Advanced Pharmacology
In every state, prescriptive authority for NPs includes the ability to write
prescriptions:
A. for controlled substances.
B. for specified classifications of medications.
C. without physician-mandated involvement.
D. with full, independent prescriptive authority. - (correct Answer) - B. for
specified classifications of medications.
A primary care NP wishes to order a drug that will be effective immediately after
administration of the drug. Which route should the NP choose?
Rectal
Topical
Sublingual
Intramuscular - (correct Answer) - Sublingual
According to the Texas BON rules and regulations, a prescription must include: -
(correct Answer) - (1) the patient's name and address;
(2) the name, strength, and quantity of the drug to be dispensed;
(3) directions to the patient regarding taking of the drug and the dosage;
(4) the intended use of the drug, if appropriate;
(5) the name, address, and telephone number of the physician with whom the APRN has
a prescriptive
authority agreement
(6) address and telephone number of the site at which the prescription drug order
was issued;
(7) the date of issuance;
(8) the number of refills permitted;
(9) the name, prescription authorization number, and original signature of the APRN
who authorized the
prescription drug order; and
(10) the United States Drug Enforcement Administration numbers of the APRN and the
delegating physician,
if the prescription drug order is for a controlled substance.
The primary care nurse practitioner (NP) writes a prescription for an antibiotic
using an electronic drug prescription system. The pharmacist will fill this
prescription when:
the electronic prescription is received.
the patient brings a written copy of the prescription.
a copy of the written prescription is faxed to the pharmacy.
the pharmacist accesses the patient's electronic record to verify. - (correct
Answer) - the electronic prescription is received.
A patient receives an inhaled corticosteroid to treat asthma. The patient asks the
nurse why the drug is given by this route instead of orally. The nurse should
explain that the inhaled form:
is absorbed less quickly.
has reduced bioavailability.
has fewer systemic side effects.
provides dosing that is easier to regulate. - (correct Answer) - has fewer systemic
side effects.
A primary care NP is prescribing a drug for a patient who does not take any other
medications. The NP should realize that:
,CYP450 enzyme reactions will not interfere with this drug's metabolism.
substrates such as alcohol cannot interfere with the drug when the patient is
abstaining.
food-drug interactions are limited to those where food enhances or inhibits drug
absorption.
a thorough history of diet, alcohol use, smoking, and over-the-counter and herbal
products is required. - (correct Answer) - a thorough history of diet, alcohol use,
smoking, and over-the-counter and herbal products is required.
The neighbor of a primary care NP asks the NP to write a prescription for an
antibiotic. The NP should tell the neighbor:
a prescription will be written one time only.
she will ask a colleague to write the prescription.
that it is illegal to write prescriptions for friends.
that it is best if the neighbor sees a health care provider before obtaining a
prescription. - (correct Answer) - that it is best if the neighbor sees a health
care provider before obtaining a prescription.
Under Texas law, Advance Practice Registered Nurses (APRNs) must receive a
prescribing number from the Texas Board of Nursing before applying for supervision
and prescriptive delegation with the Texas Medical Board?
True or False - (correct Answer) - True
A primary care nurse practitioner (NP) prescribes a drug to an 80-year-old African-
American woman. When selecting a drug and determining the correct dose, the NP
should understand that the knowledge of how age, race, and gender may affect drug
excretion is based on an understanding of:
bioavailability.
pharmacokinetics.
pharmacodynamics.
anatomy and physiology. - (correct Answer) - pharmacokinetics.
According to Texas law, "dangerous drugs" include which of the following
pharmacologic agents?
Experimental medications
Prescription medications
Controlled substances
Herbal and alternative therapies - (correct Answer) - Prescription medications
The family nurse practitioner sees a 6-month-old infant for a routine physical
examination and notes that the infant has a runny nose and a cough. The parents
report a 2-day history of a temperature of 99� F to 100� F and two to three loose
stools per day. Other family members have similar symptoms. The infant has had two
sets of immunizations at 2 and 4 months of age. The FNP should:
administer the 6-month immunizations at this visit today.
, schedule an appointment in 2 weeks for 6-month immunizations.
administer DTaP, Hib, IPV, hepatitis B, and PCV13 today and RV in 2 weeks.
withhold all immunizations until the infant's temperature returns to normal and the
cough is gone. - (correct Answer) - administer the 6-month immunizations at this
visit today.
