Chapter 1: Prescriptive Authority
1. An APRN works in a urology clinic under the supervision of a physician who does not
restrict the types of medications the APRN is allowed to prescribe. State law does not require
the APRN to practice under physician supervision. How would the APRN’s prescriptive
authority be described?
a. Full authority
b. Independent
c. Without limitation
d. Limited authority
ANS: B
1. Which factors increase the need for APRNs to have full prescriptive authority?
a. More patients will have access to health care.
b. Enrollment in medical schools is predicted to decrease.
c. Physician’s assistants are being utilized less often.
d. APRN education is more complex than education for physicians.
ANS: A
Which factors could be attributed to limited prescriptive authority for APRNs? Select all that apply
e. Inaccessibility of patient care
f. Higher health care costs
g. Higher quality medical treatment
h. Improved collaborative care
i. Enhanced health literacy
ANS: A , B
2. Which aspects support the APRN’s provision for full prescriptive
authority? Select all that apply.
a. Clinical education includes prescription of medications and disease processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN’s ability to provide safe care.
d. Licensure ensures compliance with health care and safety standards.
e. Limiting provision can decrease health care affordability.
ANS: A , C , D
3. Which aspects support the APRN’s provision for full prescriptive
authority? Select all that apply.
a. Clinical education includes prescription of medications and disease processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN’s ability to provide safe care.
d. Licensure ensures compliance with health care and safety standards.
ANS: A , C , D
4. A family nurse practitioner practicing in Maine is hired at a practice across state lines in
, Virginia. Which aspect of practice may change for the APRN?
a. The APRN will have less prescriptive authority in the new position.
b. The APRN will have more prescriptive authority in the new position.
c. The APRN will have equal prescriptive authority in the new position.
d. The APRN’s authority will depend on federal regulations.
ANS: A
Chapter 2: Rational Drug Selection and Prescription Writing
5. How can collaboration with a pharmacist improve positive outcomes for patients?
Select all that apply.
a. Pharmacists can suggest foods that will help with the patient’s condition.
b. Pharmacists have additional information on drug interactions.
c. The pharmacist can suggest adequate medication dosing.
d. Pharmacists have firsthand knowledge of the facility formulary.
e. Pharmacy can alter prescriptions when necessary to prevent patient harm.
ANS: B , C , D
6. A patient presents with delirium tremens requiring Ativan administration. The provider of
care is not in the facility. Which action by the nurse is most appropriate?
a. Obtain a telephone order.
b. Contact the on-call hospitalist.
c. Obtain an order from the charge nurse.
d. Wait for a written Ativan order.
ANS: A
7. A patient with chronic pain calls the provider’s office to request a refill on their oxycontin.
Which action is most appropriate?
a. Fax an order to the pharmacy.
b. Schedule an appointment with the patient.
c. Verify the patient’s adherence to drug regimen.
d. Determine the patient’s current medication dosage.
ANS: B
8. A patient prescribed amoxicillin for streptococcal pharyngitis reports new onset of a flat,
itchy red rash on the chest and neck. Which action is most important?
a. Provide a different prescription.
b. Discontinue the medication.
c. Prescribe an antihistamine cream.
d. Assess for respiratory compromise.
ANS: B
9. A patient taking three medications for hypertension is diagnosed with COPD. Which action
should be taken prior to prescribing medications to treat COPD?
a. Obtain baseline laboratory values.
b. Obtain a complete medication history.
c. Assess liver enzyme levels.
, d. Determine if patient has insurance coverage.
ANS: B
10. A patient with diabetes reports losing their job and an inability to purchase required
medications. Which action is most appropriate?
a. Provide a 7-day sample pack.
b. Decrease the daily dose by half.
c. Contact a different pharmacy.
d. Prescribe a different medication.
ANS: C
11. A patient recently prescribed hydrocodone calls to report they are unable to fill the
prescription. Which factors could contribute to the inability to fill the prescription?
Select all that apply.
a. DEA number missing from prescription
b. Prescription sent via electronic messenger
c. Dose higher than typically prescribed
d. Prescriber license number not included
e. Patient name and date of birth were handwritten
ANS: A , B , D
Chapter 3: Promoting Positive Outcomes of Drug Therapy
12. A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action should be taken first?
a. Ask the patient about the number and frequency of tablets taken.
b. Assess the patient’s headache pain on a scale from 1 to 10.
c. Report the patient’s complaint to the prescriber.
d. Suggest biofeedback as an adjunct to drug therapy.
