PharmacotherapeuticsgforgAdvancedgPracticegNursegPrescribers,g5thgeditiongWoogRobinsongTe
stgBank
Chapterg1.gThegRolegofgthegNursegPractitionergasgPr
escriberMultiplegChoice
Identifygthegchoicegthatgbestgcompletesgthegstatementgorganswersgthegquestion.
g gg 1.gNursegpractitionergprescriptivegauthoritygisgregulatedg by:
1. ThegNationalgCouncilgofgStategBoardsgofgNursing
2. ThegU.S.gDruggEnforcementgAdministration
3. ThegStategBoardgofgNursinggforgeachgstate
4. ThegStategBoardgofgPharmacy
g
gg 2.gThegbenefitsgtogthegpatientgofghavinggangAdvancedgPracticegRegisteredgNurseg(APRN
)gprescriberginclude:
1. NursesgknowgmoregaboutgPharmacologygthangothergprescribersgbecausegtheygtakeg
itgbothgingtheirgbasicgnursinggprogramgandgingtheirgAPRNgprogram.
2. Nursesgcaregforgthegpatientgfromgagholisticgapproachgandgincludegthegpatientgi
ngdecisiongmakinggregardinggtheirgcare.
3. APRNsgareglessglikelygtogprescribegnarcoticsgandgothergcontrolledgsubstances.
4. APRNsgaregablegtogprescribegindependentlygingallgstates,gwhereasgagphysician’
sgassistantgneedsgtoghavegagphysiciangsupervisinggtheirgpractice.
g gg 3.gClinicalgjudgmentgingprescribinggincludes:
1. Factoringgingthegcostgtogthegpatientgofgthegmedicationgprescribed
2. Alwaysgprescribinggthegnewestgmedicationgavailablegforgthegdiseasegprocess
3. Handinggoutgdruggsamplesgtogpoorgpatients
4. Prescribinggallggenericgmedicationsgtogcutgcosts
g gg 4.gCriteriagforgchoosinggangeffectivegdruggforgagdisorderginclude:
1. Askinggthegpatientgwhatgdruggtheygthinkgwouldgworkgbestgforgthem
2. Consultinggnationallygrecognizedgguidelinesgforgdiseasegmanagement
3. Prescribinggmedicationsgthatgaregavailablegasgsamplesgbeforegwritinggagprescription
4. FollowinggU.S.gDruggEnforcementgAdministrationgguidelinesgforgprescribing
g gg 5.gNursegpractitionergpracticegmaygthrivegunderghealth-caregreformgbecausegof:
1. Thegdemonstratedgabilitygofgnursegpractitionersgtogcontrolgcostsgandgimprovegpatie
ntgoutcomes
2. Thegfactgthatgnursegpractitionersgwillgbegablegtogpracticegindependently
3. Thegfactgthatgnursegpractitionersgwillghavegfullgreimbursementgunderghealt
h-gcaregreform
4. ThegabilitygtogshiftgaccountabilitygforgMedicaidgtogthegstateglevel
,Chapterg1.gThegRolegofgthegNursegPractitionergasgPrescribe
rgAnswergSection
MULTIPLEgCHOICE
1.gANS: 3 PTS: 1
2.gANS: 2 PTS: 1
3.gANS: 1 PTS: 1
4.gANS: 2 PTS: 1
5.gANS: 1 PTS: 1
,Chapterg2.gReviewgofgthegBasicgPrinciplesgofgPharmacology
MultiplegChoice
Identifygthegchoicegthatgbestgcompletesgthegstatementgorganswersgthegquestion.
g
gg 1.gAgpatient’sgnutritionalgintakegandglaboratorygresultsgreflectghypoalbuminemia.gThisgi
sgcriticalgtogprescribinggbecause:
