NR 565 WEEK 1 QUIZ ANSWERS (100%
CORRECT AND ACCURATE SOLUTIONS) |
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APRN prescribing role - answer-Prescriptive authority for nurse practitioners also
regulates prescribing rights beyond medications and controlled substances. These
rights include therapeutic devices and services and are outlined in state practice laws
and regulations and include Durable Medical Equipment (DME) such as wheelchairs,
power scooters, hospital beds, portable oxygen equipment, handicap placards, etc.
and medical services such as Physical Therapy (PT), Occupational Therapy (OT), home
health services, etc. Prescriptive authority encompasses more than writing a
prescription correctly. It requires adherence to ethical guidelines to ensure that patients
are safeguarded from harm. Ethical prescribing starts with being well-informed about
medications. Mechanism of action, efficacy, and safety are important considerations,
as are a patient's distinct needs and circumstances, including the number of
medications prescribed (Mitchell & Oliphant, 2016). Most patients receiving a
prescription are taking other medications, whether prescription or over-the-counter.
Appropriate selection, dosing, and duration of pharmaceutical agents are key to
maximizing outcomes and minimizing adverse effects
benefits of full practice authority - answer-Nurse practitioners have the autonomy to
evaluate patients, diagnose, order and interpret tests, initiate and manage treatments
and prescribe medications, including controlled substances without physician
oversight
promoting positive outcomes through prudent prescribing practices - answer-
Administering medications and prescribing medications are two distinct processes.
Prescription writing requires prudent and deliberate decision-making processes to
maintain patient safety and reduce liability, including:
*documentation of a provider-patient relationship for the recipient of the prescribed
medications
*documentation of a thorough history and physical examination for the recipient
,*documentation of discussions regarding risk factors, side effects, or therapy options
*documentation of drug monitoring or titration plan, if applicable
*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the formulation of a
diagnosis based on clinical reasoning and the selection and monitoring of the most
appropriate pharmacological treatment
Considerations include: Cost, guidelines, availability, interactions, side effects,
allergies, hepatic/renal functions, need for monitoring, & special populations
Beer's Criteria - answer-identifies drugs with a high likelihood of causing adverse effects
in older adults. Accordingly, drugs on this list should generally be avoided in adults
older than 65 years except when the benefits are significantly greater than the risks.
Pharmacodynamics - answer-the study of the biochemical and physiologic effects of
drugs on the body and the molecular mechanisms by which those effects are produced
Pharmacokinetics - answer-the study of drug movement throughout the body
Pharmacogenomics - answer-the study of how genes affect a person's response to
drugs. The purpose of this is to combine the sciences of genomics and pharmacology to
provide individualized, targeted, safe drug therapies to patients
CYP450 inducers - answer-Inducers are xenobiotics (medications and environmental
agents) that elevate CYP450 enzyme activity by increasing enzyme synthesis. This
action leads to additional sites available for biotransformation. The increased number
,of sites enhances medication metabolism, decreasing the concentration of the "parent
drug" while increasing metabolite production.
Inducers = Increase medication metabolism
(Carbamazepine, Rifampin, Alcohol, Phenytoin, Griseofulvin, Phenobarbital,
Sulfonylureas)
CYP450 inhibitors - answer-Inhibitors are medications that inhibit the metabolic activity
of one or more of the CYP450 enzymes. Medications that inhibit an enzyme potentially
slows that enzyme's activity or blocks the activity required for the metabolism of other
medications, thereby increasing the levels of medications dependent on that particular
enzyme for biotransformation. Inhibitors = decrease medication metabolism (Valproate,
Isoniazid, Sulfonamides, Amiodarone, Chloramphenicol, Ketoconazole, Grapefruit
Juice, Quinidine)
cultural influences in prescribing - answer-The greatest concern surrounding race-
based therapy has to do with genetic variability. We know there is great diversity within
and among racial groups; therefore, a "one fits all" approach based on race is unwise.
Still, we can use known associations to guide choices. For example, differences in
metabolism between people with East Asian and European heritage are common. The
provider can use this knowledge to guide initial dosing (with adjustment, as indicated
based on response) if genetic testing is not feasible or warranted
Polypharmacy: Definition, challenges, and outcomes - answer-treatment with multiple
drugs
greatly increases the risk for interactions. Some of these interactions are negligible, but
some can have life-threatening consequences. It is of crucial importance to ask the
patient about all current drugs, including over-the-counter (OTC) medications and other
herbal preparations. Many patients do not consider OTC or alternative pharmaceuticals
as "medications" and may not mention them unless you ask specifically.
