NR 565 MIDTERM EXAM QUESTIONS AND
CORRECT ANSWERS
What are medication examples of Schedule II drugs? - CORRECT ANSWER --Ativan & Valium
-Fentanyl
-Oxycodone
-Methadone
What medications are Schedule III drugs? - CORRECT ANSWER --Xanax
-Tramadol
-anabolic steroids
-<90mg of codeine
What medications are Schedule IV drugs? - CORRECT ANSWER --Ativan -
Tramadol
-Methadone
-Adderall
Which schedule drugs can APRNs prescribe? - CORRECT ANSWER -Schedule II through Schedule
IV
examples of reasons for medication non-adherence - CORRECT ANSWER --too busy -
too expensive
-ran out
-forgetting
-traveling & busy
,Distribution in medication in elderly can be affected in what ways? - CORRECT ANSWER --
decreased lean mass
-decreased albumin
-decreased body fat
-slower gastric acidity
-slower absorption results in delayed response
In the elderly decrease albumin and decreased lean mass affects medications how? - CORRECT
ANSWER -medication binds to protein so decreased protein affects how medication is absorbed
and distributed
In elderly decreased body fat affects medications how? - CORRECT ANSWER -need fat to
transport medications and some drug metabolism is dependent on body weight
When prescribing medication, we must understand that liver function declines with age due
to.... - CORRECT ANSWER -decreased blood flow to the liver, decreased hepatic enzymes
What is the most important cause of adverse drug reactions? - CORRECT ANSWER -
***overprescribing/polypharmacy
***decreased renal excretion
-high drug dosages (start low & go slow)
-lack of monitoring medications
What can a poor metabolism phenotype do to a metabolism of a drug? - CORRECT ANSWER --
slow or increase absorption
-slow the metabolism
-keep drug in body longer
, -increase toxicity
How does poor metabolism affect a high or low therapeutic index? - CORRECT ANSWER --
increase drug toxicity
(example plavix - clots & increased platelets)
Black box warning for Opioids - CORRECT ANSWER -respiratory depression
Black box warning for Fentanyl - CORRECT ANSWER -FATAL respiratory depression
Black box warning for Methadone (NP cannot prescribe) - CORRECT ANSWER -QT interval
prolongation
Black box warning for Codeine - CORRECT ANSWER --breastfeeding and infant death can occur
-10% of dose converts to morphine
Black box warning for hydromorphone & oxymorphone (NP cannot prescribe long acting
hydromorphone and oxymorphone) - CORRECT ANSWER --risk for high abuse & overdose
-respiratory depression
Black box warning for oxycodone (NP need additional training to prescribe for chronic pain) -
CORRECT ANSWER --HIGH potential for abuse
-respiratory depression
Meds that require special training for APNs to prescribe are... - CORRECT ANSWER --Opioids
-Fentanyl
-Methadone
CORRECT ANSWERS
What are medication examples of Schedule II drugs? - CORRECT ANSWER --Ativan & Valium
-Fentanyl
-Oxycodone
-Methadone
What medications are Schedule III drugs? - CORRECT ANSWER --Xanax
-Tramadol
-anabolic steroids
-<90mg of codeine
What medications are Schedule IV drugs? - CORRECT ANSWER --Ativan -
Tramadol
-Methadone
-Adderall
Which schedule drugs can APRNs prescribe? - CORRECT ANSWER -Schedule II through Schedule
IV
examples of reasons for medication non-adherence - CORRECT ANSWER --too busy -
too expensive
-ran out
-forgetting
-traveling & busy
,Distribution in medication in elderly can be affected in what ways? - CORRECT ANSWER --
decreased lean mass
-decreased albumin
-decreased body fat
-slower gastric acidity
-slower absorption results in delayed response
In the elderly decrease albumin and decreased lean mass affects medications how? - CORRECT
ANSWER -medication binds to protein so decreased protein affects how medication is absorbed
and distributed
In elderly decreased body fat affects medications how? - CORRECT ANSWER -need fat to
transport medications and some drug metabolism is dependent on body weight
When prescribing medication, we must understand that liver function declines with age due
to.... - CORRECT ANSWER -decreased blood flow to the liver, decreased hepatic enzymes
What is the most important cause of adverse drug reactions? - CORRECT ANSWER -
***overprescribing/polypharmacy
***decreased renal excretion
-high drug dosages (start low & go slow)
-lack of monitoring medications
What can a poor metabolism phenotype do to a metabolism of a drug? - CORRECT ANSWER --
slow or increase absorption
-slow the metabolism
-keep drug in body longer
, -increase toxicity
How does poor metabolism affect a high or low therapeutic index? - CORRECT ANSWER --
increase drug toxicity
(example plavix - clots & increased platelets)
Black box warning for Opioids - CORRECT ANSWER -respiratory depression
Black box warning for Fentanyl - CORRECT ANSWER -FATAL respiratory depression
Black box warning for Methadone (NP cannot prescribe) - CORRECT ANSWER -QT interval
prolongation
Black box warning for Codeine - CORRECT ANSWER --breastfeeding and infant death can occur
-10% of dose converts to morphine
Black box warning for hydromorphone & oxymorphone (NP cannot prescribe long acting
hydromorphone and oxymorphone) - CORRECT ANSWER --risk for high abuse & overdose
-respiratory depression
Black box warning for oxycodone (NP need additional training to prescribe for chronic pain) -
CORRECT ANSWER --HIGH potential for abuse
-respiratory depression
Meds that require special training for APNs to prescribe are... - CORRECT ANSWER --Opioids
-Fentanyl
-Methadone
