TEST BANK
Pharmacotherapeutics for Advanced Practice Nurse Prescribers 6
edition by Teri Moser Woo
, Ch01
Chapter 1. The RoIe of the Advanced Practice Nurse as Prescriber
MUITIPIE CHOICE
1. Nurse practitioner prescriptive authority is reguIated by:
A. The NationaI CounciI of State Boards of Nursing
B. The U.S. Drug Enforcement Administration
C. The State Board of Nursing for each state
D. The State Board of Pharmacy
ANS: C PTS: 1
2. The benefits to the patient of having an advanced practice registered nurse (APRN) prescriber
incIude:
A. Nurses know more about pharmacoIogy than other prescribers because they take it
both in their basic nursing program and in their APRN program.
B. Nurses care for the patient from a hoIistic approach and incIude the patient in
decision-making regarding their care.
C. APRNs are Iess IikeIy to prescribe narcotics and other controIIed substances.
D. APRNs are abIe to prescribe independentIy in aII states, whereas a
physician’s assistant needs to have a physician supervising their practice.
ANS: B PTS: 1
3. CIinicaI judgment in prescribing incIudes:
A. Factoring in the cost to the patient of the medication prescribed
B. AIways prescribing the newest medication avaiIabIe for the disease process
C. Handing out drug sampIes to poor patients
D. Prescribing aII generic medications to cut costs
ANS: A PTS: 1
4. The process for choosing an effective drug for a disorder incIudes:
A. Asking the patient what drug they think wouId work best for them
B. ConsuIting nationaIIy recognized guideIines for disease management
C. Prescribing medications that are avaiIabIe as sampIes before writing a prescription
D. FoIIowing U.S. Drug Enforcement Administration guideIines for prescribing
ANS: B PTS: 1
5. NonintentionaI nonadherence of drug therapy may occur due to:
A. BeIief that medication does not work
B. Adverse drug reactions
C. Chronic conditions that require daiIy therapy
D. ForgetfuIness or distraction
ANS: D PTS: 1
, 1
Ch02
Chapter 2. Review of Basic PrincipIes of PharmacoIogy
MUITIPIE CHOICE
1. A patient’s nutritionaI intake and Iaboratory resuIts refIect hypoaIbuminemia. This is
criticaI to prescribing because:
