NR565 / NR 565 Midterm(1)
What are medication examples of Schedule II drugs? - correct answer -Ativan & Valium
-Fentanyl
-Oxycodone
-Methadone
What medications are Schedule III drugs? - correct answer -Xanax
-Tramadol
-anabolic steroids
-<90mg of codeine
What medications are Schedule IV drugs? - correct answer -Ativan
-Tramadol
-Methadone
-Adderall
Which schedule drugs can APRNs prescribe? - correct answer Schedule II through Schedule
IV
examples of reasons for medication non-adherence - correct answer -too busy
-too expensive
-ran out
-forgetting
-traveling & busy
Distribution in medication in elderly can be affected in what ways? - correct answer -
decreased lean mass
-decreased albumin
-decreased body fat
-slower gastric acidity
-slower absorption results in delayed response
,NR565 / NR 565 Midterm and final Exam questions with all verified 5 versions altogether
In the elderly decrease albumin and decreased lean mass affects medications how? - correct
answer medication binds to protein so decreased protein affects how medication is absorbed
and distributed
In elderly decreased body fat affects medications how? - correct answer need fat to
transport medications and some drug metabolism is dependent on body weight
When prescribing medication, we must understand that liver function declines with age due
to.... - correct answer decreased blood flow to the liver, decreased hepatic enzymes
What is the most important cause of adverse drug reactions? - correct answer
***overprescribing/polypharmacy
***decreased renal excretion
-high drug dosages (start low & go slow)
-lack of monitoring medications
What can a poor metabolism phenotype do to a metabolism of a drug? - correct answer -
slow or increase absorption
-slow the metabolism
-keep drug in body longer
-increase toxicity
How does poor metabolism affect a high or low therapeutic index? - correct answer -
increase drug toxicity
(example plavix - clots & increased platelets)
Black box warning for Opioids - correct answer respiratory depression
Black box warning for Fentanyl - correct answer FATAL respiratory depression
Black box warning for Methadone (NP cannot prescribe) - correct answer QT interval
prolongation
Black box warning for Codeine - correct answer -breastfeeding and infant death can occur
-10% of dose converts to morphine
Black box warning for hydromorphone & oxymorphone (NP cannot prescribe long acting
hydromorphone and oxymorphone) - correct answer -risk for high abuse & overdose
-respiratory depression
,NR565 / NR 565 Midterm and final Exam questions with all verified 5 versions altogether
Black box warning for oxycodone (NP need additional training to prescribe for chronic pain) -
correct answer -HIGH potential for abuse
-respiratory depression
Meds that require special training for APNs to prescribe are... - correct answer -Opioids
-Fentanyl
-Methadone
-Codeine
-Hydromorphone & oxymorphone
-Oxycodone
What are therapeutic uses for morphine? - correct answer MODERATE TO SEVERE PAIN
-acute pain
-post op/surgical pain
-end of life pain management
-MI
-labor & delivery
-cancer
What are therapeutic uses for Fentanyl? - correct answer BREAKTHROUGH PAIN
surgical pain
severe pain
opioid tolerant patients
What are therapeutic uses for codeine? - correct answer MILD TO MODERATE PAIN
cough
What is MME and when to use it? - correct answer morphine milligram equivalent
used for overdose(OD)
assess where patient is at in their pain management and monitor them safely
What is the PDPM and when to use it? - correct answer -database to access to patient's
prescription history of controlled substances used to ensure safe prescribing to prevent
overdosing and polypharmacy
, NR565 / NR 565 Midterm and final Exam questions with all verified 5 versions altogether
-use prior to starting opioid therapy and during opioid therapy
Renal and hepatic insufficiencies with opioids
1)Codeine - correct answer stays in body longer & metabolism is effected
Renal and hepatic insufficiencies with opioids
2) Morphine - correct answer neurotoxicity
Renal and hepatic insufficiencies with opioids
3)Oxycodone - correct answer overdose
can use with extreme caution and reduction of dosage
Renal and hepatic insufficiencies with opioids
4)Fentanyl - correct answer monitor closely for sedation
Risk factors for Opioid Use Disorder (OUD) - correct answer family history
mental health disorder (anxiety, depression)
social factors
prior drug use
pain management
poly-substance abuse
prescribe post surgery for long period of time
When to prescribe Naloxone? - correct answer >50 mme/day
prior hx of OD
concurrent benzo use
Drugs not safe to take with Opioids - correct answer Benzos
Alcohol
CNS depressants
Tricyclic
Barbituates
Antihistamines