NUR-641E COMPREHENSIVE STUDY GUIDE
2026 FULL QUESTIONS AND SOLUTIONS
GRADED A+
◍ Nurse practitioner prescriptive authority is regulated by:
A. The National Council of State Boards of Nursing
B. The
U. S. Drug Enforcement Administration
C. The State Board of Nursing for each state
D. The State Board of Pharmacy.
Answer: C. The State Board of Nursing for each state
◍ Physician Assistant (PA) prescriptive authority is regulated by:
A. The National Council of State Boards of Nursing
B. The
U. S. Drug Enforcement Administration
C. The State Board of Nursing
D. The State Board of Medical Examiners.
Answer: D. The State Board of Medical Examiners
◍ Clinical judgment in prescribing includes:
A. Factoring in the cost to the patient of the medication prescribed
B. Always prescribing the newest medication available for the disease
process
C. Handing out drug samples to poor patients
D. Prescribing all generic medications to cut costs.
Answer: A. Factoring in the cost to the patient of the medication prescribed
◍ Criteria for choosing an effective drug for a disorder include:
A. Asking the patient what drug they think would work best for them
B. Consulting nationally recognized guidelines for disease management
, C. Prescribing medications that are available as samples before writing a
prescription
D. Following
U. S. Drug Enforcement Administration (DEA) guidelines for prescribing.
Answer: B. Consulting nationally recognized guidelines for disease
management
◍ Nurse practitioner practice may thrive under health-care reform due to:
A. The demonstrated ability of nurse practitioners to control costs and
improve patient outcomes
B. The fact that nurse practitioners will be able to practice independently
C. The fact that nurse practitioners will have full reimbursement under
health-care reform
D. The ability to shift accountability for Medicaid to the state level.
Answer: A. The demonstrated ability of nurse practitioners to control costs
and improve patient outcomes
◍ A patient's nutritional intake and lab work reflects hypoalbuminemia. This is
critical to prescribing because:
A. Distribution of drugs to target tissue may be affected
B. The solubility of the drug will not match the site of absorption
C. There will be less free drug available to generate an effect
D. Drugs bound to albumin are readily excreted by the kidney.
Answer: A. Distribution of drugs to target tissue may be affected
◍ Drugs that have a significant first-pass effect:
A. Must be given by the enteral (oral) route only
B. Bypass the hepatic circulation
C. Are rapidly metabolized by the liver and may have little if any desired
action
D. Are converted by the liver to more active and fat-soluble forms.
Answer: C. Are rapidly metabolized by the liver and may have little if any
desired action
◍ The route of excretion of a volatile drug will likely be:
, A. The kidneys
B. The lungs
C. The bile and feces
D. The skin.
Answer: B. The lungs
◍ Medroxyprogesterone (Depo Provera) is prescribed IM to create a storage
reservoir of the drug. Storage reservoirs:
A. Assure that the drug will reach its intended target tissue
B. Are the reason for giving loading doses
C. Increase the length of time a drug is available and active
D. Are most common in collagen tissues.
Answer: C. Increase the length of time a drug is available and active
◍ The NP chooses to give cephalexin every 8 hours based on knowledge of the
drug's:
A. Propensity to go to the target receptor
B. Biological half-life
C. Pharmacodynamics
D. Safety and side effects.
Answer: B. Biological half-life
◍ Azithromycin dosing requires the first day's dose be twice those of the other
4 days of the prescription. This is considered a loading dose. A loading
dose:
A. Rapidly achieves drug levels in the therapeutic range
B. Requires four to five half-lives to attain
C. Is influenced by renal function
D. Is directly related to the drug circulating to the target tissues.
Answer: A. Rapidly achieves drug levels in the therapeutic range
◍ The point in time on the drug concentration curve that indicates the first sign
of a therapeutic effect is the:
A. Minimum adverse effect level
B. Peak of action
, C. Onset of action
D. Therapeutic range.
Answer: C. Onset of action
◍ Phenytoin requires a trough level be drawn. Peak and trough levels are done:
A. When the drug has a wide therapeutic range
B. When the drug will be administered for a short time only
C. When there is a high correlation between the dose and saturation of
receptor sites
D. To determine if a drug is in the therapeutic range.
Answer: D. To determine if a drug is in the therapeutic range
◍ A laboratory result indicates the peak level for a drug is above the minimum
toxic concentration. This means that the:
A. Concentration will produce therapeutic effects
B. Concentration will produce an adverse response
C. Time between doses must be shortened
D. Duration of action of the drug is too long.
Answer: B. Concentration will produce an adverse response
◍ Drugs that are receptor agonists may demonstrate what property?