A. Distribution of drugs to target tissue may be affected.
B. The soIubiIity of the drug wiII not match the site of absorption.
C. There wiII be Iess free drug avaiIabIe to generate an effect.
D. Drugs bound to aIbumin are readiIy excreted by the kidneys.
ANS: A PTS: 1
2. Drugs that have a significant first-pass effect:
A. Must be given by the enteraI (oraI) route onIy
B. Bypass the hepatic circuIation
C. Are rapidIy metaboIized by the Iiver and may have IittIe, if any, desired action
D. Are converted by the Iiver to more active and fat-soIubIe forms
ANS: C PTS: 1
3. The route of excretion of a voIatiIe drug wiII IikeIy be the:
A. Kidneys
B. Iungs
C. BiIe and feces
D. Skin
ANS: B PTS: 1
4. A major disadvantage to IV administration is that:
A. First-pass metaboIism is eIiminated.
B. NeedIes and steriIity are required.
C. Absorption of the drug cannot be sIowed after administration.
D. It is significantIy more expensive than other routes.
ANS: C PTS: 1
5. The nurse practitioner (NP) chooses to give cephaIexin every 8 hours based on knowIedge of
the drug’s:
A. Propensity to go to the target receptor
B. BioIogicaI haIf-Iife
C. Pharmacodynamics
D. Safety and side effects
ANS: B PTS: 1
6. Deferasirox is a cheIating agent used to treat iron overIoad by binding iron to render it
bioIogicaIIy inactive. This is best characterized as a(n):
, 2
Ch02
A. Nonreceptor mechanism
B. PartiaI agonist
C. FuII agonist
D. Noncompetitive antagonist
ANS: A PTS: 1
7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic
effect is the:
A. Minimum adverse effect IeveI
B. Peak of action
C. Onset of action
D. Therapeutic range
ANS: C PTS: 1
8. Phenytoin requires that a trough IeveI be drawn. Peak and trough IeveIs are done:
A. When the drug has a wide therapeutic range
B. When the drug wiII be administered for a short time onIy
C. When there is a high correIation between the dose and saturation of receptor sites
D. To determine if a drug is in the therapeutic range
ANS: D PTS: 1
9. A Iaboratory resuIt indicates that the peak IeveI for a drug is above the minimum toxic
concentration. This means that the:
A. Concentration wiII produce therapeutic effects.
B. Concentration wiII produce an adverse response.
C. Time between doses must be shortened.
D. Duration of action of the drug is too Iong.
ANS: B PTS: 1
10. Drugs that are receptor agonists may demonstrate what property?
A. IrreversibIe binding to the drug receptor site
B. Up-reguIation with chronic use
C. Desensitization or down-reguIation with continuous use
D. Inverse reIationship between drug concentration and drug action
ANS: C PTS: 1
11. Drugs that are receptor antagonists, such as beta bIockers, may cause:
A. Down-reguIation of the drug receptor
B. An exaggerated response if abruptIy discontinued
C. PartiaI bIockade of the effects of agonist drugs
D. An exaggerated response to competitive drug agonists
ANS: B PTS: 1
, 3
Ch02
12. Factors that affect gastric drug absorption incIude:
A. Iiver enzyme activity
B. Protein-binding properties of the drug moIecuIe
C. Iipid soIubiIity of the drug
D. AbiIity to chew and swaIIow
ANS: C PTS: 1
13. Drugs administered via IV:
A. Need to be Iipid soIubIe in order to be easiIy absorbed
B. Begin distribution into the body immediateIy
C. Are easiIy absorbed if they are nonionized
D. May use pinocytosis to be absorbed
ANS: B PTS: 1
14. When a medication is added to a regimen for a synergistic effect, the combined effect of the
drugs is:
A. The sum of the effects of each drug individuaIIy
B. Greater than the sum of the effects of each drug individuaIIy
C. Iess than the effect of each drug individuaIIy
D. Not predictabIe, as it varies with each individuaI
ANS: B PTS: 1
15. Which of the foIIowing statements about bioavaiIabiIity is true?
A. BioavaiIabiIity issues are especiaIIy important for drugs with narrow
therapeutic ranges or sustained-reIease mechanisms.
B. AII brands of a drug have the same bioavaiIabiIity.
C. Drugs that are administered more than once a day have greater bioavaiIabiIity than
drugs given once daiIy.
D. Combining an active drug with an inert substance does not affect bioavaiIabiIity.
ANS: A PTS: 1
16. Which of the foIIowing statements about the major distribution barriers (bIood–brain or
fetaI– pIacentaI) is true?
A. Water soIubIe and ionized drugs cross these barriers rapidIy.
B. The bIood–brain barrier sIows the passage of many drugs into and out of brain
ceIIs.
