TEST BANK FOR PHARMACO- THERAPEUTICS
FOR ADVANCED PRACTICE NURSE PRESCRIBERS
5TH EDITION WOO ROBINSON
Chapter 1. The Role of the Nurse Practitioner Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Nurse practitioner prescriptive authority is regulated by:
• The National Council of State Boards of Nursing
• The U.S. Drug Enforcement Administration
• The State Board of Nursing for each state
• The State Board of Pharmacy
2. The benefits to the patient of having an Advanced Practice Registered
Nurse (APRN) prescriber include:
• Nurses know more about Pharmacology than other
prescribers because they take it both in their basic
nursing program and in their APRN program.
• Nurses care for the patient from a holistic approach
and include the patient in decision making
regarding their care.
• APRNs are less likely to prescribe narcotics and other controlled
substances.
• APRNs are able to prescribe independently in all
states, whereas a physician’s assistant needs to have
a physician supervising their practice.
3. Clinical judgment in prescribing includes:
• Factoring in the cost to the patient of the medication prescribed
• Always prescribing the newest medication available for the disease
process
• Handing out drug samples to poor patients
• Prescribing all generic medications to cut costs
4. Criteria for choosing an effective drug for a disorder include:
• Asking the patient what drug they think would work best for them
• Consulting nationally recognized guidelines for disease management
• Prescribing medications that are available as samples before writing a
prescription
, • Following U.S. Drug Enforcement Administration guidelines for
prescribing
5. Nurse practitioner practice may thrive under health-care reform because of:
• The demonstrated ability of nurse practitioners to control
costs and improve patient outcomes
• The fact that nurse practitioners will be able to practice independently
• The fact that nurse practitioners will have full
reimbursement under health-care reform
• The ability to shift accountability for Medicaid to the state leel
Chapter 1. The Role of the Nurse Practitioner Answer Section
MULTIPLE CHOICE
1. ANS: 3 PTS: 1
2. ANS: 2 PTS: 1
3. ANS: 1 PTS: 1
4. ANS: 2 PTS: 1
5. ANS: 1 PTS: 1
Chapter 2. Review of Basic
Principles of Pharmacology Multiple
Choice
Identify the choice that best completes the statement or answers the question.
1. A patient’s nutritional intake and laboratory results reflect
hypoalbuminemia. This is critical to prescribing because:
• Distribution of drugs to target tissue may be affected.
• The solubility of the drug will not match the site of absorption.
• There will be less free drug available to generate an effect.
• Drugs bound to albumin are readily excreted by the kidneys.
2. Drugs that have a significant first-pass effect:
• Must be given by the enteral (oral) route only
• Bypass the hepatic circulation
• Are rapidly metabolized by the liver and may have little if any desired
action
, • Are converted by the liver to more active and fat-soluble forms
3. The route of excretion of a volatile drug will likely be the:
• Kidneys
• Lungs
• Bile and feces
• Skin
4. Medroxyprogesterone (Depo Provera) is prescribed
intramuscularly (IM) to create a storage reservoir of the drug.
Storage reservoirs:
• Assure that the drug will reach its intended target tissue
• Are the reason for giving loading doses
• Increase the length of time a drug is available and active
• Are most common in collagen tissues
5. The NP chooses to give cephalexin every 8 hours based on knowledge of the
drug’s:
• Propensity to go to the target receptor
• Biological half-life
• Pharmacodynamics
• Safety and side effects
6. Azithromycin dosing requires that the first day’s dosage be twice those
of the other 4 days of the prescription. This is considered a loading
dose. A loading dose:
• Rapidly achieves drug levels in the therapeutic range
• Requires four- to five-half-lives to attain
• Is influenced by renal function
• Is directly related to the drug circulating to the target tissues
7. The point in time on the drug concentration curve that indicates the first
sign of a therapeutic effect is the:
• Minimum adverse effect level
• Peak of action
• Onset of action
• Therapeutic range
8. Phenytoin requires that a trough level be drawn. Peak and trough levels are
done:
• When the drug has a wide therapeutic range
• When the drug will be administered for a short time only
, • When there is a high correlation between the dose and saturation of
receptor sites
• To determine if a drug is in the therapeutic range
9. A laboratory result indicates that the peak level for a drug is above the
minimum toxic concentration.
This means that the:
• Concentration will produce therapeutic effects
• Concentration will produce an adverse response
• Time between doses must be shortened
• Duration of action of the drug is too long
10. Drugs that are receptor agonists may demonstrate what property?
• Irreversible binding to the drug receptor site
• Upregulation with chronic use
• Desensitization or downregulation with continuous use
• Inverse relationship between drug concentration and drug action
11. Drugs that are receptor antagonists, such as beta blockers, may cause:
• Downregulation of the drug receptor
• An exaggerated response if abruptly discontinued
• Partial blockade of the effects of agonist drugs
• An exaggerated response to competitive drug agonists
12. Factors that affect gastric drug absorption include:
• Liver enzyme activity
• Protein-binding properties of the drug molecule
• Lipid solubility of the drug
• Ability to chew and swallow
13. Drugs administered via IV:
• Need to be lipid soluble in order to be easily absorbed
• Begin distribution into the body immediately
• Are easily absorbed if they are nonionized
• May use pinocytosis to be absorbed
14. When a medication is added to a regimen for a synergistic effect, the combined
effect of the drugs is:
• The sum of the effects of each drug individually
• Greater than the sum of the effects of each drug individually
• Less than the effect of each drug individually
• Not predictable, as it varies with each individual
FOR ADVANCED PRACTICE NURSE PRESCRIBERS
5TH EDITION WOO ROBINSON
Chapter 1. The Role of the Nurse Practitioner Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Nurse practitioner prescriptive authority is regulated by:
• The National Council of State Boards of Nursing
• The U.S. Drug Enforcement Administration
• The State Board of Nursing for each state
• The State Board of Pharmacy
2. The benefits to the patient of having an Advanced Practice Registered
Nurse (APRN) prescriber include:
• Nurses know more about Pharmacology than other
prescribers because they take it both in their basic
nursing program and in their APRN program.
