ADVANCE PHARMACY NR565 MIDTERM EXAM QUESTIONS AND ANSWERS
·· Which schedule drugs can APRNs prescribe? - CORRECT ANSWER✅✅Schedule II-V
· Who determines and regulates prescriptive authority? - CORRECT ANSWER✅✅Nurse practitioner
scope of practice is determined by state practice and licensure laws.
· How does limited prescriptive authority impact patients within the healthcare system? - CORRECT
ANSWER✅✅limited authority creates problems for the patient. The patient is not able to get the care
they need
· What are the key responsibilities of prescribing? - CORRECT ANSWER✅✅1. Be prudent and deliberate
in your decision-making process
2. Have a documented provider-patient relationship with the person for whom you are prescribing
3. Do not prescribe medications for family or friends or for yourself
4. Document a thorough history and physical examination in your records
5.Include any discussions you have with the patient regarding risk factors, side effects, or therapy
options
6. Have a documented plan regarding drug monitoring or titration, if applicable
· What should be used to make prescribing decisions? - CORRECT ANSWER✅✅
Pharmakinetiscs and Pharmodynamics of older adults - CORRECT ANSWER✅✅drug accumulation
secondary to reduced renal function
polypharmacy (the use of five or more medications daily)
greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy
poor patient adherence
,· Beer's Criteria - CORRECT ANSWER✅✅•potentially Inappropriate Medication (PIM) use in older adults
•PIM use in older adults due to medication-disease or medication-syndrome interactions that may
exacerbate the disease or syndrome
•medications to be used cautiously in older adults
•clinically significant drug interactions that should be avoided in older adults
•medications to be avoided or dosage decreased in the presence of impaired kidney function in older
adults (American Geriatric Society Beers Criteria Update Expert Panel, 2019)
CYP450 - CORRECT ANSWER✅✅Many medications are metabolized through the liver enzyme system
called cytochrome P450 (CYP450). Metabolization can be inhibited or induced by drugs and once this
happens drug-drug interactions can occur.
VISA credit card dept Inhibits Spending on CK and GQ - CORRECT ANSWER✅✅Valproate
I-soniazid
S-ulfamids
A-miodarone
C-hloramphenical
Ketoconazole
G-rapefruit Juice
Q-uinidine
CYP450 Inhibitors - CORRECT ANSWER✅✅- Decreases the CYP450 which keeps the medication in your
body longer which can cause toxicity
CYP450 INDUCERS - CORRECT ANSWER✅✅Increase CYP450 to work faster causes
Drugs to leave your body faster.
, Inducers for PY450 Chronic Alcholics Steal Phen Phen and Never Refuse Greasy Carbs - CORRECT
ANSWER✅✅Chronic Alcoholics
St. Johns Wort
Phenytoin
Phenobarbital
Nevirapine
Refiampin
Griseofalvin
Carbamazepine
· What happens when someone has a poor metabolism phenotype? - CORRECT
ANSWER✅✅Metabolizes to slow or to fast.
How is absorption of intramuscular medication different in neonates? - CORRECT ANSWER✅✅•Slow
and erratic due to low blood flow in muscles first few days of life
•Why is absorption of medication in the stomach increased in infancy? - CORRECT ANSWER✅✅Delayed
gastric emptying (adult values reached by 6-8 months)
What are some medications that should be avoided in the pediatric patient? - CORRECT
ANSWER✅✅glucocorticoids, discoloration of developing teeth with tetracyclines, and kernicterus with
sulfonamides
•What should be included in medication administration patient education? - CORRECT ANSWER✅✅1.
dosage size and timing
2. route and technique of administration
3. duration of treatment
4.drug storage
5.nature and time course of desired responses
6. nature and time course of adverse responses
·· Which schedule drugs can APRNs prescribe? - CORRECT ANSWER✅✅Schedule II-V
· Who determines and regulates prescriptive authority? - CORRECT ANSWER✅✅Nurse practitioner
scope of practice is determined by state practice and licensure laws.
· How does limited prescriptive authority impact patients within the healthcare system? - CORRECT
ANSWER✅✅limited authority creates problems for the patient. The patient is not able to get the care
they need
· What are the key responsibilities of prescribing? - CORRECT ANSWER✅✅1. Be prudent and deliberate
in your decision-making process
2. Have a documented provider-patient relationship with the person for whom you are prescribing
3. Do not prescribe medications for family or friends or for yourself
4. Document a thorough history and physical examination in your records
5.Include any discussions you have with the patient regarding risk factors, side effects, or therapy
options
6. Have a documented plan regarding drug monitoring or titration, if applicable
· What should be used to make prescribing decisions? - CORRECT ANSWER✅✅
Pharmakinetiscs and Pharmodynamics of older adults - CORRECT ANSWER✅✅drug accumulation
secondary to reduced renal function
polypharmacy (the use of five or more medications daily)
greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy
poor patient adherence
,· Beer's Criteria - CORRECT ANSWER✅✅•potentially Inappropriate Medication (PIM) use in older adults
•PIM use in older adults due to medication-disease or medication-syndrome interactions that may
exacerbate the disease or syndrome
•medications to be used cautiously in older adults
•clinically significant drug interactions that should be avoided in older adults
•medications to be avoided or dosage decreased in the presence of impaired kidney function in older
adults (American Geriatric Society Beers Criteria Update Expert Panel, 2019)
CYP450 - CORRECT ANSWER✅✅Many medications are metabolized through the liver enzyme system
called cytochrome P450 (CYP450). Metabolization can be inhibited or induced by drugs and once this
happens drug-drug interactions can occur.
VISA credit card dept Inhibits Spending on CK and GQ - CORRECT ANSWER✅✅Valproate
I-soniazid
S-ulfamids
A-miodarone
C-hloramphenical
Ketoconazole
G-rapefruit Juice
Q-uinidine
CYP450 Inhibitors - CORRECT ANSWER✅✅- Decreases the CYP450 which keeps the medication in your
body longer which can cause toxicity
CYP450 INDUCERS - CORRECT ANSWER✅✅Increase CYP450 to work faster causes
Drugs to leave your body faster.
, Inducers for PY450 Chronic Alcholics Steal Phen Phen and Never Refuse Greasy Carbs - CORRECT
ANSWER✅✅Chronic Alcoholics
St. Johns Wort
Phenytoin
Phenobarbital
Nevirapine
Refiampin
Griseofalvin
Carbamazepine
· What happens when someone has a poor metabolism phenotype? - CORRECT
ANSWER✅✅Metabolizes to slow or to fast.
How is absorption of intramuscular medication different in neonates? - CORRECT ANSWER✅✅•Slow
and erratic due to low blood flow in muscles first few days of life
•Why is absorption of medication in the stomach increased in infancy? - CORRECT ANSWER✅✅Delayed
gastric emptying (adult values reached by 6-8 months)
What are some medications that should be avoided in the pediatric patient? - CORRECT
ANSWER✅✅glucocorticoids, discoloration of developing teeth with tetracyclines, and kernicterus with
sulfonamides
•What should be included in medication administration patient education? - CORRECT ANSWER✅✅1.
dosage size and timing
2. route and technique of administration
3. duration of treatment
4.drug storage
5.nature and time course of desired responses
6. nature and time course of adverse responses