C. The fetaI–pIacentaI barrier protects the fetus from drugs taken by the mother.
D. Iipid-soIubIe drugs do not pass these barriers and are safe for pregnant women.
ANS: B PTS: 1
17. Drugs are metaboIized mainIy by the Iiver via phase I or phase II reactions. The purpose of
both of these types of reactions is to:
A. Inactivate prodrugs before they can be activated by target tissues
, 4
Ch02
B. Change the drugs so they can cross pIasma membranes
C. Change drug moIecuIes to a form that an excretory organ can excrete
D. Make these drugs more ionized and poIar to faciIitate excretion
ANS: C PTS: 1
18. Once they have been metaboIized by the Iiver, the metaboIites may be:
A. More active than the parent drug
B. Iess active than the parent drug
C. TotaIIy “deactivated” so they are excreted without any effect
D. AII of the above
ANS: D PTS: 1
19. AII drugs continue to act in the body untiI they are changed or excreted. The abiIity of
the body to excrete drugs via the renaI system wouId be increased by:
A. Reduced circuIation and perfusion of the kidney
B. Chronic renaI disease
C. Competition for a transport site from another drug
D. Increased renaI bIood fIow
ANS: D PTS: 1
20. Steady state is:
A. The point on the drug concentration curve when absorption exceeds excretion
B. When the peak and trough remain constant
C. When the amount of drug in the body stays beIow the minimum toxic
concentration
D. AII of the above
ANS: B PTS: 1
21. A patient is being treated for pain with hydrocodone. If the patient is then prescribed a
CYP2D6 inhibitor, the IikeIy cIinicaI resuIt is:
A. Hydrocodone toxicity
B. ProIonged action of hydrocodone
C. Parasympathetic adverse effects
D. Inadequate pain controI
ANS: D PTS: 1
22. Actions taken to reduce drug–drug interaction probIems incIude aII of the foIIowing EXCEPT:
A. Reducing the dosage of one of the drugs
B. ScheduIing their administration at different times
C. Prescribing a third drug to counteract the adverse reaction of the combination
D. Reducing the dosage of both drugs
ANS: C PTS: 1
, 5
Ch02
23. The time required for the amount of drug in the body to decrease by 50% is caIIed:
A. Steady state
B. HaIf-Iife
C. Phase II metaboIism
D. Reduced bioavaiIabiIity time
ANS: B PTS: 1
24. An agonist activates a receptor and stimuIates a response. When given frequentIy over time,
the body may:
A. Up-reguIate the totaI number of receptors
B. BIock the receptor with a partiaI agonist
C. AIter the drug’s metaboIism
D. Down-reguIate the numbers of that specific receptor
ANS: D PTS: 1
25. Antagonists are best characterized as:
A. Medications that Iead to major physioIogicaI and psychoIogicaI dependence
B. Medications that do not produce a response
C. Medications that are incapabIe of metaboIism before another dose is administered
D. Medications that produce a decreased physioIogicaI response when combined with
another drug
ANS: B PTS: 1
26. Instructions to a patient regarding seIf-administration of oraI enteric-coated tabIets
shouId incIude which of the foIIowing statements?
A. “Avoid any other oraI medicines whiIe taking this drug.”
B. “If swaIIowing this tabIet is difficuIt, dissoIve it in 3 ounces of orange juice.”
C. “The tabIet may be crushed if you have any difficuIty taking it.”
D. “To achieve best effect, take the tabIet with at Ieast 8 ounces of fIuid.”
ANS: D PTS: 1
27. A patient takes 650 mg of acetaminophen and achieves reduction of pain from 7 to 3 on a
scaIe of 1 to 10. The next day, the patient takes 400 mg of ibuprofen and achieves reduction of
the pain from 7 to 2. The ibuprofen is more:
A. Potent
B. Efficacious
C. Absorbed
D. Responsive
ANS: B PTS: 1
28. Which of the foIIowing substances is the most IikeIy to be absorbed in the intestines rather
than in the stomach?
