,Pharmacotherapeutics Review & Practice
Questions: 2025 Certified Prep
📘 Verified | Detailed Rationales | 1,120 Questions | Designed for Guaranteed Clinical
Competency
Table of Contents
1. Issues for the Practitioner in Drug Therapy
2. Pharmacokinetic Basis of Therapeutics and Pharmacodynamic Principles
3. Impact of Drug Interactions and Adverse Events on Therapeutics
4. Principles of Pharmacotherapy in Pediatrics, Pregnancy and Lactation
5. Pharmacotherapy Principles in Older Adults
6. Principles of Antimicrobial Therapy
7. Pharmacogenomics
8. The Economics of Pharmacotherapeutics
9. Principles of Pharmacology in Pain Management
10. Pain Management in Opioid Use Disorder (OUD) Patients
11. Cannabis and Pain Management
12. Dermatitis
13. Bacterial, Fungal, and Viral Infections of the Skin
14. Psoriasis
15. Acne Vulgaris and Rosacea
16. Ophthalmic Disorders
17. Otitis Media and Otitis Externa
18. Hypertension
19. Hyperlipidemia
20. Chronic Stable Angina and Myocardial Infarction
21. Heart Failure
,22. Arrhythmias
23. Respiratory Infections
24. Asthma and Chronic Obstructive Pulmonary Disease
25. Gastric, Functional and Inflammatory Bowel Disorders
26. Gastroesophageal Reflux Disease and Peptic Ulcer Disease
27. Liver Diseases
28. Urinary Tract Infection
29. Prostatic Disorders and Erectile Dysfunction
30. Overactive Bladder
31. Sexually Transmitted Infections
32. Osteoarthritis and Gout
33. Osteoporosis
34. Rheumatoid Arthritis
35. Headaches
36. Seizure Disorders
37. Alzheimer’s Disease
38. Parkinson Disease
39. Major Depressive Disorder and Bipolar Disorders
40. Anxiety Disorders
41. Sleep Disorders
42. Attention Deficit Hyperactivity Disorder
43. Substance Use Disorders
44. Diabetes Mellitus
45. Thyroid and Parathyroid Disorders
46. Allergies and Allergic Reactions
47. Human Immunodeficiency Virus
48. Organ Transplantation
,49. Pharmacotherapy for Select Thromboembolic Disorders
50. Anemias
51. Immunizations
52. Smoking Cessation
53. Weight Loss
54. Contraception
55. Menopause
56. Vaginitis
,1. An APP practicing in State A wants to initiate a Schedule II
controlled substance. Which action best ensures compliance
with state regulations? A. Prescribe electronically without
consulting state law. B. Verify state-specific prescriptive
authority and complete required documentation. C. Delegate
prescription writing to a supervising physician. D. Issue a verbal
order and document it later.
Correct Answer: B Rationale: APPs must verify prescriptive
authority per state law and complete documentation (B). E-
prescribe without verification risks legal breaches (A),
delegation to physicians (C) may violate scope, and verbal
orders for Schedule II are prohibited (D).
2. A patient of Hispanic descent has difficulty understanding
medication instructions due to limited English proficiency. The
APP should: A. Provide standard written instructions in English
only. B. Use medical jargon to emphasize importance. C.
Arrange for professional interpreter services and culturally
tailored education materials. D. Ask the patient’s family
member to interpret.
Correct Answer: C Rationale: Professional interpreters and
culturally appropriate materials improve comprehension and
adherence (C). English-only instructions (A) and jargon (B)
hinder understanding. Family members (D) may misinterpret
and compromise confidentiality.
3. A 78-year-old patient with multiple chronic conditions is on
eight medications. To reduce polypharmacy, the APP should
,first: A. Discontinue all unnecessary meds without patient
input. B. Conduct a comprehensive medication review with
evidence-based tools. C. Replace all brand-name drugs with
generics. D. Ask the patient to stop the oldest prescriptions
first.
Correct Answer: B Rationale: A comprehensive review
identifies unnecessary or harmful combinations (B). Abrupt
discontinuation (A) risks withdrawal. Generics (C) reduce cost,
not count. Arbitrary stopping (D) lacks systematic approach.
