CORRECT ANSWERS 2026
NP Prescriptive authority is regulated by: correct answers >>
Board of Nursing for each state
Factors associated with clinical judgement when prescribing
medications correct answers >> o Best therapy
Least invasive
Least expensive
Least likely to cause adverse reactions
o Clinical judgement in prescribing includes factoring in the cost
to the patient of the medication prescribed
Criteria for choosing an effective drug for a disorder include
correct answers >> consulting nationally recognized guidelines
for disease management
o Consider special populations and that adjustments may need to
be made for this special population
How does Hypoalbeminemia affects the process of prescribing
correct answers >> o Low albumin = more free drug =
increased adverse effects
o When albumin is low, instead of the drug getting to target
tissues, it is floating around leading to toxicity or different effects
o This affects distribution of drugs to target tissue
,Describe First-pass metabolism correct answers >> o Drugs
with a high first-pass metabolism are rapidly metabolized by the
liver and may have little if any desired action
o It is the fraction of a drug lost through the process of absorption
o Concentration of a drug is greatly reduced before it reaches the
systemic circulation
o Greatly reduces the bioavailability of a drug
o Sublingual administration can bypass this first pass metabolism
leading to rapid absorption (faster than oral and rectal
administration)
o Nitro is given SL or topical to avoid the first-pass metabolism
Describe half life correct answers >> o How long it takes for
the drug to be increased or decreased by 50%
Important with meds, especially new meds, because it takes 4-5
half-lives to reach a steady state
o The amount of time it takes for an administered drug to be
halfway cleared from the system
o Digoxin has a half-life of 23-36 hours, because of this, a dose
change could take almost a week to take effect
o Drugs with long half-life are started with a loading dose to
achieve their desired clinical effect more quickly
Examples: amiodarone and azithromycin
• Azithromycin requires the first day's dose to be twice those of
the other four days of the prescription, otherwise known as a
loading dose, in order to rapidly achieve drug levels in the
therapeutic range
Cephalexin is given every 8 hours due to its biological half-life
o You must use the drug half-life to determine the length of need
required between dosage administrations
, Define Onset of action correct answers >> the point in time
on the drug concentration curve that indicates the first sign of a
therapeutic effect
o It is not the best therapeutic effect
Define Peak of action correct answers >> the time between
drug administration and the maximum concentration of a drug in
the blood stream
o The best therapeutic effect
Duration of action correct answers >> the time between the
onset of action and metabolism of drug below the minimum
needed for an effect; the length of time you have the drug in your
system
Describe Peak and trough levels correct answers >> o Used
to determine if a drug is in a therapeutic range
o Monitor toxicity levels
o Used for dosing purposes
o Increased peaks and troughs lead to toxicity
o Aminoglycosides (cephalosporin, gentamycin, vancomycin) and
phenytoin require monitoring of peak and trough levels to avoid
ototoxicity and renal impairment
Steady-state correct answers >> o Amount of drug needed in
the body remains constant
o Is reached when the time of four to five times half life