TEST BANK FOR LEHNE’S PHARMACOTHERAPEUTICS FOR
ADVANCED PRACTICE NURSES AND PHYSICIAN ASSISTANTS
2nd EDITION LATEST UPDATE.
Unit 01: Introduction Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Nurses
and Physician Assistants, 2nd Edition
MULTIPLE CHOICE
1. A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially? a. Fax the renewal order to the pharmacy.
b. Arrange to schedule an appointment with the patient.
c. Verify the patient’s adherence to the prescribed drug regimen.
d. Determine the patient’s current medication dosage and pain level.
CORRECT ANS: B
Schedule II medications are not eligible for refills, and prescriptions must be handwritten. It is
important to verify the patient’s adherence to the drug regimen and determine the current
dosage of medication and pain level; however, this can be accomplished by scheduling an
appointment and evaluating the patient in person.
2. A metered-dose albuterol inhaler is prescribed for asthma management. The patient
reports feeling jittery sometimes when taking the medication, and does not feel that the
medication is always effective. Which action will the provider take to best minimize patient risks
and maximize medication effectiveness?
a. Ask the patient to demonstrate use of the inhaler and assess effectiveness.
b. Assess the patient’s exposure to first- and second-hand tobacco smoke.
c. Auscultate the patient's l un Wg WsoWu.ndTsBaSndMo.bWtaSin other relevant vital
signs.
d. Decrease the dosage to reduce side effects.
,CORRECT ANS: C
Assessing and evaluating lung sounds as well as other vital signs helps determine the patient's
physical response to the medication and allows comparison to the patient's baseline vital signs.
Asking the patient to demonstrate inhaler use helps to evaluate the patient’s ability to
administer the medication properly and is part of an effective evaluation, but is not a priority
intervention based on the patient’s current report. Assessing tobacco smoke exposure helps
determine whether nondrug therapies, such as smoke avoidance, can be used as an adjunct to
drug therapy, but does not relate to the patient’s current problem. Rewriting the prescription to
decrease the dosage may address the degree of jitteriness experienced, but does not address
the patient’s concern that the drug is not always effective.
3. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history
finding would be most concerning to the provider?
a. The patient had a recent yeast infection.
b. There is a family history of cervical cancer.
c. The patient drinks two glasses of wine every night.
d. The patient is unemployed.
CORRECT ANS: C
Patients taking metronidazole should be educated not to drink alcohol to prevent a disulfiram-
like reaction. It would be concerning that the patient drinks wine daily. History of a yeast
infection may indicate increased risk for recurrence with administration of an antimicrobial. A
family history of cervical cancer is not related to administration of metronidazole.
Unemployment can indicate lack of insurance coverage, which may limit the patient’s ability to
purchase medications; however, generic metronidazole is one of the less expensive
medications.
4. The provider prepares a patient with newly diagnosed type 1 diabetes for hospital
discharge. Which action by the provider will best support the patient’s ability to effectively
manage medication therapy?
a. Asking the patient to demonstrate how to measure and administer insulin
b. Discussing methods of storing insulin and discarding syringes
,c. Giving information about how diet and exercise affect insulin requirements
d. Teaching the patient about the long-term consequences of poor diabetes control
CORRECT ANS: A
Because insulin must be given correctly to control symptoms and prevent an overdose, it is
most important for the patient to know how to measure and administer it. Asking for a
demonstration of technique is the best way to determine whether the patient has understood
the teaching. The other teaching points are important as well, but they are not as critical.
5. A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action is the prescriber’s priority when addressing the patient's concern? a. Ask
the patient about the number and frequency of tablets taken.
b. Assess the patient’s headache pain on a scale from 1 to 10.
c. Prescribe a new medicationWfWorWm.iTgrBaiSnMe .mWCorrect answer agement.
d. Suggest biofeedback as an adjunct to drug therapy.
CORRECT ANS: A
When evaluating the effectiveness of a drug, it is important to determine how often the patient
is using the drug. Asking the patient to identify how many tablets are taken and how often helps
the provider determine effective dosages and adherence to the medication regimen. The
patient has already stated that the medication is not working; the actual level of pain may
determine the degree to which it is not working, but it does not help the provider to determine
why it is not working. The assessment process should gather as much information about
compliance, symptoms, and drug effectiveness as possible before enacting a change in
treatment. Biofeedback may be an effective adjunct to treatment, but it should not be
recommended without complete information about drug effectiveness.
