NURS 657 PHARMACOLOGY WEEK 1 AND 2 STUDY GUIDE – DOWNLOAD TO ATTAIN AN A+
• A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially?
o Arrange to schedule an appt w/the pt
• A metered-dose albuterol inhaler is prescribed for asthma management. The patient reports
feeling jittery sometimes when taking the medication, and does not feel that the medication is
always effective. Which action will the provider take to best minimize patient risks and
maximize medication effectiveness?
o Auscultate the pt’s lung sounds & obtain other relevant vital signs
• A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action is the prescriber’s priority when addressing the patient's concern?
o Ask the pt about the number & frequency of tablets taken
• The drug manual states that older adult patients are at increased risk for hepatotoxicity.
Which action is most important when prescribing this medication to an 80-year-old patient?
o Obtaining baseline liver function studies
• A patient with bipolar disorder is prescribed daily lithium. Which action is most important
for the provider to take in order to determine if the therapeutic level is maintained?
o Order periodic lab testing
• Which factor best supports an increase for full prescriptive authority for both advanced
practice registered nurses (APRNs) and physician assistants (PAs)?
o More pts will have access to health care
• Which prescriber action will have the greatest impact on the patient’s commitment to
adherence to any type of medication therapy?
o Providing med education that the pt can easily understand
• Which patient statement suggests to the provider that the patient’s nonadherence with their
medication plan is related to dissatisfaction with the therapy?
o “I’ve been taking this med for well over a week & I lost only a half a pound”
• How can the prescriber’s regular collaboration with a pharmacist improve positive outcomes
for patients? (Select all that apply.)
o Pharmacists have additional info on drug interaction
o Pharmacists can suggest adequate med dosing
o Pharmacists have firsthand knowledge of the facility formulary
• Which statements made by the prescriber demonstrate an understanding of effective
medication education? (Select all that apply.)
o “This med needs to be stored in the fridge”
o “Take 3 tabs daily: 1 w/breakfast, 1 w/lunch, & 1 w/dinner”
o “You need to take the med as we discussed until all the tabs are gone”
o “Call the office immediately if you begin experiencing any itching, HA, or difficulty
breathing”
• The patient who has been prescribed lithium for a diagnosis of bipolar disorder asks why
blood tests are required on a regular basis. Which provider responses demonstrate an
understanding of why the patient requires a variety of laboratory tests? (Select all that apply.)
o “We need to monitor how your thyroid is functioning”
o “We need to monitor kidney function while you’re on this drug”
o “This med can cause you to lose Na, so we need to measure Na levels”
, • When prescribing drugs with a narrow therapeutic index, what intervention does the provider
take to decrease risk to the patient?
o Monitor the pt’s plasma drug levels at regular intervals
• A patient reports that a medication no longer effectively alleviates symptoms. What process
informs the provider’s response to the patient’s concerns?
o Desensitization of receptor sites results from continual exposure to the drug
• A patient reports that Brand X tablets work faster than Brand Y tablets of the same amount of
the same drug. Which statement informs the prescriber’s response when explaining this
phenomenon to the patient?
o Inactive ingredients used in the composition can result in differing rates of
dissolution, which can alter the drug’s onset of action
• A patient receiving intravenous gentamicin has a toxic serum drug level. The prescriber
confirms that the dosing is correct. Which possible cause of this situation will the provider
explore?
o Whether pt is taking a med that binds to serum albumin
• A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a CYP3A4 inducing
drug is prescribed, what drug adjustment may be necessary to maintain a therapeutic level of
CYP3A4 substrate?
o Increase dosage of the CYP3A4
• What instructions should the provider give regarding
alcohol intake while taking hydrocodone with acetaminophen for postsurgical pain?
• “You should avoid drinking alcohol while you are taking
the pain med I’ve ordered”
• Which order for furosemide is written appropriately by the
prescriber?
• Furosemide [Lasix] 20mg PO daily
• What action should the prescriber take to minimize the
potential risk of a drug-induced Parkinson-like syndrome?
• Thoroughly educate the pt about recognizing such symp &
the need to notify the office immediately
• What instructions should the provider give when a patient
reports mild nausea after taking a newly approved medication that does not list nausea as a known side
effect?
• “Take the next dose w/food & call the office if the nausea
reoccurs or if other symp develop”
• What medication-induced effect would lead the prescriber
to discontinue a newly prescribed medication in a patient who develops shortness of breath shortly after
taking the initial dose?
• A side effect
• What response should the provider give when asked by a
patient about the purpose of genetic testing before prescribing a medication?
• “Testing will tell us how quickly your body is likely to
metabolize or process the drug”
• What does the provider suspect is responsible for a patient
taking more than the prescribed dosage of a narcotic analgesic for chronic pain for several months?