4. When prescribing a new antihypertensive, which factor best
reflects evidence-based decision-making? A. Selecting the
newest drug on the market. B. Choosing therapy based on
clinical guidelines and patient comorbidities. C. Following only
patient preference. D. Prescribing the most expensive option
for perceived quality.
Correct Answer: B Rationale: Clinical guidelines and
comorbidity considerations ensure optimal outcomes (B).
Newness (A) and cost (D) don’t guarantee benefit. Patient
preference (C) is important but must be balanced with
evidence.
5. An APP suspects a colleague is overprescribing opioids. The
first ethical action is to: A. Report directly to the state board
without internal discussion. B. Confront the colleague and offer
to assist in reviewing prescribing patterns. C. Ignore it to
maintain workplace harmony. D. Encourage patients to seek
alternative providers.
,Correct Answer: B Rationale: Ethical accountability begins with
collegial discussion and support (B). Immediate external
reporting (A) may violate process. Ignoring (C) is unethical.
Redirecting patients (D) avoids addressing issue.
6. To improve adherence in a patient with low health literacy,
the APP should: A. Provide detailed pharmacology handouts. B.
Use the teach-back method during education. C. Assume
patient understands since they nod. D. Email instructions only.
Correct Answer: B Rationale: Teach-back confirms
understanding (B). Detailed handouts (A) may overwhelm.
Nodding isn’t reliable (C). Email excludes those with limited
access (D).
7. State law requires APPs to have a collaborating physician for
prescribing. The APP’s prescription should include: A. Only
APP’s signature. B. APP’s signature and collaborating
physician’s DEA number. C. Physician’s signature only. D. APP’s
signature with no additional info.
Correct Answer: B Rationale: Collaborative agreements and
DEA numbers ensure legal compliance (B). APP-only (A/D) or
physician-only signatures (C) do not meet state requirements.
8. When balancing risks and benefits for an elderly patient
starting a benzodiazepine, the APP should consider all EXCEPT:
A. Fall risk and cognitive impairment. B. Patient’s history of
substance use disorder. C. Potential for drug interactions. D.
Prescribing higher doses due to age-related pharmacokinetics.
,Correct Answer: D Rationale: Elderly require lower, not higher,
doses (D). The other factors (A–C) are critical safety
considerations.
9. A patient voices concern about medication costs. The APP
can enhance shared decision-making by: A. Ignoring cost
discussions. B. Prescribing the cheapest option without efficacy
consideration. C. Discussing therapeutic alternatives and costs,
aligning with patient values. D. Referring to a specialist without
addressing costs.
Correct Answer: C Rationale: Discussing options and costs
empowers patients (C). Ignoring (A) or assenting to cheapest
always (B) may compromise treatment. Referrals (D) avoid
addressing immediate needs.
10. An APP documents a prescription error and notifies the
patient. This reflects: A. Lack of accountability. B. Ethical
transparency and patient safety. C. Admission of incompetence.
D. Legal malpractice.
Correct Answer: B Rationale: Transparency fosters trust and
safety (B). It’s not incompetence (C), malpractice (D), or lack of
accountability (A).
11. An APP’s collaborative agreement expires. To continue
prescribing, the APP must: A. Continue as usual and renew
later. B. Cease prescribing until agreement is reinstated. C.
,Substitute another APP as collaborator. D. Delegate prescribing
to a nurse.
Correct Answer: B Rationale: Without a valid agreement, APPs
cannot legally prescribe (B). Continuing (A) risks violation.
Another APP (C) must have proper agreement. Nurses cannot
prescribe Schedule II (D).
12. A pharmaceutical rep offers gifts to influence prescribing.
The APP should: A. Accept small gifts to maintain rapport. B.
Refuse gifts and follow institutional policies. C. Accept and
reciprocate with favors. D. Ignore conflict of interest concerns.
Correct Answer: B Rationale: Ethical standards prohibit undue
influence; refusal aligns with policy (B). Accepting (A/C) biases
prescribing. Ignoring (D) breaches ethics.
