement about food and drug interactions is true? - answerSome foods can
inhibit CYP isoenzymes and alter drug metabolism.
A nurse is teaching a patient about a drug that induces P-glycoprotein. The nurse will
explain that this drug may cause which effect on other drugs? - answerDecreased
elimination through the kidneys
A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet
of Brand Y of the same drug. Both brands contain the same amount of the active
ingredient. What does the nurse know to be most likely? - answerTablets can differ in
composition and can have differing rates of disintegration and dissolution, which can
alter the drug's effects in the body
Two nurses are discussing theories of drug-receptor interaction. Which statements are
true regarding the affinity of a drug and its receptor? Select all that apply. - answerb.
Affinity refers to the strength of the attraction between a drug and its receptor.
c. Drugs with high affinity are strongly attracted to their receptors.
e. The affinity of a drug for its receptors is reflected in its potency.
A patient receives a drug that has a narrow therapeutic range. The nurse administering
this medication will expect to do what? - answerMonitor Plasma Levels
What occurs when a drug binds to a receptor in the body? - answerIt increases or
decreases the activity of that receptor
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels.
The dosing is correct, and this medication has been tolerated by this patient in the past.
Which could be a probable cause of the test result? - answerThe patient is taking
another medication that binds to serum albumin
A patient reports becoming "immune" to a medication because it no longer works to
alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely
caused by? - answerdesensitization of receptor sites by continual exposure to the drug.
A patient who is taking morphine for pain asks the nurse how a pain medication can
also cause constipation. What does the nurse know about morphine? - answerIt is
selective to receptors that regulate more than one body process.
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? - answer Independent
Which factors increase the need for APRNs to have full prescriptive authority? -
answerMore patients will have access to health care.
Which factors could be attributed to limited prescriptive authority for APRNs? SATA -
answerInaccessibility of patient care
Higher health care costs
Which aspects support the APRN's provision for full prescriptive authority? SATA -
answer-Clinical education includes prescription of medications and disease processes
-National examinations provide validation of the APRN's ability to provide safecare
-Licensure ensures compliance with health care and safety standards.
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? - answerThe APRN will
have less prescriptive authority in the new position.
How can collaboration with a pharmacist improve positive outcomes for patients? Select
all that apply - answer-Pharmacists have additional information on drug interactions.
- The pharmacist can suggest adequate medication dosing.
- Pharmacists have firsthand knowledge of the facility formulary
A patient presents with deliriumtremens requiring Ativan administration. The provider of
care is not in the facility. Which action by the nurse is most appropriate? - answerobtain
a telephone order
A patient with chronic pain calls the provider's office to request a refill on their oxycontin.
Which action is most appropriate? - answerSchedule an appointment with the patient.
A patient prescribed amoxicillin for streptococcal pharyngitis reports new onset of a flat,
itchy red rash on the chest and neck. Which action is most important? -
answerdiscontinue the medication
A patient taking three medications for hypertension is diagnosed with COPD. Which
action should be taken prior to prescribing medications to treat COPD? - answerObtain
a complete medication history.
,A patient with diabetes reports losing their job and an inability to purchase required
medications. Which action is most appropriate? - answerContact a different pharmacy
A patient recently prescribed hydrocodone calls to report they are unable to fill the
prescription. Which factors could contribute to the inability to fill the prescription? Select
all that apply. - answera. DEA number missing from prescription
b. Prescription sent via electronic messenger
d. Prescriber license number not included
A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action should be taken first? - answerAsk the patient about the number
and frequency of tablets taken
A patient is prescribed metronidazole for bacterial vaginosis. Which patient history
finding would be most concerning? - answerDrinks two glasses of wine every night
A patient is using a metered-dose inhaler containing albuterol for asthma. The
medication label instructs the patient to administer "two puffs every 4 hours as needed
for coughing or wheezing." The patient reports feeling jittery sometimes when taking the
medication, and she doesn't feel that the medication is always effective. Which action is
most appropriate? - answerAuscultating lung sounds and obtaining vital signs
A patient newly diagnosed with diabetes is to be discharged from the hospital. Which
action should be taken first during medication education? - answerAsking the patient to
demonstrate how to measure and administer insulin
The drug manual states that older adult patients are at increased risk for hepatic side
effects. Which action is most important when prescribing this medication to an 80-year-
old patient? - answerObtain pretreatment laboratory work.
A patient recently diagnosed with HIV is prescribed several medications to treat the
condition. Which factors could impact the patient's adherence to the treatment regimen?
Select all that apply - answera. The patient is uninsured
b. The patient works three part-time jobs
c. The medication regimen includes six different pills
e. Medication regimen requires medication be taken at regular 4-hour intervals.
A patient diagnosed with bipolar disorder is prescribed daily lithium. Which action is
most important to determine if the therapeutic level is maintained? - answerEnsure
periodic laboratory testing is completed
The nurse administers naloxone [Narcan] to a patient who has received a toxic dose of
morphine sulfate. The nurse understands that the naloxone is effective because of
which action? - answerPreventing activation of opioid receptors through antagonist
actions
, A patient is taking drug X and receives a new prescription for drug Y, which is listed as
an inducing agent. The nurse caring for this patient understands that this patient may
require doses of drug ? - answerhigher; X
The nurse is preparing to administer penicillin G intramuscularly to a child. The child's
parents ask why the drug cannot be given in an oral liquid form. What is the nurse's
reply? - answerThis drug would be inactivated by enzymes in the stomach
Which statement about food and drug interactions is true? - answerSome foods can
inhibit CYP isoenzymes and alter drug metabolism.
A nurse is teaching a patient about a drug that induces P-glycoprotein. The nurse will
explain that this drug may cause which effect on other drugs? - answerDecreased
elimination through the kidneys
A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet
of Brand Y of the same drug. Both brands contain the same amount of the active
ingredient. What does the nurse know to be most likely? - answerTablets can differ in
composition and can have differing rates of disintegration and dissolution, which can
alter the drug's effects in the body
Two nurses are discussing theories of drug-receptor interaction. Which statements are
true regarding the affinity of a drug and its receptor? Select all that apply. - answerb.
Affinity refers to the strength of the attraction between a drug and its receptor.
c. Drugs with high affinity are strongly attracted to their receptors.
e. The affinity of a drug for its receptors is reflected in its potency.
A patient receives a drug that has a narrow therapeutic range. The nurse administering
this medication will expect to do what? - answerMonitor Plasma Levels
What occurs when a drug binds to a receptor in the body? - answerIt increases or
decreases the activity of that receptor
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels.
The dosing is correct, and this medication has been tolerated by this patient in the past.
Which could be a probable cause of the test result? - answerThe patient is taking
another medication that binds to serum albumin
A patient reports becoming "immune" to a medication because it no longer works to
alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely
caused by? - answerdesensitization of receptor sites by continual exposure to the drug.
A patient who is taking morphine for pain asks the nurse how a pain medication can
also cause constipation. What does the nurse know about morphine? - answerIt is
selective to receptors that regulate more than one body process.
