NR565 Midterm Study
APRN prescribing role - correct answer Prescriptive authority for nurse practitioners also
regulates prescribing rights beyond medications and controlled substances. These rights include
therapeutic devices and services and are outlined in state practice laws and regulations and
include Durable Medical Equipment (DME) such as wheelchairs, power scooters, hospital beds,
portable oxygen equipment, handicap placards, etc. and medical services such as Physical
Therapy (PT), Occupational Therapy (OT), home health services, etc. Prescriptive authority
encompasses more than writing a prescription correctly. It requires adherence to ethical
guidelines to ensure that patients are safeguarded from harm. Ethical prescribing starts with
being well-informed about medications. Mechanism of action, efficacy, and safety are important
considerations, as are a patient's distinct needs and circumstances, including the number of
medications prescribed (Mitchell & Oliphant, 2016). Most patients receiving a prescription are
taking other medications, whether prescription or over-the-counter. Appropriate selection,
dosing, and duration of pharmaceutical agents are key to maximizing outcomes and minimizing
adverse effects
benefits of full practice authority - correct answer Nurse practitioners have the autonomy to
evaluate patients, diagnose, order and interpret tests, initiate and manage treatments and
prescribe medications, including controlled substances without physician oversight
promoting positive outcomes through prudent prescribing practices - correct answer
Administering medications and prescribing medications are two distinct processes. Prescription
writing requires prudent and deliberate decision-making processes to maintain patient safety
and reduce liability, including:
*documentation of a provider-patient relationship for the recipient of the prescribed
medications
*documentation of a thorough history and physical examination for the recipient
*documentation of discussions regarding risk factors, side effects, or therapy options
*documentation of drug monitoring or titration plan, if applicable
, NR565 Midterm Study
*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the formulation of a diagnosis
based on clinical reasoning and the selection and monitoring of the most appropriate
pharmacological treatment
Considerations include: Cost, guidelines, availability, interactions, side effects, allergies,
hepatic/renal functions, need for monitoring, & special populations
Beer's Criteria - correct answer identifies drugs with a high likelihood of causing adverse effects
in older adults. Accordingly, drugs on this list should generally be avoided in adults older than
65 years except when the benefits are significantly greater than the risks.
Pharmacodynamics - correct answer the study of the biochemical and physiologic effects of
drugs on the body and the molecular mechanisms by which those effects are produced
Pharmacokinetics - correct answer the study of drug movement throughout the body
Pharmacogenomics - correct answer the study of how genes affect a person's response to
drugs. The purpose of this is to combine the sciences of genomics and pharmacology to provide
individualized, targeted, safe drug therapies to patients
CYP450 inducers - correct answer Inducers are xenobiotics (medications and environmental
agents) that elevate CYP450 enzyme activity by increasing enzyme synthesis. This action leads
to additional sites available for biotransformation. The increased number of sites enhances
medication metabolism, decreasing the concentration of the "parent drug" while increasing
metabolite production.
APRN prescribing role - correct answer Prescriptive authority for nurse practitioners also
regulates prescribing rights beyond medications and controlled substances. These rights include
therapeutic devices and services and are outlined in state practice laws and regulations and
include Durable Medical Equipment (DME) such as wheelchairs, power scooters, hospital beds,
portable oxygen equipment, handicap placards, etc. and medical services such as Physical
Therapy (PT), Occupational Therapy (OT), home health services, etc. Prescriptive authority
encompasses more than writing a prescription correctly. It requires adherence to ethical
guidelines to ensure that patients are safeguarded from harm. Ethical prescribing starts with
being well-informed about medications. Mechanism of action, efficacy, and safety are important
considerations, as are a patient's distinct needs and circumstances, including the number of
medications prescribed (Mitchell & Oliphant, 2016). Most patients receiving a prescription are
taking other medications, whether prescription or over-the-counter. Appropriate selection,
dosing, and duration of pharmaceutical agents are key to maximizing outcomes and minimizing
adverse effects
benefits of full practice authority - correct answer Nurse practitioners have the autonomy to
evaluate patients, diagnose, order and interpret tests, initiate and manage treatments and
prescribe medications, including controlled substances without physician oversight
promoting positive outcomes through prudent prescribing practices - correct answer
Administering medications and prescribing medications are two distinct processes. Prescription
writing requires prudent and deliberate decision-making processes to maintain patient safety
and reduce liability, including:
*documentation of a provider-patient relationship for the recipient of the prescribed
medications
*documentation of a thorough history and physical examination for the recipient
*documentation of discussions regarding risk factors, side effects, or therapy options
*documentation of drug monitoring or titration plan, if applicable
, NR565 Midterm Study
*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the formulation of a diagnosis
based on clinical reasoning and the selection and monitoring of the most appropriate
pharmacological treatment
Considerations include: Cost, guidelines, availability, interactions, side effects, allergies,
hepatic/renal functions, need for monitoring, & special populations
Beer's Criteria - correct answer identifies drugs with a high likelihood of causing adverse effects
in older adults. Accordingly, drugs on this list should generally be avoided in adults older than
65 years except when the benefits are significantly greater than the risks.
Pharmacodynamics - correct answer the study of the biochemical and physiologic effects of
drugs on the body and the molecular mechanisms by which those effects are produced
Pharmacokinetics - correct answer the study of drug movement throughout the body
Pharmacogenomics - correct answer the study of how genes affect a person's response to
drugs. The purpose of this is to combine the sciences of genomics and pharmacology to provide
individualized, targeted, safe drug therapies to patients
CYP450 inducers - correct answer Inducers are xenobiotics (medications and environmental
agents) that elevate CYP450 enzyme activity by increasing enzyme synthesis. This action leads
to additional sites available for biotransformation. The increased number of sites enhances
medication metabolism, decreasing the concentration of the "parent drug" while increasing
metabolite production.