ANS: A
13. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding
would be most concerning?
a. Recent yeast infection
b. Family history of cervical cancer
c. Drinks two glasses of wine every night
d. Patient is currently unemployed
ANS: C
14. A patient is using a metered-dose inhaler containing albuterol for asthma. The medication
label instructs the patient to administer “two puffs every 4 hours as needed for coughing or
wheezing.” The patient reports feeling jittery sometimes when taking the medication, and she
doesn’t feel that the medication is always effective. Which action is most appropriate?
a. Asking the patient to demonstrate use of the inhaler
b. Assessing the patient’s exposure to tobacco smoke
c. Auscultating lung sounds and obtaining vital signs
, d. Suggesting that the patient use one puff to reduce side effects
ANS: C
15. A patient newly diagnosed with diabetes is to be discharged from the hospital. Which action
should be taken first during medication education?
a. Asking the patient to demonstrate how to measure and administer insulin
b. Discussing methods of storing insulin and discarding syringes
c. Giving information about how diet and exercise affect insulin requirements
d. Teaching the patient about the long-term consequences of poor diabetes control
ANS: A
16. The drug manual states that older adult patients are at increased risk for hepatic side effects.
Which action is most important when prescribing this medication to an 80-year-old patient?
a. Obtain pretreatment laboratory work.
b. Ensure that the drug is given in the correct dose at the correct time to minimize the risk of
adverse effects.
c. Discontinue the order; the drug is contraindicated for this patient.
d. Give the medication intravenously so that the drug does not pass through the liver.
ANS: A
17. A patient recently diagnosed with HIV is prescribed several medications to treat the
condition. Which factors could impact the patient’s adherence to the treatment regimen?
Select all that apply.
a. The patient is uninsured
b. The patient works three part-time jobs
c. The medication regimen includes six different pills
d. Patient has an eighth-grade reading comprehension level
e. Medication regimen requires medication be taken at regular 4-hour intervals.
ANS: A , B , C , E
18. A patient diagnosed with bipolar disorder is prescribed daily lithium. Which action is most
important to determine if the therapeutic level is maintained?
a. Obtain preadministration blood work.
b. Administer medication at regular intervals.
c. Ensure periodic laboratory testing is completed.
d. Assess the patient for adverse effects.
ANS: C
Chapter 4: Pharmacokinetics, Pharmacodynamics, and Drug Interactions
19. The nurse administers naloxone [Narcan] to a patient who has received a toxic dose of
morphine sulfate. The nurse understands that the naloxone is effective because of which
action?
a. Countering the effects of morphine sulfate by agonist actions
b. Increasing the excretion of morphine sulfate by altering serum pH
c. Preventing activation of opioid receptors through antagonist actions
1. An APRN works in a urology clinic under the supervision of a physician who does not
restrict the types of medications the APRN is allowed to prescribe. State law does not require
the APRN to practice under physician supervision. How would the APRN’s prescriptive
authority be described?
a. Full authority
b. Independent
c. Without limitation
d. Limited authority
ANS: B
1. Which factors increase the need for APRNs to have full prescriptive authority?
a. More patients will have access to health care.
b. Enrollment in medical schools is predicted to decrease.
c. Physician’s assistants are being utilized less often.
d. APRN education is more complex than education for physicians.
ANS: A
Which factors could be attributed to limited prescriptive authority for APRNs? Select all that apply
e. Inaccessibility of patient care
f. Higher health care costs
g. Higher quality medical treatment
h. Improved collaborative care
i. Enhanced health literacy
ANS: A , B
2. Which aspects support the APRN’s provision for full prescriptive
authority? Select all that apply.
a. Clinical education includes prescription of medications and disease processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN’s ability to provide safe care.
d. Licensure ensures compliance with health care and safety standards.
e. Limiting provision can decrease health care affordability.
ANS: A , C , D
3. Which aspects support the APRN’s provision for full prescriptive
authority? Select all that apply.
a. Clinical education includes prescription of medications and disease processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN’s ability to provide safe care.
d. Licensure ensures compliance with health care and safety standards.
ANS: A , C , D
4. A family nurse practitioner practicing in Maine is hired at a practice across state lines in
, Virginia. Which aspect of practice may change for the APRN?
a. The APRN will have less prescriptive authority in the new position.
b. The APRN will have more prescriptive authority in the new position.
c. The APRN will have equal prescriptive authority in the new position.
d. The APRN’s authority will depend on federal regulations.
ANS: A
Chapter 2: Rational Drug Selection and Prescription Writing
5. How can collaboration with a pharmacist improve positive outcomes for patients?
Select all that apply.
a. Pharmacists can suggest foods that will help with the patient’s condition.
b. Pharmacists have additional information on drug interactions.
c. The pharmacist can suggest adequate medication dosing.
d. Pharmacists have firsthand knowledge of the facility formulary.
e. Pharmacy can alter prescriptions when necessary to prevent patient harm.