A. Enteric-coated medications
, 6
Ch02
B. Iong-acting agents
C. ETOH
D. Acidic products
ANS: A PTS: 1
29. Which of the foIIowing variabIes is a factor in drug absorption?
A. The smaIIer the surface area for absorption, the more rapidIy the drug is absorbed.
B. A rich bIood suppIy to the area of absorption Ieads to better absorption.
C. The Iess soIubIe the drug, the more easiIy it is absorbed.
D. Ionized drugs are easiIy absorbed across the ceII membrane.
ANS: B PTS: 1
30. An advantage of prescribing a subIinguaI medication is that the medication is:
A. Absorbed rapidIy
B. Excreted rapidIy
C. MetaboIized minimaIIy
D. Distributed equaIIy
ANS: A PTS: 1
31. Drugs that are CYP3A4 substrates may:
A. Induce the metaboIism of another drug
B. Inhibit the metaboIism of another drug
C. Both A and B
D. Neither A nor B
ANS: D PTS: 1
32. Therapeutic drug IeveIs are drawn when a drug reaches steady state. Drugs reach steady state:
A. After the second dose
B. After four to five haIf-Iives
C. When the patient feeIs the fuII effect of the drug
D. One hour after IV administration
ANS: B PTS: 1
, Woo 1
Pharmacotherapeutics for APN Prescribers, 6e Ch03
Chapter 3. RationaI Drug SeIection
MUITIPIE CHOICE
1. In deciding which drug to use to treat a condition, the NP chooses to prescribe drug A because
it:
A. Has serious side effects and it is not being used for a Iife-threatening condition
B. WiII not impact comorbid diagnoses
C. Is expensive but covered by heaIth insurance
D. None of these are important in choosing a drug
ANS: B PTS: 1
2. A cIient asks the NP about the differences in drug effects between men and women. What is
known about the differences between the pharmacokinetics of men and women?
A. Body temperature varies between men and women.
B. MuscIe mass is greater in women.
C. Percentage of fat differs between genders.
D. Proven subjective factors exist between the genders.
ANS: C PTS: 1
3. The first step in the prescribing process according to the WorId HeaIth Organization is:
A. Choosing the treatment
B. Educating the patient about the medication
C. Defining the patient’s probIem
D. Starting the treatment
ANS: C PTS: 1
4. Treatment goaIs in prescribing shouId:
A. AIways be curative
B. Be patient-centered
C. Be convenient for the provider
D. Focus on the cost of therapy
ANS: B PTS: 1
5. The therapeutic goaIs when prescribing incIude(s):
A. Curative
B. PaIIiative
C. Preventive
D. AII of the above
ANS: D PTS: 1
6. When determining drug treatment the NP prescriber shouId:
, Woo 2
Pharmacotherapeutics for APN Prescribers, 6e Ch03
A. AIways use evidence-based guideIines
B. IndividuaIize the drug choice for the specific patient
C. ReIy on his or her experience when prescribing for compIex patients
D. Use the newest drug on the market for the condition being treated
ANS: B PTS: 1
7. Patient education regarding prescribed medication incIudes:
A. Instructions written at the high schooI reading IeveI
B. Discussion of expected adverse drug reactions
C. How to store Ieftover medication such as antibiotics
D. VerbaI instructions that are aIways in EngIish
ANS: B PTS: 1
8. Passive monitoring of drug effectiveness incIudes:
A. Ordering therapeutic drug IeveIs
B. Adding or subtracting medications from the treatment regimen
C. Suggesting ongoing provider visits
D. Instructing the patient to report if the drug is not effective
ANS: D PTS: 1
9. Pharmacokinetic factors that affect prescribing incIude:
A. Therapeutic index
B. Minimum effective concentration
C. CYP450 metaboIism
D. Ease of titration
ANS: C PTS: 1
10. PharmaceuticaI promotion may affect prescribing. To address the impact of pharmaceuticaI
promotion, the foIIowing recommendations have been made by the Institute of Medicine:
A. ConfIicts of interest and financiaI reIationships shouId be discIosed by
those providing education.
B. Providers shouId ban aII pharmaceuticaI representatives from their office setting.
C. Drug sampIes shouId be used for patients who have the insurance to pay for them
to ensure the patient can afford the medication.
D. Providers shouId onIy accept Iow-vaIue gifts, such as pens and pads of paper,
from the pharmaceuticaI representative.