6. The drug manual states that older adult patients are at increased risk for hepatotoxicity.
Which action is most important when prescribing this medication to an 80-year-old patient? a.
Obtaining baseline liver function studies
b. Ensuring that the drug is taken in the correct dose at the correct time
c. Discontinuing the order; the drug is contraindicated for this patient
d. Giving the medication intravenously to avoid first pass metabolism
, CORRECT ANS: A
2
The drug manual indicates that this drug increases risk of hepatotoxicity for elderly patients.
Getting information about liver function before giving the drug establishes baseline data that
can be compared with posttreatment data to determine whether the drug is affecting the liver.
Taking the correct dose at the correct interval may minimize risk, but without baseline
information, the effects cannot be determined. Drugs are not routinely contraindicated for an
increased risk of adverse effects.
7. A patient with bipolar disorder is prescribed daily lithium. Which action is most
important for the provider to take in order to determine if the therapeutic level is maintained?
a. Evaluate preadministration blood work.
b. Prescribe the lithium to be taken at regular intervals.
c. Order periodic laboratory testing.
d. Assess the patient for signs and symptoms of lithium toxicity.
CORRECT ANS: C
Therapeutic serum levels are determined through periodic laboratory testing.
Preadministration blood work may be necessary to obtain baseline status prior to initiating
treatment, but it will not determine therapeutic levels. Scheduling medication administration at
regular intervals will help to ensure medication is absorbed and metabolized predictably, but it
will not determine therapeutic blood levels. Assessing the patient for signs and symptoms of
toxicity will help to determine if the therapeutic level has been exceeded, not maintained.
8. Which factor best supports an increase for full prescriptive authority for both advanced
practice registered nurses (APRNs) and physician assistants (PAs)? a. More patients will have
access to health care.
b. Enrollment in medical schoWoWlsWis.pTreBdSicMte.dWtoSdecrease.
c. Enrollment in both APRN and PA programs has increased.
d. Physician practices have become so large, quality care is in jeopardy.
CORRECT ANS: A
ADVANCED PRACTICE NURSES AND PHYSICIAN ASSISTANTS
2nd EDITION LATEST UPDATE.
Unit 01: Introduction Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Nurses
and Physician Assistants, 2nd Edition
MULTIPLE CHOICE
1. A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially? a. Fax the renewal order to the pharmacy.
b. Arrange to schedule an appointment with the patient.
c. Verify the patient’s adherence to the prescribed drug regimen.
d. Determine the patient’s current medication dosage and pain level.
CORRECT ANS: B
Schedule II medications are not eligible for refills, and prescriptions must be handwritten. It is
important to verify the patient’s adherence to the drug regimen and determine the current
dosage of medication and pain level; however, this can be accomplished by scheduling an
appointment and evaluating the patient in person.
2. A metered-dose albuterol inhaler is prescribed for asthma management. The patient
reports feeling jittery sometimes when taking the medication, and does not feel that the
medication is always effective. Which action will the provider take to best minimize patient risks
and maximize medication effectiveness?
a. Ask the patient to demonstrate use of the inhaler and assess effectiveness.
b. Assess the patient’s exposure to first- and second-hand tobacco smoke.
c. Auscultate the patient's l un Wg WsoWu.ndTsBaSndMo.bWtaSin other relevant vital
signs.
d. Decrease the dosage to reduce side effects.
,CORRECT ANS: C
Assessing and evaluating lung sounds as well as other vital signs helps determine the patient's
physical response to the medication and allows comparison to the patient's baseline vital signs.
Asking the patient to demonstrate inhaler use helps to evaluate the patient’s ability to
administer the medication properly and is part of an effective evaluation, but is not a priority
intervention based on the patient’s current report. Assessing tobacco smoke exposure helps
determine whether nondrug therapies, such as smoke avoidance, can be used as an adjunct to
drug therapy, but does not relate to the patient’s current problem. Rewriting the prescription to
decrease the dosage may address the degree of jitteriness experienced, but does not address
the patient’s concern that the drug is not always effective.