• Nurses care for the patient from a holistic approach
and include the patient in decision making
regarding their care.
• APRNs are less likely to prescribe narcotics and other controlled
substances.
• APRNs are able to prescribe independently in all
states, whereas a physician’s assistant needs to have
a physician supervising their practice.
3. Clinical judgment in prescribing includes:
• Factoring in the cost to the patient of the medication prescribed
• Always prescribing the newest medication available for the disease
process
• Handing out drug samples to poor patients
• Prescribing all generic medications to cut costs
4. Criteria for choosing an effective drug for a disorder include:
• Asking the patient what drug they think would work best for them
• Consulting nationally recognized guidelines for disease management
• Prescribing medications that are available as samples before writing a
prescription
, • Following U.S. Drug Enforcement Administration guidelines for
prescribing
5. Nurse practitioner practice may thrive under health-care reform because of:
• The demonstrated ability of nurse practitioners to control
costs and improve patient outcomes
• The fact that nurse practitioners will be able to practice independently
• The fact that nurse practitioners will have full
reimbursement under health-care reform
• The ability to shift accountability for Medicaid to the state leel
Chapter 1. The Role of the Nurse Practitioner Answer Section
MULTIPLE CHOICE
1. ANS: 3 PTS: 1
2. ANS: 2 PTS: 1
3. ANS: 1 PTS: 1
4. ANS: 2 PTS: 1
5. ANS: 1 PTS: 1
Chapter 2. Review of Basic
Principles of Pharmacology Multiple
Choice
Identify the choice that best completes the statement or answers the question.
1. A patient’s nutritional intake and laboratory results reflect
hypoalbuminemia. This is critical to prescribing because:
• Distribution of drugs to target tissue may be affected.
• The solubility of the drug will not match the site of absorption.
• There will be less free drug available to generate an effect.
• Drugs bound to albumin are readily excreted by the kidneys.
2. Drugs that have a significant first-pass effect:
• Must be given by the enteral (oral) route only
• Bypass the hepatic circulation
• Are rapidly metabolized by the liver and may have little if any desired
action
, • Are converted by the liver to more active and fat-soluble forms
3. The route of excretion of a volatile drug will likely be the:
• Kidneys
• Lungs
• Bile and feces
• Skin
4. Medroxyprogesterone (Depo Provera) is prescribed
intramuscularly (IM) to create a storage reservoir of the drug.
Storage reservoirs:
• Assure that the drug will reach its intended target tissue
• Are the reason for giving loading doses
• Increase the length of time a drug is available and active
• Are most common in collagen tissues
5. The NP chooses to give cephalexin every 8 hours based on knowledge of the
drug’s:
• Propensity to go to the target receptor
• Biological half-life
• Pharmacodynamics
• Safety and side effects
6. Azithromycin dosing requires that the first day’s dosage be twice those
of the other 4 days of the prescription. This is considered a loading
dose. A loading dose:
• Rapidly achieves drug levels in the therapeutic range
• Requires four- to five-half-lives to attain
• Is influenced by renal function
• Is directly related to the drug circulating to the target tissues
7. The point in time on the drug concentration curve that indicates the first
sign of a therapeutic effect is the:
• Minimum adverse effect level
• Peak of action
• Onset of action
• Therapeutic range
8. Phenytoin requires that a trough level be drawn. Peak and trough levels are
done:
• When the drug has a wide therapeutic range
• When the drug will be administered for a short time only
, • When there is a high correlation between the dose and saturation of
receptor sites
• To determine if a drug is in the therapeutic range
9. A laboratory result indicates that the peak level for a drug is above the
minimum toxic concentration.
This means that the:
• Concentration will produce therapeutic effects
• Concentration will produce an adverse response
• Time between doses must be shortened
• Duration of action of the drug is too long
10. Drugs that are receptor agonists may demonstrate what property?
• Irreversible binding to the drug receptor site
• Upregulation with chronic use
• Desensitization or downregulation with continuous use
• Inverse relationship between drug concentration and drug action
11. Drugs that are receptor antagonists, such as beta blockers, may cause:
• Downregulation of the drug receptor
• An exaggerated response if abruptly discontinued
• Partial blockade of the effects of agonist drugs
• An exaggerated response to competitive drug agonists
12. Factors that affect gastric drug absorption include:
• Liver enzyme activity
• Protein-binding properties of the drug molecule
• Lipid solubility of the drug
• Ability to chew and swallow
13. Drugs administered via IV:
• Need to be lipid soluble in order to be easily absorbed
• Begin distribution into the body immediately
• Are easily absorbed if they are nonionized
• May use pinocytosis to be absorbed
14. When a medication is added to a regimen for a synergistic effect, the combined
effect of the drugs is:
• The sum of the effects of each drug individually
• Greater than the sum of the effects of each drug individually
• Less than the effect of each drug individually
• Not predictable, as it varies with each individual