1. Distributiongofgdrugsgtogtargetgtissuegmaygbegaffected.
2. Thegsolubilitygofgthegdruggwillgnotgmatchgthegsitegofgabsorption.
3. Theregwillgbeglessgfreegdruggavailablegtoggenerategangeffect.
4. Drugsgboundgtogalbumingaregreadilygexcretedgbygthegkidneys.
g gg 2.gDrugsgthatghavegagsignificantgfirst-passgeffect:
1. Mustgbeggivengbygthegenteralg(oral)groutegonly
2. Bypassgtheghepaticgcirculation
3. Aregrapidlygmetabolizedgbygtheglivergandgmayghaveglittlegifganygdesiredgaction
4. Aregconvertedgbygtheglivergtogmoregactivegandgfat-solublegforms
g gg 3.gThegroutegofgexcretiongofgagvolatilegdruggwillglikelygbegthe:
1. Kidneys
2. Lungs
3. Bilegandgfeces
4. Skin
g
gg 4.gMedroxyprogesteroneg(DepogProvera)gisgprescribedgintramuscularlyg(IM)gtogcrea
tegagstoragegreservoirgofgthegdrug.gStoragegreservoirs:
1. Assuregthatgthegdruggwillgreachgitsgintendedgtargetgtissue
2. Aregthegreasongforggivinggloadinggdoses
3. Increasegtheglengthgofgtimegagdruggisgavailablegandgactive
4. Aregmostgcommongingcollagengtissues
g gg 5.gThegNPgchoosesgtoggivegcephalexingeveryg8ghoursgbasedgongknowledgegofgthegdrug’s:
1. Propensitygtoggogtogthegtargetgreceptor
2. Biologicalghalf-life
3. Pharmacodynamics
4. Safetygandgsidegeffects
g
gg 6.gAzithromycin gdosinggrequiresgthatgthegfirstgday’sgdosagegbegtwicegthosegofgthegotherg4
gdaysgofgthegprescription.gThisgisgconsideredgagloadinggdose.gAgloadinggdose:
1. Rapidlygachievesgdrugglevelsgingthegtherapeuticgrange
2. Requiresgfour-gtogfive-half-livesgtogattain
3. Isginfluencedgbygrenalgfunction
4. Isgdirectlygrelatedgtogthegdruggcirculatinggtogthegtargetgtissues
g
gg 7.gThegpointgingtimegongthegdruggconcentrationgcurvegthatgindicatesgthegfirstgsigngofgagthera
peuticgeffectgisgthe:
1. Minimumgadversegeffectglevel
2. Peakgofgaction
, 3. Onsetgofgaction
4. Therapeuticgrange
g gg 8.gPhenytoingrequiresgthatgagtroughglevelgbegdrawn.gPeakgandgtroughglevelsgaregdone:
1. Whengthegdrugghasgagwidegtherapeuticgrange
2. Whengthegdruggwillgbegadministeredgforgagshortgtimegonly
3. Whengtheregisgaghighgcorrelationgbetweengthegdosegandgsaturationgofgreceptorgsites
4. Togdeterminegifgagdruggisgingthegtherapeuticgrange
g gg 9.gAglaboratorygresultgindicatesgthatgthegpeakglevelgforgagdruggisgabovegthegminimumg toxicgconcentration.
Thisgmeansgthatgthe:
1. Concentrationgwillgproducegtherapeuticgeffects
2. Concentrationgwillgproducegangadversegresponse
3. Timegbetweengdosesgmustgbegshortened
4. Durationgofgactiongofgthegdruggisgtooglong
g 10.gDrugsgthatgaregreceptorgagonistsgmaygdemonstrategwhatg property?
g
1. Irreversiblegbindinggtogthegdruggreceptorgsite
2. Upregulationgwithgchronicguse
3. Desensitizationgorgdownregulationgwithgcontinuousguse
4. Inversegrelationshipgbetweengdruggconcentrationgandgdruggaction
g 11.gDrugsgthatgaregreceptorgantagonists,gsuchgasgbetagblockers,gmaygcause:
g
1. Downregulationgofgthegdruggreceptor
2. Angexaggeratedgresponsegifgabruptlygdiscontinued
3. Partialgblockadegofgthegeffectsgofgagonistgdrugs
4. Angexaggeratedgresponsegtogcompetitivegdruggagonists
g 12.gFactorsgthatgaffectggastricgdruggabsorptionginclude:
g
1. Livergenzymegactivity
2. Protein-bindinggpropertiesgofgthegdruggmolecule
3. Lipidgsolubilitygofgthegdrug
4. Abilitygtogchewgandgswallow
g 13.gDrugsgadministeredgviag IV:
g
1. Needgtogbeglipidgsolublegingordergtogbegeasilygabsorbed
2. Begingdistributiongintogthegbodygimmediately
3. Aregeasilygabsorbedgifgtheygaregnonionized
4. Maygusegpinocytosisgtogbegabsorbed
g 14.gWhengagmedicationgisgaddedgtogagregimengforgagsynergisticgeffect,gthegcombinedgeffectgofgthegdrugsgis:
g
1. Thegsumgofgthegeffectsgofgeachgdruggindividually
2. Greatergthangthegsumgofgthegeffectsgofgeachgdruggindividually
3. Lessgthangthegeffectgofgeachgdruggindividually
4. Notgpredictable,gasgitgvariesgwithgeachgindividual
g 15.gWhichgofgthegfollowinggstatementsgaboutgbioavailabilitygisgtrue?
g
1. Bioavailabilitygissuesgaregespeciallygimportantgforgdrugsgwithgnarrowgtherapeuti
cgrangesgorgsustained-releasegmechanisms.
