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. Process 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. Nonintentional nonadherence of drug therapy may occur due to:
1. Belief that medication does not work
2. Adverse drug reactions
3. Chronic conditions that require daily therapy
4. Forgetfulness or distraction
Copyright © 2020 F. A. Davis Company
,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: 4 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:
1. Distribution of drugs to target tissue may be affected.
2. The solubility of the drug will not match the site of absorption.
3. There will be less free drug available to generate an effect.
4. Drugs bound to albumin are readily excreted by the kidneys.
____ 2. Drugs that have a significant first-pass effect:
1. Must be given by the enteral (oral) route only
2. Bypass the hepatic circulation
3. Are rapidly metabolized by the liver and may have little, if any, desired action
4. 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:
1. Kidneys
2. Lungs
3. Bile and feces
4. Skin
____ 4. Medroxyprogesterone (Depo-Provera) is prescribed intramuscularly (IM) to create a storage
reservoir of the drug. Storage reservoirs:
1. Assure that the drug will reach its intended target tissue
2. Are the reason for giving loading doses
3. Increase the length of time a drug is available and active
4. Are most common in collagen tissues
____ 5. The nurse practitioner (NP) chooses to give cephalexin every 8 hours based on knowledge of the
drug’s:
1. Propensity to go to the target receptor
2. Biological half-life
3. Pharmacodynamics
4. Safety and side effects
Copyright © 2020 F. A. Davis Company
,____ 6. Azithromycin dosing requires that the first day’s dosage is twice that of the other 4 days of the
prescription. This is considered a loading dose. A loading dose:
1. Rapidly achieves drug levels in the therapeutic range
2. Requires four to five half-lives to attain
3. Is influenced by renal function
4. 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:
1. Minimum adverse effect level
2. Peak of action
3. Onset of action
4. Therapeutic range
____ 8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
1. When the drug has a wide therapeutic range
2. When the drug will be administered for a short time only
3. When there is a high correlation between the dose and saturation of receptor sites
4. 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:
1. Concentration will produce therapeutic effects
2. Concentration will produce an adverse response
3. Time between doses must be shortened
4. Duration of action of the drug is too long
____ 10. Drugs that are receptor agonists may demonstrate what property?
1. Irreversible binding to the drug receptor site
2. Up-regulation with chronic use
3. Desensitization or down-regulation with continuous use
4. Inverse relationship between drug concentration and drug action
____ 11. Drugs that are receptor antagonists, such as beta blockers, may cause:
1. Down-regulation 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 that affect 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. Need to be lipid soluble in order to be easily absorbed
2. Begin distribution into the body immediately
Copyright © 2020 F. A. Davis Company
, 3. Are easily absorbed if they are nonionized
4. 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:
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 passage of many drugs into and out of 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
Copyright © 2020 F. A. Davis Company
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. Process 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. Nonintentional nonadherence of drug therapy may occur due to:
1. Belief that medication does not work
2. Adverse drug reactions
3. Chronic conditions that require daily therapy
4. Forgetfulness or distraction
Copyright © 2020 F. A. Davis Company
,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: 4 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:
1. Distribution of drugs to target tissue may be affected.
2. The solubility of the drug will not match the site of absorption.
3. There will be less free drug available to generate an effect.
4. Drugs bound to albumin are readily excreted by the kidneys.
____ 2. Drugs that have a significant first-pass effect:
1. Must be given by the enteral (oral) route only
2. Bypass the hepatic circulation
3. Are rapidly metabolized by the liver and may have little, if any, desired action
4. 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:
1. Kidneys
2. Lungs
3. Bile and feces
4. Skin
____ 4. Medroxyprogesterone (Depo-Provera) is prescribed intramuscularly (IM) to create a storage
reservoir of the drug. Storage reservoirs:
1. Assure that the drug will reach its intended target tissue
2. Are the reason for giving loading doses
3. Increase the length of time a drug is available and active
4. Are most common in collagen tissues
____ 5. The nurse practitioner (NP) chooses to give cephalexin every 8 hours based on knowledge of the
drug’s:
1. Propensity to go to the target receptor
2. Biological half-life
3. Pharmacodynamics
4. Safety and side effects
Copyright © 2020 F. A. Davis Company
,____ 6. Azithromycin dosing requires that the first day’s dosage is twice that of the other 4 days of the
prescription. This is considered a loading dose. A loading dose:
1. Rapidly achieves drug levels in the therapeutic range
2. Requires four to five half-lives to attain
3. Is influenced by renal function
4. 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:
1. Minimum adverse effect level
2. Peak of action
3. Onset of action
4. Therapeutic range
____ 8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
1. When the drug has a wide therapeutic range
2. When the drug will be administered for a short time only
3. When there is a high correlation between the dose and saturation of receptor sites
4. 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:
1. Concentration will produce therapeutic effects
2. Concentration will produce an adverse response
3. Time between doses must be shortened
4. Duration of action of the drug is too long
____ 10. Drugs that are receptor agonists may demonstrate what property?
1. Irreversible binding to the drug receptor site
2. Up-regulation with chronic use
3. Desensitization or down-regulation with continuous use
4. Inverse relationship between drug concentration and drug action
____ 11. Drugs that are receptor antagonists, such as beta blockers, may cause:
1. Down-regulation 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 that affect 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. Need to be lipid soluble in order to be easily absorbed
2. Begin distribution into the body immediately
Copyright © 2020 F. A. Davis Company
, 3. Are easily absorbed if they are nonionized
4. 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:
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 passage of many drugs into and out of 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
Copyright © 2020 F. A. Davis Company
