Leigh
NR565 / Advanced Pharmacology Q-bank with 180 answers and
rationales, Midterm Study Guide (2025/2026)
PRESCRIPTIVE AUTHORITY, LEGAL & ETHICAL FOUNDATIONS
1. Which statement best describes APRN prescriptive authority in the United States?
A. It is identical in every state.
B. It is determined by federal nursing regulations.
C. It is defined by each state’s practice act and regulatory boards.
D. It is determined solely by the DEA.
Correct answer: C
Rationale:
Prescriptive authority is state specific, set by statutes and rules of state practice acts and
regulatory boards (e.g., board of nursing or medicine). The DEA regulates controlled substances
at the federal level but does not define all aspects of APRN prescriptive authority.
2. In a state where APRNs have restricted prescriptive authority, which is the most likely
consequence for patients?
A. Faster access to specialty medications
B. Fewer emergency department visits
C. More delays and barriers in obtaining needed medications
D. Increased continuity of care
Correct answer: C
Rationale:
When APRNs require physician cosignature or supervision for prescribing, patients may face
delays, limited availability of providers, and additional costs—all of which reduce access to
timely, affordable pharmacologic therapy.
3. An APRN wishes to prescribe a Schedule II opioid. Which agency must have issued the
provider’s DEA number?
,Leigh
A. State Board of Nursing
B. Centers for Medicare & Medicaid Services (CMS)
C. Drug Enforcement Administration (DEA)
D. Food and Drug Administration (FDA)
Correct answer: C
Rationale:
The DEA issues registration numbers that authorize clinicians to prescribe controlled
substances. State boards govern licensure and scope, but a DEA number is needed to legally
prescribe scheduled drugs.
4. Which of the following best reflects best practice regarding prescribing for family
members?
A. It is encouraged to reduce health-care costs.
B. It is acceptable for chronic conditions only.
C. It should be avoided except in true emergencies.
D. It is acceptable if the APRN documents consent.
Correct answer: C
Rationale:
Prescribing for yourself or family members should generally be avoided due to impaired
objectivity, inadequate assessment, and ethical concerns. Exceptions may occur in emergencies
when no other provider is reasonably available.
5. The most important first step in safe prescribing is:
A. Checking insurance coverage
B. Establishing a legitimate provider–patient relationship
C. Choosing the lowest-cost generic option
D. Signing an informed consent form
Correct answer: B
Rationale:
Safe prescribing requires a valid provider–patient relationship, including a thorough history,
,Leigh
examination, and documentation. Without this, any prescription may be considered
inappropriate or illegal.
6. Which factor is least appropriate as the primary basis for choosing a medication?
A. Current clinical guidelines
B. Patient comorbidities
C. Drug–drug interaction profile
D. Pharmaceutical company marketing
Correct answer: D
Rationale:
Evidence-based prescribing relies on guidelines, safety, and patient-specific factors. Marketing
and sales promotions should not drive prescribing decisions.
7. An APRN is choosing an antihypertensive for an older adult on multiple medications. Which
consideration is most critical to review before prescribing?
A. Brand name recognition
B. Potential drug–drug interactions and Beers Criteria
C. How often samples are available
D. Whether the drug is new to the market
Correct answer: B
Rationale:
In older adults, polypharmacy and age-related physiologic changes increase risk of adverse
events. Reviewing interactions and Beers Criteria reduces risk of harm.
8. Which statement about the Beers Criteria is accurate?
A. It is a law that prohibits certain drugs in older adults.
B. It is a guideline listing potentially inappropriate medications in older adults.
C. It only applies to patients in nursing homes.
D. It lists only medications that are absolutely contraindicated after age 65.
Correct answer: B
, Leigh
Rationale:
The Beers Criteria is a guideline, not a law. It highlights drugs that may be potentially
inappropriate in older adults due to higher risk of adverse effects, but individual clinical
decisions still apply.
9. One key outcome of polypharmacy in older adults is:
A. Increased medication adherence
B. Reduced hospitalizations
C. Higher risk of adverse drug events and interactions
D. Lower overall health-care costs
Correct answer: C
Rationale:
Polypharmacy (≥5 medications, often more) increases complexity, confusion, and adverse drug
events, leading to falls, hospitalizations, and higher costs.
10. Which strategy is most effective in reducing polypharmacy?
A. Automatic refill programs
B. “Brown bag” medication review at each visit
C. Using multiple pharmacies
D. Switching to brand-name drugs
Correct answer: B
Rationale:
Asking patients to bring in all medications (“brown bag review”) allows the APRN to identify
duplications, unnecessary drugs, interactions, and nonadherence.
PHARMACOKINETICS & PHARMACODYNAMICS
11. A patient with liver cirrhosis is prescribed a medication that is extensively metabolized
hepatically. Which dosage adjustment is most likely?