Acute Pain Management - answer-
, Chronic Pain Management - answer-
Opioid Management - answer-
Regulations of Controlled Substances - answer-The U.S. Department of Justice Drug
Enforcement Agency (DEA) coordinates with local, state, and federal agents to reduce
illicit drug use. The DEA enacted the Controlled Substances Act (CSA) in 1970 to
regulate drugs and other substances based on their potential for abuse and
dependency. Five schedules of controlled substances were created that are updated
annually. Classes of scheduled substances include narcotics, depressants, stimulants,
hallucinogens, and anabolic steroids. The DEA issues eligible providers with a
registration number to write prescriptions for controlled substances. Characteristics of
a valid DEA number include:
-The first letter identifies the type of provider: A=before 1985; B=after 1985; F=after
2007; M=nurse practitioner or physician assistant
-The 2nd letter the 1st letter of the provider's last name at the time of initial registration
Example: Tammy Greene applies for and receives a DEA number of MG2705208
M=nurse practitioner and G=Greene
Opioid Epidemic & Responsible Prescribing - answer-
Opioid Use Disorder - answer-a pattern of use that leads to significant impairment or
distress. Typically, this disorder is marked by unsuccessful efforts to reduce or control
use resulting in the inability to fulfill work, school, or home responsibilities. Opioid use
disorder is different from drug tolerance and physical dependence, which may also
exist. Opioid use creates high levels of positive reinforcement, increasing the likelihood
of continued use. It is often a chronic lifelong disorder, leading to serious consequences
such as disability and death. Although it is similar to other substance use disorders, it
has distinct features that have fueled the current opioid epidemic. Opioids can lead to
physical dependence in only 4-8 weeks. Abruptly stopping use in chronic users leads to
severe symptoms, which motivates continued use to prevent withdrawal. The 2016 CDC
guidelines for prescribing opioids recommends calculating the total daily dose of
CORRECT AND ACCURATE SOLUTIONS) |
DOWNLOAD TO SCORE AN A+ GRADE LATEST
2026!!
APRN prescribing role - answer-Prescriptive authority for nurse practitioners also
regulates prescribing rights beyond medications and controlled substances. These
rights include therapeutic devices and services and are outlined in state practice laws
and regulations and include Durable Medical Equipment (DME) such as wheelchairs,
power scooters, hospital beds, portable oxygen equipment, handicap placards, etc.
and medical services such as Physical Therapy (PT), Occupational Therapy (OT), home
health services, etc. Prescriptive authority encompasses more than writing a
prescription correctly. It requires adherence to ethical guidelines to ensure that patients
are safeguarded from harm. Ethical prescribing starts with being well-informed about
medications. Mechanism of action, efficacy, and safety are important considerations,
as are a patient's distinct needs and circumstances, including the number of
medications prescribed (Mitchell & Oliphant, 2016). Most patients receiving a
prescription are taking other medications, whether prescription or over-the-counter.
Appropriate selection, dosing, and duration of pharmaceutical agents are key to
maximizing outcomes and minimizing adverse effects
benefits of full practice authority - answer-Nurse practitioners have the autonomy to
evaluate patients, diagnose, order and interpret tests, initiate and manage treatments
and prescribe medications, including controlled substances without physician
oversight
promoting positive outcomes through prudent prescribing practices - answer-
Administering medications and prescribing medications are two distinct processes.
Prescription writing requires prudent and deliberate decision-making processes to
maintain patient safety and reduce liability, including:
*documentation of a provider-patient relationship for the recipient of the prescribed
medications
*documentation of a thorough history and physical examination for the recipient
,*documentation of discussions regarding risk factors, side effects, or therapy options
*documentation of drug monitoring or titration plan, if applicable
*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the formulation of a
diagnosis based on clinical reasoning and the selection and monitoring of the most
appropriate pharmacological treatment
Considerations include: Cost, guidelines, availability, interactions, side effects,
allergies, hepatic/renal functions, need for monitoring, & special populations
Beer's Criteria - answer-identifies drugs with a high likelihood of causing adverse effects
in older adults. Accordingly, drugs on this list should generally be avoided in adults
older than 65 years except when the benefits are significantly greater than the risks.
