NR 565 ADVANCED PHARMACOLOGY MIDTERM – CHAMBERLAIN | PRACTICE QUESTIONS &
ANSWERS | COMPREHENSIVE STUDY GUIDE 2026/2027
1st trimester (fetus most at risk d/t rapid growth) - ANS ✔✔During what trimester is a pregnant
woman most at risk for adverse drug reactions with potential long term consequences?
Recommendations of medications inappropriate for elderly (65 and older), prescriber ultimately
decides - ANS ✔✔What is BEERS criteria?
liver enzyme system where medications are metabolized, can either be inducers or inhibitors
and create drug-drug interactions - ANS ✔✔What is the CYP450 (cytochrome P450)
Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect (decrease blood
levels of drug), elevate CYP450 enzymes - ANS ✔✔CYP450 inducers
"Bullshit Crap GPS INDUCES rage" - ANS ✔✔CYP450 inducers pneumonic
Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin, griseofulvin,
phenobarbital, sulfonylureas - ANS ✔✔CYP450 inducer drug names
inhibit metabolism, increase blood levels of medications - ANS ✔✔CYP450 inhibitors
"VISA credit card debt INHIBITS spending on designers like CK to look GQ" - ANS ✔✔CYP450
pneumonic
Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol, ketoconazole, grapefruit
juice, quinidine - ANS ✔✔CYP450 inhibitors drug names
increase glomerular filtration rate leads to increase durg excretion
,increase hepatic metabolism
decrease tone and motility of bowel
increase drug absorption - ANS ✔✔Physiological changes during pregnancy that impact
pharmacodynamics and pharmacokinetic properties of drugs?
Antiepileptic drugs, antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large
doses, some anticoagulants, and hormonal medications such as diethylstilbestrol (DES). - ANS
✔✔Examples of medications that can be teratogenic
slow and erratic due to low blood flow in muscles first few days of life - ANS ✔✔How is
absorption of intramuscular medications different in neonates?
delayed gastric emptying - ANS ✔✔Why is absorption of medication in the stomach increased in
infancy?
glucocorticoids, discoloration of developing teeth with tetracyclines, and kernicterus with
sulfonamides, levofloxacin (antibiotics)
aspirin (Severe intoxication from acute overdose) - ANS ✔✔Some medications that should be
avoided in the pediatric patient?
dosage size and timing
route and technique of administration
duration of treatment
drug storage
nature and time course of desired responses
nature and time course of adverse responses
finish taking antibiotic - ANS ✔✔what should be included in medication administration patient
education?
,reduced renal function
polypharmacy (the use of five or more medications daily)
greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy
poor patient adherence - ANS ✔✔What are some things that put the elderly patient at higher
risk for adverse drug reactions?
obtaining a thorough drug history that includes over-the-counter medications
considering pharmacokinetic and pharmacodynamics changes due to age
monitoring the patient's clinical response and plasma drug levels
using the simplest regimen possible
monitoring for drug-drug interactions and iatrogenic illness
periodically reviewing the need for continued drug therapy
encouraging the patient to dispose of old medications
taking steps to promote adherence and to avoid drugs on the Beers list - ANS ✔✔How can
healthcare providers decrease likelihood of an elderly patient experiencing an adverse drug
reaction?
simplifying drug regimens
providing clear and concise verbal and written instructions
using an appropriate dosage form
clearly labeling and dispensing easy-to-open containers
developing daily reminders
monitoring frequently
, affordability of drugs
support systems - ANS ✔✔How can we promote medication adherence with elderly patients?
Need nitrate free interval so tolerance doesn't develop - ANS ✔✔Why do nitrates need to be
taken no later than 4 PM?
Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight - ANS ✔✔Nine factors that impact outcome of medication?
yes - ANS ✔✔Do you need informed consent for genetic testing?
Protects patients from discrimination by employers and insurance providers based on genetic
information - ANS ✔✔What is the purpose of the Genetic Information Non-Discriminatory Act?
Practice authority refers to the nurse practitioner's ability to practice without physician
oversight, whereas prescriptive authority refers to the nurse practitioner's authority to
prescribe medications independently and without limitations. - ANS ✔✔Difference between
practice authority and prescriptive authority?
the jurisdiction of a health professional board. This may be the State Board of Nursing, the State
Board of Medicine, or the State Board of Pharmacy, as determined by each state. - ANS
✔✔Who regulates prescriptive authority?