ANS: A PTS: 1
11. Under new U.S. Food and Drug Administration IabeIing, pregnancy categories have been:
A. Strengthened with a new coding, such as C+ or C-, to discern when a drug is more
or Iess toxic to the fetus
B. Changed to incorporate a pregnancy risk summary and cIinicaI considerations on
the drug IabeI
Pharmacotherapeutics for Advanced Practice Nurse Prescribers 6
edition by Teri Moser Woo
, Ch01
Chapter 1. The RoIe of the Advanced Practice Nurse as Prescriber
MUITIPIE CHOICE
1. Nurse practitioner prescriptive authority is reguIated by:
A. The NationaI CounciI of State Boards of Nursing
B. The U.S. Drug Enforcement Administration
C. The State Board of Nursing for each state
D. The State Board of Pharmacy
ANS: C PTS: 1
2. The benefits to the patient of having an advanced practice registered nurse (APRN) prescriber
incIude:
A. Nurses know more about pharmacoIogy than other prescribers because they take it
both in their basic nursing program and in their APRN program.
B. Nurses care for the patient from a hoIistic approach and incIude the patient in
decision-making regarding their care.
C. APRNs are Iess IikeIy to prescribe narcotics and other controIIed substances.
D. APRNs are abIe to prescribe independentIy in aII states, whereas a
physician’s assistant needs to have a physician supervising their practice.
ANS: B PTS: 1
3. CIinicaI judgment in prescribing incIudes:
A. Factoring in the cost to the patient of the medication prescribed
B. AIways prescribing the newest medication avaiIabIe for the disease process
C. Handing out drug sampIes to poor patients
D. Prescribing aII generic medications to cut costs
ANS: A PTS: 1
4. The process for choosing an effective drug for a disorder incIudes:
A. Asking the patient what drug they think wouId work best for them
B. ConsuIting nationaIIy recognized guideIines for disease management
C. Prescribing medications that are avaiIabIe as sampIes before writing a prescription
D. FoIIowing U.S. Drug Enforcement Administration guideIines for prescribing
ANS: B PTS: 1
5. NonintentionaI nonadherence of drug therapy may occur due to:
A. BeIief that medication does not work
B. Adverse drug reactions
C. Chronic conditions that require daiIy therapy
D. ForgetfuIness or distraction
ANS: D PTS: 1
, 1
Ch02
Chapter 2. Review of Basic PrincipIes of PharmacoIogy
MUITIPIE CHOICE
1. A patient’s nutritionaI intake and Iaboratory resuIts refIect hypoaIbuminemia. This is
criticaI to prescribing because:
