Edmund's Pharmacology Mid-term
Which of the following has influenced an emphasis on primary care education in medical schools? -
(correct Answer) - Changes in Medicare reimbursement methods recommended in 1992
Which of the following statements is true about the prescribing practices of physicians? - (correct
Answer) - The dominant form of drug information used by primary care physicians continues to be that
provided by pharmaceutical companies
As primary care nurse practitioners (NPs) continue to develop their role as prescribers of medications, it
will be important to: - (correct Answer) - learn from the experiences of physicians and develop expertise
based on evidence-based practice.
A primary care NP will begin practicing in a state in which the governor has opted out of the federal
facility reimbursement requirement. The NP should be aware that this defines how NPs may write
prescriptions: - (correct Answer) - as CRNAs without physician supervision in a hospital setting.
CRNAs in most states: - (correct Answer) - order and administer controlled substances but do not have
full prescriptive authority.
A CNM: - (correct Answer) - has prescriptive authority in all 50 states.
In every state, prescriptive authority for NPs includes the ability to write prescriptions: - (correct Answer)
- for specified classifications of medications.
The current trend toward transitioning NP programs to the doctoral level will mean that: - (correct
Answer) - NPs will be better prepared to meet emerging health care needs of patients.
An important difference between physician assistants (PAs) and NPs is PAs: - (correct Answer) - always
work under physician supervision.
To increase the likelihood of successful pharmacotherapy, when teaching a patient about using a
medication, the primary care nurse practitioner (NP) should: - (correct Answer) - encourage the patient
to participate in the choice of the medication.
A patient has recurrent symptoms and tells the primary care NP that she can't remember to take her
medication all the time. The NP should: - (correct Answer) - ask her about her lifestyle, her schedule, and
her understanding of her condition.
A primary care NP prepares to teach a patient about the management of a chronic condition. The patient
says, "I don't want to know all of that. Just tell me what to take and when." The NP should initially: -
(correct Answer) - give the patient basic written instructions about medications, follow up visits, and
symptoms.
A parent brings a child who has moderate-persistent asthma to the clinic and tells the primary care NP
,that none of the child's medications are working. The parent says, "Everybody tells me something
different. I don't know what to do." The NP suspects that the parent is not administering the medications
appropriately. The NP should initially: - (correct Answer) - perform a careful history of the child's
symptoms and the medications that are given.
A primary care NP sees a 5-year-old child who is morbidly obese. The child has an elevated hemoglobin
A1c and increased lipid levels. Both of the child's parents are overweight but not obese, and they tell the
NP that they see nothing wrong with their child. They both state that it is difficult to refuse their child's
requests for soda or ice cream. The NP should: - (correct Answer) - initiate a dialogue with the parents
about the implications of the child's laboratory values.
A patient bursts into tears when the primary care NP diagnoses diabetes. The NP should: - (correct
Answer) - ask the patient about past experiences with anyone who has this diagnosis.
A primary care NP writes a prescription for an off-label use for a drug. To help ensure compliance, the NP
should: - (correct Answer) - include information about the off-label use on the E-script
The primary care nurse practitioner (NP) writes a prescription for an antibiotic using an electronic drug
prescription system. The pharmacist will fill this prescription when: - (correct Answer) - the electronic
prescription is received.
When prescribing a medication for a chronic condition, the primary care NP should tell the patient: -
(correct Answer) - about the frequency of clinic visits necessary for the number of refills authorized.
The neighbor of a primary care NP asks the NP to write a prescription for an antibiotic. The NP should tell
the neighbor: - (correct Answer) - that it is best if the neighbor sees a health care provider before
obtaining a prescription.
The primary care NP is prescribing a medication for an off-label use. To help prevent a medication error,
the NP should: - (correct Answer) - write "off-label use" on the prescription and provide a rationale.
The primary care NP sees a patient covered by Medicaid, writes a prescription for a medication, and is
informed by the pharmacist that the medication is "off-formulary." The NP should: - (correct Answer) -
write the prescription for a generic drug if it meets the patient's needs.
A patient who has asthma and who is known to the primary care NP calls the NP after hours and asks for
a refill of an albuterol metered-dose inhaler. The patient has not been seen in the clinic for more than a
year. The NP should: - (correct Answer) - refill the drug and tell the patient that an office visit is necessary
for further refills.
A patient who has chronic pain and who takes oxycodone (Percodan) calls the clinic to ask for a refill of
the medication. The primary care NP notes that the medication refill is not due for 2 weeks. The patient
tells the NP that the refill is needed because he is going out of town. The NP should: - (correct Answer) -
review the patient's chart to see if this is a one-time or repeat occurrence.
The primary care nurse practitioner (NP) is using critical thinking skills when: - (correct Answer) -
analyzing current research and synthesizing new approaches to patient care.
The primary care NP has referred a child who has significant gastrointestinal reflux disease to a specialist
for consideration for a fundoplication and gastrostomy tube placement. The child's weight is 80% of
, what is recommended for age, and a recent swallow study revealed significant risk for aspiration. The
child's parents do not want the procedure. The NP should: - (correct Answer) - initiate a discussion with
the parents about the potential outcomes of each possible action.
