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TEST BANK For Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 6th Edition by Woo & Wright, All 57 Chapters Covered, Verified Latest Edition latest version updated 2025

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Pharmacotherapeutics for Advanced Practice Nurse Prescribers 5th Edition Woo Robinson Test Bank 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: 1. The National Council of State Boards of Nursing 2. The U.S. Drug Enforcement Administration 3. The State Board of Nursing for each state 4. The State Board of Pharmacy 2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include: 1. Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program. 2. Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care. 3. APRNs are less likely to prescribe narcotics and other controlled substances. 4. 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: 1. Factoring in the cost to the patient of the medication prescribed 2. Always prescribing the newest medication available for the disease process 3. Handing out drug samples to poor patients 4. Prescribing all generic medications to cut costs 4. Criteria for choosing an effective drug for a disorder include: 1. Asking the patient what drug they think would work best for them 2. Consulting nationally recognized guidelines for disease management 3. Prescribing medications that are available as samples before writing a prescription 4. Following U.S. Drug Enforcement Administration guidelines for prescribing 5. Nurse practitioner practice may thrive under health-care reform because of: 1. The demonstrated ability of nurse practitioners to control costs and improve patient outcomes 2. The fact that nurse practitioners will be able to practice independently 3. The fact that nurse practitioners will have full reimbursement under health-care reform 4. The ability to shift accountability for Medicaid to the state level 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. When a patient has low levels of albumin, it is important in prescribing because: 1. Affects how drugs are distributed to target tissues. 2. The drug's solubility may not match where it needs to be absorbed. 3. Less free drug is available to produce an effect. 4. Drugs bound to albumin are easily excreted by the kidneys. 2. Drugs with a significant first-pass effect: 1. Must only be given orally. 2. Bypass the liver's circulation. 3. Are quickly metabolized by the liver with little desired effect. 4. Are converted by the liver into more active and fat-soluble forms. 3. Volatile drugs are likely excreted via the: 1. Kidneys 2. Lungs 3. Bile and feces 4. Skin 4. Medroxyprogesterone (Depo Provera) is given intramuscularly to: 1. Ensure the drug reaches its target tissue. 2. Justify the use of loading doses. 3. Extend the drug's availability and activity. 4. Target collagen tissues. 5. The dosing interval of cephalexin every 8 hours is based on its: 1. Affinity to the target receptor. 2. Biological half-life. 3. Pharmacodynamics. 4. Safety profile and side effects. 6. A loading dose of azithromycin on the first day rapidly achieves: 1. Therapeutic drug levels. 2. Requires several half-lives to attain. 3. Is affected by renal function. 4. Directly correlates with drug distribution to target tissues. 7. The point in the drug concentration curve that indicates the first therapeutic effect is: 1. Minimum adverse effect level. 2. Peak of action. 3. Onset of action. 4. Therapeutic range. 8. Phenytoin requires drawing a trough level to determine if the drug: 1. Has a wide therapeutic range. 2. Will be administered for a short time. 3. Correlates with dose and receptor saturation. 4. Is within the therapeutic range. 9. A peak drug level above the minimum toxic concentration indicates: 1. Therapeutic effects. 2. Adverse responses. 3. Need for shortened dosing intervals. 4. Prolonged duration of action. 10. Receptor agonists may demonstrate: 1. Irreversible binding. 