ANS: B , C , D
6. A patient presents with delirium tremens requiring Ativan administration. The provider of
care is not in the facility. Which action by the nurse is most appropriate?
a. Obtain a telephone order.
b. Contact the on-call hospitalist.
c. Obtain an order from the charge nurse.
d. Wait for a written Ativan order.
ANS: A
7. A patient with chronic pain calls the provider’s office to request a refill on their oxycontin.
Which action is most appropriate?
a. Fax an order to the pharmacy.
b. Schedule an appointment with the patient.
c. Verify the patient’s adherence to drug regimen.
d. Determine the patient’s current medication dosage.
ANS: B
8. A patient prescribed amoxicillin for streptococcal pharyngitis reports new onset of a flat,
itchy red rash on the chest and neck. Which action is most important?
a. Provide a different prescription.
b. Discontinue the medication.
c. Prescribe an antihistamine cream.
d. Assess for respiratory compromise.
ANS: B
9. A patient taking three medications for hypertension is diagnosed with COPD. Which action
should be taken prior to prescribing medications to treat COPD?
a. Obtain baseline laboratory values.
b. Obtain a complete medication history.
c. Assess liver enzyme levels.
, d. Determine if patient has insurance coverage.
ANS: B
10. A patient with diabetes reports losing their job and an inability to purchase required
medications. Which action is most appropriate?
a. Provide a 7-day sample pack.
b. Decrease the daily dose by half.
c. Contact a different pharmacy.
d. Prescribe a different medication.
ANS: C
11. A patient recently prescribed hydrocodone calls to report they are unable to fill the
prescription. Which factors could contribute to the inability to fill the prescription?
Select all that apply.
a. DEA number missing from prescription
b. Prescription sent via electronic messenger
c. Dose higher than typically prescribed
d. Prescriber license number not included
e. Patient name and date of birth were handwritten
ANS: A , B , D
Chapter 3: Promoting Positive Outcomes of Drug Therapy
12. A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action should be taken first?
a. Ask the patient about the number and frequency of tablets taken.
b. Assess the patient’s headache pain on a scale from 1 to 10.
c. Report the patient’s complaint to the prescriber.
d. Suggest biofeedback as an adjunct to drug therapy.
ANS: A
13. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding
would be most concerning?
a. Recent yeast infection
b. Family history of cervical cancer
c. Drinks two glasses of wine every night
d. Patient is currently unemployed
ANS: C
14. A patient is using a metered-dose inhaler containing albuterol for asthma. The medication
label instructs the patient to administer “two puffs every 4 hours as needed for coughing or
wheezing.” The patient reports feeling jittery sometimes when taking the medication, and she
doesn’t feel that the medication is always effective. Which action is most appropriate?
a. Asking the patient to demonstrate use of the inhaler
b. Assessing the patient’s exposure to tobacco smoke
c. Auscultating lung sounds and obtaining vital signs
, d. Suggesting that the patient use one puff to reduce side effects
ANS: C
15. A patient newly diagnosed with diabetes is to be discharged from the hospital. Which action
should be taken first during medication education?
a. Asking the patient to demonstrate how to measure and administer insulin
b. Discussing methods of storing insulin and discarding syringes
c. Giving information about how diet and exercise affect insulin requirements
d. Teaching the patient about the long-term consequences of poor diabetes control
ANS: A
16. The drug manual states that older adult patients are at increased risk for hepatic side effects.
Which action is most important when prescribing this medication to an 80-year-old patient?
a. Obtain pretreatment laboratory work.
b. Ensure that the drug is given in the correct dose at the correct time to minimize the risk of
adverse effects.
c. Discontinue the order; the drug is contraindicated for this patient.
d. Give the medication intravenously so that the drug does not pass through the liver.
ANS: A
17. A patient recently diagnosed with HIV is prescribed several medications to treat the
condition. Which factors could impact the patient’s adherence to the treatment regimen?
Select all that apply.
a. The patient is uninsured
b. The patient works three part-time jobs
c. The medication regimen includes six different pills
d. Patient has an eighth-grade reading comprehension level
e. Medication regimen requires medication be taken at regular 4-hour intervals.
ANS: A , B , C , E
18. A patient diagnosed with bipolar disorder is prescribed daily lithium. Which action is most
important to determine if the therapeutic level is maintained?
a. Obtain preadministration blood work.
b. Administer medication at regular intervals.
c. Ensure periodic laboratory testing is completed.
d. Assess the patient for adverse effects.
ANS: C
Chapter 4: Pharmacokinetics, Pharmacodynamics, and Drug Interactions
19. The nurse administers naloxone [Narcan] to a patient who has received a toxic dose of
morphine sulfate. The nurse understands that the naloxone is effective because of which
action?
a. Countering the effects of morphine sulfate by agonist actions
b. Increasing the excretion of morphine sulfate by altering serum pH
c. Preventing activation of opioid receptors through antagonist actions
