NR565 / NR 565 Midterm Exam Study
Guide (Latest 2026 UPDATED): Advanced
Pharmacology
Rules for prescribing schedule II drugs - ANSWER✔✔written in ink, can
write in emergency cases but must submit within 72 hour, no refills,
can have multiple scripts by different MDs
Depends on state
Which drugs are high risk in pregnancy with RA? -
ANSWER✔✔methotrexate
leflunomide
biologics: anti-TNF agents, rituximab and abatacept (end in -mab)
Which drugs are safe for pregnancy with RA ? - ANSWER✔✔NSAIDs
corticosteroids, plus several DMARDs, including sulfasalazine and
hydroxychloroquine
NSAID black box warning - ANSWER✔✔NSAIDs may increase the risk
for myocardial infarction, stroke, and other thromboembolic events.
NSAIDs increase the risk for dangerous gastrointestinal adverse
effects such as bleeding, ulceration, and perforation.
Drug interactions with Allopurinol - ANSWER✔✔Mercaptopurine and
azathioprine (immunosuppressants)
,warfarin
Theophylline
Ampicillin
therapeutic response for methotrexate - ANSWER✔✔ If you are taking
methotrexate to treat rheumatoid arthritis, it may take 3 to 6 weeks
for your symptoms to begin to improve, and 12 weeks or longer for
you to feel the full benefit of methotrexate. Continue to take
methotrexate even if you feel well.
adverse effects for bisphosphonates - ANSWER✔✔osteonecrosis of the
jaw and hip fracture, Esophagitis
When are bisphosphonates contraindicated? - ANSWER✔✔esophageal
disorders
cr below 30 -35
therapeutic action of NSAIDS - ANSWER✔✔relieve pain/discomfort,
reduce inflammation, and bring down a high temperature.
MOA NSAIDS - ANSWER✔✔inhibition of the enzyme cyclooxygenase
(COX), decreased synthesis of prostaglandins
Women who have hypertension and osteoporosis should be prescribed
which antihypertensive? - ANSWER✔✔thiazide diuretic
Drug interactions with NSAIDS - ANSWER✔✔other NSAIDS, alcohol,
,warfarin (blood thinners), ACE inhibitors and diuretics
APRN prescribing role - ANSWER✔✔Prescriptive authority for nurse
practitioners also regulates prescribing rights beyond medications and
controlled substances. These rights include therapeutic devices and
services and are outlined in state practice laws and regulations and
include Durable Medical Equipment (DME) such as wheelchairs, power
scooters, hospital beds, portable oxygen equipment, handicap
placards, etc. and medical services such as Physical Therapy (PT),
Occupational Therapy (OT), home health services, etc. Prescriptive
authority encompasses more than writing a prescription correctly. It
requires adherence to ethical guidelines to ensure that patients are
safeguarded from harm. Ethical prescribing starts with being well-
informed about medications. Mechanism of action, efficacy, and safety
are important considerations, as are a patient's distinct needs and
circumstances, including the number of medications prescribed
(Mitchell & Oliphant, 2016). Most patients receiving a prescription are
taking other medications, whether prescription or over-the-counter.
Appropriate selection, dosing, and duration of pharmaceutical agents
are key to maximizing outcomes and minimizing adverse effects
benefits of full practice authority - ANSWER✔✔Nurse practitioners
have the autonomy to evaluate patients, diagnose, order and interpret
tests, initiate and manage treatments and prescribe medications,
including controlled substances without physician oversight
promoting positive outcomes through prudent prescribing practices -
ANSWER✔✔Administemedications and ring prescribing medications
are two distinct processes. Prescription writing requires prudent and
deliberate decision-making processes to maintain patient safety and
reduce liability, including:
, *documentation of a provider-patient relationship for the recipient of
the prescribed medications
*documentation of a thorough history and physical examination for
the recipient
*documentation of discussions regarding risk factors, side effects, or
therapy options
*documentation of drug monitoring or titration plan, if applicable
*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the
formulation of a diagnosis based on clinical reasoning and the
selection and monitoring of the most appropriate pharmacological
treatment
Considerations include: Cost, guidelines, availability, interactions, side
effects, allergies, hepatic/renal functions, need for monitoring, &
special populations
Beer's Criteria - ANSWER✔✔identifies drugs with a high likelihood of
causing adverse effects in older adults. Accordingly, drugs on this list
should generally be avoided in adults older than 65 years except
when the benefits are significantly greater than the risks.
