NUR 600 Advanced Nursing Practice & Theory
Examination 1, 2026/2027 – 50-Question
Evidence-Based Advanced Nursing
Competency Assessment
SECTION 1: PHARMACOLOGY & PRESCRIBING
PRACTICE
Q1. Nurse practitioner prescriptive authority is regulated by:
A. The National Council of State Boards of Nursing
B. The U.S. Drug Enforcement Administration
C. The State Board of Nursing for each state
D. The State Board of Pharmacy
Correct Answer: C. The State Board of Nursing for each state
Rationale: Prescriptive authority for nurse practitioners is regulated at the
state level by each state's Board of Nursing. While the DEA issues
registrations for controlled substances, the authority to prescribe is granted
by state law through the Board of Nursing .
Q2. Physician Assistant (PA) prescriptive authority is regulated by:
A. The National Council of State Boards of Nursing
B. The U.S. Drug Enforcement Administration
C. The State Board of Nursing
D. The State Board of Medical Examiners
Correct Answer: D. The State Board of Medical Examiners
,Rationale: PAs are regulated by the State Board of Medical Examiners, as
they practice under the supervision of physicians. This differs from NPs who
are regulated by State Boards of Nursing .
Q3. Clinical judgment in prescribing includes:
A. Factoring in the cost to the patient of the medication prescribed
B. Always prescribing the newest medication available for the disease
process
C. Handing out drug samples to poor patients
D. Prescribing all generic medications to cut costs
Correct Answer: A. Factoring in the cost to the patient of the
medication prescribed
Rationale: Clinical judgment includes considering the patient's financial
ability to afford prescribed medications. Cost can significantly affect
adherence, and the most expensive or newest medication may not always be
the best choice for an individual patient .
Q4. Criteria for choosing an effective drug for a disorder include:
A. Asking the patient what drug they think would work best for them
B. Consulting nationally recognized guidelines for disease management
C. Prescribing medications that are available as samples before writing a
prescription
D. Following U.S. Drug Enforcement Administration (DEA) guidelines for
prescribing
Correct Answer: B. Consulting nationally recognized guidelines for
disease management
Rationale: Evidence-based practice requires using nationally recognized
clinical practice guidelines (e.g., from the American Heart Association,
American Diabetes Association) to select the most effective medications for
specific disorders .
, Q5. Nurse practitioner practice may thrive under health-care reform
due to:
A. The demonstrated ability of nurse practitioners to control costs and
improve patient outcomes
B. The fact that nurse practitioners will be able to practice independently
C. The fact that nurse practitioners will have full reimbursement under
health-care reform
D. The ability to shift accountability for Medicaid to the state level
Correct Answer: A. The demonstrated ability of nurse practitioners to
control costs and improve patient outcomes
Rationale: Research consistently shows that NPs provide high-quality, cost-
effective care with outcomes comparable to or better than physicians. This
evidence supports expanded NP roles under healthcare reform .
Q6. A patient's nutritional intake and lab work reflects
hypoalbuminemia. This is critical to prescribing because:
A. Distribution of drugs to target tissue may be affected
B. The solubility of the drug will not match the site of absorption
C. There will be less free drug available to generate an effect
D. Drugs bound to albumin are readily excreted by the kidney
Correct Answer: A. Distribution of drugs to target tissue may be
affected
Rationale: Hypoalbuminemia means there are fewer protein binding sites for
drugs that are highly protein-bound. This results in more free (active) drug
circulating, which increases both therapeutic and toxic effects. Drug
distribution to target tissues is affected .
Q7. Drugs that have a significant first-pass effect:
Examination 1, 2026/2027 – 50-Question
Evidence-Based Advanced Nursing
Competency Assessment
SECTION 1: PHARMACOLOGY & PRESCRIBING
PRACTICE
Q1. Nurse practitioner prescriptive authority is regulated by:
A. The National Council of State Boards of Nursing
B. The U.S. Drug Enforcement Administration
C. The State Board of Nursing for each state
D. The State Board of Pharmacy
Correct Answer: C. The State Board of Nursing for each state
Rationale: Prescriptive authority for nurse practitioners is regulated at the
state level by each state's Board of Nursing. While the DEA issues
registrations for controlled substances, the authority to prescribe is granted
by state law through the Board of Nursing .
Q2. Physician Assistant (PA) prescriptive authority is regulated by:
A. The National Council of State Boards of Nursing
B. The U.S. Drug Enforcement Administration
C. The State Board of Nursing
D. The State Board of Medical Examiners
Correct Answer: D. The State Board of Medical Examiners
,Rationale: PAs are regulated by the State Board of Medical Examiners, as
they practice under the supervision of physicians. This differs from NPs who
are regulated by State Boards of Nursing .
Q3. Clinical judgment in prescribing includes:
A. Factoring in the cost to the patient of the medication prescribed
B. Always prescribing the newest medication available for the disease
process
C. Handing out drug samples to poor patients
D. Prescribing all generic medications to cut costs
Correct Answer: A. Factoring in the cost to the patient of the
medication prescribed
Rationale: Clinical judgment includes considering the patient's financial
ability to afford prescribed medications. Cost can significantly affect
adherence, and the most expensive or newest medication may not always be
the best choice for an individual patient .
Q4. Criteria for choosing an effective drug for a disorder include:
A. Asking the patient what drug they think would work best for them
B. Consulting nationally recognized guidelines for disease management
C. Prescribing medications that are available as samples before writing a
prescription
D. Following U.S. Drug Enforcement Administration (DEA) guidelines for
prescribing
Correct Answer: B. Consulting nationally recognized guidelines for
disease management
Rationale: Evidence-based practice requires using nationally recognized
clinical practice guidelines (e.g., from the American Heart Association,
American Diabetes Association) to select the most effective medications for
specific disorders .
, Q5. Nurse practitioner practice may thrive under health-care reform
due to:
A. The demonstrated ability of nurse practitioners to control costs and
improve patient outcomes
B. The fact that nurse practitioners will be able to practice independently
C. The fact that nurse practitioners will have full reimbursement under
health-care reform
D. The ability to shift accountability for Medicaid to the state level
Correct Answer: A. The demonstrated ability of nurse practitioners to
control costs and improve patient outcomes
Rationale: Research consistently shows that NPs provide high-quality, cost-
effective care with outcomes comparable to or better than physicians. This
evidence supports expanded NP roles under healthcare reform .
Q6. A patient's nutritional intake and lab work reflects
hypoalbuminemia. This is critical to prescribing because:
A. Distribution of drugs to target tissue may be affected
B. The solubility of the drug will not match the site of absorption
C. There will be less free drug available to generate an effect
D. Drugs bound to albumin are readily excreted by the kidney
Correct Answer: A. Distribution of drugs to target tissue may be
affected
Rationale: Hypoalbuminemia means there are fewer protein binding sites for
drugs that are highly protein-bound. This results in more free (active) drug
circulating, which increases both therapeutic and toxic effects. Drug
distribution to target tissues is affected .
Q7. Drugs that have a significant first-pass effect:
