NR565 MIDTERM STUDY GUIDE:
PHARMACOLOGY AND PRESCRIPTIVE
AUTHORITY INSIGHTS | 2026 ACCURATE
QUESTIONS AND VERIFIED ANSWERS
~CHAMBERLAIN UNIVERSITY.
Chapter 1
State laws impact on prescriptive authority
o Whether state requires APRN practice in collaboration with or under supervision of a
physician.
Full Practice Authority
o The legal right to prescribe independently and without limitations
Role: Prescriptive Authority
o Safe and competent practice of prescribing and managing medication. Requires
understanding of drugs and the condition that they are used to manage.
Chapter 2
Assessing drug interactions
o Monitor for polypharmacy and ask pt about all current meds, OTC, and herbal meds.
Prescriptions
o Telephone, written, e-prescribing, and refills
Role of Formularies
o This formulary is selected by a panel of pharmacists and providers and may be subject
to following guidelines created by regulatory agencies, such as the Centers for Medicare
and Medicaid Services (CMS). The formulary may also depend on regional and national
drug supplies, drug costs and available rebates, and the presence of generic
medications on the market.
• Impact of drug selectivity on side effects
Chapter 3
Generic vs Brand Name: Value of Knowing
o Pts should know generic and trade name of medications. Knowing the generic name
empowers the pt to catch medication errors in the event two different providers prescribe
the same generic drug under different brand names.
Duration of Therapy
o Educating the pt on if medication therapy will be short term or long term. Failure to
recognize the need for prolonged therapy is a common reason pts stop medication
prematurely when prescription runs out.
,Chapter 4
Excretion Process
o Movement of drug and their metabolites out of the body
Metabolism Process
o Body chemically alters drugs for therapeutic use and forms into components that can be
easily excreted.
, Distribution Process
o Drug must be distributed to sites of action throughout the body via vascular system. To
enter target tissue, it must exit vascular system. Blood flow and drug ability to exit
vascular system and enter cells and the degree of plasma protein binding.
Passage Across Membranes
o Drug needs to pass through cells rather than between them to cross the membrane.
Passage through channels or pores, passage with the aid of a transport system, and
direct penetration of the membrane.
Absorption Process
o Process which the drug moves from its administration site into the bloodstream. It starts
where the drug is administered and ends when it enters systemic circulation.
Rate of Dissolution
o Helps determine the rate of absorption. Drugs in formulations that allow rapid dissolution
to have a faster onset than drugs for slow dissolution.
Surface Area and Absorption
o Major determinants of the rate of absorption. The larger the surface area the faster the
absorption. Ex: small intines have larger surface area than the stomach.
Blood Flow Impact on Absorption
o Drugs are absorbed rapidly from sites where blood flow is high. The greater the
concentration gradient, the more rapid absorption will be.
Multiple drugs on metabolic pathways
o Drugs may compete with each other for metabolism which may decrease the rate at
which one or both agents are metabolized. If metabolized is depressed enough drugs
can accumulate to dangerous levels.
Therapeutic Consequences
o Accelerated renal excretion of drugs, drug inactivation, increased therapeutic action,
activation of prodrugs, increased toxicity, decreased toxicity.
Receptors and Selectivity of Drug Action
o Selectivity is having only the response in which the drug is given. The more selective the
drug the less side effects it will produce. If a drug interacts with only one receptor the
effects of the drug will be limited. If a drug interacts with several receptor types the drug
could have a wide variety of responses.
Noncompetitive Antagonists
o Bind irreversibly to receptors and reduce the maximal response of an agonist.
Noncompetitive Antagonists Action
o The effect of irreversible binding is equivalent to reducing the total number of receptors
available for activation by an agonist.
Chapter 5
FDA & QT Interval Drugs
o Prolong the QT interval and serious risk for dysrhythmias. Torsade’s de pontes.
PHARMACOLOGY AND PRESCRIPTIVE
AUTHORITY INSIGHTS | 2026 ACCURATE
QUESTIONS AND VERIFIED ANSWERS
~CHAMBERLAIN UNIVERSITY.
Chapter 1
State laws impact on prescriptive authority
o Whether state requires APRN practice in collaboration with or under supervision of a
physician.
Full Practice Authority
o The legal right to prescribe independently and without limitations
Role: Prescriptive Authority
o Safe and competent practice of prescribing and managing medication. Requires
understanding of drugs and the condition that they are used to manage.
Chapter 2
Assessing drug interactions
o Monitor for polypharmacy and ask pt about all current meds, OTC, and herbal meds.
Prescriptions
o Telephone, written, e-prescribing, and refills
Role of Formularies
o This formulary is selected by a panel of pharmacists and providers and may be subject
to following guidelines created by regulatory agencies, such as the Centers for Medicare
and Medicaid Services (CMS). The formulary may also depend on regional and national
drug supplies, drug costs and available rebates, and the presence of generic
medications on the market.
• Impact of drug selectivity on side effects
Chapter 3
Generic vs Brand Name: Value of Knowing
o Pts should know generic and trade name of medications. Knowing the generic name
empowers the pt to catch medication errors in the event two different providers prescribe
the same generic drug under different brand names.
Duration of Therapy
o Educating the pt on if medication therapy will be short term or long term. Failure to
recognize the need for prolonged therapy is a common reason pts stop medication
prematurely when prescription runs out.
,Chapter 4
Excretion Process
o Movement of drug and their metabolites out of the body
Metabolism Process
o Body chemically alters drugs for therapeutic use and forms into components that can be
easily excreted.
, Distribution Process
o Drug must be distributed to sites of action throughout the body via vascular system. To
enter target tissue, it must exit vascular system. Blood flow and drug ability to exit
vascular system and enter cells and the degree of plasma protein binding.
Passage Across Membranes
o Drug needs to pass through cells rather than between them to cross the membrane.
Passage through channels or pores, passage with the aid of a transport system, and
direct penetration of the membrane.
Absorption Process
o Process which the drug moves from its administration site into the bloodstream. It starts
where the drug is administered and ends when it enters systemic circulation.
Rate of Dissolution
o Helps determine the rate of absorption. Drugs in formulations that allow rapid dissolution
to have a faster onset than drugs for slow dissolution.
Surface Area and Absorption
o Major determinants of the rate of absorption. The larger the surface area the faster the
absorption. Ex: small intines have larger surface area than the stomach.
Blood Flow Impact on Absorption
o Drugs are absorbed rapidly from sites where blood flow is high. The greater the
concentration gradient, the more rapid absorption will be.
Multiple drugs on metabolic pathways
o Drugs may compete with each other for metabolism which may decrease the rate at
which one or both agents are metabolized. If metabolized is depressed enough drugs
can accumulate to dangerous levels.
Therapeutic Consequences
o Accelerated renal excretion of drugs, drug inactivation, increased therapeutic action,
activation of prodrugs, increased toxicity, decreased toxicity.
Receptors and Selectivity of Drug Action
o Selectivity is having only the response in which the drug is given. The more selective the
drug the less side effects it will produce. If a drug interacts with only one receptor the
effects of the drug will be limited. If a drug interacts with several receptor types the drug
could have a wide variety of responses.
Noncompetitive Antagonists
o Bind irreversibly to receptors and reduce the maximal response of an agonist.
Noncompetitive Antagonists Action
o The effect of irreversible binding is equivalent to reducing the total number of receptors
available for activation by an agonist.
Chapter 5
FDA & QT Interval Drugs
o Prolong the QT interval and serious risk for dysrhythmias. Torsade’s de pontes.
