NURS 676 ADVANCED PHARMACOLOGY
MIDTERM EXAM SCRIPT 2026 FULL SOLUTIONS
AND CORRECT ANSWERS ALREADY PASSED
◉ Which drugs increase myocardial oxygen supply. Answer:
Nitrates, BBs, and CCBs
◉ Causes of hypertension. Answer: primary HTN has no identifiable
cause
◉ Which drugs to treat hypertension & BPH, MI, heart failure in
African Americans?. Answer:
◉ Chapter 1. Answer:
◉ Roles and responsibilities of APRN prescribers. Answer: As of
January 2015:
-all states have title protection for NPs
-only Oregon has mandated third-party reimbursement parity for
NP services
-only five states have joint control of practice and licensure between
the board of nursing and board of medicine
,-in 17 states and the District of Columbia NPs have independent
scope of practice and prescriptive authority
-six states have full autonomous practice and prescriptive authority
following a period of postlicensure/post-certification supervision or
collaboration
◉ Advanced Knowledge. Answer: The APRN role requires advanced
knowledge to diagnosis, prescribe the appropriate drug, monitor the
expected outcome, and incorporate a holistic assessment of the
impact of disease and therapy on patient lives
◉ Clinical judgment in prescribing. Answer: -Is there a clear
indication for drug therapy?
-What drugs are effective at treating this disorder?
*The Agency for Health Care Quality (AHCQ) and the National
Institutes of Health (NIH) publish disease specific treatment
guidelines that include both pharmacological and
nonpharmacological therapies
-What is the goal of therapy with this drug?
-Under what conditions is it determined that a drug is not meeting
the goal and a different therapy or drug should be tried?
**consider concurrent disease processes
-Are there unnecessary duplications with other drugs that the
patient is already taking?
,-Would an over the counter drug be just as useful as a prescription
drug?
-What about cost?
-Where is the information to answer these questions?
◉ Chapter 1
Autonomy and Prescriptive Authority. Answer: By January 2004 all
states had recognized the NP title scope of practice and prescriptive
authority in legislation
- As of 2015 26 states allow independent practice and 21 states
allow independent full prescribing (these are not written in stone
and can be reversed)
◉ Chapter 2. Answer:
◉ Types of drug responses. Answer: quantal and graded
quantal: may or may not occur (convulsions, pregnancy, rash, sleep,
death)
graded: biological effects that can be measured (BP, heart rate, pain)
, ◉ Metabolism. Answer: -important factor in determining drug
activity
-when drugs are metabolized, they are chemically altered by
enzymes into new molecules, called metabolites
-can increase or decrease the onset, duration of action and toxicity of
a medication
◉ Where does metabolism of drugs occur?. Answer: mostly in the
smooth endoplasmic reticulum of cells in the liver
-metabolism of drugs however can occur un every biological tissue
**the liver is a major organ for drug metabolism because it contains
high amounts of drug-metabolizing enzymes and because it is the
first organ encountered by drugs once they are absorbed from the
gastrointestinal tract
◉ First-pass metabolism. Answer: Metabolism by the liver following
oral administration of a drug. And is important in determining
whether a drug can be orally administered
◉ Phase I Metabolism. Answer: Oxidation, reduction, hydrolysis
- also called non-synthetic reactions
MIDTERM EXAM SCRIPT 2026 FULL SOLUTIONS
AND CORRECT ANSWERS ALREADY PASSED
◉ Which drugs increase myocardial oxygen supply. Answer:
Nitrates, BBs, and CCBs
◉ Causes of hypertension. Answer: primary HTN has no identifiable
cause
◉ Which drugs to treat hypertension & BPH, MI, heart failure in
African Americans?. Answer:
◉ Chapter 1. Answer:
◉ Roles and responsibilities of APRN prescribers. Answer: As of
January 2015:
-all states have title protection for NPs
-only Oregon has mandated third-party reimbursement parity for
NP services
-only five states have joint control of practice and licensure between
the board of nursing and board of medicine
,-in 17 states and the District of Columbia NPs have independent
scope of practice and prescriptive authority
-six states have full autonomous practice and prescriptive authority
following a period of postlicensure/post-certification supervision or
collaboration
◉ Advanced Knowledge. Answer: The APRN role requires advanced
knowledge to diagnosis, prescribe the appropriate drug, monitor the
expected outcome, and incorporate a holistic assessment of the
impact of disease and therapy on patient lives
◉ Clinical judgment in prescribing. Answer: -Is there a clear
indication for drug therapy?
-What drugs are effective at treating this disorder?
*The Agency for Health Care Quality (AHCQ) and the National
Institutes of Health (NIH) publish disease specific treatment
guidelines that include both pharmacological and
nonpharmacological therapies
-What is the goal of therapy with this drug?
-Under what conditions is it determined that a drug is not meeting
the goal and a different therapy or drug should be tried?
**consider concurrent disease processes
-Are there unnecessary duplications with other drugs that the
patient is already taking?
,-Would an over the counter drug be just as useful as a prescription
drug?
-What about cost?
-Where is the information to answer these questions?
◉ Chapter 1
Autonomy and Prescriptive Authority. Answer: By January 2004 all
states had recognized the NP title scope of practice and prescriptive
authority in legislation
- As of 2015 26 states allow independent practice and 21 states
allow independent full prescribing (these are not written in stone
and can be reversed)
◉ Chapter 2. Answer:
◉ Types of drug responses. Answer: quantal and graded
quantal: may or may not occur (convulsions, pregnancy, rash, sleep,
death)
graded: biological effects that can be measured (BP, heart rate, pain)
, ◉ Metabolism. Answer: -important factor in determining drug
activity
-when drugs are metabolized, they are chemically altered by
enzymes into new molecules, called metabolites
-can increase or decrease the onset, duration of action and toxicity of
a medication
◉ Where does metabolism of drugs occur?. Answer: mostly in the
smooth endoplasmic reticulum of cells in the liver
-metabolism of drugs however can occur un every biological tissue
**the liver is a major organ for drug metabolism because it contains
high amounts of drug-metabolizing enzymes and because it is the
first organ encountered by drugs once they are absorbed from the
gastrointestinal tract
◉ First-pass metabolism. Answer: Metabolism by the liver following
oral administration of a drug. And is important in determining
whether a drug can be orally administered
◉ Phase I Metabolism. Answer: Oxidation, reduction, hydrolysis
- also called non-synthetic reactions
