ADVANCED PHARMACOLOGY
FUNDAMENTALS MIDTERM PRACTICE AND
STUDY GUIDE 2026 CLINICAL DECISION
MAKING IN PHARMACOLOGY APPLICATION
FRAMEWORK
◉ Prescriptive authority. Answer: Defined by state law and nurse
practice acts
◉ Prescriptive authority determines. Answer: Which drugs can be
prescribed and level of autonomy (independent vs collaborative)
◉ Accountability of APRNs. Answer: Safe, ethical prescribing and
practicing within legal scope
◉ Consequences of prescribing outside scope. Answer: Legal and
ethical violation
◉ Valid Prescription Requirements. Answer: Must include patient
name and identifiers, drug name (generic preferred), dose, route,
frequency, quantity and refills, prescriber name, credentials, and
signature.
,◉ Types of Prescriptions. Answer: Written, Electronic, Verbal
(limited use).
◉ What must prescribing consider?. Answer: Diagnosis and
indication, patient age, weight, comorbidities, renal and hepatic
function, pregnancy and lactation status, genetic variability, and cost
and adherence.
◉ Patient medication education. Answer: ■ Purpose of medication
■ How and when to take it
■ Expected benefits
■ Common adverse effects
■ When to seek medical attention
■ Importance of adherence
Improves outcomes/reduces errors
◉ Drug absorption. Answer: Entry of drug into bloodstream
◉ When does the absorption process begin and end?. Answer: It
begins when the drug is administered and ends when it enters
systemic circulation.
,◉ What determines how quickly a drug enters the bloodstream?.
Answer: The rate of absorption determines how quickly a drug
enters the bloodstream.
◉ What does the extent of absorption describe?. Answer: The extent
of absorption describes the amount of drug entering the
bloodstream.
◉ Factors influencing drug absorption. Answer: Route of
administration, blood flow, GI motility and pH
◉ How does the route of drug administration affect absorption?.
Answer: The route of drug administration affects the rate and extent
of absorption.
◉ First-pass metabolism. Answer: Reduces oral bioavailability
◉ Bioavailability. Answer: The fraction of administered drug that
reaches systemic circulation unchanged.
◉ What is the bioavailability of intravenous (IV) drugs?. Answer:
Intravenous (IV) drugs are 100% bioavailable.
, ◉ How does bioavailability vary with intramuscular and
subcutaneous routes?. Answer: Intramuscular and subcutaneous
routes of administration demonstrate varied bioavailability.
◉ Effect of extensive first-pass metabolism. Answer: Low oral
bioavailability due to a large portion of the drug being metabolized
in the liver.
◉ First-pass metabolism does NOT. Answer: Increase drug effect,
occur with IV drugs, or affect distribution directly.
◉ What is drug distribution?. Answer: Movement from blood to
tissues.
◉ What factors influence drug distribution?. Answer: Plasma protein
binding, tissue perfusion, body fat and water.
◉ What is plasma protein binding?. Answer: The binding of drugs in
the bloodstream to plasma proteins, mainly albumin, affecting their
distribution and free drug levels.
◉ Which form of the drug is active?. Answer: Only unbound drug is
active.
FUNDAMENTALS MIDTERM PRACTICE AND
STUDY GUIDE 2026 CLINICAL DECISION
MAKING IN PHARMACOLOGY APPLICATION
FRAMEWORK
◉ Prescriptive authority. Answer: Defined by state law and nurse
practice acts
◉ Prescriptive authority determines. Answer: Which drugs can be
prescribed and level of autonomy (independent vs collaborative)
◉ Accountability of APRNs. Answer: Safe, ethical prescribing and
practicing within legal scope
◉ Consequences of prescribing outside scope. Answer: Legal and
ethical violation
◉ Valid Prescription Requirements. Answer: Must include patient
name and identifiers, drug name (generic preferred), dose, route,
frequency, quantity and refills, prescriber name, credentials, and
signature.
,◉ Types of Prescriptions. Answer: Written, Electronic, Verbal
(limited use).
◉ What must prescribing consider?. Answer: Diagnosis and
indication, patient age, weight, comorbidities, renal and hepatic
function, pregnancy and lactation status, genetic variability, and cost
and adherence.
◉ Patient medication education. Answer: ■ Purpose of medication
■ How and when to take it
■ Expected benefits
■ Common adverse effects
■ When to seek medical attention
■ Importance of adherence
Improves outcomes/reduces errors
◉ Drug absorption. Answer: Entry of drug into bloodstream
◉ When does the absorption process begin and end?. Answer: It
begins when the drug is administered and ends when it enters
systemic circulation.
,◉ What determines how quickly a drug enters the bloodstream?.
Answer: The rate of absorption determines how quickly a drug
enters the bloodstream.
◉ What does the extent of absorption describe?. Answer: The extent
of absorption describes the amount of drug entering the
bloodstream.
◉ Factors influencing drug absorption. Answer: Route of
administration, blood flow, GI motility and pH
◉ How does the route of drug administration affect absorption?.
Answer: The route of drug administration affects the rate and extent
of absorption.
◉ First-pass metabolism. Answer: Reduces oral bioavailability
◉ Bioavailability. Answer: The fraction of administered drug that
reaches systemic circulation unchanged.
◉ What is the bioavailability of intravenous (IV) drugs?. Answer:
Intravenous (IV) drugs are 100% bioavailable.
, ◉ How does bioavailability vary with intramuscular and
subcutaneous routes?. Answer: Intramuscular and subcutaneous
routes of administration demonstrate varied bioavailability.
◉ Effect of extensive first-pass metabolism. Answer: Low oral
bioavailability due to a large portion of the drug being metabolized
in the liver.
◉ First-pass metabolism does NOT. Answer: Increase drug effect,
occur with IV drugs, or affect distribution directly.
◉ What is drug distribution?. Answer: Movement from blood to
tissues.
◉ What factors influence drug distribution?. Answer: Plasma protein
binding, tissue perfusion, body fat and water.
◉ What is plasma protein binding?. Answer: The binding of drugs in
the bloodstream to plasma proteins, mainly albumin, affecting their
distribution and free drug levels.
◉ Which form of the drug is active?. Answer: Only unbound drug is
active.
