TestBankforPharmacotherapeuticsforAdvancedPracticeA
yPracticalApproach5thEditionByVirginiaPooleArcangelo,
AndrewMPeterson,VeronicaWilbur,TepM.Kang/All
y y y y y y y y y
ChaptersCovered–LatestUpdate2024. y
Nursepractitionerprescriptiveauthorityisregulatedby:
1. TheNationalCouncilofStateBoardsofNursing
2. TheU.S.DrugEnforcement Administration v
3. TheStateBoardofNursingforeachstate
4. TheStateBoardofPharmacy - Correct Answer - 3. The State Board of Nursing for each state y v v v v v v v v v v v v
ThebenefitstothepatientofhavinganAdvancedPracticeRegisteredNurse(APRN)prescriberinclude: y y y
1. NursesknowmoreaboutPharmacologythanotherprescribersbecausetheytakeitbothintheirbasic
y y y y y y y y y
nursing program and in their APRN program.
y y y y y y y
2. Nursescareforthepatientfromaholisticapproachandincludethepatient indecisionmaking y y v y
regarding their care.
y y y
3. APRNsarelesslikelyto prescribenarcoticsandothercontrolledsubstances. y
4. APRNsareabletoprescribeindependentlyinallstates,whereasaphysician'sassistantneeds tohavea v y
physician supervising their practice. - Correct Answer - 2. Nurses care for the patient from a holistic
y y y y y v v v v v v v v v v v
approach and include the patient in decision making regarding their care.
v v v v v v v v v v v
Clinicaljudgmentinprescribingincludes:
1. Factoringinthecost tothepatientofthemedicationprescribed
y y y y
2. Alwaysprescribingthenewestmedication available for thediseaseprocess y y y
3. Handingout drugsamplesto poorpatients v y y
4. Prescribingallgenericmedicationsto cutcosts - Correct Answer - 1. Factoring in the cost to the y y v v v v v v v v v v vv
patient of the medication prescribed
v v v v
pg. 1
y
,Criteriaforchoosing aneffectivedrugforadisorderinclude: v
1. Askingthe patientwhatdrugthey thinkwouldworkbestforthem
y y y y y
2. Consultingnationallyrecognizedguidelinesfordiseasemanagement
3. Prescribingmedicationsthat areavailableas samples beforewritingaprescription y y y
4. FollowingU.S.DrugEnforcementAdministration guidelinesforprescribing - Correct Answer - 2. y y y v v v vv
Consulting nationally recognized guidelines for disease management
v v v v v v
Nursepractitionerpracticemay thriveunderhealth-carereformbecauseof: y
1. Thedemonstratedabilityofnursepractitionerstocontrolcostsandimprovepatientoutcomes y y
2. Thefactthatnursepractitionerswillbeabletopracticeindependently
3. The fact thatnursepractitionerswillhave full reimbursementunderhealth-carereform
y y y y
4. Theabilityto shiftaccountabilityforMedicaidtothestatelevel - Correct Answer - 1. The
y v y y y v v v v v
demonstrated ability of nurse practitioners to control costs and improve patient outcomes
y v v v v v v v v v v v
Apatient'snutritionalintake andlaboratoryresultsreflecthypoalbuminemia.This is v y y y
critical to prescribing because:
y y y y
1. Distributionofdrugsto target tissuemay beaffected. y y y y
2. Thesolubilityofthedrugwill notmatchthe siteof absorption. y y y
3. Therewillbeless freedrugavailableto generateaneffect. v v
4. Drugs boundtoalbuminarereadilyexcretedbythekidneys. -Correct Answer - 1. Distribution of drugs to
v y y y y v v v v v v v
target tissue may be affected.
