Test Bank for Pharmacotherapeutics for Advanced Practice 5th
Edition (Arcangelo All Chapters.
Chapter 3. Rational Drug Selection
Multiple Choice Identify the choice that best completes the statement or
answers the question.
1. An NP would prescribe the liquid form of ibuprofen for a 6-year-old child because:
1. Drugs given in liquid form are less irritating to the stomach.
2. A 6-year-old child may have problems swallowing a pill.
3. Liquid forms of medication eliminate the concern for first-pass effect.
4. Liquid ibuprofen does not have to be dosed as often as the tablet form.
2. In deciding which of multiple drugs used to use to treat a condition, the NP chooses Drug
A because it:
1. Has serious side effects and it is not being used for a life-threatening condition
2. Will be taken twice daily and will be taken at home
3. Is expensive, but covered by health insurance
4. None of these are important in choosing a drug
3. A client asks the NP about the differences in drug effects between men and women.
What is known about the differences between the pharmacokinetics of men and women?
1. Body temperature varies between men and women.
2. Muscle mass is greater in women.
3. Percentage of fat differs between genders.
4. Proven subjective factors exist between the genders.
4. The first step in the prescribing process according to the World Health Organization is:
1. Choosing the treatment
2. Educating the patient about the medication
3. Diagnosing the patient’s problem
4. Starting the treatment
5. Treatment goals in prescribing should:
1. Always be curative
2. Be patient-centered
3. Be convenient for the provider
4. Focus on the cost of therapy
6. The therapeutic goals when prescribing include(s):
1. Curative
2. Palliative
3. Preventive
4. All of the above
7. When determining drug treatment, the NP prescriber should:
1. Always use evidence-based guidelines
, 2. Individualize the drug choice for the specific patient
3. Rely on his or her experience when prescribing for complex patients
4. Use the newest drug on the market for the condition being treated
8. Patient education regarding prescribed medication includes:
1. Instructions written at the high school reading level
2. Discussion of expected adverse drug reactions
3. How to store leftover medication such as antibiotics
4. Verbal instructions always in English
9. Passive monitoring of drug effectiveness includes:
1. Therapeutic drug levels
2. Adding or subtracting medications from the treatment regimen
3. Ongoing provider visits
4. Instructing the patient to report if the drug is not effective
10. Pharmacokinetic factors that affect prescribing include:
1. Therapeutic index
2. Minimum effective concentration
3. Bioavailability
4. Ease of titration
11. Pharmaceutical promotion may affect prescribing. To address the impact of pharmaceutical
promotion, the following recommendations have been made by the Institute of Medicine:
1. Conflicts of interest and financial relationships should be disclosed by those providing
education.
2. Providers should ban all pharmaceutical representatives from their office setting.
3. Drug samples should be used for patients who have the insurance to pay for them, to ensure the
patient can afford the medication.
4. Providers should only accept low-value gifts, such as pens and pads of paper, from the
pharmaceutical representative.
12. Under new U.S. Food and Drug Administration labeling, Pregnancy Categories will be:
1. Strengthened with a new coding such as C+ or C- to discern when a drug is more or less toxic
to the fetus
2. Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label
3. Eliminated, and replaced with a link to the National Library of Medicine TOXNET Web site
for in-depth information regarding pregnancy concerns
4. Clarified to include information such as safe dosages in each trimester of pregnancy
Chapter 3. Rational Drug Selection
Answer Section
MULTIPLE CHOICE
1. ANS: 2 PTS: 1
2. ANS: 2 PTS: 1
3. ANS: 3 PTS: 1
, 4. ANS: 3 PTS: 1
5. ANS: 2 PTS: 1
6. ANS: 4 PTS: 1
7. ANS: 2 PTS: 1
8. ANS: 2 PTS: 1
9. ANS: 4 PTS: 1
10. ANS: 3 PTS: 1
11. ANS: 1 PTS: 1
12. ANS: 2 PTS: 1
Chapter 1. The Role of the Nurse Practitioner as
Prescriber 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. Criteria 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. Nurse practitioner practice may thrive under health-care reform because of:
, 1. The demonstrated ability of nurse practitioners to control costs and improve patient
outcomes
2. The fact that nurse practitioners will be able to practice independently
3. The fact that nurse practitioners will have full reimbursement under health- care reform
4. The ability to shift accountability for Medicaid to the state level
Chapter 1. The Role of the Nurse Practitioner as Prescriber
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: 1 PTS: 1
Chapter 2. Review of the 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
Edition (Arcangelo All Chapters.
