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Chapter 1. The Role of the Nurse Practitioner as Prescriber
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Identify the choice that best completes the statement or answers the question.
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Y . F T L 1. Y. FT Nurse practitioner prescriptive authority is regulated
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1. The National Council of State Boards of Nursing
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2. The U.S. Drug Enforcement Administration
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3. The State Board of Nursing for each state
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4. The State Board of Pharmacy Y.FT L Y.FT L Y.FT L Y.FT L
Y . F T L 2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN)
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prescriber include:
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1. Nurses know more about Pharmacology than other prescribers because they take it L
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both in their basic nursing program and in their APRN program.
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2. Nurses care for the patient from a holistic approach and include the patient Y.FT L L
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in decision making regarding their care.
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3. APRNs are less likely to prescribe narcotics and other controlled substances. Y.FT L Y.FT L Y.FT L Y.FT L Y.FT L L
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4. APRNs are able to prescribe independently in all states, whereas a physician’s Y.FT L L
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assistant needs to have a physician supervising their practice.
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Y . F T L 3. Y. FT Clinical judgment in prescribing includes:
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1. Factoring in the cost to the patient of the medication prescribed Y.FT L Y . FT L L
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2. Always prescribing the newest medication available for the disease process Y.FT L L
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3. Handing out drug samples to poor patients Y.FT L Y.FT L Y.FT L Y.FT L Y.FT L Y . FT L
4. Prescribing all generic medications to cut costs Y.FT L L
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Y . F T L 4. Y. FT Criteria for choosing an effective drug for a disorder include:
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1. Asking the patient what drug they think would work best for them Y.FT L Y.FT L Y.FT L L
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2. Consulting nationally recognized guidelines for disease management Y.FT L Y.FT L Y.FT L Y.FT L Y.FTL YFL
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3. Prescribing medications that are available as samples before writing a prescription Y.FT L Y.FT L YF
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4. Following U.S. Drug Enforcement Administration guidelines for prescribing L
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Y . F T L 5. Nurse practitioner practice may thrive under health-care reform because of:
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1. The demonstrated ability of nurse practitioners to control costs and improve patient
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outcomes Y.FT L
2. The fact that nurse practitioners will be able to practice independently
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3. The fact that nurse practitioners will have full reimbursement under health-
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care reform Y.FT L
4. The ability to shift accountability for Medicaid to the state level
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,Chapter 1. The Role of the Nurse Practitioner as Prescriber
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Answer Section
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MULTIPLE CHOICE L
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,Chapter 2. Review of the Basic Principles of Pharmacology
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Multiple Choice YF
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Identify the choice that best completes the statement or answers the question.
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Y . F T L 1. A patient’s nutritional intake and laboratory results reflect hypoalbuminemia. This is
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Y.FT critical to prescribing because:
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1. Distribution of drugs to target tissue may be affected. Y.FT L Y.FT L Y. FT L Y.FT L Y. FT L Y.FT L Y.FTL L
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2. The solubility of the drug will not match the site of absorption. Y.FTL Y.FT L Y.FT L Y.FTL Y.FT L Y.FT L Y.FTL Y.FT L Y.FTL L
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3. There will be less free drug available to generate an effect. L
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4. Drugs bound to albumin are readily excreted by the kidneys. Y.FTL Y.FT L Y.FT L Y.FT L Y.FTL Y.FTL Y.FT L Y . FT L Y . FT L
Y . F T L 2. Y. FT L Drugs that have a significant first-pass effect: Y.FT L Y.FT L Y.FT L Y.FT L Y. FT L Y . F T L
1. Must be given by the enteral (oral) route only Y.FT L Y.FT L Y.FT L Y.FT L Y. FT L Y.FT L Y.FT L Y. FT L
2. Bypass the hepatic circulation Y.FT L Y.FTL Y.FT L
3. Are rapidly metabolized by the liver and may have little if any desired action
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4. Are converted by the liver to more active and fat-soluble forms
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Y . F T L Y . F T 3. The route of excretion of a volatile drug will likely be the:
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1. Kidneys
2. Lungs
3. Bile and feces YF
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4. Skin
Y . F T L 4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a
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. storage reservoir of the drug. Storage reservoirs:
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1. Assure that the drug will reach its intended target tissue Y.FTL Y.FTL L