ANSWERS | COMPREHENSIVE STUDY GUIDE 2026/2027
1st trimester (fetus most at risk d/t rapid growth) - ANS ✔✔During what trimester is a pregnant
woman most at risk for adverse drug reactions with potential long term consequences?
Recommendations of medications inappropriate for elderly (65 and older), prescriber ultimately
decides - ANS ✔✔What is BEERS criteria?
liver enzyme system where medications are metabolized, can either be inducers or inhibitors
and create drug-drug interactions - ANS ✔✔What is the CYP450 (cytochrome P450)
Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect (decrease blood
levels of drug), elevate CYP450 enzymes - ANS ✔✔CYP450 inducers
"Bullshit Crap GPS INDUCES rage" - ANS ✔✔CYP450 inducers pneumonic
Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin, griseofulvin,
phenobarbital, sulfonylureas - ANS ✔✔CYP450 inducer drug names
inhibit metabolism, increase blood levels of medications - ANS ✔✔CYP450 inhibitors
"VISA credit card debt INHIBITS spending on designers like CK to look GQ" - ANS ✔✔CYP450
pneumonic
Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol, ketoconazole, grapefruit
juice, quinidine - ANS ✔✔CYP450 inhibitors drug names
increase glomerular filtration rate leads to increase durg excretion
,increase hepatic metabolism
decrease tone and motility of bowel
increase drug absorption - ANS ✔✔Physiological changes during pregnancy that impact
pharmacodynamics and pharmacokinetic properties of drugs?
Antiepileptic drugs, antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large
doses, some anticoagulants, and hormonal medications such as diethylstilbestrol (DES). - ANS
✔✔Examples of medications that can be teratogenic
slow and erratic due to low blood flow in muscles first few days of life - ANS ✔✔How is
absorption of intramuscular medications different in neonates?
delayed gastric emptying - ANS ✔✔Why is absorption of medication in the stomach increased in
infancy?
glucocorticoids, discoloration of developing teeth with tetracyclines, and kernicterus with
sulfonamides, levofloxacin (antibiotics)
aspirin (Severe intoxication from acute overdose) - ANS ✔✔Some medications that should be
avoided in the pediatric patient?
dosage size and timing
route and technique of administration
duration of treatment
drug storage
nature and time course of desired responses
nature and time course of adverse responses
finish taking antibiotic - ANS ✔✔what should be included in medication administration patient
education?
,reduced renal function
polypharmacy (the use of five or more medications daily)
greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy
poor patient adherence - ANS ✔✔What are some things that put the elderly patient at higher
risk for adverse drug reactions?
obtaining a thorough drug history that includes over-the-counter medications
considering pharmacokinetic and pharmacodynamics changes due to age
monitoring the patient's clinical response and plasma drug levels
using the simplest regimen possible
monitoring for drug-drug interactions and iatrogenic illness
periodically reviewing the need for continued drug therapy
encouraging the patient to dispose of old medications
taking steps to promote adherence and to avoid drugs on the Beers list - ANS ✔✔How can
healthcare providers decrease likelihood of an elderly patient experiencing an adverse drug
reaction?
simplifying drug regimens
providing clear and concise verbal and written instructions
using an appropriate dosage form
clearly labeling and dispensing easy-to-open containers
developing daily reminders
monitoring frequently
, affordability of drugs
support systems - ANS ✔✔How can we promote medication adherence with elderly patients?
Need nitrate free interval so tolerance doesn't develop - ANS ✔✔Why do nitrates need to be
taken no later than 4 PM?
Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight - ANS ✔✔Nine factors that impact outcome of medication?
yes - ANS ✔✔Do you need informed consent for genetic testing?
Protects patients from discrimination by employers and insurance providers based on genetic
information - ANS ✔✔What is the purpose of the Genetic Information Non-Discriminatory Act?
Practice authority refers to the nurse practitioner's ability to practice without physician
oversight, whereas prescriptive authority refers to the nurse practitioner's authority to
prescribe medications independently and without limitations. - ANS ✔✔Difference between
practice authority and prescriptive authority?
the jurisdiction of a health professional board. This may be the State Board of Nursing, the State
Board of Medicine, or the State Board of Pharmacy, as determined by each state. - ANS
✔✔Who regulates prescriptive authority?