NR565 / Advanced Pharmacology Q-bank with 180 answers and
rationales, Midterm Study Guide (2025/2026)
PRESCRIPTIVE AUTHORITY, LEGAL & ETHICAL FOUNDATIONS
1. Which statement best describes APRN prescriptive authority in the United States?
A. It is identical in every state.
B. It is determined by federal nursing regulations.
C. It is defined by each state’s practice act and regulatory boards.
D. It is determined solely by the DEA.
Correct answer: C
Rationale:
Prescriptive authority is state specific, set by statutes and rules of state practice acts and
regulatory boards (e.g., board of nursing or medicine). The DEA regulates controlled substances
at the federal level but does not define all aspects of APRN prescriptive authority.
2. In a state where APRNs have restricted prescriptive authority, which is the most likely
consequence for patients?
A. Faster access to specialty medications
B. Fewer emergency department visits
C. More delays and barriers in obtaining needed medications
D. Increased continuity of care
Correct answer: C
Rationale:
When APRNs require physician cosignature or supervision for prescribing, patients may face
delays, limited availability of providers, and additional costs—all of which reduce access to
timely, affordable pharmacologic therapy.
3. An APRN wishes to prescribe a Schedule II opioid. Which agency must have issued the
provider’s DEA number?
,Leigh
A. State Board of Nursing
B. Centers for Medicare & Medicaid Services (CMS)
C. Drug Enforcement Administration (DEA)
D. Food and Drug Administration (FDA)
Correct answer: C
Rationale:
The DEA issues registration numbers that authorize clinicians to prescribe controlled
substances. State boards govern licensure and scope, but a DEA number is needed to legally
prescribe scheduled drugs.
4. Which of the following best reflects best practice regarding prescribing for family
members?
A. It is encouraged to reduce health-care costs.
B. It is acceptable for chronic conditions only.
C. It should be avoided except in true emergencies.
D. It is acceptable if the APRN documents consent.
Correct answer: C
Rationale:
Prescribing for yourself or family members should generally be avoided due to impaired
objectivity, inadequate assessment, and ethical concerns. Exceptions may occur in emergencies
when no other provider is reasonably available.
5. The most important first step in safe prescribing is:
A. Checking insurance coverage
B. Establishing a legitimate provider–patient relationship
C. Choosing the lowest-cost generic option
D. Signing an informed consent form
Correct answer: B
Rationale:
Safe prescribing requires a valid provider–patient relationship, including a thorough history,
,Leigh
examination, and documentation. Without this, any prescription may be considered
inappropriate or illegal.
6. Which factor is least appropriate as the primary basis for choosing a medication?
A. Current clinical guidelines
B. Patient comorbidities
C. Drug–drug interaction profile
D. Pharmaceutical company marketing
Correct answer: D
Rationale:
Evidence-based prescribing relies on guidelines, safety, and patient-specific factors. Marketing
and sales promotions should not drive prescribing decisions.
7. An APRN is choosing an antihypertensive for an older adult on multiple medications. Which
consideration is most critical to review before prescribing?
A. Brand name recognition
B. Potential drug–drug interactions and Beers Criteria
C. How often samples are available
D. Whether the drug is new to the market
Correct answer: B
Rationale:
In older adults, polypharmacy and age-related physiologic changes increase risk of adverse
events. Reviewing interactions and Beers Criteria reduces risk of harm.
8. Which statement about the Beers Criteria is accurate?
A. It is a law that prohibits certain drugs in older adults.
B. It is a guideline listing potentially inappropriate medications in older adults.
C. It only applies to patients in nursing homes.
D. It lists only medications that are absolutely contraindicated after age 65.
Correct answer: B
, Leigh
Rationale:
The Beers Criteria is a guideline, not a law. It highlights drugs that may be potentially
inappropriate in older adults due to higher risk of adverse effects, but individual clinical
decisions still apply.
9. One key outcome of polypharmacy in older adults is:
A. Increased medication adherence
B. Reduced hospitalizations
C. Higher risk of adverse drug events and interactions
D. Lower overall health-care costs
Correct answer: C
Rationale:
Polypharmacy (≥5 medications, often more) increases complexity, confusion, and adverse drug
events, leading to falls, hospitalizations, and higher costs.
10. Which strategy is most effective in reducing polypharmacy?
A. Automatic refill programs
B. “Brown bag” medication review at each visit
C. Using multiple pharmacies
D. Switching to brand-name drugs
Correct answer: B
Rationale:
Asking patients to bring in all medications (“brown bag review”) allows the APRN to identify
duplications, unnecessary drugs, interactions, and nonadherence.
PHARMACOKINETICS & PHARMACODYNAMICS
11. A patient with liver cirrhosis is prescribed a medication that is extensively metabolized
hepatically. Which dosage adjustment is most likely?
