NR 565 VERIFIED EXAM QUESTIONS AND ANSWERS
APRN prescribing role
Prescriptive authority for nurse practitioners also regulates prescribing rights beyond
medications and controlled substances. These rights include therapeutic devices and
services and are outlined in state practice laws and regulations and include Durable
Medical Equipment (DME) such as wheelchairs, power scooters, hospital beds, portable
oxygen equipment, handicap placards, etc. and medical services such as Physical
Therapy (PT), Occupational Therapy (OT), home health services, etc. Prescriptive
authority encompasses more than writing a prescription correctly. It requires adherence
to ethical guidelines to ensure that patients are safeguarded from harm. Ethical
prescribing starts with being well-informed about medications. Mechanism of action,
efficacy, and safety are important considerations, as are a patient's distinct needs and
circumstances, including the number of medications prescribed (Mitchell & Oliphant,
2016). Most patients receiving a prescription are taking other medications, whether
prescription or over-the-counter. Appropriate selection, dosing, and duration of
pharmaceutical agents are key to maximizing outcomes and minimizing adverse effects
benefits of full practice authority
Nurse practitioners have the autonomy to evaluate patients, diagnose, order and
interpret tests, initiate and manage treatments and prescribe medications, including
controlled substances without physician oversight
promoting positive outcomes through prudent prescribing practices
Administering medications and prescribing medications are two distinct processes.
Prescription writing requires prudent and deliberate decision-making processes to
maintain patient safety and reduce liability, including:
*documentation of a provider-patient relationship for the recipient of the prescribed
medications
*documentation of a thorough history and physical examination for the recipient
*documentation of discussions regarding risk factors, side effects, or therapy options
, *documentation of drug monitoring or titration plan, if applicable
*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the formulation of a
diagnosis based on clinical reasoning and the selection and monitoring of the most
appropriate pharmacological treatment
Considerations include: Cost, guidelines, availability, interactions, side effects, allergies,
hepatic/renal functions, need for monitoring, & special populations
Beer's Criteria
identifies drugs with a high likelihood of causing adverse effects in older adults.
Accordingly, drugs on this list should generally be avoided in adults older than 65 years
except when the benefits are significantly greater than the risks.
Pharmacodynamics
the study of the biochemical and physiologic effects of drugs on the body and the
molecular mechanisms by which those effects are produced
Pharmacokinetics
the study of drug movement throughout the body
Pharmacogenomics
the study of how genes affect a person's response to drugs. The purpose of this is to
combine the sciences of genomics and pharmacology to provide individualized,
targeted, safe drug therapies to patients
CYP450 inducers
Inducers are xenobiotics (medications and environmental agents) that elevate CYP450
enzyme activity by increasing enzyme synthesis. This action leads to additional sites
available for biotransformation. The increased number of sites enhances medication
metabolism, decreasing the concentration of the "parent drug" while increasing
metabolite production.
APRN prescribing role
Prescriptive authority for nurse practitioners also regulates prescribing rights beyond
medications and controlled substances. These rights include therapeutic devices and
services and are outlined in state practice laws and regulations and include Durable
Medical Equipment (DME) such as wheelchairs, power scooters, hospital beds, portable
oxygen equipment, handicap placards, etc. and medical services such as Physical
Therapy (PT), Occupational Therapy (OT), home health services, etc. Prescriptive
authority encompasses more than writing a prescription correctly. It requires adherence
to ethical guidelines to ensure that patients are safeguarded from harm. Ethical
prescribing starts with being well-informed about medications. Mechanism of action,
efficacy, and safety are important considerations, as are a patient's distinct needs and
circumstances, including the number of medications prescribed (Mitchell & Oliphant,
2016). Most patients receiving a prescription are taking other medications, whether
prescription or over-the-counter. Appropriate selection, dosing, and duration of
pharmaceutical agents are key to maximizing outcomes and minimizing adverse effects
benefits of full practice authority
Nurse practitioners have the autonomy to evaluate patients, diagnose, order and
interpret tests, initiate and manage treatments and prescribe medications, including
controlled substances without physician oversight
promoting positive outcomes through prudent prescribing practices
Administering medications and prescribing medications are two distinct processes.
Prescription writing requires prudent and deliberate decision-making processes to
maintain patient safety and reduce liability, including:
*documentation of a provider-patient relationship for the recipient of the prescribed
medications
*documentation of a thorough history and physical examination for the recipient
*documentation of discussions regarding risk factors, side effects, or therapy options
, *documentation of drug monitoring or titration plan, if applicable
*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the formulation of a
diagnosis based on clinical reasoning and the selection and monitoring of the most
appropriate pharmacological treatment
Considerations include: Cost, guidelines, availability, interactions, side effects, allergies,
hepatic/renal functions, need for monitoring, & special populations
Beer's Criteria
identifies drugs with a high likelihood of causing adverse effects in older adults.
Accordingly, drugs on this list should generally be avoided in adults older than 65 years
except when the benefits are significantly greater than the risks.
Pharmacodynamics
the study of the biochemical and physiologic effects of drugs on the body and the
molecular mechanisms by which those effects are produced
Pharmacokinetics
the study of drug movement throughout the body
Pharmacogenomics
the study of how genes affect a person's response to drugs. The purpose of this is to
combine the sciences of genomics and pharmacology to provide individualized,
targeted, safe drug therapies to patients
CYP450 inducers
Inducers are xenobiotics (medications and environmental agents) that elevate CYP450
enzyme activity by increasing enzyme synthesis. This action leads to additional sites
available for biotransformation. The increased number of sites enhances medication
metabolism, decreasing the concentration of the "parent drug" while increasing
metabolite production.