A. Irreversible binding to the drug receptor site
B. Up-regulation with chronic use
C. Desensitization or down-regulation with continuous use
D. Inverse relationship between drug concentration and drug action.
Answer: C. Desensitization or down-regulation with continuous use
◍ Drugs that are receptor antagonists, such as beta blockers, may cause:
A. Down-regulation of the drug receptor
B. An exaggerated response if abruptly discontinued
C. Partial blockade of the effects of agonist drugs
D. An exaggerated response to competitive drug agonists.
Answer: B. An exaggerated response if abruptly discontinued
◍ Factors that affect gastric drug absorption include:
A. Liver enzyme activity
2026 FULL QUESTIONS AND SOLUTIONS
GRADED A+
◍ Nurse practitioner prescriptive authority is regulated by:
A. The National Council of State Boards of Nursing
B. The
U. S. Drug Enforcement Administration
C. The State Board of Nursing for each state
D. The State Board of Pharmacy.
Answer: C. The State Board of Nursing for each state
◍ Physician Assistant (PA) prescriptive authority is regulated by:
A. The National Council of State Boards of Nursing
B. The
U. S. Drug Enforcement Administration
C. The State Board of Nursing
D. The State Board of Medical Examiners.
Answer: D. The State Board of Medical Examiners
◍ Clinical judgment in prescribing includes:
A. Factoring in the cost to the patient of the medication prescribed
B. Always prescribing the newest medication available for the disease
process
C. Handing out drug samples to poor patients
D. Prescribing all generic medications to cut costs.
Answer: A. Factoring in the cost to the patient of the medication prescribed
◍ Criteria for choosing an effective drug for a disorder include:
A. Asking the patient what drug they think would work best for them
B. Consulting nationally recognized guidelines for disease management
, C. Prescribing medications that are available as samples before writing a
prescription
D. Following
U. S. Drug Enforcement Administration (DEA) guidelines for prescribing.
Answer: B. Consulting nationally recognized guidelines for disease
management
◍ Nurse practitioner practice may thrive under health-care reform due to:
A. The demonstrated ability of nurse practitioners to control costs and
improve patient outcomes
B. The fact that nurse practitioners will be able to practice independently
C. The fact that nurse practitioners will have full reimbursement under
health-care reform
D. The ability to shift accountability for Medicaid to the state level.
Answer: A. The demonstrated ability of nurse practitioners to control costs
and improve patient outcomes
◍ A patient's nutritional intake and lab work reflects hypoalbuminemia. This is
critical to prescribing because:
A. Distribution of drugs to target tissue may be affected
B. The solubility of the drug will not match the site of absorption
C. There will be less free drug available to generate an effect
D. Drugs bound to albumin are readily excreted by the kidney.
Answer: A. Distribution of drugs to target tissue may be affected
◍ Drugs that have a significant first-pass effect:
A. Must be given by the enteral (oral) route only
B. Bypass the hepatic circulation
C. Are rapidly metabolized by the liver and may have little if any desired
action
D. Are converted by the liver to more active and fat-soluble forms.
Answer: C. Are rapidly metabolized by the liver and may have little if any
desired action
◍ The route of excretion of a volatile drug will likely be:
, A. The kidneys
B. The lungs
C. The bile and feces
D. The skin.
Answer: B. The lungs
◍ Medroxyprogesterone (Depo Provera) is prescribed IM to create a storage
reservoir of the drug. Storage reservoirs:
A. Assure that the drug will reach its intended target tissue
B. Are the reason for giving loading doses
C. Increase the length of time a drug is available and active
D. Are most common in collagen tissues.
Answer: C. Increase the length of time a drug is available and active
◍ The NP chooses to give cephalexin every 8 hours based on knowledge of the
drug's:
A. Propensity to go to the target receptor
B. Biological half-life
C. Pharmacodynamics
D. Safety and side effects.
Answer: B. Biological half-life
◍ Azithromycin dosing requires the first day's dose be twice those of the other
4 days of the prescription. This is considered a loading dose. A loading
dose:
A. Rapidly achieves drug levels in the therapeutic range
B. Requires four to five half-lives to attain
C. Is influenced by renal function
D. Is directly related to the drug circulating to the target tissues.
Answer: A. Rapidly achieves drug levels in the therapeutic range
◍ The point in time on the drug concentration curve that indicates the first sign
of a therapeutic effect is the:
A. Minimum adverse effect level
B. Peak of action
, C. Onset of action
D. Therapeutic range.
Answer: C. Onset of action
◍ Phenytoin requires a trough level be drawn. Peak and trough levels are done:
A. When the drug has a wide therapeutic range
B. When the drug will be administered for a short time only
C. When there is a high correlation between the dose and saturation of
receptor sites
D. To determine if a drug is in the therapeutic range.
Answer: D. To determine if a drug is in the therapeutic range
◍ A laboratory result indicates the peak level for a drug is above the minimum
toxic concentration. This means that the:
A. Concentration will produce therapeutic effects
B. Concentration will produce an adverse response
C. Time between doses must be shortened
D. Duration of action of the drug is too long.
Answer: B. Concentration will produce an adverse response
◍ Drugs that are receptor agonists may demonstrate what property?
A. Irreversible binding to the drug receptor site
B. Up-regulation with chronic use
C. Desensitization or down-regulation with continuous use
D. Inverse relationship between drug concentration and drug action.
Answer: C. Desensitization or down-regulation with continuous use
◍ Drugs that are receptor antagonists, such as beta blockers, may cause:
A. Down-regulation of the drug receptor
B. An exaggerated response if abruptly discontinued
C. Partial blockade of the effects of agonist drugs
D. An exaggerated response to competitive drug agonists.
Answer: B. An exaggerated response if abruptly discontinued
◍ Factors that affect gastric drug absorption include:
A. Liver enzyme activity