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2. Are the reason for giving loading doses Y.FT L Y.FTL Y.FT L Y.FT L Y.FT L Y. FT L
3. Increase the length of time a drug is available and active Y.FT L Y.FT L Y.FT L Y .F T L L
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4. Are most common in collagen tissues YF
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Y . F T L Y . F T 5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
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1. Propensity to go to the target receptor Y.FT L Y.FT L Y.FT L Y.FT L L
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2. Biological half-life YF
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3. Pharmacodynamics
4. Safety and side effects Y.FTL L
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Y . F T L 6. Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days
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Y.FT of the prescription. This is considered a loading dose. A loading dose:
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1. Rapidly achieves drug levels in the therapeutic range Y.FTL Y.FTL L
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2. Requires four- to five-half-lives to attain Y.FT L Y.FTL Y.FT L Y.FT L Y.FT L
3. Is influenced by renal function L
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4. Is directly related to the drug circulating to the target tissues
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Y . F T L 7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic
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1. Minimum adverse effect level Y.FT L Y.FT L Y.FT L
2. Peak of action Y.FT L Y.FT L
, 3. Onset of action Y.FTL Y. FT L
4. Therapeutic range Y.F
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Y . F T L 8. Y. FT L Phenytoin requires that a trough level be drawn. Peak and trough levels are done: Y.FT L Y.FT L Y. FT L Y .FT L Y.FT L Y. FT L Y.FT L Y.FT L Y. FT L Y.FT L Y.FT L Y.FT L Y . F T L
1. When the drug has a wide therapeutic range Y.FT L L
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2. When the drug will be administered for a short time only Y.FT L L
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3. When there is a high correlation between the dose and saturation of receptor sites
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4. To determine if a drug is in the therapeutic range
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Y 9. A laboratory result indicates that the peak level for a drug is above the minimum toxic
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. concentration.
This means that the: Y.FTL Y.FT L L
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1. Concentration will produce therapeutic effects L
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2. Concentration will produce an adverse response Y.FT L Y.FT L Y.FT L Y . FT L Y.FT L
3. Time between doses must be shortened L
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4. Duration of action of the drug is too long Y.FT L Y.FT L Y.FT L Y.FTL Y.FT L Y.FT L Y.FT L L
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Y . F T L 10. Drugs that are receptor agonists may demonstrate what property?
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1. Irreversible binding to the drug receptor site YF
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2. Upregulation with chronic use Y.FT L Y.FT L Y.FT L
3. Desensitization or downregulation with continuous use Y.FTL L
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4. Inverse relationship between drug concentration and drug action Y.FT L Y.FT L Y.FTL Y.FT L Y.FT L Y . FT L Y.FT L
Y . F T L 11. Drugs that are receptor antagonists, such as beta blockers, may cause:
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1. Downregulation of the drug receptor Y.FT L Y.FT L Y.FT L Y . FT L
2. An exaggerated response if abruptly discontinued Y.FT L Y.FT L L
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3. Partial blockade of the effects of agonist drugs L
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4. An exaggerated response to competitive drug agonists Y.FT L Y.FT L Y.FT L Y.FT L Y.FT L Y . FT L
Y . F T L 12. Factors that affect gastric drug absorption include:
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1. Liver enzyme activity YF
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2. Protein-binding properties of the drug molecule Y.FT L Y.FT L Y.FT L Y.FTL Y. FT L
3. Lipid solubility of the drug Y.FT L Y.FT L Y. FT L Y.FT L
4. Ability to chew and swallow L
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Y . F T L 13. Drugs administered via IV:
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1. Need to be lipid soluble in order to be easily absorbed Y.FT L Y.FT L Y.FTL Y.FT L Y.FTL L
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2. Begin distribution into the body immediately Y.FT L Y.FT L Y.FT L Y.FT L Y.FT L
3. Are easily absorbed if they are nonionized YF
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4. May use pinocytosis to be absorbed Y.FTL Y.FT L Y.FT L Y.FTL Y.FT L
Y . F T L 14. When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs
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1. The sum of the effects of each drug individually
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2. Greater than the sum of the effects of each drug individually Y.FT L Y.FT L Y.FTL Y.FT L Y . FT L Y.FT L Y.FT L Y.FT L Y.FT L Y.FT L
3. Less than the effect of each drug individually Y.FTL Y.FT L Y.FT L Y.FTL Y . FT L Y.FT L Y. FT L
4. Not predictable, as it varies with each individual
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Y . F T L 15. Which of the following statements about bioavailability is true?
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1. Bioavailability issues are especially important for drugs with narrow therapeutic Y.FTL YF
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ranges or sustained-release mechanisms. Y.FT L Y. FT L Y.FT L Y. FT L
2. All brands of a drug have the same bioavailability. Y.FTL Y.FT L Y.FT L Y.FT L Y.FTL Y . FT L L
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3. Drugs that are administered more than once a day have greater bioavailability than Y.FT L L
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