Pharmacodynamics - answer-the study of the biochemical and physiologic effects of
drugs on the body and the molecular mechanisms by which those effects are produced
Pharmacokinetics - answer-the study of drug movement throughout the body
Pharmacogenomics - answer-the study of how genes affect a person's response to
drugs. The purpose of this is to combine the sciences of genomics and pharmacology to
provide individualized, targeted, safe drug therapies to patients
CYP450 inducers - answer-Inducers are xenobiotics (medications and environmental
agents) that elevate CYP450 enzyme activity by increasing enzyme synthesis. This
action leads to additional sites available for biotransformation. The increased number
,of sites enhances medication metabolism, decreasing the concentration of the "parent
drug" while increasing metabolite production.
Inducers = Increase medication metabolism
(Carbamazepine, Rifampin, Alcohol, Phenytoin, Griseofulvin, Phenobarbital,
Sulfonylureas)
CYP450 inhibitors - answer-Inhibitors are medications that inhibit the metabolic activity
of one or more of the CYP450 enzymes. Medications that inhibit an enzyme potentially
slows that enzyme's activity or blocks the activity required for the metabolism of other
medications, thereby increasing the levels of medications dependent on that particular
enzyme for biotransformation. Inhibitors = decrease medication metabolism (Valproate,
Isoniazid, Sulfonamides, Amiodarone, Chloramphenicol, Ketoconazole, Grapefruit
Juice, Quinidine)
cultural influences in prescribing - answer-The greatest concern surrounding race-
based therapy has to do with genetic variability. We know there is great diversity within
and among racial groups; therefore, a "one fits all" approach based on race is unwise.
Still, we can use known associations to guide choices. For example, differences in
metabolism between people with East Asian and European heritage are common. The
provider can use this knowledge to guide initial dosing (with adjustment, as indicated
based on response) if genetic testing is not feasible or warranted
Polypharmacy: Definition, challenges, and outcomes - answer-treatment with multiple
drugs
greatly increases the risk for interactions. Some of these interactions are negligible, but
some can have life-threatening consequences. It is of crucial importance to ask the
patient about all current drugs, including over-the-counter (OTC) medications and other
herbal preparations. Many patients do not consider OTC or alternative pharmaceuticals
as "medications" and may not mention them unless you ask specifically.
Acute Pain Management - answer-
, Chronic Pain Management - answer-
Opioid Management - answer-
Regulations of Controlled Substances - answer-The U.S. Department of Justice Drug
Enforcement Agency (DEA) coordinates with local, state, and federal agents to reduce
illicit drug use. The DEA enacted the Controlled Substances Act (CSA) in 1970 to
regulate drugs and other substances based on their potential for abuse and
dependency. Five schedules of controlled substances were created that are updated
annually. Classes of scheduled substances include narcotics, depressants, stimulants,
hallucinogens, and anabolic steroids. The DEA issues eligible providers with a
registration number to write prescriptions for controlled substances. Characteristics of
a valid DEA number include:
-The first letter identifies the type of provider: A=before 1985; B=after 1985; F=after
2007; M=nurse practitioner or physician assistant
-The 2nd letter the 1st letter of the provider's last name at the time of initial registration
Example: Tammy Greene applies for and receives a DEA number of MG2705208
M=nurse practitioner and G=Greene
Opioid Epidemic & Responsible Prescribing - answer-
Opioid Use Disorder - answer-a pattern of use that leads to significant impairment or
distress. Typically, this disorder is marked by unsuccessful efforts to reduce or control
use resulting in the inability to fulfill work, school, or home responsibilities. Opioid use
disorder is different from drug tolerance and physical dependence, which may also
exist. Opioid use creates high levels of positive reinforcement, increasing the likelihood
of continued use. It is often a chronic lifelong disorder, leading to serious consequences
such as disability and death. Although it is similar to other substance use disorders, it
has distinct features that have fueled the current opioid epidemic. Opioids can lead to
physical dependence in only 4-8 weeks. Abruptly stopping use in chronic users leads to
severe symptoms, which motivates continued use to prevent withdrawal. The 2016 CDC
guidelines for prescribing opioids recommends calculating the total daily dose of
