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 newly certified family nurse practitioner is reviewing state and
federal prescribing requirements before beginning practice. Which
action best demonstrates the APRN’s primary responsibility as an
independent prescriber?
A. Relying on pharmaceutical representatives for current medication
information
B. Prescribing medications solely according to supervising physician
preferences
C. Integrating evidence, patient-specific factors, and legal authority to
make safe prescribing decisions
D. Prescribing only medications that have FDA-approved indications
Correct Answer: C
Rationale:
Advanced practice prescribers are responsible for independent clinical
decision-making that incorporates evidence, patient characteristics,
safety considerations, and applicable legal requirements. Evidence-
based prescribing requires ongoing evaluation of benefits, risks,
comorbidities, cost, adherence, and monitoring. Pharmaceutical
representatives may provide information but are not primary evidence
sources. Supervising physician preferences should not replace
evidence-based clinical reasoning. Off-label prescribing may be
appropriate when supported by evidence and within legal scope of
practice.
,Question 2
An APRN is prescribing an antihypertensive medication for a patient
with stage 3 chronic kidney disease. Before selecting therapy, which
action best reflects rational prescribing principles?
A. Choosing the medication with the lowest acquisition cost
B. Selecting the medication with the fewest listed adverse effects
C. Assessing renal function, comorbid conditions, current medications,
and patient goals
D. Prescribing the newest medication because it is likely to be more
effective
Correct Answer: C
Rationale:
Rational prescribing begins with a comprehensive assessment that
includes renal function, concurrent illnesses, current medications,
contraindications, patient preferences, and treatment goals. Cost is
important but should not be the sole factor. Newer medications are not
automatically superior. Adverse-effect profiles must be considered in
the context of patient-specific risks and expected benefits.
Question 3
An APRN is considering a medication for an older adult with multiple
chronic illnesses. Which characteristic most strongly increases the risk
of adverse drug events?
A. Increased body water and enhanced renal clearance
B. Polypharmacy and age-related changes in pharmacokinetics
, C. Increased hepatic metabolism and decreased drug sensitivity
D. Lower medication adherence because of younger age
Correct Answer: B
Rationale:
Older adults are particularly vulnerable to adverse drug events because
of polypharmacy, reduced renal function, altered hepatic metabolism,
changes in body composition, and increased pharmacodynamic
sensitivity. These changes can increase drug exposure and toxicity.
Aging is generally associated with decreased—not increased—
clearance and metabolism.
Question 4
An APRN prescribes a medication for a patient with limited health
literacy. Which intervention is most appropriate to improve medication
adherence and reduce errors?
A. Provide written instructions using medical terminology
B. Ask whether the patient understands the instructions
C. Use the teach-back method to confirm understanding
D. Provide only verbal instructions to avoid confusion
Correct Answer: C
Rationale:
Teach-back is an evidence-based communication strategy in which
patients explain instructions in their own words, allowing the prescriber
to confirm understanding and correct misunderstandings. Simply asking
whether the patient understands often overestimates comprehension.