2. Allgbrandsgofgagdrugghavegthegsamegbioavailability.
3. Drugsgthatgaregadministeredgmoregthangoncegagdayghaveggreatergbioavailabilitygthan
stgBank
Chapterg1.gThegRolegofgthegNursegPractitionergasgPr
escriberMultiplegChoice
Identifygthegchoicegthatgbestgcompletesgthegstatementgorganswersgthegquestion.
g gg 1.gNursegpractitionergprescriptivegauthoritygisgregulatedg by:
1. ThegNationalgCouncilgofgStategBoardsgofgNursing
2. ThegU.S.gDruggEnforcementgAdministration
3. ThegStategBoardgofgNursinggforgeachgstate
4. ThegStategBoardgofgPharmacy
g
gg 2.gThegbenefitsgtogthegpatientgofghavinggangAdvancedgPracticegRegisteredgNurseg(APRN
)gprescriberginclude:
1. NursesgknowgmoregaboutgPharmacologygthangothergprescribersgbecausegtheygtakeg
itgbothgingtheirgbasicgnursinggprogramgandgingtheirgAPRNgprogram.
2. Nursesgcaregforgthegpatientgfromgagholisticgapproachgandgincludegthegpatientgi
ngdecisiongmakinggregardinggtheirgcare.
3. APRNsgareglessglikelygtogprescribegnarcoticsgandgothergcontrolledgsubstances.
4. APRNsgaregablegtogprescribegindependentlygingallgstates,gwhereasgagphysician’
sgassistantgneedsgtoghavegagphysiciangsupervisinggtheirgpractice.
g gg 3.gClinicalgjudgmentgingprescribinggincludes:
1. Factoringgingthegcostgtogthegpatientgofgthegmedicationgprescribed
2. Alwaysgprescribinggthegnewestgmedicationgavailablegforgthegdiseasegprocess
3. Handinggoutgdruggsamplesgtogpoorgpatients
4. Prescribinggallggenericgmedicationsgtogcutgcosts
g gg 4.gCriteriagforgchoosinggangeffectivegdruggforgagdisorderginclude:
1. Askinggthegpatientgwhatgdruggtheygthinkgwouldgworkgbestgforgthem
2. Consultinggnationallygrecognizedgguidelinesgforgdiseasegmanagement
3. Prescribinggmedicationsgthatgaregavailablegasgsamplesgbeforegwritinggagprescription
4. FollowinggU.S.gDruggEnforcementgAdministrationgguidelinesgforgprescribing
g gg 5.gNursegpractitionergpracticegmaygthrivegunderghealth-caregreformgbecausegof:
1. Thegdemonstratedgabilitygofgnursegpractitionersgtogcontrolgcostsgandgimprovegpatie
ntgoutcomes
2. Thegfactgthatgnursegpractitionersgwillgbegablegtogpracticegindependently
3. Thegfactgthatgnursegpractitionersgwillghavegfullgreimbursementgunderghealt
h-gcaregreform
4. ThegabilitygtogshiftgaccountabilitygforgMedicaidgtogthegstateglevel
,Chapterg1.gThegRolegofgthegNursegPractitionergasgPrescribe
rgAnswergSection
MULTIPLEgCHOICE
1.gANS: 3 PTS: 1
2.gANS: 2 PTS: 1
3.gANS: 1 PTS: 1
4.gANS: 2 PTS: 1
5.gANS: 1 PTS: 1
,Chapterg2.gReviewgofgthegBasicgPrinciplesgofgPharmacology
MultiplegChoice
Identifygthegchoicegthatgbestgcompletesgthegstatementgorganswersgthegquestion.
g
gg 1.gAgpatient’sgnutritionalgintakegandglaboratorygresultsgreflectghypoalbuminemia.gThisgi
sgcriticalgtogprescribinggbecause:
