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
,Question 1
A family nurse practitioner (FNP) evaluates a 58-year-old man with
newly diagnosed hypertension. Before initiating pharmacotherapy, the
APRN reviews the patient's medical history, current medications,
laboratory findings, and allergies. Which prescribing action best
demonstrates safe, evidence-based prescribing?
A. Prescribe an antihypertensive solely based on the patient's age.
B. Delay treatment until all lifestyle modifications have been attempted
for 12 months.
C. Select a medication after integrating the patient's clinical condition,
comorbidities, concurrent medications, laboratory data, and
preferences.
D. Choose the medication with the lowest acquisition cost regardless of
patient-specific factors.
Correct Answer: C
Rationale:
Evidence-based prescribing requires individualized therapeutic
decision-making that incorporates the patient's diagnosis,
comorbidities, medication history, renal and hepatic function, allergies,
potential drug interactions, and treatment goals while considering
patient preferences and shared decision-making. Medication selection
should never rely on a single characteristic such as age or cost alone.
Delaying indicated pharmacologic therapy may expose the patient to
preventable complications.
Question 2
,A nurse practitioner is preparing to prescribe an oral antibiotic for a
patient with acute bacterial sinusitis. The patient states, "I'm allergic to
penicillin." Which action should the APRN take first?
A. Avoid all antibiotics containing a beta-lactam ring.
B. Clarify the nature, timing, and severity of the reported allergic
reaction.
C. Automatically prescribe a fluoroquinolone.
D. Document the allergy and continue prescribing without additional
assessment.
Correct Answer: B
Rationale:
A reported drug allergy should always be investigated before
prescribing. Many patients confuse adverse effects (e.g.,
gastrointestinal upset) with true immunologic reactions. Determining
the specific medication, symptoms, timing, severity, and treatment of
the reaction helps distinguish intolerance from IgE-mediated
hypersensitivity or severe delayed reactions. This information guides
safe antibiotic selection and avoids unnecessary avoidance of effective
therapies. Automatically excluding all beta-lactams or prescribing
broader-spectrum agents may contribute to antimicrobial resistance
and unnecessary adverse effects.
Question 3
A 76-year-old woman with chronic kidney disease is prescribed a
medication that is primarily eliminated through the kidneys. Which
prescribing principle is most appropriate?
, A. Use the standard adult dosage because age alone should not affect
prescribing.
B. Increase the dose to achieve therapeutic drug concentrations.
C. Assess renal function and adjust the dosage or dosing interval when
indicated.
D. Prescribe the medication without laboratory evaluation because
serum creatinine is usually normal in older adults.
Correct Answer: C
Rationale:
Many medications require dosage adjustment in patients with reduced
kidney function to minimize toxicity while maintaining efficacy. APRNs
should evaluate renal function using appropriate measures such as
estimated glomerular filtration rate (eGFR) or creatinine clearance,
depending on the medication. Older adults may have deceptively
normal serum creatinine values despite reduced renal function because
of decreased muscle mass. Standard dosing or dose escalation can
increase the risk of adverse drug events.
Question 4
An APRN discusses treatment options with a patient who has newly
diagnosed type 2 diabetes mellitus. The patient expresses concern
about medication costs, daily dosing, and potential adverse effects.
Which prescribing approach best reflects patient-centered care?
A. Select the medication the clinician prefers because it has the
greatest prescribing experience.
B. Recommend the newest medication available regardless of
affordability.