2. Upregulation with chronic use. 3. Desensitization with continuous use. 4. Inverse relationship between concentration and action. Certainly! Here are the paraphrased questions with multiple-choice options: 11. Drugs that act as receptor antagonists, such as beta blockers, may cause: - 1. Downregulation of the drug receptor - 2. An exaggerated response if abruptly discontinued - 3. Partial blockade of the effects of agonist drugs - 4. An exaggerated response to competitive drug agonists 12. Factors affecting gastric drug absorption include: - 1. Liver enzyme activity - 2. Protein-binding properties of the drug molecule - 3. Lipid solubility of the drug - 4. Ability to chew and swallow 13. Drugs administered via IV: - 1. Begin distribution into the body immediately - 2. Are easily absorbed if they are nonionized - 3. May use pinocytosis to be absorbed - 4. Do not need to be lipid soluble in order to be easily absorbed 14. When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is: - 1. The sum of the effects of each drug individually - 2. Greater than the sum of the effects of each drug individually - 3. Less than the effect of each drug individually - 4. Not predictable, as it varies with each individual 15. Which of the following statements about bioavailability is true? - 1. Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms. - 2. All brands of a drug have the same bioavailability. - 3. Drugs that are administered more than once a day have greater bioavailability than drugs given once daily. - 4. Combining an active drug with an inert substance does not affect bioavailability. 16. Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true? - 1. Water soluble and ionized drugs cross these barriers rapidly. - 2. The blood-brain barrier slows the entry of many drugs into and from brain cells. - 3. The fetal-placental barrier protects the fetus from drugs taken by the mother. - 4. Lipid-soluble drugs do not pass these barriers and are safe for pregnant women. 17. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to: - 1. Inactivate prodrugs before they can be activated by target tissues - 2. Change the drugs so they can cross plasma membranes - 3. Change drug molecules to a form that an excretory organ can excrete - 4. Make these drugs more ionized and polar to facilitate excretion 18. Once they have been metabolized by the liver, the metabolites may be: - 1. More active than the parent drug - 2. Less active than the parent drug - 3. Totally "deactivated" so they are excreted without any effect - 4. All of the above 19. All drugs continue to act in the body until they are changed or excreted. The ability of the body to excrete drugs via the renal system would be increased by: - 1. Reduced circulation and perfusion of the kidney - 2. Chronic renal disease - 3. Competition for a transport site by another drug - 4. Unbinding a nonvolatile drug from plasma proteins 20. Steady state is: - 1. The point on the drug concentration curve when absorption exceeds excretion - 2. When the amount of drug in the body remains constant - 3. When the amount of drug in the body stays below the minimum toxic concentration - 4. All of the above 21. Two different pain medications are given together for pain relief. The drug-drug interaction is: - 1. Synergistic - 2. Antagonistic - 3. Potentiative - 4. Additive 22. Actions taken to reduce drug-drug interaction problems include all of the following EXCEPT: - 1. Reducing the dosage of one of the drugs - 2. Scheduling their administration at different times - 3. Prescribing a third drug to counteract the adverse reaction of the combination - 4. Reducing the dosage of both drugs 23. Phase I oxidative-reductive processes of drug metabolism require certain nutritional elements. Which of the following would reduce or inhibit this process? - 1. Protein malnutrition - 2. Iron-deficiency anemia - 3. Both 1 and 2 - 4. Neither 1 nor 2 24. The time required for the amount of drug in the body to decrease by 50% is called: - 1. Steady state - 2. Half-life - 3. Phase II metabolism - 4. Reduced bioavailability time 25. An agonist activates a receptor and stimulates a response. When given frequently over time, the body may: - 1. Upregulate the total number of receptors - 2. Block the receptor with a partial agonist - 3. Alter the drug's metabolism - 4. Downregulate the numbers of that specific receptor 26. Drug antagonism is best defined as an effect of a drug that: - 1. Leads to major physiological and psychological dependence - 2. Is modified by the concurrent administration of another drug - 3. Cannot be metabolized before another dose is administered - 4. Leads to a decreased physiological response when combined with another drug 27. Instructions to a client regarding self-administration of oral enteric-coated tablets should include which of the following statements? - 1. "Avoid any other oral medicines while taking this drug." - 2. "If swallowing this tablet is difficult, dissolve it in 3 ounces of orange juice." - 3. "The tablet may be crushed if you have any difficulty taking it." - 4. "To achieve best effect, take the tablet with at least 8 ounces of fluid." 