1. Distributiongofgdrugsgtogtargetgtissuegmaygbegaffected.
2. Thegsolubilitygofgthegdruggwillgnotgmatchgthegsitegofgabsorption.
3. Theregwillgbeglessgfreegdruggavailablegtoggenerategangeffect.
4. Drugsgboundgtogalbumingaregreadilygexcretedgbygthegkidneys.
g gg 2.gDrugsgthatghavegagsignificantgfirst-passgeffect:
1. Mustgbeggivengbygthegenteralg(oral)groutegonly
2. Bypassgtheghepaticgcirculation
3. Aregrapidlygmetabolizedgbygtheglivergandgmayghaveglittlegifganygdesiredgaction
4. Aregconvertedgbygtheglivergtogmoregactivegandgfat-solublegforms
g gg 3.gThegroutegofgexcretiongofgagvolatilegdruggwillglikelygbegthe:
1. Kidneys
2. Lungs
3. Bilegandgfeces
4. Skin
g
gg 4.gMedroxyprogesteroneg(DepogProvera)gisgprescribedgintramuscularlyg(IM)gtogcrea
tegagstoragegreservoirgofgthegdrug.gStoragegreservoirs:
1. Assuregthatgthegdruggwillgreachgitsgintendedgtargetgtissue
2. Aregthegreasongforggivinggloadinggdoses
3. Increasegtheglengthgofgtimegagdruggisgavailablegandgactive
4. Aregmostgcommongingcollagengtissues
g gg 5.gThegNPgchoosesgtoggivegcephalexingeveryg8ghoursgbasedgongknowledgegofgthegdrug’s:
1. Propensitygtoggogtogthegtargetgreceptor
2. Biologicalghalf-life
3. Pharmacodynamics
4. Safetygandgsidegeffects
g
gg 6.gAzithromycin gdosinggrequiresgthatgthegfirstgday’sgdosagegbegtwicegthosegofgthegotherg4
gdaysgofgthegprescription.gThisgisgconsideredgagloadinggdose.gAgloadinggdose:
1. Rapidlygachievesgdrugglevelsgingthegtherapeuticgrange
2. Requiresgfour-gtogfive-half-livesgtogattain
3. Isginfluencedgbygrenalgfunction
4. Isgdirectlygrelatedgtogthegdruggcirculatinggtogthegtargetgtissues
g
gg 7.gThegpointgingtimegongthegdruggconcentrationgcurvegthatgindicatesgthegfirstgsigngofgagthera
peuticgeffectgisgthe:
1. Minimumgadversegeffectglevel
2. Peakgofgaction
, 3. Onsetgofgaction
4. Therapeuticgrange
g gg 8.gPhenytoingrequiresgthatgagtroughglevelgbegdrawn.gPeakgandgtroughglevelsgaregdone:
1. Whengthegdrugghasgagwidegtherapeuticgrange
2. Whengthegdruggwillgbegadministeredgforgagshortgtimegonly
3. Whengtheregisgaghighgcorrelationgbetweengthegdosegandgsaturationgofgreceptorgsites
4. Togdeterminegifgagdruggisgingthegtherapeuticgrange
g gg 9.gAglaboratorygresultgindicatesgthatgthegpeakglevelgforgagdruggisgabovegthegminimumg toxicgconcentration.
Thisgmeansgthatgthe:
1. Concentrationgwillgproducegtherapeuticgeffects
2. Concentrationgwillgproducegangadversegresponse
3. Timegbetweengdosesgmustgbegshortened
4. Durationgofgactiongofgthegdruggisgtooglong
g 10.gDrugsgthatgaregreceptorgagonistsgmaygdemonstrategwhatg property?
g
1. Irreversiblegbindinggtogthegdruggreceptorgsite
2. Upregulationgwithgchronicguse
3. Desensitizationgorgdownregulationgwithgcontinuousguse
4. Inversegrelationshipgbetweengdruggconcentrationgandgdruggaction
g 11.gDrugsgthatgaregreceptorgantagonists,gsuchgasgbetagblockers,gmaygcause:
g
1. Downregulationgofgthegdruggreceptor
2. Angexaggeratedgresponsegifgabruptlygdiscontinued
3. Partialgblockadegofgthegeffectsgofgagonistgdrugs
4. Angexaggeratedgresponsegtogcompetitivegdruggagonists
g 12.gFactorsgthatgaffectggastricgdruggabsorptionginclude:
g
1. Livergenzymegactivity
2. Protein-bindinggpropertiesgofgthegdruggmolecule
3. Lipidgsolubilitygofgthegdrug
4. Abilitygtogchewgandgswallow
g 13.gDrugsgadministeredgviag IV:
g
1. Needgtogbeglipidgsolublegingordergtogbegeasilygabsorbed
2. Begingdistributiongintogthegbodygimmediately
3. Aregeasilygabsorbedgifgtheygaregnonionized
4. Maygusegpinocytosisgtogbegabsorbed
g 14.gWhengagmedicationgisgaddedgtogagregimengforgagsynergisticgeffect,gthegcombinedgeffectgofgthegdrugsgis:
g
1. Thegsumgofgthegeffectsgofgeachgdruggindividually
2. Greatergthangthegsumgofgthegeffectsgofgeachgdruggindividually
3. Lessgthangthegeffectgofgeachgdruggindividually
4. Notgpredictable,gasgitgvariesgwithgeachgindividual
g 15.gWhichgofgthegfollowinggstatementsgaboutgbioavailabilitygisgtrue?
g
1. Bioavailabilitygissuesgaregespeciallygimportantgforgdrugsgwithgnarrowgtherapeuti
cgrangesgorgsustained-releasegmechanisms.
2. Allgbrandsgofgagdrugghavegthegsamegbioavailability.
3. Drugsgthatgaregadministeredgmoregthangoncegagdayghaveggreatergbioavailabilitygthan
