ADVANCE PHARMACY NR565 MIDTERM QUESTIONS
WITH ACCURATE ANSWERS
· Beer's Criteria correct answer •potentially Inappropriate Medication (PIM) use in
older adults
•PIM use in older adults due to medication-disease or medication-syndrome
interactions that may exacerbate the disease or syndrome
•medications to be used cautiously in older adults
•clinically significant drug interactions that should be avoided in older adults
•medications to be avoided or dosage decreased in the presence of impaired
kidney function in older adults (American Geriatric Society Beers Criteria Update
Expert Panel, 2019)
· How does limited prescriptive authority impact patients within the healthcare
system? correct answer limited authority creates problems for the patient. The
patient is not able to get the care they need
· What are the key responsibilities of prescribing? correct answer 1. Be prudent
and deliberate in your decision-making process
2. Have a documented provider-patient relationship with the person for whom
you are prescribing
3. Do not prescribe medications for family or friends or for yourself
4. Document a thorough history and physical examination in your records
5.Include any discussions you have with the patient regarding risk factors, side
effects, or therapy options
6. Have a documented plan regarding drug monitoring or titration, if applicable
,· What happens when someone has a poor metabolism phenotype? correct
answer Metabolizes to slow or to fast.
· What should be used to make prescribing decisions? correct answer
· Who determines and regulates prescriptive authority? correct answer Nurse
practitioner scope of practice is determined by state practice and licensure laws.
·· Which schedule drugs can APRNs prescribe? correct answer Schedule II-V
•During what trimester is a pregnant woman most at risk for adverse drug
reactions with potential long-term consequences? correct answer 1 trimester
•How can we as healthcare providers decrease the likelihood of a elderly patient
experiencing an adverse drug reaction? correct answer •- obtaining a thorough
drug history that includes over-the-counter medications
•considering pharmacokinetic and pharmacodynamic changes due to age
•monitoring the patient's clinical response and plasma drug levels
•using the simplest regimen possible
•monitoring for drug-drug interactions and iatrogenic illness
•periodically reviewing the need for continued drug therapy
•encouraging the patient to dispose of old medications
•taking steps to promote adherence and to avoid drugs on the Beers list
•What are some medications that we know to be teratogenic? correct answer
•Antiepileptic drugs, antimicrobials such as tetracyclines and fluoroquinolones,
, vitamin A in large doses, some anticoagulants, and hormonal medications such as
diethylstilbestrol (DES).
•What are some of the Physiologic changes that occur in the body when a woman
is pregnant that can change the pharmacodynamic and pharmacokinetic
properties of many drugs? correct answer - Increased GFR= Increased drug
excretion
- Increased hepatic metabolism for some drugs.
- Decreased tone and mobility of bowel
- Increased drug absorption.
•What are the nine factors that impact the outcome of medication according to
Rosenthal & Burcham? correct answer •Gender and race
•Genetics and pharmacogenomics
•Variability in absorption
•placebo effect
•Tolerance
•patho
•age
•bodyweight
•What is full-practice authority? correct 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.
WITH ACCURATE ANSWERS
· Beer's Criteria correct answer •potentially Inappropriate Medication (PIM) use in
older adults
•PIM use in older adults due to medication-disease or medication-syndrome
interactions that may exacerbate the disease or syndrome
•medications to be used cautiously in older adults
•clinically significant drug interactions that should be avoided in older adults
•medications to be avoided or dosage decreased in the presence of impaired
kidney function in older adults (American Geriatric Society Beers Criteria Update
Expert Panel, 2019)
· How does limited prescriptive authority impact patients within the healthcare
system? correct answer limited authority creates problems for the patient. The
patient is not able to get the care they need
· What are the key responsibilities of prescribing? correct answer 1. Be prudent
and deliberate in your decision-making process
2. Have a documented provider-patient relationship with the person for whom
you are prescribing
3. Do not prescribe medications for family or friends or for yourself
4. Document a thorough history and physical examination in your records
5.Include any discussions you have with the patient regarding risk factors, side
effects, or therapy options
6. Have a documented plan regarding drug monitoring or titration, if applicable
,· What happens when someone has a poor metabolism phenotype? correct
answer Metabolizes to slow or to fast.
· What should be used to make prescribing decisions? correct answer
· Who determines and regulates prescriptive authority? correct answer Nurse
practitioner scope of practice is determined by state practice and licensure laws.
·· Which schedule drugs can APRNs prescribe? correct answer Schedule II-V
•During what trimester is a pregnant woman most at risk for adverse drug
reactions with potential long-term consequences? correct answer 1 trimester
•How can we as healthcare providers decrease the likelihood of a elderly patient
experiencing an adverse drug reaction? correct answer •- obtaining a thorough
drug history that includes over-the-counter medications
•considering pharmacokinetic and pharmacodynamic changes due to age
•monitoring the patient's clinical response and plasma drug levels
•using the simplest regimen possible
•monitoring for drug-drug interactions and iatrogenic illness
•periodically reviewing the need for continued drug therapy
•encouraging the patient to dispose of old medications
•taking steps to promote adherence and to avoid drugs on the Beers list
•What are some medications that we know to be teratogenic? correct answer
•Antiepileptic drugs, antimicrobials such as tetracyclines and fluoroquinolones,
, vitamin A in large doses, some anticoagulants, and hormonal medications such as
diethylstilbestrol (DES).
•What are some of the Physiologic changes that occur in the body when a woman
is pregnant that can change the pharmacodynamic and pharmacokinetic
properties of many drugs? correct answer - Increased GFR= Increased drug
excretion
- Increased hepatic metabolism for some drugs.
- Decreased tone and mobility of bowel
- Increased drug absorption.
•What are the nine factors that impact the outcome of medication according to
Rosenthal & Burcham? correct answer •Gender and race
•Genetics and pharmacogenomics
•Variability in absorption
•placebo effect
•Tolerance
•patho
•age
•bodyweight
•What is full-practice authority? correct 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.