28. The major reason for not crushing a sustained-release capsule is that, if crushed, the coated beads of the drugs could possibly result in: - 1. Disintegration - 2. Toxicity - 3. Malabsorption - 4. Deterioration 29. Which of the following substances is the most likely to be absorbed in the intestines rather than in the stomach? - 1. Sodium bicarbonate - 2. Ascorbic acid - 3. Salicylic acid - 4. Glucose 30. Which of the following variables is a factor in drug absorption? - 1. The smaller the surface area for absorption, the more rapidly the drug is absorbed. - 2. A rich blood supply to the area of absorption leads to better absorption. - 3. The less soluble the drug, the more easily it is absorbed. - 4. Ionized drugs are easily absorbed across the cell membrane. 31. An advantage of prescribing a sublingual medication is that the medication is: - 1. Absorbed rapidly - 2. Excreted rapidly - 3. Metabolized minimally - 4. Distributed equally 32. Drugs that use CYP 3A4 isoenzymes for metabolism may: - 1. Induce the metabolism of another drug - 2. Inhibit the metabolism of another drug - 3. Both 1 and 2 - 4. Neither 1 nor 2 33. Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state: - 1. After the second dose - 2. After four to five half-lives - 3. When the patient feels the full effect of the drug - 4. One hour after IV administration 34. Upregulation or hypersensitization may lead to: - 1. Increased response to a drug - 2. Decreased response to a drug - 3. An exaggerated response if the drug is withdrawn - 4. Refractoriness or complete lack of response Chapter 2. Review of Basic Principles of Pharmacology Answer Section MULTIPLE CHOICE 1. ANS 1 PTS: 1 : 2. ANS 3 PTS: 1 : 3. ANS 2 PTS: 1 : 4. ANS 3 PTS: 1 : 5. ANS 2 PTS: 1 : 6. ANS 1 PTS: 1 : 7. ANS 3 PTS: 1 : 8. ANS 4 PTS: 1 : 9. ANS 2 PTS: 1 : 10. ANS 3 PTS: 1 : 11. ANS 2 PTS: 1 : 12. ANS 3 PTS: 1 : 13. ANS 2 PTS: 1 : 14. ANS 2 PTS: 1 : 15. ANS 1 PTS: 1 : 16. ANS 2 PTS: 1 : 17. ANS 3 PTS: 1 : 18. ANS 4 PTS: 1 : 19. ANS 4 PTS: 1 : 20. ANS 2 PTS: 1 : 21. ANS 4 PTS: 1 : 22. ANS 3 PTS: 1 : 23. ANS 4 PTS: 1 : 24. ANS 2 PTS: 1 : 25. ANS 4 PTS: 1 : 26. ANS 2 PTS: 1 : 27. ANS 4 PTS: 1 28. ANS 2 PTS: 1 : 29. ANS 1 PTS: 1 : 30. ANS 2 PTS: 1 : 31. ANS 1 PTS: 1 : 32. ANS 3 PTS: 1 : 33. ANS 2 PTS: 1 34. : ANS 3 PTS: 1 **Chapter 3: Rational Drug Selection** **Multiple Choice** 1. An NP would choose liquid ibuprofen for a 6-year-old child primarily because: 1. It is less irritating to the stomach. 2. A child may have difficulty swallowing pills. 3. It eliminates concerns about first-pass effect. 4. It requires less frequent dosing compared to tablets. 2. When deciding between multiple drugs to treat a condition, an NP selects Drug A because it: 1. Has serious side effects but is not for a life-threatening condition. 2. Requires twice-daily administration and can be taken at home. 3. Is covered by health insurance despite being expensive. 4. None of these factors are considered in drug selection. 3. A client asks about differences in drug effects between men and women. Known differences in pharmacokinetics include: 1. Variations in body temperature between genders. 2. Greater muscle mass in women. 3. Differences in the percentage of body fat. 4. Subjective factors proven to affect both genders equally. 4. The initial step in the prescribing process according to the World Health Organization is: 1. Choosing the treatment. 2. Educating the patient about the medication. 3. Diagnosing the patient’s problem. 4. Initiating the treatment plan. 5. Treatment goals in prescribing should primarily be: 1. Always curative. 2. Centered around the patient. 3. Convenient for the provider. 4. Focused on the cost of therapy. 6. Therapeutic goals when prescribing medications typically include: 1. Curative. 2. Palliative. 3. Preventive. 4. All of the above. 7. When determining drug treatment, the NP should: 1. Strictly adhere to evidence-based guidelines. 2. Tailor drug choices to each patient’s specific needs. 3. Rely on personal experience in prescribing complex cases. 4. Utilize the newest drugs available for the condition. 8. Patient education regarding prescribed medications should cover: 1. Instructions written at a high school reading level. 2. Discussion of expected adverse drug reactions. 3. Proper storage of leftover medications like antibiotics. 4. Verbal instructions always provided in English. 9. Passive monitoring of drug effectiveness involves: 1. Monitoring therapeutic drug levels. 2. Adjusting the treatment regimen by adding or removing medications. 3. Scheduling ongoing provider visits. 