©THESTAR 2024/2025 ALL RIGHTS RESERVED 10:08PM.
NUR 607 FINAL STUDY GUIDE (Mods
1,2,8 only) Exam Questions And Answers
2025 Update.
What factors affect medication compliance? - Answer✔complex medication regimens, cost of
the drug, side effects of the drug, ease of administration and/or drug form (e.g., large tablets or
capsules), education and communication between provider and patient, perceived side effects
not truly related to the medication, functional and/or mental deficits (eg. vision changes,
dementia, arthritis of hands), provider approachability, perception of patient respect, belief
that the therapy is beneficial and outweighs the risks or side effects, the degree to which the
patient participates in the development of the treatment regimen, degree to which patient
believes that expectations and concerns are being met, degree to which the practitioner
motivates the patient to adhere to the regimen, degree to which the regimen is compatible
with the patient's busy lifestyle, medication taste.
What are important aspects of patient teaching to consider? - Answer✔Clear verbal
instructions with readable written instructions to take home if indicated. Educating regarding
side effects in advance and instructing patient to report to clinic with symptoms in order to
prevent early discontinuation of drug. Instill the belief in the patient that the drug will work for
them in order to maintain adherence, advise patient to use only one pharmacy in order to
reduce drug to drug interactions.
Causes of poly-pharmacy in the elderly. - Answer✔Varied symptoms and complaints associated
with chronic illnesses; when a drug doesn't work, another is prescribed (known as the
prescribing cascade); stockpiling discontinued medications due (primarily due to the cost);
placing prescriptions in different bottles; sharing of medications between family members;
seeing "polyproviders": seeing multiple specialists for various chronic diseases; failure of
providers to fully review the patient's other medications before prescribing; lack of primary
care provider;
Risks associated with polypharmacy in the elderly: - Answer✔Drug overuse and complications;
ADRs; creation of avoidable side effects and related complications
How do you address medication compliance issues? - Answer✔Consider the cost of the drug;
give a written list and instructions to the patient after each office visit of the medications to be
taken; give written instructions in large, easy to understand instructions to the elderly; explain
1
, ©THESTAR 2024/2025 ALL RIGHTS RESERVED 10:08PM.
and document both the brand and generic names of the drug with the patient to avoid
confusion and explain the important reason for taking the medication; review medication
changes with family/caregivers (especially for those with cognitive impairments); recommend
or provide medication planners or weekly/daily dosage containers to improve compliance and
promote safe administration; schedule timely follow-ups and check for adherence at each visit.
What data collection is included in a patient's health history encounter? - Answer✔Biographic
data, reason for seeking care, history of present illness (if in pain, remember old cart); past
health history; family history; ROS; functional health patterns (including activities of daily
living); allergies; surgical history; health habits; social history; current medications, vaccination
history; travel history. The physical exam and diagnostic tests then serve to develop differential
diagnoses.
What variables are associated with improved medication adherence? - Answer✔The patient's
perception of the encounter and benefit of treatment; If a patient is non-adherent, it is
important to document this in the chart; Discuss the risks of non adherence and document; Ask
the patient why they aren't adhering and take actions to rectify this. Document.
If patient is using a SABA more than twice a week, they are not well-controlled. - Answer✔True
If a patient has any form of persistent asthma, they should be using an ICS. - Answer✔True.
How often should a patient with persistent asthma using an ICS be monitored? - Answer✔Every
1-6 mos. A PEF (peak expiratory flow) should be done often. (Think of this as a simple FEv1). But
you MUST know the patient's baseline first. If it is 80% or above, this is good. If it is 50-80%,
caution. If it is below 50% emergency! If a patient has an exacerbation, they should be seen
back in the office in one week. If a patient has just started treatment for asthma, they should be
seen in 3 months.
What vaccinations are especially important for those with COPD and asthma? -
Answer✔influenza and pneumococcal
When are oral corticosteroids indicated in asthma patients? - Answer✔When a patient has an
acute exacerbation, they will need a 5-10 day course of oral prednisone with rapid dose
reduction. They may also be prescribed for patients with poorly controlled asthma (e.g. severe
persistent).
Should an ICS be prescribed as needed? - Answer✔Never. It should be used as maintenance
therapy.
How should cortisone therapy be discontinued in asthma patients? - Answer✔If asthma
symptoms are well controlled for three months, oral steroids can be D/C'd first. Then the dose
of inhaled corticosteroids can be reduced by 50%. Further reduction in therapy can include
reducing the ICS/LABA dose to once daily. If the patient's asthma has been symptom-free for 6-
12 months AND there are no risk factors for exacerbations, the long term control regimen may
be stopped.
