Edmund's Pharmacology Mid-term
1. Which of the following has influenced an emphasis on primary care
education in medical schools?: Changes in Medicare reimbursement methods
recommended in 1992
2. Which of the following statements is true about the prescribing practices
of physicians?: The dominant form of drug information used by primary care
physicians continues to be that provided by pharmaceutical companies
3. As primary care nurse practitioners (NPs) continue to develop their role as
prescribers of medications, it will be important to:: learn from the experiences
of physicians and develop expertise based on evidence-based practice.
4. 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:: as CRNAs
without physician supervision in a hospital setting.
5. CRNAs in most states:: order and administer controlled substances but do not
have full prescriptive authority.
6. A CNM:: has prescriptive authority in all 50 states.
7. In every state, prescriptive authority for NPs includes the ability to write
prescriptions:: for specified classifications of medications.
8. The current trend toward transitioning NP programs to the doctoral level
will mean that:: NPs will be better prepared to meet emerging health care needs
of patients.
9. An important difference between physician assistants (PAs) and NPs is
PAs:: always work under physician supervision.
10. To increase the likelihood of successful pharmacotherapy, when
teaching a patient about using a medication, the primary care nurse
practitioner (NP) should:: encourage the patient to participate in the choice of
the medication.
11. 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:: ask her
about her lifestyle, her schedule, and her understanding of her condition.
12. 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:: give the patient basic
written instructions about medications, follow up visits, and symptoms.
13. 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:: perform a careful history
of the child's symptoms and the medications that are given.
14 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:: initiate a
dialogue with the parents about the implications of the child's laboratory values.
15. A patient bursts into tears when the primary care NP diagnoses diabetes.
The NP should:: ask the patient about past experiences with anyone who has this
diagnosis.
16. A primary care NP writes a prescription for an off-label use for a drug. To
help ensure compliance, the NP should:: include information about the off-label
use on the E-script
17. 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:: the electronic prescription is received.
18. When prescribing a medication for a chronic condition, the primary care
NP should tell the patient:: about the frequency of clinic visits necessary for the
number of refills authorized.
19. The neighbor of a primary care NP asks the NP to write a prescription for
an antibiotic. The NP should tell the neighbor:: that it is best if the neighbor sees
a health care provider before obtaining a prescription.
20. The primary care NP is prescribing a medication for an off-label use. To
help prevent a medication error, the NP should:: write "off-label use" on the
prescription and provide a rationale.
21. 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:: write the prescription for a
generic drug if it meets the patient's needs.
22. 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:: refill the drug and tell the patient that an office visit is necessary for further
refills.
23. 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:: review
the patient's chart to see if this is a one-time or repeat occurrence.
24 The primary care nurse practitioner (NP) is using critical thinking skills
when:: analyzing current research and synthesizing new approaches to patient
care.
25. 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:: initiate a discussion with the parents about the potential outcomes of each
possible action. 26. 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:: order the closest formulary-approved approximation of the drug
and monitor effectiveness.
27. 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::
contact the insurance provider to explain why this particular formulation is
necessary.
28. 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:: hypothesis triggering and information processing.
29. 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:: confirm the
diagnosis.
30. 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
1. Which of the following has influenced an emphasis on primary care
education in medical schools?: Changes in Medicare reimbursement methods
recommended in 1992
2. Which of the following statements is true about the prescribing practices
of physicians?: The dominant form of drug information used by primary care
physicians continues to be that provided by pharmaceutical companies
3. As primary care nurse practitioners (NPs) continue to develop their role as
prescribers of medications, it will be important to:: learn from the experiences
of physicians and develop expertise based on evidence-based practice.
4. 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:: as CRNAs
without physician supervision in a hospital setting.
5. CRNAs in most states:: order and administer controlled substances but do not
have full prescriptive authority.
6. A CNM:: has prescriptive authority in all 50 states.
7. In every state, prescriptive authority for NPs includes the ability to write
prescriptions:: for specified classifications of medications.
8. The current trend toward transitioning NP programs to the doctoral level
will mean that:: NPs will be better prepared to meet emerging health care needs
of patients.
9. An important difference between physician assistants (PAs) and NPs is
PAs:: always work under physician supervision.
10. To increase the likelihood of successful pharmacotherapy, when
teaching a patient about using a medication, the primary care nurse
practitioner (NP) should:: encourage the patient to participate in the choice of
the medication.
11. 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:: ask her
about her lifestyle, her schedule, and her understanding of her condition.
12. 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:: give the patient basic
written instructions about medications, follow up visits, and symptoms.
13. 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:: perform a careful history
of the child's symptoms and the medications that are given.
14 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:: initiate a
dialogue with the parents about the implications of the child's laboratory values.
15. A patient bursts into tears when the primary care NP diagnoses diabetes.
The NP should:: ask the patient about past experiences with anyone who has this
diagnosis.
16. A primary care NP writes a prescription for an off-label use for a drug. To
help ensure compliance, the NP should:: include information about the off-label
use on the E-script
17. 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:: the electronic prescription is received.
18. When prescribing a medication for a chronic condition, the primary care
NP should tell the patient:: about the frequency of clinic visits necessary for the
number of refills authorized.
19. The neighbor of a primary care NP asks the NP to write a prescription for
an antibiotic. The NP should tell the neighbor:: that it is best if the neighbor sees
a health care provider before obtaining a prescription.
20. The primary care NP is prescribing a medication for an off-label use. To
help prevent a medication error, the NP should:: write "off-label use" on the
prescription and provide a rationale.
21. 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:: write the prescription for a
generic drug if it meets the patient's needs.
22. 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:: refill the drug and tell the patient that an office visit is necessary for further
refills.
23. 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:: review
the patient's chart to see if this is a one-time or repeat occurrence.
24 The primary care nurse practitioner (NP) is using critical thinking skills
when:: analyzing current research and synthesizing new approaches to patient
care.
25. 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:: initiate a discussion with the parents about the potential outcomes of each
possible action. 26. 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:: order the closest formulary-approved approximation of the drug
and monitor effectiveness.
27. 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::
contact the insurance provider to explain why this particular formulation is
necessary.
28. 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:: hypothesis triggering and information processing.
29. 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:: confirm the
diagnosis.
30. 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