Minor upper respiratory infection or gastroenteritis, with or without fever, is not
an indication for withholding a scheduled vaccine dose.
DIF: Cognitive Level: Applying (Application)
REF: 757
A patient has been using a nicotine patch for several weeks and uses the 15 mg/16
hour patch. The patient reports having frequent continual cravings for cigarettes,
especially on awakening in the morning. The MSN-prepared nurse should:
prescribe varenicline (Chantix).
prescribe bupropion (Wellbutrin).
change to a 21 mg/24 hour nicotine patch.
suggest adding nicotine nasal spray for cravings. - (correct Answer) - change to a
21 mg/24 hour nicotine patch.
It is important to begin therapy with a dose sufficient to deliver enough nicotine
so that patients will not want to smoke. Patients who awaken with nicotine cravings
should wear a 24-hour patch. Prescribing varenicline or bupropion may be necessary
if the patch fails after appropriate dosing is established. Whichever nicotine
replacement method is chosen, the patient should use only one particular product to
avoid nicotine toxicity.
DIF: Cognitive Level: Applying (Application)
REF: 785
A patient who smokes reports repeated attempts to quit smoking using a nicotine
replacement patch. The patient says, "I always do well for a few weeks and then I
just start smoking again." The advance practice nurse with prescriptive authority
should prescribe:
nortriptyline.
Nicorette gum.
a Nicotrol inhaler.
varenicline (Chantix). - (correct Answer) - varenicline (Chantix).
Varenicline interferes with the enjoyment of nicotine so that smokers do not get
pleasure when they smoke. Nicotine replacement medications do not improve relapse
rates, and this patient has relapsed several times. Nortriptyline is not a first-
line smoking cessation medication.
DIF: Cognitive Level: Applying (Application)
REF: 780
A parent calls a clinic for advice about giving an over-the-counter cough medicine
to a 6-year-old child. The parent explains that the medication label does not give
instructions about how much to give a child. The best action is to:
order a prescription antitussive medication for the child.
In every state, prescriptive authority for NPs includes the ability to write
prescriptions:
A. for controlled substances.
B. for specified classifications of medications.
C. without physician-mandated involvement.
D. with full, independent prescriptive authority. - (correct Answer) - B. for
specified classifications of medications.
A primary care NP wishes to order a drug that will be effective immediately after
administration of the drug. Which route should the NP choose?
Rectal
Topical
Sublingual
Intramuscular - (correct Answer) - Sublingual
According to the Texas BON rules and regulations, a prescription must include: -
(correct Answer) - (1) the patient's name and address;
(2) the name, strength, and quantity of the drug to be dispensed;
(3) directions to the patient regarding taking of the drug and the dosage;
(4) the intended use of the drug, if appropriate;
(5) the name, address, and telephone number of the physician with whom the APRN has
a prescriptive
authority agreement
(6) address and telephone number of the site at which the prescription drug order
was issued;
(7) the date of issuance;
(8) the number of refills permitted;
(9) the name, prescription authorization number, and original signature of the APRN
who authorized the
prescription drug order; and
(10) the United States Drug Enforcement Administration numbers of the APRN and the
delegating physician,
if the prescription drug order is for a controlled substance.
The primary care nurse practitioner (NP) writes a prescription for an antibiotic
using an electronic drug prescription system. The pharmacist will fill this
prescription when:
the electronic prescription is received.
the patient brings a written copy of the prescription.
a copy of the written prescription is faxed to the pharmacy.
the pharmacist accesses the patient's electronic record to verify. - (correct
Answer) - the electronic prescription is received.
A patient receives an inhaled corticosteroid to treat asthma. The patient asks the
nurse why the drug is given by this route instead of orally. The nurse should
explain that the inhaled form:
is absorbed less quickly.
has reduced bioavailability.
has fewer systemic side effects.
provides dosing that is easier to regulate. - (correct Answer) - has fewer systemic
side effects.