2
NUR 607 FINAL STUDY GUIDE (Mods
1,2,8 only) Exam Questions And Answers
2025 Update.
What factors affect medication compliance? - Answer✔complex medication regimens, cost of
the drug, side effects of the drug, ease of administration and/or drug form (e.g., large tablets or
capsules), education and communication between provider and patient, perceived side effects
not truly related to the medication, functional and/or mental deficits (eg. vision changes,
dementia, arthritis of hands), provider approachability, perception of patient respect, belief
that the therapy is beneficial and outweighs the risks or side effects, the degree to which the
patient participates in the development of the treatment regimen, degree to which patient
believes that expectations and concerns are being met, degree to which the practitioner
motivates the patient to adhere to the regimen, degree to which the regimen is compatible
with the patient's busy lifestyle, medication taste.
What are important aspects of patient teaching to consider? - Answer✔Clear verbal
instructions with readable written instructions to take home if indicated. Educating regarding
side effects in advance and instructing patient to report to clinic with symptoms in order to
prevent early discontinuation of drug. Instill the belief in the patient that the drug will work for
them in order to maintain adherence, advise patient to use only one pharmacy in order to
reduce drug to drug interactions.
Causes of poly-pharmacy in the elderly. - Answer✔Varied symptoms and complaints associated
with chronic illnesses; when a drug doesn't work, another is prescribed (known as the
prescribing cascade); stockpiling discontinued medications due (primarily due to the cost);
placing prescriptions in different bottles; sharing of medications between family members;
seeing "polyproviders": seeing multiple specialists for various chronic diseases; failure of
providers to fully review the patient's other medications before prescribing; lack of primary
care provider;
Risks associated with polypharmacy in the elderly: - Answer✔Drug overuse and complications;
ADRs; creation of avoidable side effects and related complications
How do you address medication compliance issues? - Answer✔Consider the cost of the drug;
give a written list and instructions to the patient after each office visit of the medications to be
taken; give written instructions in large, easy to understand instructions to the elderly; explain
1
, ©THESTAR 2024/2025 ALL RIGHTS RESERVED 10:08PM.
and document both the brand and generic names of the drug with the patient to avoid
confusion and explain the important reason for taking the medication; review medication
changes with family/caregivers (especially for those with cognitive impairments); recommend
or provide medication planners or weekly/daily dosage containers to improve compliance and
promote safe administration; schedule timely follow-ups and check for adherence at each visit.
What data collection is included in a patient's health history encounter? - Answer✔Biographic
data, reason for seeking care, history of present illness (if in pain, remember old cart); past
health history; family history; ROS; functional health patterns (including activities of daily
living); allergies; surgical history; health habits; social history; current medications, vaccination
history; travel history. The physical exam and diagnostic tests then serve to develop differential
diagnoses.
What variables are associated with improved medication adherence? - Answer✔The patient's
perception of the encounter and benefit of treatment; If a patient is non-adherent, it is
important to document this in the chart; Discuss the risks of non adherence and document; Ask
the patient why they aren't adhering and take actions to rectify this. Document.
If patient is using a SABA more than twice a week, they are not well-controlled. - Answer✔True
If a patient has any form of persistent asthma, they should be using an ICS. - Answer✔True.
How often should a patient with persistent asthma using an ICS be monitored? - Answer✔Every
1-6 mos. A PEF (peak expiratory flow) should be done often. (Think of this as a simple FEv1). But
you MUST know the patient's baseline first. If it is 80% or above, this is good. If it is 50-80%,
caution. If it is below 50% emergency! If a patient has an exacerbation, they should be seen
back in the office in one week. If a patient has just started treatment for asthma, they should be
seen in 3 months.
What vaccinations are especially important for those with COPD and asthma? -
Answer✔influenza and pneumococcal
When are oral corticosteroids indicated in asthma patients? - Answer✔When a patient has an
acute exacerbation, they will need a 5-10 day course of oral prednisone with rapid dose
reduction. They may also be prescribed for patients with poorly controlled asthma (e.g. severe
persistent).
Should an ICS be prescribed as needed? - Answer✔Never. It should be used as maintenance
therapy.
How should cortisone therapy be discontinued in asthma patients? - Answer✔If asthma
symptoms are well controlled for three months, oral steroids can be D/C'd first. Then the dose
of inhaled corticosteroids can be reduced by 50%. Further reduction in therapy can include
reducing the ICS/LABA dose to once daily. If the patient's asthma has been symptom-free for 6-
12 months AND there are no risk factors for exacerbations, the long term control regimen may
be stopped.
2