4. Instructing patients to report ineffectiveness of the drug. 10. Pharmacokinetic factors influencing drug prescribing include: 1. Therapeutic index. 2. Minimum effective concentration. 3. Bioavailability. 4. Ease of titration. 11. Pharmaceutical promotion's impact on prescribing can be mitigated by: 1. Disclosing conflicts of interest and financial relationships during education. 2. Banning pharmaceutical representatives from office settings. 3. Providing drug samples to insured patients to ensure affordability. 4. Accepting low-value gifts like pens and notepads from representatives. 12. Under new FDA labeling, Pregnancy Categories are now: 1. Strengthened with new coding (e.g., C+ or C-) indicating varying fetal toxicity. 2. Enhanced to include a pregnancy risk summary and clinical considerations. 3. Eliminated and replaced with a link to TOXNET for detailed pregnancy information. 4. Clarified with safe dosage information for each trimester of pregnancy. Chapter 3. Rational Drug Selection Answer Section MULTIPLE CHOICE 1. ANS: 2 PTS: 1 2. ANS: 2 PTS: 1 3. ANS: 3 PTS: 1 4. ANS: 3 PTS: 1 5. ANS: 2 PTS: 1 6. ANS: 4 PTS: 1 7. ANS: 2 PTS: 1 8. ANS: 2 PTS: 1 9. ANS: 4 PTS: 1 10. ANS: 3 PTS: 1 11. ANS: 1 PTS: 1 12. ANS: 2 PTS: 1 Chapter 4. Legal and Professional Issues in Prescribing Multiple Choice Select the best answer to complete each statement or question. 1. The U.S. Food and Drug Administration oversees: 1. Prescribing of drugs by MDs and NPs 2. The official labeling for all prescription and over-the-counter drugs 3. Off-label recommendations for prescribing 4. Pharmaceutical educational offerings 2. FDA approval is required for: 1. Medical devices, including artificial joints 2. Over-the-counter vitamins 3. Herbal products, such as St John’s wort 4. Dietary supplements, such as Ensure 3. An Investigational New Drug is filed with the FDA: 1. When the manufacturer has completed phase III trials 2. When a new drug is discovered 3. Prior to animal testing of any new drug entity 4. Prior to human testing of any new drug entity 4. Phase IV clinical trials in the U.S. are also known as: 1. Human bioavailability trials 2. Postmarketing research 3. Human safety and efficacy studies 4. The last stage of animal trials before the human trials begin 5. Off-label prescribing: 1. Is regulated by the FDA 2. Is illegal by NPs in all states (provinces) 3. Is legal if there is scientific evidence for the use 4. Is regulated by the Drug Enforcement Administration 6. The U.S. Drug Enforcement Administration: 1. Registers manufacturers and prescribers of controlled substances 2. Regulates NP prescribing at the state level 3. Sanctions providers who prescribe drugs off-label 4. Provides prescribers with a number they can use for insurance billing 7. Drugs designated Schedule II by the DEA: 1. Are known teratogens during pregnancy 2. May not be refilled; a new prescription must be written 3. Have a low abuse potential 4. May be dispensed without a prescription unless regulated by the state 8. Precautions when prescribing controlled substances include: 1. Faxing the prescription for a Schedule II drug directly to the pharmacy 2. Using tamper-proof paper for all prescriptions written for controlled drugs 3. Keeping any pre-signed prescription pads in a locked drawer in the clinic 4. Using only numbers to indicate the amount of drug to be prescribed 9. Strategies to prevent misuse of controlled prescription drugs include: 1. Use of chemical dependency screening tools 2. Firm limit-setting regarding prescribing controlled substances 3. Practicing "just say no" to deal with patients who are pushing the provider to prescribe controlled substances 4. All of the above 10. Behaviors predictive of addiction to controlled substances include: 1. Stealing or borrowing another patient’s drugs 2. Requiring increasing doses of opiates for pain associated with malignancy 3. Receiving refills of a Schedule II prescription on a regular basis 4. Requesting that only their own primary care provider prescribe for them 11. Medication agreements or "Pain Medication Contracts" are recommended to be used: 1. Universally for all prescribing for chronic pain 2. For patients who have repeated requests for pain medication 3. When you suspect a patient is exhibiting drug-seeking behavior 4. For patients with pain associated with malignancy 12. A prescription needs to be written for: 1. Legend drugs 2. Most controlled drugs 3. Medical devices 4. All of the above Chapter 4. Legal and Professional Issues in Prescribing Answer Section MULTIPLE CHOICE Chapter 5. Adverse Drug Reactions