The primary care NP prescribes an inhaled corticosteroid for a patient who has asthma. The third-party
payer for this patient denies coverage for the brand that comes in the specific strength the NP
prescribes. The NP should: - (correct Answer) - order the closest formulary-approved approximation of
the drug and monitor effectiveness.
A patient takes a cardiac medication that has a very narrow therapeutic range. The primary care NP
learns that the particular brand the patient is taking is no longer covered by the patient's medical plan.
The NP knows that the bioavailability of the drug varies from brand to brand. The NP should: - (correct
Answer) - contact the insurance provider to explain why this particular formulation is necessary.
A patient comes to the clinic reporting dizziness and fatigue associated with nausea and vomiting. The
primary care NP suspects anemia and orders a complete blood count. The patient's hemoglobin is
elevated. The NP correctly concludes that the patient is not anemic. The NP has made an error in: -
(correct Answer) - hypothesis triggering and information processing.
A patient comes to the clinic with a 2-day history of cough and wheezing. The patient has no previous
history of asthma. The patient reports having heartburn for several months, which has worsened
considerably. The primary care NP makes a diagnosis of asthma and orders oral steroids and inhaled
albuterol. The patient's condition worsens, and a chest radiograph obtained 2 days later shows bilateral
infiltrates. The NP has failed to: - (correct Answer) - confirm the diagnosis.
A patient comes to the clinic and asks the primary care NP about using a newly developed formulation of
the drug the patient has been taking for a year. When deciding whether or not to prescribe this
formulation, the NP should: - (correct Answer) - tell the patient that when postmarketing data is
available, it will be considered.
The primary care NP is reviewing evidence-based recommendations about the off-label use of a
particular drug. Which recommendation should influence the NP's decision about prescribing the
medication? - (correct Answer) - Data from randomized, experimental studies
A primary care NP is developing a clinical practice guideline for management of a patient population in a
midsized suburban hospital. The NP should: - (correct Answer) - review expert opinion and experimental,
anecdotal, correlational study data.
A primary care nurse practitioner (NP) prescribes a drug to an 80-year-old African-American woman.
When selecting a drug and determining the correct dose, the NP should understand that the knowledge
of how age, race, and gender may affect drug excretion is based on an understanding of: - (correct
Answer) - pharmacokinetics.
A patient asks the primary care NP which medication to use for mild to moderate pain. The NP should
recommend:
a. APAP.
b. Tylenol.
Which of the following has influenced an emphasis on primary care education in medical schools? -
(correct Answer) - Changes in Medicare reimbursement methods recommended in 1992
Which of the following statements is true about the prescribing practices of physicians? - (correct
Answer) - The dominant form of drug information used by primary care physicians continues to be that
provided by pharmaceutical companies
As primary care nurse practitioners (NPs) continue to develop their role as prescribers of medications, it
will be important to: - (correct Answer) - learn from the experiences of physicians and develop expertise
based on evidence-based practice.
A primary care NP will begin practicing in a state in which the governor has opted out of the federal
facility reimbursement requirement. The NP should be aware that this defines how NPs may write
prescriptions: - (correct Answer) - as CRNAs without physician supervision in a hospital setting.
CRNAs in most states: - (correct Answer) - order and administer controlled substances but do not have
full prescriptive authority.
A CNM: - (correct Answer) - has prescriptive authority in all 50 states.
In every state, prescriptive authority for NPs includes the ability to write prescriptions: - (correct Answer)
- for specified classifications of medications.
The current trend toward transitioning NP programs to the doctoral level will mean that: - (correct
Answer) - NPs will be better prepared to meet emerging health care needs of patients.
An important difference between physician assistants (PAs) and NPs is PAs: - (correct Answer) - always
work under physician supervision.
To increase the likelihood of successful pharmacotherapy, when teaching a patient about using a
medication, the primary care nurse practitioner (NP) should: - (correct Answer) - encourage the patient
to participate in the choice of the medication.
A patient has recurrent symptoms and tells the primary care NP that she can't remember to take her
medication all the time. The NP should: - (correct Answer) - ask her about her lifestyle, her schedule, and
her understanding of her condition.
A primary care NP prepares to teach a patient about the management of a chronic condition. The patient
says, "I don't want to know all of that. Just tell me what to take and when." The NP should initially: -
(correct Answer) - give the patient basic written instructions about medications, follow up visits, and
symptoms.
A parent brings a child who has moderate-persistent asthma to the clinic and tells the primary care NP
,that none of the child's medications are working. The parent says, "Everybody tells me something
different. I don't know what to do." The NP suspects that the parent is not administering the medications
appropriately. The NP should initially: - (correct Answer) - perform a careful history of the child's
symptoms and the medications that are given.