A primary care NP is prescribing a drug for a patient who does not take any other
medications. The NP should realize that:
,CYP450 enzyme reactions will not interfere with this drug's metabolism.
substrates such as alcohol cannot interfere with the drug when the patient is
abstaining.
food-drug interactions are limited to those where food enhances or inhibits drug
absorption.
a thorough history of diet, alcohol use, smoking, and over-the-counter and herbal
products is required. - (correct Answer) - a thorough history of diet, alcohol use,
smoking, and over-the-counter and herbal products is required.
The neighbor of a primary care NP asks the NP to write a prescription for an
antibiotic. The NP should tell the neighbor:
a prescription will be written one time only.
she will ask a colleague to write the prescription.
that it is illegal to write prescriptions for friends.
that it is best if the neighbor sees a health care provider before obtaining a
prescription. - (correct Answer) - that it is best if the neighbor sees a health
care provider before obtaining a prescription.
Under Texas law, Advance Practice Registered Nurses (APRNs) must receive a
prescribing number from the Texas Board of Nursing before applying for supervision
and prescriptive delegation with the Texas Medical Board?
True or False - (correct Answer) - True
A primary care nurse practitioner (NP) prescribes a drug to an 80-year-old African-
American woman. When selecting a drug and determining the correct dose, the NP
should understand that the knowledge of how age, race, and gender may affect drug
excretion is based on an understanding of:
bioavailability.
pharmacokinetics.
pharmacodynamics.
anatomy and physiology. - (correct Answer) - pharmacokinetics.
According to Texas law, "dangerous drugs" include which of the following
pharmacologic agents?
Experimental medications
Prescription medications
Controlled substances
Herbal and alternative therapies - (correct Answer) - Prescription medications
The family nurse practitioner sees a 6-month-old infant for a routine physical
examination and notes that the infant has a runny nose and a cough. The parents
report a 2-day history of a temperature of 99� F to 100� F and two to three loose
stools per day. Other family members have similar symptoms. The infant has had two
sets of immunizations at 2 and 4 months of age. The FNP should:
administer the 6-month immunizations at this visit today.
, schedule an appointment in 2 weeks for 6-month immunizations.
administer DTaP, Hib, IPV, hepatitis B, and PCV13 today and RV in 2 weeks.
withhold all immunizations until the infant's temperature returns to normal and the
cough is gone. - (correct Answer) - administer the 6-month immunizations at this
visit today.
Minor upper respiratory infection or gastroenteritis, with or without fever, is not
an indication for withholding a scheduled vaccine dose.
DIF: Cognitive Level: Applying (Application)
REF: 757
A patient has been using a nicotine patch for several weeks and uses the 15 mg/16
hour patch. The patient reports having frequent continual cravings for cigarettes,
especially on awakening in the morning. The MSN-prepared nurse should:
prescribe varenicline (Chantix).
prescribe bupropion (Wellbutrin).
change to a 21 mg/24 hour nicotine patch.
suggest adding nicotine nasal spray for cravings. - (correct Answer) - change to a
21 mg/24 hour nicotine patch.
It is important to begin therapy with a dose sufficient to deliver enough nicotine
so that patients will not want to smoke. Patients who awaken with nicotine cravings
should wear a 24-hour patch. Prescribing varenicline or bupropion may be necessary
if the patch fails after appropriate dosing is established. Whichever nicotine
replacement method is chosen, the patient should use only one particular product to
avoid nicotine toxicity.
DIF: Cognitive Level: Applying (Application)
REF: 785
A patient who smokes reports repeated attempts to quit smoking using a nicotine
replacement patch. The patient says, "I always do well for a few weeks and then I
just start smoking again." The advance practice nurse with prescriptive authority
should prescribe:
nortriptyline.
Nicorette gum.
a Nicotrol inhaler.
varenicline (Chantix). - (correct Answer) - varenicline (Chantix).
Varenicline interferes with the enjoyment of nicotine so that smokers do not get
pleasure when they smoke. Nicotine replacement medications do not improve relapse
rates, and this patient has relapsed several times. Nortriptyline is not a first-
line smoking cessation medication.
DIF: Cognitive Level: Applying (Application)
REF: 780
A parent calls a clinic for advice about giving an over-the-counter cough medicine
to a 6-year-old child. The parent explains that the medication label does not give
instructions about how much to give a child. The best action is to:
order a prescription antitussive medication for the child.
