Pharmacotherapeutics for
Advanced Practice Nurse
Prescribers with Davis Edge
6th Edition
• Author(s)Teri Moser Woo; Wendy
L. Wright
TEST BANK
▪ The Foundation
▪ Pharmacotherapeutics with Single Drugs
▪ Pharmacotherapeutics with Multiple Drugs
▪ Special Drug Treatment Considerations
, 1. A newly certified family nurse practitioner is evaluating a 62-year-
old patient with hypertension, type 2 diabetes, and chronic kidney
disease. Before prescribing a new medication, the APRN reviews
the patient's complete medication list, allergies, renal function,
and recent laboratory results. Which action best demonstrates
the APRN's responsibility as a prescriber?
A. Select the medication based primarily on the patient's reported
symptoms
B. Use clinical judgment to integrate patient-specific factors with
current evidence and prescribing information
C. Follow the medication regimen previously used by the patient's
family member
D. Defer all prescribing decisions to the pharmacist because medication
selection is outside the APRN's scope
Correct Answer: B
Rationale: APRN prescribing requires independent clinical reasoning
that integrates the patient's history, comorbidities, current
medications, laboratory data, evidence-based recommendations, and
medication-specific safety information. Prescribing is more than
selecting a drug for a diagnosis; it requires individualized assessment
and ongoing responsibility for therapeutic outcomes. The other options
fail to account for comprehensive patient assessment and professional
prescribing responsibilities.
2. A patient asks an APRN why a prescription medication is being
recommended instead of an over-the-counter product that the
, patient saw advertised online. Which response best reflects
evidence-based prescribing?
A. "Prescription medications are always safer because they require a
prescription."
B. "The medication I prescribe is the strongest available treatment for
your condition."
C. "I will consider the evidence for effectiveness and safety along with
your specific health conditions and preferences."
D. "You should avoid all over-the-counter medications because they can
interact with prescriptions."
Correct Answer: C
Rationale: Evidence-based prescribing incorporates the best available
clinical evidence, clinician expertise, patient-specific characteristics, and
patient preferences. Prescription status alone does not guarantee
greater safety or effectiveness, and some OTC products are appropriate
when used correctly. Individualized risk-benefit assessment is central to
advanced practice prescribing.
3. An APRN is preparing to prescribe a new medication for a 74-year-
old patient who takes eight chronic medications. Which
assessment is most important before initiating therapy?
A. Determine whether the patient prefers tablets or capsules
B. Review the complete medication regimen for potential drug-drug
interactions and duplication
C. Ask whether the patient has ever missed a medication dose
D. Determine whether the medication is available in a generic
formulation
Correct Answer: B
, Rationale: Polypharmacy substantially increases the risk of drug-drug
interactions, therapeutic duplication, adverse effects, and prescribing
cascades. A complete medication reconciliation should include
prescription drugs, OTC medications, supplements, and herbal
products. Adherence and formulation preferences are also relevant but
should not replace comprehensive medication review.
4. A 68-year-old patient with chronic kidney disease is prescribed a
medication that is primarily eliminated unchanged by the kidneys.
The APRN notes that the patient's estimated glomerular filtration
rate has declined substantially since the previous visit. What is the
most appropriate prescribing action?
A. Prescribe the usual adult dose because the medication's hepatic
metabolism is minimal
B. Increase the dose because reduced renal function prolongs the
medication's duration
C. Review renal dosing recommendations and adjust the dose or dosing
interval as appropriate
D. Discontinue all medications until renal function returns to baseline
Correct Answer: C
Rationale: Reduced renal clearance can increase drug exposure and
toxicity for medications substantially eliminated by the kidneys. The
APRN should determine whether dose reduction, increased dosing
interval, or an alternative medication is appropriate based on the drug's
pharmacokinetics and the degree of renal impairment. The correct
adjustment depends on the specific medication and clinical context.
5. An APRN is prescribing a medication for a patient who reports a
previous severe immediate reaction to the same drug class. What
is the priority action?
