NR565 / NR 565 Midterm Exam Study
Guide (Latest 2026/2027 UPDATED):
Advanced Pharmacology
Fundamentals Real Exam
APRN prescribing role
- ............ SOLUTION✔✔✔..........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
, Page | 2
Benefits of full practice authority
- ............ SOLUTION✔✔✔..........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
- ............ SOLUTION✔✔✔..........Administering medications
and 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
, Page | 3
*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
- ............ SOLUTION✔✔✔..........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.
Pharmacodynamics - ............ SOLUTION✔✔✔..........the study
of the biochemical and physiologic effects of drugs on the body
and the molecular mechanisms by which those effects are
produced
Pharmacokinetics - ............ SOLUTION✔✔✔..........the study
of drug movement throughout the body
, Page | 4
Pharmacogenomics - ............ SOLUTION✔✔✔..........the study
of how genes affect a person's response to drugs. The purpose of
this is to combine the sciences of genomics and pharmacology to
provide individualized, targeted, safe drug therapies to patients
CYP450 inducers - ............ SOLUTION✔✔✔..........Inducers
are xenobiotics (medications and environmental agents) that
elevate CYP450 enzyme activity by increasing enzyme synthesis.
This action leads to additional sites available for
biotransformation. The increased number of sites enhances
medication metabolism, decreasing the concentration of the
"parent drug" while increasing metabolite production.
Inducers = Increase medication metabolism
(Carbamazepine, Rifampin, Alcohol, Phenytoin, Griseofulvin,
Phenobarbital, Sulfonylureas)
CYP450 inhibitors - ............ SOLUTION✔✔✔..........Inhibitors
are medications that inhibit the metabolic activity of one or more
of the CYP450 enzymes. Medications that inhibit an enzyme
potentially slows that enzyme's activity or blocks the activity
required for the metabolism of other medications, thereby
increasing the levels of medications dependent on that particular
enzyme for biotransformation. Inhibitors = decrease medication