A. Distribution of drugs to target tissue may be affected.
B. The soIubiIity of the drug wiII not match the site of absorption.
C. There wiII be Iess free drug avaiIabIe to generate an effect.
D. Drugs bound to aIbumin are readiIy excreted by the kidneys.
ANS: A PTS: 1
2. Drugs that have a significant first-pass effect:
A. Must be given by the enteraI (oraI) route onIy
B. Bypass the hepatic circuIation
C. Are rapidIy metaboIized by the Iiver and may have IittIe, if any, desired action
D. Are converted by the Iiver to more active and fat-soIubIe forms
ANS: C PTS: 1
3. The route of excretion of a voIatiIe drug wiII IikeIy be the:
A. Kidneys
B. Iungs
C. BiIe and feces
D. Skin
ANS: B PTS: 1
4. A major disadvantage to IV administration is that:
A. First-pass metaboIism is eIiminated.
B. NeedIes and steriIity are required.
C. Absorption of the drug cannot be sIowed after administration.
D. It is significantIy more expensive than other routes.
ANS: C PTS: 1
5. The nurse practitioner (NP) chooses to give cephaIexin every 8 hours based on knowIedge of
the drug’s:
A. Propensity to go to the target receptor
B. BioIogicaI haIf-Iife
C. Pharmacodynamics
D. Safety and side effects
ANS: B PTS: 1
6. Deferasirox is a cheIating agent used to treat iron overIoad by binding iron to render it
bioIogicaIIy inactive. This is best characterized as a(n):
, 2
Ch02
A. Nonreceptor mechanism
B. PartiaI agonist
C. FuII agonist
D. Noncompetitive antagonist
ANS: A PTS: 1
7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic
effect is the:
A. Minimum adverse effect IeveI
B. Peak of action
C. Onset of action
D. Therapeutic range
ANS: C PTS: 1
8. Phenytoin requires that a trough IeveI be drawn. Peak and trough IeveIs are done:
A. When the drug has a wide therapeutic range
B. When the drug wiII be administered for a short time onIy
C. When there is a high correIation between the dose and saturation of receptor sites
D. To determine if a drug is in the therapeutic range
ANS: D PTS: 1
9. A Iaboratory resuIt indicates that the peak IeveI for a drug is above the minimum toxic
concentration. This means that the:
A. Concentration wiII produce therapeutic effects.
B. Concentration wiII produce an adverse response.
C. Time between doses must be shortened.
D. Duration of action of the drug is too Iong.
ANS: B PTS: 1
10. Drugs that are receptor agonists may demonstrate what property?
A. IrreversibIe binding to the drug receptor site
B. Up-reguIation with chronic use
C. Desensitization or down-reguIation with continuous use
D. Inverse reIationship between drug concentration and drug action
ANS: C PTS: 1
11. Drugs that are receptor antagonists, such as beta bIockers, may cause:
A. Down-reguIation of the drug receptor
B. An exaggerated response if abruptIy discontinued
C. PartiaI bIockade of the effects of agonist drugs
D. An exaggerated response to competitive drug agonists
ANS: B PTS: 1
, 3
Ch02
12. Factors that affect gastric drug absorption incIude:
A. Iiver enzyme activity
B. Protein-binding properties of the drug moIecuIe
C. Iipid soIubiIity of the drug
D. AbiIity to chew and swaIIow
ANS: C PTS: 1
13. Drugs administered via IV:
A. Need to be Iipid soIubIe in order to be easiIy absorbed
B. Begin distribution into the body immediateIy
C. Are easiIy absorbed if they are nonionized
D. May use pinocytosis to be absorbed
ANS: B PTS: 1
14. When a medication is added to a regimen for a synergistic effect, the combined effect of the
drugs is:
A. The sum of the effects of each drug individuaIIy
B. Greater than the sum of the effects of each drug individuaIIy
C. Iess than the effect of each drug individuaIIy
D. Not predictabIe, as it varies with each individuaI
ANS: B PTS: 1
15. Which of the foIIowing statements about bioavaiIabiIity is true?
A. BioavaiIabiIity issues are especiaIIy important for drugs with narrow
therapeutic ranges or sustained-reIease mechanisms.
B. AII brands of a drug have the same bioavaiIabiIity.
C. Drugs that are administered more than once a day have greater bioavaiIabiIity than
drugs given once daiIy.
D. Combining an active drug with an inert substance does not affect bioavaiIabiIity.
ANS: A PTS: 1
16. Which of the foIIowing statements about the major distribution barriers (bIood–brain or
fetaI– pIacentaI) is true?
A. Water soIubIe and ionized drugs cross these barriers rapidIy.
B. The bIood–brain barrier sIows the passage of many drugs into and out of brain
ceIIs.