3. A patient is prescribed metronidazole for bacterial vaginosis. Which patient history
finding would be most concerning to the provider?
a. The patient had a recent yeast infection.
b. There is a family history of cervical cancer.
c. The patient drinks two glasses of wine every night.
d. The patient is unemployed.
CORRECT ANS: C
Patients taking metronidazole should be educated not to drink alcohol to prevent a disulfiram-
like reaction. It would be concerning that the patient drinks wine daily. History of a yeast
infection may indicate increased risk for recurrence with administration of an antimicrobial. A
family history of cervical cancer is not related to administration of metronidazole.
Unemployment can indicate lack of insurance coverage, which may limit the patient’s ability to
purchase medications; however, generic metronidazole is one of the less expensive
medications.
4. The provider prepares a patient with newly diagnosed type 1 diabetes for hospital
discharge. Which action by the provider will best support the patient’s ability to effectively
manage medication therapy?
a. Asking the patient to demonstrate how to measure and administer insulin
b. Discussing methods of storing insulin and discarding syringes
,c. Giving information about how diet and exercise affect insulin requirements
d. Teaching the patient about the long-term consequences of poor diabetes control
CORRECT ANS: A
Because insulin must be given correctly to control symptoms and prevent an overdose, it is
most important for the patient to know how to measure and administer it. Asking for a
demonstration of technique is the best way to determine whether the patient has understood
the teaching. The other teaching points are important as well, but they are not as critical.
5. A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action is the prescriber’s priority when addressing the patient's concern? a. Ask
the patient about the number and frequency of tablets taken.
b. Assess the patient’s headache pain on a scale from 1 to 10.
c. Prescribe a new medicationWfWorWm.iTgrBaiSnMe .mWCorrect answer agement.
d. Suggest biofeedback as an adjunct to drug therapy.
CORRECT ANS: A
When evaluating the effectiveness of a drug, it is important to determine how often the patient
is using the drug. Asking the patient to identify how many tablets are taken and how often helps
the provider determine effective dosages and adherence to the medication regimen. The
patient has already stated that the medication is not working; the actual level of pain may
determine the degree to which it is not working, but it does not help the provider to determine
why it is not working. The assessment process should gather as much information about
compliance, symptoms, and drug effectiveness as possible before enacting a change in
treatment. Biofeedback may be an effective adjunct to treatment, but it should not be
recommended without complete information about drug effectiveness.
6. The drug manual states that older adult patients are at increased risk for hepatotoxicity.
Which action is most important when prescribing this medication to an 80-year-old patient? a.
Obtaining baseline liver function studies
b. Ensuring that the drug is taken in the correct dose at the correct time
c. Discontinuing the order; the drug is contraindicated for this patient
d. Giving the medication intravenously to avoid first pass metabolism
, CORRECT ANS: A
2
The drug manual indicates that this drug increases risk of hepatotoxicity for elderly patients.
Getting information about liver function before giving the drug establishes baseline data that
can be compared with posttreatment data to determine whether the drug is affecting the liver.
Taking the correct dose at the correct interval may minimize risk, but without baseline
information, the effects cannot be determined. Drugs are not routinely contraindicated for an
increased risk of adverse effects.
7. A patient with bipolar disorder is prescribed daily lithium. Which action is most
important for the provider to take in order to determine if the therapeutic level is maintained?
a. Evaluate preadministration blood work.
b. Prescribe the lithium to be taken at regular intervals.
c. Order periodic laboratory testing.
d. Assess the patient for signs and symptoms of lithium toxicity.
CORRECT ANS: C
Therapeutic serum levels are determined through periodic laboratory testing.
Preadministration blood work may be necessary to obtain baseline status prior to initiating
treatment, but it will not determine therapeutic levels. Scheduling medication administration at
regular intervals will help to ensure medication is absorbed and metabolized predictably, but it
will not determine therapeutic blood levels. Assessing the patient for signs and symptoms of
toxicity will help to determine if the therapeutic level has been exceeded, not maintained.
8. Which factor best supports an increase for full prescriptive authority for both advanced
practice registered nurses (APRNs) and physician assistants (PAs)? a. More patients will have
access to health care.
b. Enrollment in medical schoWoWlsWis.pTreBdSicMte.dWtoSdecrease.
c. Enrollment in both APRN and PA programs has increased.
d. Physician practices have become so large, quality care is in jeopardy.
CORRECT ANS: A