v v v v v
Drugsthat haveasignificant first-pass effect:
y y y v
1. Mustbegivenbytheenteral(oral)routeonly
2. Bypassthehepaticcirculation y
3. Arerapidlymetabolizedby theliverandmayhavelittleifanydesiredaction y
pg. 2 y
,4. Areconvertedbythelivertomoreactiveandfat-solubleforms - Correct Answer - 3. Are rapidly v y v v v v v vv
metabolized by the liver and may have little if any desired action
v v v v v v v v v v v
Therouteofexcretionofavolatiledrugwilllikelybe the:
y y y y y y
1. Kidneys
2. Lungs
3. Bileandfeces y
4. Skin - Correct Answer - 2. Lungs
v v v v v v
Medroxyprogesterone(DepoProvera)isprescribedintramuscularly(IM)tocreateastoragereservoirofthe y
drug. Storage reservoirs:
y y y
1. Assurethatthedrugwillreach itsintendedtarget tissue y y y
2. Arethereasonforgivingloading doses y y
3. Increasethelengthoftime adrugis availableandactive y v
4. Aremostcommonincollagentissues- Correct Answer - 3. Increase the length of time a drug is y y y v v v v v v v v v v v v vv
available and active v v
TheNPchoosestogivecephalexinevery8hours basedonknowledgeofthedrug's: y y v
1. Propensitytogotothetargetreceptor y y
2. Biological half-life y
3. Pharmacodynamics
4. Safetyandsideeffects-Correct Answer - 2. Biological half-life v v v v v
Azithromycindosingrequires thatthefirstday'sdosagebetwicethoseoftheother 4days ofthe prescription. y y y y y y y y v y y
This is considered a loading dose. A loading dose:
y y y y y y y y y
1. Rapidly achievesdruglevels inthetherapeuticrange
y y
2. Requiresfour-to five-half-livestoattain v
3. Isinfluencedbyrenalfunction
4. Isdirectly relatedtothedrugcirculatingtothetargettissues - Correct Answer - 1. Rapidly achieves
y y y v v v v v vv
drug levels in the therapeutic range
v v v v v
pg. 3
y
, Thepointintimeonthedrugconcentrationcurvethatindicatesthefirstsignofatherapeuticeffectis the:
y y y y y y y y y y y y
1. Minimumadverse effectlevel y y y
2. Peak ofaction v
3. Onsetof action y
4. Therapeuticrange-Correct Answer - 3. Onset of action y v v v v v v
Phenytoinrequiresthatatroughlevel be drawn.Peakandtroughlevels are done: y y y y y
1. Whenthe drughas awide therapeuticrange
y y y y
2. Whenthe drugwillbeadministeredforashorttimeonly
v y y y y
3. Whenthereisahighcorrelation betweenthedoseandsaturationofreceptorsites
y y y y y y y
4. Todetermineifadrug isinthetherapeuticrange - Correct Answer - 4. To determine if a drug is in the
v y y v v v v v v v v v v v vv
therapeutic range v
Alaboratoryresultindicatesthatthepeaklevelforadrug is abovetheminimum toxicconcentration. Thismeans
y y y v y y y
thatthe:
y y
1. Concentrationwill produce therapeutic effects y y y
2. Concentrationwillproduceanadverseresponse
3. Timebetweendosesmustbeshortened
4. Durationofactionofthedrugistoolong- Correct Answer - 2. Concentration will produce an adverse y y y v v v v v v v v
response
y
Drugsthatarereceptoragonistsmaydemonstratewhatproperty?
1. Irreversiblebindingto thedrugreceptorsite y y
2. Upregulationwithchronicuse
3. Desensitizationordownregulation withcontinuous use y y y y y
4. Inverserelationshipbetweendrugconcentrationanddrugaction- Correct Answer - 3. Desensitization or y y v v v v v v
downregulation with continuous use
v v v v
pg. 4
y
yPracticalApproach5thEditionByVirginiaPooleArcangelo,
AndrewMPeterson,VeronicaWilbur,TepM.Kang/All
y y y y y y y y y
ChaptersCovered–LatestUpdate2024. y
Nursepractitionerprescriptiveauthorityisregulatedby:
1. TheNationalCouncilofStateBoardsofNursing
2. TheU.S.DrugEnforcement Administration v
3. TheStateBoardofNursingforeachstate
4. TheStateBoardofPharmacy - Correct Answer - 3. The State Board of Nursing for each state y v v v v v v v v v v v v
ThebenefitstothepatientofhavinganAdvancedPracticeRegisteredNurse(APRN)prescriberinclude: y y y
1. NursesknowmoreaboutPharmacologythanotherprescribersbecausetheytakeitbothintheirbasic
y y y y y y y y y
nursing program and in their APRN program.
y y y y y y y
2. Nursescareforthepatientfromaholisticapproachandincludethepatient indecisionmaking y y v y
regarding their care.
y y y
3. APRNsarelesslikelyto prescribenarcoticsandothercontrolledsubstances. y
4. APRNsareabletoprescribeindependentlyinallstates,whereasaphysician'sassistantneeds tohavea v y
physician supervising their practice. - Correct Answer - 2. Nurses care for the patient from a holistic
y y y y y v v v v v v v v v v v
approach and include the patient in decision making regarding their care.