13. To deprescribe proton pump inhibitors safely, the APP
should: A. Stop abruptly in all patients. B. Taper dose based on
symptom control and guidelines. C. Replace with H2-blocker in
all cases. D. Ignore patient input.
Correct Answer: B Rationale: Tapering reduces rebound acid
(B). Abrupt cessation (A) causes symptoms. H2-blockers (C) not
always indicated. Patient input (D) is essential.
14. A patient misses doses due to forgetfulness. The best
motivational strategy is to: A. Lecture about consequences. B.
Collaborate to set reminders and goals. C. Impose fines for
nonadherence. D. Blame the patient.
, Correct Answer: B Rationale: Collaborative goal-setting and
reminders support adherence (B). Lecturing (A), fines (C), and
blame (D) demotivate.
15. An APP uses teach-back to assess understanding of inhaler
technique. This method: A. Tests patient medical knowledge. B.
Confirms accurate comprehension and skill. C. Is time-
consuming and unnecessary. D. Relies on patient guessing.
Correct Answer: B Rationale: Teach-back ensures patients
demonstrate proper use (B). It’s not a trivia test (A). Time
invested improves outcomes. It’s guided, not guessing (D).
16. A patient’s cultural diet includes herbal teas that may
interact with warfarin. The APP should: A. Advise immediate
discontinuation without discussion. B. Explore beliefs, educate
on interaction, and collaborate on safe alternatives. C. Ignore
cultural practices. D. Substitute low-molecular-weight heparin.
Correct Answer: B Rationale: Cultural competence involves
respectful dialogue and joint planning (B). Abrupt edicts (A) and
ignoring (C) harm trust. Heparin substitution (D) unrelated.
17. State law mandates electronic prescribing of controlled
substances. The APP’s paper prescription is: A. Acceptable if
signed. B. Invalid and noncompliant. C. Preferred for patient
convenience. D. Valid for noncontrolled drugs.
Correct Answer: B Rationale: Controlled substances require
electronic prescriptions by law (B). Signed paper is
noncompliant (A). Convenience (C) doesn’t override. Paper
Questions: 2025 Certified Prep
📘 Verified | Detailed Rationales | 1,120 Questions | Designed for Guaranteed Clinical
Competency
Table of Contents
1. Issues for the Practitioner in Drug Therapy
2. Pharmacokinetic Basis of Therapeutics and Pharmacodynamic Principles
3. Impact of Drug Interactions and Adverse Events on Therapeutics
4. Principles of Pharmacotherapy in Pediatrics, Pregnancy and Lactation
5. Pharmacotherapy Principles in Older Adults
6. Principles of Antimicrobial Therapy
7. Pharmacogenomics
8. The Economics of Pharmacotherapeutics
9. Principles of Pharmacology in Pain Management
10. Pain Management in Opioid Use Disorder (OUD) Patients
11. Cannabis and Pain Management
12. Dermatitis
13. Bacterial, Fungal, and Viral Infections of the Skin
14. Psoriasis
15. Acne Vulgaris and Rosacea
16. Ophthalmic Disorders
17. Otitis Media and Otitis Externa
18. Hypertension
19. Hyperlipidemia
20. Chronic Stable Angina and Myocardial Infarction
21. Heart Failure
,22. Arrhythmias
23. Respiratory Infections
24. Asthma and Chronic Obstructive Pulmonary Disease
25. Gastric, Functional and Inflammatory Bowel Disorders
26. Gastroesophageal Reflux Disease and Peptic Ulcer Disease
27. Liver Diseases
28. Urinary Tract Infection
29. Prostatic Disorders and Erectile Dysfunction
30. Overactive Bladder
31. Sexually Transmitted Infections
32. Osteoarthritis and Gout
33. Osteoporosis
34. Rheumatoid Arthritis
35. Headaches
36. Seizure Disorders
37. Alzheimer’s Disease
38. Parkinson Disease
39. Major Depressive Disorder and Bipolar Disorders
40. Anxiety Disorders
41. Sleep Disorders
42. Attention Deficit Hyperactivity Disorder
43. Substance Use Disorders
44. Diabetes Mellitus
45. Thyroid and Parathyroid Disorders
46. Allergies and Allergic Reactions
47. Human Immunodeficiency Virus
48. Organ Transplantation
,49. Pharmacotherapy for Select Thromboembolic Disorders
50. Anemias
51. Immunizations
52. Smoking Cessation
53. Weight Loss
54. Contraception
55. Menopause
56. Vaginitis
,1. An APP practicing in State A wants to initiate a Schedule II
controlled substance. Which action best ensures compliance
with state regulations? A. Prescribe electronically without
consulting state law. B. Verify state-specific prescriptive
authority and complete required documentation. C. Delegate
prescription writing to a supervising physician. D. Issue a verbal
order and document it later.