A primary care NP sees a 5-year-old child who is morbidly obese. The child has an elevated hemoglobin
A1c and increased lipid levels. Both of the child's parents are overweight but not obese, and they tell the
NP that they see nothing wrong with their child. They both state that it is difficult to refuse their child's
requests for soda or ice cream. The NP should: - (correct Answer) - initiate a dialogue with the parents
about the implications of the child's laboratory values.
A patient bursts into tears when the primary care NP diagnoses diabetes. The NP should: - (correct
Answer) - ask the patient about past experiences with anyone who has this diagnosis.
A primary care NP writes a prescription for an off-label use for a drug. To help ensure compliance, the NP
should: - (correct Answer) - include information about the off-label use on the E-script
The primary care nurse practitioner (NP) writes a prescription for an antibiotic using an electronic drug
prescription system. The pharmacist will fill this prescription when: - (correct Answer) - the electronic
prescription is received.
When prescribing a medication for a chronic condition, the primary care NP should tell the patient: -
(correct Answer) - about the frequency of clinic visits necessary for the number of refills authorized.
The neighbor of a primary care NP asks the NP to write a prescription for an antibiotic. The NP should tell
the neighbor: - (correct Answer) - that it is best if the neighbor sees a health care provider before
obtaining a prescription.
The primary care NP is prescribing a medication for an off-label use. To help prevent a medication error,
the NP should: - (correct Answer) - write "off-label use" on the prescription and provide a rationale.
The primary care NP sees a patient covered by Medicaid, writes a prescription for a medication, and is
informed by the pharmacist that the medication is "off-formulary." The NP should: - (correct Answer) -
write the prescription for a generic drug if it meets the patient's needs.
A patient who has asthma and who is known to the primary care NP calls the NP after hours and asks for
a refill of an albuterol metered-dose inhaler. The patient has not been seen in the clinic for more than a
year. The NP should: - (correct Answer) - refill the drug and tell the patient that an office visit is necessary
for further refills.
A patient who has chronic pain and who takes oxycodone (Percodan) calls the clinic to ask for a refill of
the medication. The primary care NP notes that the medication refill is not due for 2 weeks. The patient
tells the NP that the refill is needed because he is going out of town. The NP should: - (correct Answer) -
review the patient's chart to see if this is a one-time or repeat occurrence.
The primary care nurse practitioner (NP) is using critical thinking skills when: - (correct Answer) -
analyzing current research and synthesizing new approaches to patient care.
The primary care NP has referred a child who has significant gastrointestinal reflux disease to a specialist
for consideration for a fundoplication and gastrostomy tube placement. The child's weight is 80% of
, what is recommended for age, and a recent swallow study revealed significant risk for aspiration. The
child's parents do not want the procedure. The NP should: - (correct Answer) - initiate a discussion with
the parents about the potential outcomes of each possible action.
The primary care NP prescribes an inhaled corticosteroid for a patient who has asthma. The third-party
payer for this patient denies coverage for the brand that comes in the specific strength the NP
prescribes. The NP should: - (correct Answer) - order the closest formulary-approved approximation of
the drug and monitor effectiveness.
A patient takes a cardiac medication that has a very narrow therapeutic range. The primary care NP
learns that the particular brand the patient is taking is no longer covered by the patient's medical plan.
The NP knows that the bioavailability of the drug varies from brand to brand. The NP should: - (correct
Answer) - contact the insurance provider to explain why this particular formulation is necessary.
A patient comes to the clinic reporting dizziness and fatigue associated with nausea and vomiting. The
primary care NP suspects anemia and orders a complete blood count. The patient's hemoglobin is
elevated. The NP correctly concludes that the patient is not anemic. The NP has made an error in: -
(correct Answer) - hypothesis triggering and information processing.
A patient comes to the clinic with a 2-day history of cough and wheezing. The patient has no previous
history of asthma. The patient reports having heartburn for several months, which has worsened
considerably. The primary care NP makes a diagnosis of asthma and orders oral steroids and inhaled
albuterol. The patient's condition worsens, and a chest radiograph obtained 2 days later shows bilateral
infiltrates. The NP has failed to: - (correct Answer) - confirm the diagnosis.
A patient comes to the clinic and asks the primary care NP about using a newly developed formulation of
the drug the patient has been taking for a year. When deciding whether or not to prescribe this
formulation, the NP should: - (correct Answer) - tell the patient that when postmarketing data is
available, it will be considered.
The primary care NP is reviewing evidence-based recommendations about the off-label use of a
particular drug. Which recommendation should influence the NP's decision about prescribing the
medication? - (correct Answer) - Data from randomized, experimental studies
A primary care NP is developing a clinical practice guideline for management of a patient population in a
midsized suburban hospital. The NP should: - (correct Answer) - review expert opinion and experimental,
anecdotal, correlational study data.
A primary care nurse practitioner (NP) prescribes a drug to an 80-year-old African-American woman.
When selecting a drug and determining the correct dose, the NP should understand that the knowledge
of how age, race, and gender may affect drug excretion is based on an understanding of: - (correct
Answer) - pharmacokinetics.
A patient asks the primary care NP which medication to use for mild to moderate pain. The NP should
recommend:
a. APAP.
b. Tylenol.