Guide (Latest 2026 UPDATED): Advanced
Pharmacology
Rules for prescribing schedule II drugs - ANSWER✔✔written in ink, can
write in emergency cases but must submit within 72 hour, no refills,
can have multiple scripts by different MDs
Depends on state
Which drugs are high risk in pregnancy with RA? -
ANSWER✔✔methotrexate
leflunomide
biologics: anti-TNF agents, rituximab and abatacept (end in -mab)
Which drugs are safe for pregnancy with RA ? - ANSWER✔✔NSAIDs
corticosteroids, plus several DMARDs, including sulfasalazine and
hydroxychloroquine
NSAID black box warning - ANSWER✔✔NSAIDs may increase the risk
for myocardial infarction, stroke, and other thromboembolic events.
NSAIDs increase the risk for dangerous gastrointestinal adverse
effects such as bleeding, ulceration, and perforation.
Drug interactions with Allopurinol - ANSWER✔✔Mercaptopurine and
azathioprine (immunosuppressants)
,warfarin
Theophylline
Ampicillin
therapeutic response for methotrexate - ANSWER✔✔ If you are taking
methotrexate to treat rheumatoid arthritis, it may take 3 to 6 weeks
for your symptoms to begin to improve, and 12 weeks or longer for
you to feel the full benefit of methotrexate. Continue to take
methotrexate even if you feel well.
adverse effects for bisphosphonates - ANSWER✔✔osteonecrosis of the
jaw and hip fracture, Esophagitis
When are bisphosphonates contraindicated? - ANSWER✔✔esophageal
disorders
cr below 30 -35
therapeutic action of NSAIDS - ANSWER✔✔relieve pain/discomfort,
reduce inflammation, and bring down a high temperature.
MOA NSAIDS - ANSWER✔✔inhibition of the enzyme cyclooxygenase
(COX), decreased synthesis of prostaglandins
Women who have hypertension and osteoporosis should be prescribed
which antihypertensive? - ANSWER✔✔thiazide diuretic
Drug interactions with NSAIDS - ANSWER✔✔other NSAIDS, alcohol,
,warfarin (blood thinners), ACE inhibitors and diuretics
APRN prescribing role - ANSWER✔✔Prescriptive authority for nurse
practitioners also regulates prescribing rights beyond medications and
controlled substances. These rights include therapeutic devices and
services and are outlined in state practice laws and regulations and
include Durable Medical Equipment (DME) such as wheelchairs, power
scooters, hospital beds, portable oxygen equipment, handicap
placards, etc. and medical services such as Physical Therapy (PT),
Occupational Therapy (OT), home health services, etc. Prescriptive
authority encompasses more than writing a prescription correctly. It
requires adherence to ethical guidelines to ensure that patients are
safeguarded from harm. Ethical prescribing starts with being well-
informed about medications. Mechanism of action, efficacy, and safety
are important considerations, as are a patient's distinct needs and
circumstances, including the number of medications prescribed
(Mitchell & Oliphant, 2016). Most patients receiving a prescription are
taking other medications, whether prescription or over-the-counter.
Appropriate selection, dosing, and duration of pharmaceutical agents
are key to maximizing outcomes and minimizing adverse effects
benefits of full practice authority - ANSWER✔✔Nurse practitioners
have the autonomy to evaluate patients, diagnose, order and interpret
tests, initiate and manage treatments and prescribe medications,
including controlled substances without physician oversight
promoting positive outcomes through prudent prescribing practices -
ANSWER✔✔Administemedications and ring prescribing medications
are two distinct processes. Prescription writing requires prudent and
deliberate decision-making processes to maintain patient safety and
reduce liability, including:
, *documentation of a provider-patient relationship for the recipient of
the prescribed medications
*documentation of a thorough history and physical examination for
the recipient
*documentation of discussions regarding risk factors, side effects, or
therapy options
*documentation of drug monitoring or titration plan, if applicable
*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the
formulation of a diagnosis based on clinical reasoning and the
selection and monitoring of the most appropriate pharmacological
treatment
Considerations include: Cost, guidelines, availability, interactions, side
effects, allergies, hepatic/renal functions, need for monitoring, &
special populations
Beer's Criteria - ANSWER✔✔identifies drugs with a high likelihood of
causing adverse effects in older adults. Accordingly, drugs on this list
should generally be avoided in adults older than 65 years except
when the benefits are significantly greater than the risks.