Correct Answer: B Rationale: APPs must verify prescriptive
authority per state law and complete documentation (B). E-
prescribe without verification risks legal breaches (A),
delegation to physicians (C) may violate scope, and verbal
orders for Schedule II are prohibited (D).
2. A patient of Hispanic descent has difficulty understanding
medication instructions due to limited English proficiency. The
APP should: A. Provide standard written instructions in English
only. B. Use medical jargon to emphasize importance. C.
Arrange for professional interpreter services and culturally
tailored education materials. D. Ask the patient’s family
member to interpret.
Correct Answer: C Rationale: Professional interpreters and
culturally appropriate materials improve comprehension and
adherence (C). English-only instructions (A) and jargon (B)
hinder understanding. Family members (D) may misinterpret
and compromise confidentiality.
3. A 78-year-old patient with multiple chronic conditions is on
eight medications. To reduce polypharmacy, the APP should
,first: A. Discontinue all unnecessary meds without patient
input. B. Conduct a comprehensive medication review with
evidence-based tools. C. Replace all brand-name drugs with
generics. D. Ask the patient to stop the oldest prescriptions
first.
Correct Answer: B Rationale: A comprehensive review
identifies unnecessary or harmful combinations (B). Abrupt
discontinuation (A) risks withdrawal. Generics (C) reduce cost,
not count. Arbitrary stopping (D) lacks systematic approach.
4. When prescribing a new antihypertensive, which factor best
reflects evidence-based decision-making? A. Selecting the
newest drug on the market. B. Choosing therapy based on
clinical guidelines and patient comorbidities. C. Following only
patient preference. D. Prescribing the most expensive option
for perceived quality.
Correct Answer: B Rationale: Clinical guidelines and
comorbidity considerations ensure optimal outcomes (B).
Newness (A) and cost (D) don’t guarantee benefit. Patient
preference (C) is important but must be balanced with
evidence.
5. An APP suspects a colleague is overprescribing opioids. The
first ethical action is to: A. Report directly to the state board
without internal discussion. B. Confront the colleague and offer
to assist in reviewing prescribing patterns. C. Ignore it to
maintain workplace harmony. D. Encourage patients to seek
alternative providers.
,Correct Answer: B Rationale: Ethical accountability begins with
collegial discussion and support (B). Immediate external
reporting (A) may violate process. Ignoring (C) is unethical.
Redirecting patients (D) avoids addressing issue.
6. To improve adherence in a patient with low health literacy,
the APP should: A. Provide detailed pharmacology handouts. B.
Use the teach-back method during education. C. Assume
patient understands since they nod. D. Email instructions only.
Correct Answer: B Rationale: Teach-back confirms
understanding (B). Detailed handouts (A) may overwhelm.
Nodding isn’t reliable (C). Email excludes those with limited
access (D).
7. State law requires APPs to have a collaborating physician for
prescribing. The APP’s prescription should include: A. Only
APP’s signature. B. APP’s signature and collaborating
physician’s DEA number. C. Physician’s signature only. D. APP’s
signature with no additional info.
Correct Answer: B Rationale: Collaborative agreements and
DEA numbers ensure legal compliance (B). APP-only (A/D) or
physician-only signatures (C) do not meet state requirements.
8. When balancing risks and benefits for an elderly patient
starting a benzodiazepine, the APP should consider all EXCEPT:
A. Fall risk and cognitive impairment. B. Patient’s history of
substance use disorder. C. Potential for drug interactions. D.
