NR 565 - advanced pharmacology midterm –
Chamberlain Updated Questions And Answers
Why do nitrates need to be taken no later than 4 PM? - ANSWER -Need nitrate
free interval so tolerance doesn't develop
Nine factors that impact outcome of medication? - ANSWER -Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight
Do you need informed consent for genetic testing? - ANSWER -yes
What is the purpose of the Genetic Information Non-Discriminatory Act? -
ANSWER -Protects patients from discrimination by employers and insurance
providers based on genetic information
Difference between practice authority and prescriptive authority? - ANSWER -
Practice authority refers to the nurse practitioner's ability to practice without
physician oversight, whereas prescriptive authority refers to the nurse practitioner's
authority to prescribe medications independently and without limitations.
Who regulates prescriptive authority? - ANSWER -the jurisdiction of a health
professional board. This may be the State Board of Nursing, the State Board of
Medicine, or the State Board of Pharmacy, as determined by each state.
What is scope of practice determined by? - ANSWER -is determined by state
practice and licensure laws.
, What is 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.
What is reduced practice authority? - ANSWER -Nurse practitioners are limited
in at least one element of practice. The state requires a formal collaborative
agreement with an outside health discipline for the nurse practitioner to provide
patient care. ex/ physician involvement for 5 yrs than independent
What is restricted practice authority? - ANSWER -Nurse practitioners are limited
in at least one element of practice by requiring supervision, delegation, or team
management by an outside health discipline for the nurse practitioner to provide
patient care.- typically doctor on site
What are components of Rx? - ANSWER -Prescriber Contact info
Prescribers name
NPI
DEA
Patient name
DOB
Date
Allergies
Medication name
Strength
Quantity
Indication for use
Direction for use
Refills
Signature
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
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
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.
Chamberlain Updated Questions And Answers
Why do nitrates need to be taken no later than 4 PM? - ANSWER -Need nitrate
free interval so tolerance doesn't develop
Nine factors that impact outcome of medication? - ANSWER -Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight
Do you need informed consent for genetic testing? - ANSWER -yes
What is the purpose of the Genetic Information Non-Discriminatory Act? -
ANSWER -Protects patients from discrimination by employers and insurance
providers based on genetic information
Difference between practice authority and prescriptive authority? - ANSWER -
Practice authority refers to the nurse practitioner's ability to practice without
physician oversight, whereas prescriptive authority refers to the nurse practitioner's
authority to prescribe medications independently and without limitations.
Who regulates prescriptive authority? - ANSWER -the jurisdiction of a health
professional board. This may be the State Board of Nursing, the State Board of
Medicine, or the State Board of Pharmacy, as determined by each state.
What is scope of practice determined by? - ANSWER -is determined by state
practice and licensure laws.
, What is 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.
What is reduced practice authority? - ANSWER -Nurse practitioners are limited
in at least one element of practice. The state requires a formal collaborative
agreement with an outside health discipline for the nurse practitioner to provide
patient care. ex/ physician involvement for 5 yrs than independent
What is restricted practice authority? - ANSWER -Nurse practitioners are limited
in at least one element of practice by requiring supervision, delegation, or team
management by an outside health discipline for the nurse practitioner to provide
patient care.- typically doctor on site
What are components of Rx? - ANSWER -Prescriber Contact info
Prescribers name
NPI
DEA
Patient name
DOB
Date
Allergies
Medication name
Strength
Quantity
Indication for use
Direction for use
Refills
Signature
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
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
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.