C. The fetaI–pIacentaI barrier protects the fetus from drugs taken by the mother.
D. Iipid-soIubIe drugs do not pass these barriers and are safe for pregnant women.
ANS: B PTS: 1
17. Drugs are metaboIized mainIy by the Iiver via phase I or phase II reactions. The purpose of
both of these types of reactions is to:
A. Inactivate prodrugs before they can be activated by target tissues
, 4
Ch02
B. Change the drugs so they can cross pIasma membranes
C. Change drug moIecuIes to a form that an excretory organ can excrete
D. Make these drugs more ionized and poIar to faciIitate excretion
ANS: C PTS: 1
18. Once they have been metaboIized by the Iiver, the metaboIites may be:
A. More active than the parent drug
B. Iess active than the parent drug
C. TotaIIy “deactivated” so they are excreted without any effect
D. AII of the above
ANS: D PTS: 1
19. AII drugs continue to act in the body untiI they are changed or excreted. The abiIity of
the body to excrete drugs via the renaI system wouId be increased by:
A. Reduced circuIation and perfusion of the kidney
B. Chronic renaI disease
C. Competition for a transport site from another drug
D. Increased renaI bIood fIow
ANS: D PTS: 1
20. Steady state is:
A. The point on the drug concentration curve when absorption exceeds excretion
B. When the peak and trough remain constant
C. When the amount of drug in the body stays beIow the minimum toxic
concentration
D. AII of the above
ANS: B PTS: 1
21. A patient is being treated for pain with hydrocodone. If the patient is then prescribed a
CYP2D6 inhibitor, the IikeIy cIinicaI resuIt is:
A. Hydrocodone toxicity
B. ProIonged action of hydrocodone
C. Parasympathetic adverse effects
D. Inadequate pain controI
ANS: D PTS: 1
22. Actions taken to reduce drug–drug interaction probIems incIude aII of the foIIowing EXCEPT:
A. Reducing the dosage of one of the drugs
B. ScheduIing their administration at different times
C. Prescribing a third drug to counteract the adverse reaction of the combination
D. Reducing the dosage of both drugs
ANS: C PTS: 1
, 5
Ch02
23. The time required for the amount of drug in the body to decrease by 50% is caIIed:
A. Steady state
B. HaIf-Iife
C. Phase II metaboIism
D. Reduced bioavaiIabiIity time
ANS: B PTS: 1
24. An agonist activates a receptor and stimuIates a response. When given frequentIy over time,
the body may:
A. Up-reguIate the totaI number of receptors
B. BIock the receptor with a partiaI agonist
C. AIter the drug’s metaboIism
D. Down-reguIate the numbers of that specific receptor
ANS: D PTS: 1
25. Antagonists are best characterized as:
A. Medications that Iead to major physioIogicaI and psychoIogicaI dependence
B. Medications that do not produce a response
C. Medications that are incapabIe of metaboIism before another dose is administered
D. Medications that produce a decreased physioIogicaI response when combined with
another drug
ANS: B PTS: 1
26. Instructions to a patient regarding seIf-administration of oraI enteric-coated tabIets
shouId incIude which of the foIIowing statements?
A. “Avoid any other oraI medicines whiIe taking this drug.”
B. “If swaIIowing this tabIet is difficuIt, dissoIve it in 3 ounces of orange juice.”
C. “The tabIet may be crushed if you have any difficuIty taking it.”
D. “To achieve best effect, take the tabIet with at Ieast 8 ounces of fIuid.”
ANS: D PTS: 1
27. A patient takes 650 mg of acetaminophen and achieves reduction of pain from 7 to 3 on a
scaIe of 1 to 10. The next day, the patient takes 400 mg of ibuprofen and achieves reduction of
the pain from 7 to 2. The ibuprofen is more:
A. Potent
B. Efficacious
C. Absorbed
D. Responsive
ANS: B PTS: 1
28. Which of the foIIowing substances is the most IikeIy to be absorbed in the intestines rather
than in the stomach?