Prescribing higher doses due to age-related pharmacokinetics.
,Correct Answer: D Rationale: Elderly require lower, not higher,
doses (D). The other factors (A–C) are critical safety
considerations.
9. A patient voices concern about medication costs. The APP
can enhance shared decision-making by: A. Ignoring cost
discussions. B. Prescribing the cheapest option without efficacy
consideration. C. Discussing therapeutic alternatives and costs,
aligning with patient values. D. Referring to a specialist without
addressing costs.
Correct Answer: C Rationale: Discussing options and costs
empowers patients (C). Ignoring (A) or assenting to cheapest
always (B) may compromise treatment. Referrals (D) avoid
addressing immediate needs.
10. An APP documents a prescription error and notifies the
patient. This reflects: A. Lack of accountability. B. Ethical
transparency and patient safety. C. Admission of incompetence.
D. Legal malpractice.
Correct Answer: B Rationale: Transparency fosters trust and
safety (B). It’s not incompetence (C), malpractice (D), or lack of
accountability (A).
11. An APP’s collaborative agreement expires. To continue
prescribing, the APP must: A. Continue as usual and renew
later. B. Cease prescribing until agreement is reinstated. C.
,Substitute another APP as collaborator. D. Delegate prescribing
to a nurse.
Correct Answer: B Rationale: Without a valid agreement, APPs
cannot legally prescribe (B). Continuing (A) risks violation.
Another APP (C) must have proper agreement. Nurses cannot
prescribe Schedule II (D).
12. A pharmaceutical rep offers gifts to influence prescribing.
The APP should: A. Accept small gifts to maintain rapport. B.
Refuse gifts and follow institutional policies. C. Accept and
reciprocate with favors. D. Ignore conflict of interest concerns.
Correct Answer: B Rationale: Ethical standards prohibit undue
influence; refusal aligns with policy (B). Accepting (A/C) biases
prescribing. Ignoring (D) breaches ethics.
13. To deprescribe proton pump inhibitors safely, the APP
should: A. Stop abruptly in all patients. B. Taper dose based on
symptom control and guidelines. C. Replace with H2-blocker in
all cases. D. Ignore patient input.
Correct Answer: B Rationale: Tapering reduces rebound acid
(B). Abrupt cessation (A) causes symptoms. H2-blockers (C) not
always indicated. Patient input (D) is essential.
14. A patient misses doses due to forgetfulness. The best
motivational strategy is to: A. Lecture about consequences. B.
Collaborate to set reminders and goals. C. Impose fines for
nonadherence. D. Blame the patient.
, Correct Answer: B Rationale: Collaborative goal-setting and
reminders support adherence (B). Lecturing (A), fines (C), and
blame (D) demotivate.
15. An APP uses teach-back to assess understanding of inhaler
technique. This method: A. Tests patient medical knowledge. B.
Confirms accurate comprehension and skill. C. Is time-
consuming and unnecessary. D. Relies on patient guessing.
Correct Answer: B Rationale: Teach-back ensures patients
demonstrate proper use (B). It’s not a trivia test (A). Time
invested improves outcomes. It’s guided, not guessing (D).
16. A patient’s cultural diet includes herbal teas that may
interact with warfarin. The APP should: A. Advise immediate
discontinuation without discussion. B. Explore beliefs, educate
on interaction, and collaborate on safe alternatives. C. Ignore
cultural practices. D. Substitute low-molecular-weight heparin.
Correct Answer: B Rationale: Cultural competence involves
respectful dialogue and joint planning (B). Abrupt edicts (A) and
ignoring (C) harm trust. Heparin substitution (D) unrelated.
17. State law mandates electronic prescribing of controlled
substances. The APP’s paper prescription is: A. Acceptable if
signed. B. Invalid and noncompliant. C. Preferred for patient
convenience. D. Valid for noncontrolled drugs.
Correct Answer: B Rationale: Controlled substances require
electronic prescriptions by law (B). Signed paper is
noncompliant (A). Convenience (C) doesn’t override. Paper
