TEST BANK For Primary Care: Art and Science of
Advanced Practice Nursing - An Interprofessional
Approach 6th edition Dunphy
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 - ANSWER:3
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 - ANSWER:1
Drugs that are prone to cause adverse drug effects include:
1. Diuretics
2. Inhaled anticholinergics
3. Insulins
4. Stimulants - ANSWER:3
The U.S. Food and Drug Administration MedWatch system is activated when:
1. There is an adverse event to a vaccine.
2. The patient has a severe reaction that is noted in the "Severe Reaction" section in
the medication label.
3. A lactating woman takes a medication that is potentially toxic to the breastfeeding
infant.
,4. An adverse event or serious problem occurs with a medication that is not already
identified on the label. - ANSWER:4
The Vaccine Adverse Events Reporting System is:
1. A mandatory reporting system for all health-care providers when they encounter
an adverse vaccine event
2. A voluntary reporting system that health-care providers or consumers may use to
report vaccine adverse events
3. Utilized to send out safety alerts regarding emerging vaccine safety issues
4. Activated when a vaccine has been proven to cause significant adverse effects -
ANSWER:2
A comprehensive assessment of a patient should be holistic when trying to
determine competence in drug administration. Which of the following factors would
the NP omit from this type of assessment?
1. Financial status
2. Mobility
3. Social support
4. Sexual practices - ANSWER:4
Elena Vasquez's primary language is Spanish, and she speaks very limited English.
Which technique would be appropriate to use in teaching her about a new drug you
have just prescribed?
1. Use correct medical terminology because Spanish has a Latin base.
2. Use a family member who speaks more English to act as an interpreter.
3. Use a professional interpreter or a reliable staff member who can act as an
interpreter.
4. Use careful, detailed explanations. - ANSWER:3
Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in
assuring that he understands teaching about his drug?
1. Stand facing him and speak slowly and clearly.
2. Speak in low tones or find a provider who has a lower voice.
,3. Write down the instructions as well as speaking them.
4. If he reads lips, exaggerate lips movements when pronouncing the vowel sounds. -
ANSWER:4
Which of the following factors may adversely affect a patient's adherence to a
therapeutic drug regimen?
1. Complexity of the drug regimen
2. Patient perception of the potential adverse effects of the drugs
3. Both 1 and 2
4. Neither 1 nor 2 - ANSWER:3
The health-care delivery system itself can create barriers to adherence to a
treatment regimen. Which of the following system variables creates such a barrier?
1. Increasing copayments for care
2. Unrestricted formularies for drugs, including brand names
3. Increasing the number of people who have access to care
4. Treating a wider range of disorders - ANSWER:1
Ralph's blood pressure remains elevated despite increased doses of his drug. The NP
is concerned that he might not be adhering to his treatment regimen. Which of the
following events would suggest that he might not be adherent?
1. Ralph states that he always takes the drug "when I feel my pressure is going up."
2. Ralph contacts his NP to discuss the need to increase the dosage.
3. Ralph consistently keeps his follow-up appointments to check his blood pressure.
4. All of the above show that he is adherent to the drug regimen. - ANSWER:1
Nonadherence is especially common in drugs that treat asymptomatic conditions,
such as hypertension. One way to reduce the likelihood of nonadherence to these
drugs is to prescribe a drug that:
1. Has a short half-life so that missing one dose has limited effect
, 2. Requires several dosage titrations so that missed doses can be replaced with
lower doses to keep costs down
3. Has a tolerability profile with fewer of the adverse effects that are considered
"irritating," such as nausea and dizziness
4. Must be taken no more than twice a day - ANSWER:3
Factors in chronic conditions that contribute to nonadherence include:
1. The complexity of the treatment regimen
2. The length of time over which it must be taken
3. Breaks in the usual daily routine, such as vacations and weekends
4. All of the above - ANSWER:4
While patient education about their drugs is important, information alone does not
necessarily lead to adherence to a drug regimen. Patients report greater adherence
when:
1. The provider spent a lot of time discussing the drugs with them
2. Their concerns and specific area of knowledge deficit were addressed
3. They were given written material, such as pamphlets, about the drugs
4. The provider used appropriate medical and pharmacological terms - ANSWER:2
Patients with psychiatric illnesses have adherence rates to their drug regimen
between 35% and 60%. To improve adherence in this population, prescribe drugs:
1. With a longer half-life so that missed doses produce a longer taper on the drug
curve
2. In oral formulations that are more easily taken
3. That do not require frequent monitoring
4. Combined with patient education about the need to adhere even when symptoms
are absent - ANSWER:1
Many disorders require multiple drugs to treat them. The more complex the drug
regimen, the less likely the patient will adhere to it. Which of the following
interventions will NOT improve adherence?