• A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially?
o Arrange to schedule an appt w/the pt
• A metered-dose albuterol inhaler is prescribed for asthma management. The patient reports
feeling jittery sometimes when taking the medication, and does not feel that the medication is
always effective. Which action will the provider take to best minimize patient risks and
maximize medication effectiveness?
o Auscultate the pt’s lung sounds & obtain other relevant vital signs
• A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action is the prescriber’s priority when addressing the patient's concern?
o Ask the pt about the number & frequency of tablets taken
• The drug manual states that older adult patients are at increased risk for hepatotoxicity.
Which action is most important when prescribing this medication to an 80-year-old patient?
o Obtaining baseline liver function studies
• A patient with bipolar disorder is prescribed daily lithium. Which action is most important
for the provider to take in order to determine if the therapeutic level is maintained?
o Order periodic lab testing
• Which factor best supports an increase for full prescriptive authority for both advanced
practice registered nurses (APRNs) and physician assistants (PAs)?
o More pts will have access to health care
• Which prescriber action will have the greatest impact on the patient’s commitment to
adherence to any type of medication therapy?
o Providing med education that the pt can easily understand
• Which patient statement suggests to the provider that the patient’s nonadherence with their
medication plan is related to dissatisfaction with the therapy?
o “I’ve been taking this med for well over a week & I lost only a half a pound”
• How can the prescriber’s regular collaboration with a pharmacist improve positive outcomes
for patients? (Select all that apply.)
o Pharmacists have additional info on drug interaction
o Pharmacists can suggest adequate med dosing
o Pharmacists have firsthand knowledge of the facility formulary
• Which statements made by the prescriber demonstrate an understanding of effective
medication education? (Select all that apply.)
o “This med needs to be stored in the fridge”
o “Take 3 tabs daily: 1 w/breakfast, 1 w/lunch, & 1 w/dinner”
o “You need to take the med as we discussed until all the tabs are gone”
o “Call the office immediately if you begin experiencing any itching, HA, or difficulty
breathing”
• The patient who has been prescribed lithium for a diagnosis of bipolar disorder asks why
blood tests are required on a regular basis. Which provider responses demonstrate an
understanding of why the patient requires a variety of laboratory tests? (Select all that apply.)
o “We need to monitor how your thyroid is functioning”
o “We need to monitor kidney function while you’re on this drug”
o “This med can cause you to lose Na, so we need to measure Na levels”
, • When prescribing drugs with a narrow therapeutic index, what intervention does the provider
take to decrease risk to the patient?
o Monitor the pt’s plasma drug levels at regular intervals
• A patient reports that a medication no longer effectively alleviates symptoms. What process
informs the provider’s response to the patient’s concerns?
o Desensitization of receptor sites results from continual exposure to the drug
• A patient reports that Brand X tablets work faster than Brand Y tablets of the same amount of
the same drug. Which statement informs the prescriber’s response when explaining this
phenomenon to the patient?
o Inactive ingredients used in the composition can result in differing rates of
dissolution, which can alter the drug’s onset of action
• A patient receiving intravenous gentamicin has a toxic serum drug level. The prescriber
confirms that the dosing is correct. Which possible cause of this situation will the provider
explore?
o Whether pt is taking a med that binds to serum albumin
• A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a CYP3A4 inducing
drug is prescribed, what drug adjustment may be necessary to maintain a therapeutic level of
CYP3A4 substrate?
o Increase dosage of the CYP3A4
• What instructions should the provider give regarding
alcohol intake while taking hydrocodone with acetaminophen for postsurgical pain?
• “You should avoid drinking alcohol while you are taking
the pain med I’ve ordered”
• Which order for furosemide is written appropriately by the
prescriber?
• Furosemide [Lasix] 20mg PO daily
• What action should the prescriber take to minimize the
potential risk of a drug-induced Parkinson-like syndrome?
• Thoroughly educate the pt about recognizing such symp &
the need to notify the office immediately
• What instructions should the provider give when a patient
reports mild nausea after taking a newly approved medication that does not list nausea as a known side
effect?
• “Take the next dose w/food & call the office if the nausea
reoccurs or if other symp develop”
• What medication-induced effect would lead the prescriber
to discontinue a newly prescribed medication in a patient who develops shortness of breath shortly after
taking the initial dose?
• A side effect
• What response should the provider give when asked by a
patient about the purpose of genetic testing before prescribing a medication?
• “Testing will tell us how quickly your body is likely to
metabolize or process the drug”
• What does the provider suspect is responsible for a patient
taking more than the prescribed dosage of a narcotic analgesic for chronic pain for several months?
