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NR 565 MIDTERM EXAM 2025 | ADVANCED PHARMACOLOGY | ALL QUESTIONS AND CORRECT ANSWERS, EXAMS OF PHARMACOLOGY

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NR 565 MIDTERM EXAM 2025 | ADVANCED PHARMACOLOGY | ALL QUESTIONS AND CORRECT ANSWERS, EXAMS OF PHARMACOLOGY What are some potential problems that arise with written prescriptions? - ANSWER-Must contain all elements May have pre-populated information Write legibly Avoid error prone abbreviations Tamper resistant scripts are often required Reasons for monitoring drug therapy - ANSWER-determining therapeutic dosage evaluating medication adequacy identifying adverse effects serious or life-threatening risks. Which schedules of drugs can APRNs prescribe? - ANSWER-depends on state - most II-V How does limited prescriptive authority impact patients within the healthcare system? - ANSWER-longer wait times to sign a prescription limits practitioners that are needed in rural areas unequal relationships between providers. Ex. one has more power high need for providers due to lack of providers and high amounts of patients. Independent practitioners= more patients being seen= lessens the patient/provider load Provider key responsibilities when prescribing? - ANSWER-safe and competent practice understanding of the drugs, reactions, and pharmacology 2 | P a g e Be aware of the age group you are prescribing to Ex. Children vs older adults What should be used to make prescribing decisions? - ANSWER-documented provider-patient relationship, not prescribing for family or friends, documenting a thorough H&P, including discussions with the patient, drug monitoring/titrating. cost, guidelines, availability, interactions, side effects, allergies, hepatic and renal function, need for monitoring, and special populations What happens when someone has a poor metabolism phenotype? - ANSWER-medications metabolized slower, medication might not work or put them at risk for side-effects What does the US food and drug administration regulate when it comes to medications? - ANSWER-Whether the drug is safe, effective, and benefits of a drug outweigh the risks reasons for medication non-adherence - ANSWER-patients never filling/refilling prescriptions (resulting in therapeutic failure) multiple chronic disorders multiple prescription medications multiple doses per day for each medication drug packaging that is difficult to open multiple prescribers changes in the regimen (adding meds, changes in dose or timing) cognitive or physical impairment (reduction in memory, hearing, visual, color, or manual dexterity) living alone recent discharge from hospital low literacy 3 | P a g e inability to pay for meds personal conviction that a drug is unnecessary or the dosage is too high presence of side effects Which statements are possible reasons for medication non-adherence? - ANSWER-"I tried to take for weeks and it just wasn't working" "It was so expensive I only took it once a day instead of twice" "I dropped the whole medication bottle on the floor" "I was traveling and busy" "I lost the medication level" "I ran out" "I couldn't remember if I took it this morning and sometimes I just forget" What are black box warnings? - ANSWER-Is the strongest safety warning a drug can carry and still remain on the market. Usually presented on the label with a heavy black border. Why are black box warnings issued? - ANSWER-Issued by the FDA due to having serious or life threatening risks What is neonate and infant drug dosing based on? - ANSWER-weight or body surface area (BSA) After age one what happens to pharmacokinetic parameters, including drug sensitivity? - ANSWER-mirror adult parameters Children under two have fast metabolism - ANSWER-true

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NR 565 MIDTERM EXAM 2025 | ADVANCED PHARMACOLOGY |
ALL QUESTIONS AND CORRECT ANSWERS, EXAMS OF
PHARMACOLOGY
What are some potential problems that arise with written prescriptions? - ANSWER-Must
contain all elements

May have pre-populated information

Write legibly

Avoid error prone abbreviations

Tamper resistant scripts are often required



Reasons for monitoring drug therapy - ANSWER-determining therapeutic dosage

evaluating medication adequacy

identifying adverse effects

serious or life-threatening risks.



Which schedules of drugs can APRNs prescribe? - ANSWER-depends on state - most II-V



How does limited prescriptive authority impact patients within the healthcare system? -
ANSWER-longer wait times to sign a prescription

limits practitioners that are needed in rural areas

unequal relationships between providers. Ex. one has more power

high need for providers due to lack of providers and high amounts of patients.

Independent practitioners= more patients being seen= lessens the patient/provider load



Provider key responsibilities when prescribing? - ANSWER-safe and competent practice

understanding of the drugs, reactions, and pharmacology

,2|Page


Be aware of the age group you are prescribing to

Ex. Children vs older adults



What should be used to make prescribing decisions? - ANSWER-documented provider-patient
relationship, not prescribing for family or friends, documenting a thorough H&P, including
discussions with the patient, drug monitoring/titrating.

cost, guidelines, availability, interactions, side effects, allergies, hepatic and renal function, need
for monitoring, and special populations



What happens when someone has a poor metabolism phenotype? - ANSWER-medications
metabolized slower, medication might not work or put them at risk for side-effects



What does the US food and drug administration regulate when it comes to medications? -
ANSWER-Whether the drug is safe, effective, and benefits of a drug outweigh the risks



reasons for medication non-adherence - ANSWER-patients never filling/refilling prescriptions
(resulting in therapeutic failure)

multiple chronic disorders

multiple prescription medications

multiple doses per day for each medication

drug packaging that is difficult to open

multiple prescribers

changes in the regimen (adding meds, changes in dose or timing)

cognitive or physical impairment (reduction in memory, hearing, visual, color, or manual
dexterity)

living alone

recent discharge from hospital

low literacy

,3|Page


inability to pay for meds

personal conviction that a drug is unnecessary or the dosage is too high

presence of side effects



Which statements are possible reasons for medication non-adherence? - ANSWER-"I tried to
take for weeks and it just wasn't working"

"It was so expensive I only took it once a day instead of twice"

"I dropped the whole medication bottle on the floor"

"I was traveling and busy"

"I lost the medication level"

"I ran out"

"I couldn't remember if I took it this morning and sometimes I just forget"



What are black box warnings? - ANSWER-Is the strongest safety warning a drug can carry and
still remain on the market. Usually presented on the label with a heavy black border.



Why are black box warnings issued? - ANSWER-Issued by the FDA due to having serious or life-
threatening risks



What is neonate and infant drug dosing based on? - ANSWER-weight or body surface area (BSA)



After age one what happens to pharmacokinetic parameters, including drug sensitivity? -
ANSWER-mirror adult parameters



Children under two have fast metabolism - ANSWER-true

, 4|Page


How is absorption of transdermal medications different in neonates? - ANSWER-more rapid and
complete in infants than in older children and adults. the skin is very thin and blood flow is great
in infants



How is absorption of oral medications different in neonates? - ANSWER-absorption may be
enhanced or impeded depending on the properties of the drug. gastric emptying is irregular,
drugs absrobed in the intestine are absorbed slower.



Common fears with genetic testing - ANSWER-Lack of education - many health care providers do
not possess the knowledge or comfort to interpret the tesgin

financial cost - many insurance plans do not cover this. cost can be from $100-2000.

discrimination from employers, insurance companies or providers



12 CDC guidelines for prescribing opioids - ANSWER-Opioids are not first line therapy

establish goals for pain and function

Discuss risks and benefits

Use immediate release opioids when starting

Use the lowest effective dose

Prescribe short durations for acute pain

Evaluate benefits and harms frequently

Use strategies to migrate risk

Review PDMP data

Use urine drug testing

Avoid concurrent opioid and benzo prescribing

Offer treatment for opioid use disorder



Pure opioid agonist - ANSWER-activate opioid receptors in brain resulting in opioid effect

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