Advanced Practice Nursing - An Interprofessional
Approach 6th edition Dunphy
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 - ANSWER:3
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 - ANSWER:1
Drugs that are prone to cause adverse drug effects include:
1. Diuretics
2. Inhaled anticholinergics
3. Insulins
4. Stimulants - ANSWER:3
The U.S. Food and Drug Administration MedWatch system is activated when:
1. There is an adverse event to a vaccine.
2. The patient has a severe reaction that is noted in the "Severe Reaction" section in
the medication label.
3. A lactating woman takes a medication that is potentially toxic to the breastfeeding
infant.
,4. An adverse event or serious problem occurs with a medication that is not already
identified on the label. - ANSWER:4
The Vaccine Adverse Events Reporting System is:
1. A mandatory reporting system for all health-care providers when they encounter
an adverse vaccine event
2. A voluntary reporting system that health-care providers or consumers may use to
report vaccine adverse events
3. Utilized to send out safety alerts regarding emerging vaccine safety issues
4. Activated when a vaccine has been proven to cause significant adverse effects -
ANSWER:2
A comprehensive assessment of a patient should be holistic when trying to
determine competence in drug administration. Which of the following factors would
the NP omit from this type of assessment?
1. Financial status
2. Mobility
3. Social support
4. Sexual practices - ANSWER:4
Elena Vasquez's primary language is Spanish, and she speaks very limited English.
Which technique would be appropriate to use in teaching her about a new drug you
have just prescribed?
1. Use correct medical terminology because Spanish has a Latin base.
2. Use a family member who speaks more English to act as an interpreter.
3. Use a professional interpreter or a reliable staff member who can act as an
interpreter.
4. Use careful, detailed explanations. - ANSWER:3
Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in
assuring that he understands teaching about his drug?
1. Stand facing him and speak slowly and clearly.
2. Speak in low tones or find a provider who has a lower voice.
,3. Write down the instructions as well as speaking them.
4. If he reads lips, exaggerate lips movements when pronouncing the vowel sounds. -
ANSWER:4
Which of the following factors may adversely affect a patient's adherence to a
therapeutic drug regimen?
1. Complexity of the drug regimen
2. Patient perception of the potential adverse effects of the drugs
3. Both 1 and 2
4. Neither 1 nor 2 - ANSWER:3
The health-care delivery system itself can create barriers to adherence to a
treatment regimen. Which of the following system variables creates such a barrier?
1. Increasing copayments for care
2. Unrestricted formularies for drugs, including brand names
3. Increasing the number of people who have access to care
4. Treating a wider range of disorders - ANSWER:1
Ralph's blood pressure remains elevated despite increased doses of his drug. The NP
is concerned that he might not be adhering to his treatment regimen. Which of the
following events would suggest that he might not be adherent?
1. Ralph states that he always takes the drug "when I feel my pressure is going up."
2. Ralph contacts his NP to discuss the need to increase the dosage.
3. Ralph consistently keeps his follow-up appointments to check his blood pressure.
4. All of the above show that he is adherent to the drug regimen. - ANSWER:1
Nonadherence is especially common in drugs that treat asymptomatic conditions,
such as hypertension. One way to reduce the likelihood of nonadherence to these
drugs is to prescribe a drug that:
1. Has a short half-life so that missing one dose has limited effect
, 2. Requires several dosage titrations so that missed doses can be replaced with
lower doses to keep costs down
3. Has a tolerability profile with fewer of the adverse effects that are considered
"irritating," such as nausea and dizziness
4. Must be taken no more than twice a day - ANSWER:3
Factors in chronic conditions that contribute to nonadherence include:
1. The complexity of the treatment regimen
2. The length of time over which it must be taken
3. Breaks in the usual daily routine, such as vacations and weekends
4. All of the above - ANSWER:4
While patient education about their drugs is important, information alone does not
necessarily lead to adherence to a drug regimen. Patients report greater adherence
when:
1. The provider spent a lot of time discussing the drugs with them
2. Their concerns and specific area of knowledge deficit were addressed
3. They were given written material, such as pamphlets, about the drugs
4. The provider used appropriate medical and pharmacological terms - ANSWER:2
Patients with psychiatric illnesses have adherence rates to their drug regimen
between 35% and 60%. To improve adherence in this population, prescribe drugs:
1. With a longer half-life so that missed doses produce a longer taper on the drug
curve
2. In oral formulations that are more easily taken
3. That do not require frequent monitoring
4. Combined with patient education about the need to adhere even when symptoms
are absent - ANSWER:1
Many disorders require multiple drugs to treat them. The more complex the drug
regimen, the less likely the patient will adhere to it. Which of the following
interventions will NOT improve adherence?