Advanced Practice Nurse
Prescribers with Davis Edge
6th Edition
• Author(s)Teri Moser Woo; Wendy
L. Wright
TEST BANK
▪ The Foundation
▪ Pharmacotherapeutics with Single Drugs
▪ Pharmacotherapeutics with Multiple Drugs
▪ Special Drug Treatment Considerations
, 1. A newly certified family nurse practitioner is evaluating a 62-year-
old patient with hypertension, type 2 diabetes, and chronic kidney
disease. Before prescribing a new medication, the APRN reviews
the patient's complete medication list, allergies, renal function,
and recent laboratory results. Which action best demonstrates
the APRN's responsibility as a prescriber?
A. Select the medication based primarily on the patient's reported
symptoms
B. Use clinical judgment to integrate patient-specific factors with
current evidence and prescribing information
C. Follow the medication regimen previously used by the patient's
family member
D. Defer all prescribing decisions to the pharmacist because medication
selection is outside the APRN's scope
Correct Answer: B
Rationale: APRN prescribing requires independent clinical reasoning
that integrates the patient's history, comorbidities, current
medications, laboratory data, evidence-based recommendations, and
medication-specific safety information. Prescribing is more than
selecting a drug for a diagnosis; it requires individualized assessment
and ongoing responsibility for therapeutic outcomes. The other options
fail to account for comprehensive patient assessment and professional
prescribing responsibilities.
2. A patient asks an APRN why a prescription medication is being
recommended instead of an over-the-counter product that the
, patient saw advertised online. Which response best reflects
evidence-based prescribing?
A. "Prescription medications are always safer because they require a
prescription."
B. "The medication I prescribe is the strongest available treatment for
your condition."
C. "I will consider the evidence for effectiveness and safety along with
your specific health conditions and preferences."
D. "You should avoid all over-the-counter medications because they can
interact with prescriptions."
Correct Answer: C
Rationale: Evidence-based prescribing incorporates the best available
clinical evidence, clinician expertise, patient-specific characteristics, and
patient preferences. Prescription status alone does not guarantee
greater safety or effectiveness, and some OTC products are appropriate
when used correctly. Individualized risk-benefit assessment is central to
advanced practice prescribing.
3. An APRN is preparing to prescribe a new medication for a 74-year-
old patient who takes eight chronic medications. Which
assessment is most important before initiating therapy?
A. Determine whether the patient prefers tablets or capsules
B. Review the complete medication regimen for potential drug-drug
interactions and duplication
C. Ask whether the patient has ever missed a medication dose
D. Determine whether the medication is available in a generic
formulation
Correct Answer: B
, Rationale: Polypharmacy substantially increases the risk of drug-drug
interactions, therapeutic duplication, adverse effects, and prescribing
cascades. A complete medication reconciliation should include
prescription drugs, OTC medications, supplements, and herbal
products. Adherence and formulation preferences are also relevant but
should not replace comprehensive medication review.
4. A 68-year-old patient with chronic kidney disease is prescribed a
medication that is primarily eliminated unchanged by the kidneys.
The APRN notes that the patient's estimated glomerular filtration
rate has declined substantially since the previous visit. What is the
most appropriate prescribing action?
A. Prescribe the usual adult dose because the medication's hepatic
metabolism is minimal
B. Increase the dose because reduced renal function prolongs the
medication's duration
C. Review renal dosing recommendations and adjust the dose or dosing
interval as appropriate
D. Discontinue all medications until renal function returns to baseline
Correct Answer: C
Rationale: Reduced renal clearance can increase drug exposure and
toxicity for medications substantially eliminated by the kidneys. The
APRN should determine whether dose reduction, increased dosing
interval, or an alternative medication is appropriate based on the drug's
pharmacokinetics and the degree of renal impairment. The correct
adjustment depends on the specific medication and clinical context.
5. An APRN is prescribing a medication for a patient who reports a
previous severe immediate reaction to the same drug class. What
is the priority action?