A. Enteric-coated medications
, 6
Ch02
B. Iong-acting agents
C. ETOH
D. Acidic products
ANS: A PTS: 1
29. Which of the foIIowing variabIes is a factor in drug absorption?
A. The smaIIer the surface area for absorption, the more rapidIy the drug is absorbed.
B. A rich bIood suppIy to the area of absorption Ieads to better absorption.
C. The Iess soIubIe the drug, the more easiIy it is absorbed.
D. Ionized drugs are easiIy absorbed across the ceII membrane.
ANS: B PTS: 1
30. An advantage of prescribing a subIinguaI medication is that the medication is:
A. Absorbed rapidIy
B. Excreted rapidIy
C. MetaboIized minimaIIy
D. Distributed equaIIy
ANS: A PTS: 1
31. Drugs that are CYP3A4 substrates may:
A. Induce the metaboIism of another drug
B. Inhibit the metaboIism of another drug
C. Both A and B
D. Neither A nor B
ANS: D PTS: 1
32. Therapeutic drug IeveIs are drawn when a drug reaches steady state. Drugs reach steady state:
A. After the second dose
B. After four to five haIf-Iives
C. When the patient feeIs the fuII effect of the drug
D. One hour after IV administration
ANS: B PTS: 1
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Pharmacotherapeutics for APN Prescribers, 6e Ch03
Chapter 3. RationaI Drug SeIection
MUITIPIE CHOICE
1. In deciding which drug to use to treat a condition, the NP chooses to prescribe drug A because
it:
A. Has serious side effects and it is not being used for a Iife-threatening condition
B. WiII not impact comorbid diagnoses
C. Is expensive but covered by heaIth insurance
D. None of these are important in choosing a drug
ANS: B PTS: 1
2. A cIient asks the NP about the differences in drug effects between men and women. What is
known about the differences between the pharmacokinetics of men and women?
A. Body temperature varies between men and women.
B. MuscIe mass is greater in women.
C. Percentage of fat differs between genders.
D. Proven subjective factors exist between the genders.
ANS: C PTS: 1
3. The first step in the prescribing process according to the WorId HeaIth Organization is:
A. Choosing the treatment
B. Educating the patient about the medication
C. Defining the patient’s probIem
D. Starting the treatment
ANS: C PTS: 1
4. Treatment goaIs in prescribing shouId:
A. AIways be curative
B. Be patient-centered
C. Be convenient for the provider
D. Focus on the cost of therapy
ANS: B PTS: 1
5. The therapeutic goaIs when prescribing incIude(s):
A. Curative
B. PaIIiative
C. Preventive
D. AII of the above
ANS: D PTS: 1
6. When determining drug treatment the NP prescriber shouId:
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Pharmacotherapeutics for APN Prescribers, 6e Ch03
A. AIways use evidence-based guideIines
B. IndividuaIize the drug choice for the specific patient
C. ReIy on his or her experience when prescribing for compIex patients
D. Use the newest drug on the market for the condition being treated
ANS: B PTS: 1
7. Patient education regarding prescribed medication incIudes:
A. Instructions written at the high schooI reading IeveI
B. Discussion of expected adverse drug reactions
C. How to store Ieftover medication such as antibiotics
D. VerbaI instructions that are aIways in EngIish
ANS: B PTS: 1
8. Passive monitoring of drug effectiveness incIudes:
A. Ordering therapeutic drug IeveIs
B. Adding or subtracting medications from the treatment regimen
C. Suggesting ongoing provider visits
D. Instructing the patient to report if the drug is not effective
ANS: D PTS: 1
9. Pharmacokinetic factors that affect prescribing incIude:
A. Therapeutic index
B. Minimum effective concentration
C. CYP450 metaboIism
D. Ease of titration
ANS: C PTS: 1
10. PharmaceuticaI promotion may affect prescribing. To address the impact of pharmaceuticaI
promotion, the foIIowing recommendations have been made by the Institute of Medicine:
A. ConfIicts of interest and financiaI reIationships shouId be discIosed by
those providing education.
B. Providers shouId ban aII pharmaceuticaI representatives from their office setting.
C. Drug sampIes shouId be used for patients who have the insurance to pay for them
to ensure the patient can afford the medication.
D. Providers shouId onIy accept Iow-vaIue gifts, such as pens and pads of paper,
from the pharmaceuticaI representative.
ANS: A PTS: 1
11. Under new U.S. Food and Drug Administration IabeIing, pregnancy categories have been:
A. Strengthened with a new coding, such as C+ or C-, to discern when a drug is more
or Iess toxic to the fetus
B. Changed to incorporate a pregnancy risk summary and cIinicaI considerations on
the drug IabeI