Chapter 3. Rational Drug Selection
Multiple Choice Identify the choice that best completes the statement or
answers the question.
1. An NP would prescribe the liquid form of ibuprofen for a 6-year-old child because:
1. Drugs given in liquid form are less irritating to the stomach.
2. A 6-year-old child may have problems swallowing a pill.
3. Liquid forms of medication eliminate the concern for first-pass effect.
4. Liquid ibuprofen does not have to be dosed as often as the tablet form.
2. In deciding which of multiple drugs used to use to treat a condition, the NP chooses Drug
A because it:
1. Has serious side effects and it is not being used for a life-threatening condition
2. Will be taken twice daily and will be taken at home
3. Is expensive, but covered by health insurance
4. None of these are important in choosing a drug
3. A client asks the NP about the differences in drug effects between men and women.
What is known about the differences between the pharmacokinetics of men and women?
1. Body temperature varies between men and women.
2. Muscle mass is greater in women.
3. Percentage of fat differs between genders.
4. Proven subjective factors exist between the genders.
4. The first step in the prescribing process according to the World Health Organization is:
1. Choosing the treatment
2. Educating the patient about the medication
3. Diagnosing the patient’s problem
4. Starting the treatment
5. Treatment goals in prescribing should:
1. Always be curative
2. Be patient-centered
3. Be convenient for the provider
4. Focus on the cost of therapy
6. The therapeutic goals when prescribing include(s):
1. Curative
2. Palliative
3. Preventive
4. All of the above
7. When determining drug treatment, the NP prescriber should:
1. Always use evidence-based guidelines
, 2. Individualize the drug choice for the specific patient
3. Rely on his or her experience when prescribing for complex patients
4. Use the newest drug on the market for the condition being treated
8. Patient education regarding prescribed medication includes:
1. Instructions written at the high school reading level
2. Discussion of expected adverse drug reactions
3. How to store leftover medication such as antibiotics
4. Verbal instructions always in English
9. Passive monitoring of drug effectiveness includes:
1. Therapeutic drug levels
2. Adding or subtracting medications from the treatment regimen
3. Ongoing provider visits
4. Instructing the patient to report if the drug is not effective
10. Pharmacokinetic factors that affect prescribing include:
1. Therapeutic index
2. Minimum effective concentration
3. Bioavailability
4. Ease of titration
11. Pharmaceutical promotion may affect prescribing. To address the impact of pharmaceutical
promotion, the following recommendations have been made by the Institute of Medicine:
1. Conflicts of interest and financial relationships should be disclosed by those providing
education.
2. Providers should ban all pharmaceutical representatives from their office setting.
3. Drug samples should be used for patients who have the insurance to pay for them, to ensure the
patient can afford the medication.
4. Providers should only accept low-value gifts, such as pens and pads of paper, from the
pharmaceutical representative.
12. Under new U.S. Food and Drug Administration labeling, Pregnancy Categories will be:
1. Strengthened with a new coding such as C+ or C- to discern when a drug is more or less toxic
to the fetus
2. Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label
3. Eliminated, and replaced with a link to the National Library of Medicine TOXNET Web site
for in-depth information regarding pregnancy concerns
4. Clarified to include information such as safe dosages in each trimester of pregnancy
Chapter 3. Rational Drug Selection
Answer Section
MULTIPLE CHOICE
1. ANS: 2 PTS: 1
2. ANS: 2 PTS: 1
3. ANS: 3 PTS: 1
, 4. ANS: 3 PTS: 1
5. ANS: 2 PTS: 1
6. ANS: 4 PTS: 1
7. ANS: 2 PTS: 1
8. ANS: 2 PTS: 1
9. ANS: 4 PTS: 1
10. ANS: 3 PTS: 1
11. ANS: 1 PTS: 1
12. ANS: 2 PTS: 1
Chapter 1. The Role of the Nurse Practitioner as
Prescriber 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. Criteria 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. Nurse practitioner practice may thrive under health-care reform because of:
, 1. The demonstrated ability of nurse practitioners to control costs and improve patient
outcomes
2. The fact that nurse practitioners will be able to practice independently
3. The fact that nurse practitioners will have full reimbursement under health- care reform
4. The ability to shift accountability for Medicaid to the state level
Chapter 1. The Role of the Nurse Practitioner as Prescriber
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: 1 PTS: 1
Chapter 2. Review of the 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