v v v v v v v v v v v
Clinicaljudgmentinprescribingincludes:
1. Factoringinthecost tothepatientofthemedicationprescribed
y y y y
2. Alwaysprescribingthenewestmedication available for thediseaseprocess y y y
3. Handingout drugsamplesto poorpatients v y y
4. Prescribingallgenericmedicationsto cutcosts - Correct Answer - 1. Factoring in the cost to the y y v v v v v v v v v v vv
patient of the medication prescribed
v v v v
pg. 1
y
,Criteriaforchoosing aneffectivedrugforadisorderinclude: v
1. Askingthe patientwhatdrugthey thinkwouldworkbestforthem
y y y y y
2. Consultingnationallyrecognizedguidelinesfordiseasemanagement
3. Prescribingmedicationsthat areavailableas samples beforewritingaprescription y y y
4. FollowingU.S.DrugEnforcementAdministration guidelinesforprescribing - Correct Answer - 2. y y y v v v vv
Consulting nationally recognized guidelines for disease management
v v v v v v
Nursepractitionerpracticemay thriveunderhealth-carereformbecauseof: y
1. Thedemonstratedabilityofnursepractitionerstocontrolcostsandimprovepatientoutcomes y y
2. Thefactthatnursepractitionerswillbeabletopracticeindependently
3. The fact thatnursepractitionerswillhave full reimbursementunderhealth-carereform
y y y y
4. Theabilityto shiftaccountabilityforMedicaidtothestatelevel - Correct Answer - 1. The
y v y y y v v v v v
demonstrated ability of nurse practitioners to control costs and improve patient outcomes
y v v v v v v v v v v v
Apatient'snutritionalintake andlaboratoryresultsreflecthypoalbuminemia.This is v y y y
critical to prescribing because:
y y y y
1. Distributionofdrugsto target tissuemay beaffected. y y y y
2. Thesolubilityofthedrugwill notmatchthe siteof absorption. y y y
3. Therewillbeless freedrugavailableto generateaneffect. v v
4. Drugs boundtoalbuminarereadilyexcretedbythekidneys. -Correct Answer - 1. Distribution of drugs to
v y y y y v v v v v v v
target tissue may be affected.
v v v v v
Drugsthat haveasignificant first-pass effect:
y y y v
1. Mustbegivenbytheenteral(oral)routeonly
2. Bypassthehepaticcirculation y
3. Arerapidlymetabolizedby theliverandmayhavelittleifanydesiredaction y
pg. 2 y
,4. Areconvertedbythelivertomoreactiveandfat-solubleforms - Correct Answer - 3. Are rapidly v y v v v v v vv
metabolized by the liver and may have little if any desired action
v v v v v v v v v v v
Therouteofexcretionofavolatiledrugwilllikelybe the:
y y y y y y
1. Kidneys
2. Lungs
3. Bileandfeces y
4. Skin - Correct Answer - 2. Lungs
v v v v v v
Medroxyprogesterone(DepoProvera)isprescribedintramuscularly(IM)tocreateastoragereservoirofthe y
drug. Storage reservoirs:
y y y
1. Assurethatthedrugwillreach itsintendedtarget tissue y y y
2. Arethereasonforgivingloading doses y y
3. Increasethelengthoftime adrugis availableandactive y v
4. Aremostcommonincollagentissues- Correct Answer - 3. Increase the length of time a drug is y y y v v v v v v v v v v v v vv
available and active v v
TheNPchoosestogivecephalexinevery8hours basedonknowledgeofthedrug's: y y v
1. Propensitytogotothetargetreceptor y y
2. Biological half-life y
3. Pharmacodynamics
4. Safetyandsideeffects-Correct Answer - 2. Biological half-life v v v v v
Azithromycindosingrequires thatthefirstday'sdosagebetwicethoseoftheother 4days ofthe prescription. y y y y y y y y v y y
This is considered a loading dose. A loading dose:
y y y y y y y y y
1. Rapidly achievesdruglevels inthetherapeuticrange
y y
2. Requiresfour-to five-half-livestoattain v
3. Isinfluencedbyrenalfunction
4. Isdirectly relatedtothedrugcirculatingtothetargettissues - Correct Answer - 1. Rapidly achieves
y y y v v v v v vv
drug levels in the therapeutic range
v v v v v
pg. 3
y
, Thepointintimeonthedrugconcentrationcurvethatindicatesthefirstsignofatherapeuticeffectis the:
y y y y y y y y y y y y
1. Minimumadverse effectlevel y y y
2. Peak ofaction v
3. Onsetof action y
4. Therapeuticrange-Correct Answer - 3. Onset of action y v v v v v v
Phenytoinrequiresthatatroughlevel be drawn.Peakandtroughlevels are done: y y y y y
1. Whenthe drughas awide therapeuticrange
y y y y
2. Whenthe drugwillbeadministeredforashorttimeonly
v y y y y
3. Whenthereisahighcorrelation betweenthedoseandsaturationofreceptorsites
y y y y y y y
4. Todetermineifadrug isinthetherapeuticrange - Correct Answer - 4. To determine if a drug is in the
v y y v v v v v v v v v v v vv
therapeutic range v
Alaboratoryresultindicatesthatthepeaklevelforadrug is abovetheminimum toxicconcentration. Thismeans
y y y v y y y
thatthe:
y y
1. Concentrationwill produce therapeutic effects y y y
2. Concentrationwillproduceanadverseresponse
3. Timebetweendosesmustbeshortened
4. Durationofactionofthedrugistoolong- Correct Answer - 2. Concentration will produce an adverse y y y v v v v v v v v
response
y
Drugsthatarereceptoragonistsmaydemonstratewhatproperty?
1. Irreversiblebindingto thedrugreceptorsite y y
2. Upregulationwithchronicuse
3. Desensitizationordownregulation withcontinuous use y y y y y
4. Inverserelationshipbetweendrugconcentrationanddrugaction- Correct Answer - 3. Desensitization or y y v v v v v v
downregulation with continuous use
v v v v
pg. 4
y