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, Pharmacotherapeutics

for Advanced Practice Nurse Prescribers 5th Edition Woo Robinson Test Bank


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:

1. The National Council of State Boards of Nursing

2. The U.S. Drug Enforcement Administration

3. The State Board of Nursing for each state

4. The State Board of Pharmacy



2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:

1. Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing
program and in their APRN program.

2. Nurses care for the patient from a holistic approach and include the patient in decision making regarding their
care.

3. APRNs are less likely to prescribe narcotics and other controlled substances.

4. 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:

1. Factoring in the cost to the patient of the medication prescribed

2. Always prescribing the newest medication available for the disease process

3. Handing out drug samples to poor patients

4. Prescribing all generic medications to cut costs

,4. Criteria for choosing an effective drug for a disorder include:

1. Asking the patient what drug they think would work best for them

2. Consulting nationally recognized guidelines for disease management

3. Prescribing medications that are available as samples before writing a prescription

4. Following U.S. Drug Enforcement Administration guidelines for prescribing



5. Nurse practitioner practice may thrive under health-care reform because of:

1. The demonstrated ability of nurse practitioners to control costs and improve patient outcomes

2. The fact that nurse practitioners will be able to practice independently

3. The fact that nurse practitioners will have full reimbursement under health-care reform

4. The ability to shift accountability for Medicaid to the state level



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. When a patient has low levels of albumin, it is important in prescribing because:

, 1. Affects how drugs are distributed to target tissues.

2. The drug's solubility may not match where it needs to be absorbed.

3. Less free drug is available to produce an effect.

4. Drugs bound to albumin are easily excreted by the kidneys.



2. Drugs with a significant first-pass effect:

1. Must only be given orally.

2. Bypass the liver's circulation.

3. Are quickly metabolized by the liver with little desired effect.

4. Are converted by the liver into more active and fat-soluble forms.



3. Volatile drugs are likely excreted via the:

1. Kidneys

2. Lungs

3. Bile and feces

4. Skin



4. Medroxyprogesterone (Depo Provera) is given intramuscularly to:

1. Ensure the drug reaches its target tissue.

2. Justify the use of loading doses.

3. Extend the drug's availability and activity.

4. Target collagen tissues.



5. The dosing interval of cephalexin every 8 hours is based on its:

1. Affinity to the target receptor.

2. Biological half-life.

3. Pharmacodynamics.

4. Safety profile and side effects.

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