,2025 PHARMACOTHERAPEUTICS EXAM GUIDE:
ARCANGELO & PETERSON TEST BANK
📘 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
,Focus Area 1: Prescriptive Authority and State-Specific Legal
Scope
1. An advanced practice provider (APP) licensed in State X
wants to prescribe a Schedule II opioid. Which action
ensures compliance with state law?
A. Prescribe via verbal order and follow up with a written
prescription within seven days
B. Use a state-approved e-prescribing system with
prescriptive privileges indicated
C. Delegate prescription writing to a collaborating
physician
D. Issue a paper prescription with the physician’s signature
on behalf of the APP
Answer: B
Rationale: Only e-prescribing systems recognized by State
X link APP credentials to prescribing authority; verbal
orders (A) are disallowed for Schedule II, delegation (C) is
impermissible, and signing for a physician (D) violates
scope.
2. A nurse practitioner moves from State A to State B.
Which step is most critical before writing medication
orders in State B?
A. Notify former state board of relocation
B. Verify prescriptive authority under State B’s statutes
C. Review federal Controlled Substances Act
, D. Establish a collaborative agreement remotely
Answer: B
Rationale: APP must confirm State B’s legal scope;
notifying (A) and federal knowledge (C) don’t grant
authority, and a collaborative agreement (D) requires local
statutes first.
3. Under a collaborative practice agreement, the APP can
independently initiate which class of medication?
A. Antihypertensives, if protocols specify dosage ranges
B. Chemotherapy agents without physician signature
C. Schedule I controlled substances
D. Biologics not listed in the agreement
Answer: A
Rationale: Protocol-based antihypertensive initiation is
allowed; chemotherapy (B), Schedule I (C), and non-
protocol biologics (D) exceed typical agreement scope.
4. Which documentation demonstrates that an APP is
practicing within state-prescribed authority?
A. Inclusion of supervising physician name on all
prescriptions
B. Reference to state protocol number in the medical
record
C. Use of APP credentials in all drug orders
D. Notation of collaborative agreement date in chart
Answer: D
Rationale: Documenting the active collaborative
, agreement evidences legal scope; credential use (C) alone
insufficient, protocol number (B) not always required, and
physician name (A) may mislead.
5. An APP prescribes a new antidepressant. Which
requirement is mandated by most state laws?
A. Co-signature by physician on first prescription
B. Completion of a risk-management training program
C. Documentation of patient education on side effects
D. Reporting to the state prescription monitoring program
Answer: D
Rationale: Reporting controlled prescriptions is mandated;
co-signature (A) and training (B) vary by state, and patient
education (C) is standard but not always legally required.
6. Which scenario exemplifies practicing beyond scope?
A. Ordering diagnostic labs before initiating a medication
B. Adjusting insulin dosage per protocol
C. Prescribing off-label chemotherapy without specialist
oversight
D. Counseling on diet and exercise with weight-loss agents
Answer: C
Rationale: Off-label chemo requires oncology oversight;
labs (A), insulin per protocol (B), and counseling (D) fall
within typical NP scope.
7. State law permits a clinical nurse specialist (CNS) to
prescribe under which condition?
A. CNS holds national certification only
, B. CNS signs a collaborative agreement with a physician
C. CNS has five years’ clinical experience
D. CNS prescribes only over-the-counter drugs
Answer: B
Rationale: Collaborative agreement grants prescriptive
authority; certification (A) and experience (C) alone are
insufficient, and OTC prescribing (D) does not require CNS
authority.
8. Which document should an APP consult to verify federal
controlled substance regulations?
A. State nurse practice act
B. Federal Register
C. Institutional policy manual
D. Collaborative practice agreement
Answer: B
Rationale: The Federal Register publishes DEA regulations;
state acts (A) and policies (C) refer to but don’t replace
federal law, and agreements (D) are state-level.
9. In states with full practice authority, APPs can do all
except:
A. Prescribe controlled substances independently
B. Sign death certificates
C. Practice without physician supervision
D. Open independent clinics
Answer: B
, Rationale: Death certificates often require physician
signature; the rest are allowed under full practice.
10. Which factor most influences an APP’s legal
prescribing scope?
A. Years of experience
B. Specialty certification
C. State statutes and regulations
D. Employer preference
Answer: C
Rationale: State laws define scope; experience (A),
certification (B), and employer rules (D) cannot override
statutes.
Focus Area 2: Ethical Prescribing and Provider Accountability
11. An APP is asked by a pharmaceutical rep to write
samples for a new drug. Ethically, the APP should:
A. Accept all samples to promote patient access
B. Refuse if samples bias prescribing patterns
C. Prescribe only well-known medications
D. Provide samples only when insurance denies coverage
Answer: B
Rationale: Rejecting biased promotions aligns with ethical
standards; accepting unrestricted (A) risks bias, prescribing
known meds (C) ignores need, and offering only on denial
(D) is reactive.
, 12. If an APP discovers a medication error they made,
the first action is to:
A. Document in patient record without notification
B. Notify the patient and supervising provider immediately
C. Correct the order and continue care silently
D. Contact pharmacy and ask them not to report it
Answer: B
Rationale: Transparency and patient safety require
notification; silent correction (C) hides error, nondisclosure
(A) breaches ethics, and silencing pharmacy (D) is
unethical.
13. Which principle supports refusing to prescribe an
antibiotic for viral infection?
A. Beneficence
B. Autonomy
C. Justice
D. Nonmaleficence
Answer: D
Rationale: Avoiding harm from resistance reflects
nonmaleficence; beneficence (A) is doing good, autonomy
(B) is patient choice, and justice (C) is resource fairness.
14. An APP prescribes a costly brand drug when an
equally effective generic is available. Which ethical
concern arises?
A. Justice in resource allocation
B. Autonomy infringement
ARCANGELO & PETERSON TEST BANK
📘 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
,Focus Area 1: Prescriptive Authority and State-Specific Legal
Scope
1. An advanced practice provider (APP) licensed in State X
wants to prescribe a Schedule II opioid. Which action
ensures compliance with state law?
A. Prescribe via verbal order and follow up with a written
prescription within seven days
B. Use a state-approved e-prescribing system with
prescriptive privileges indicated
C. Delegate prescription writing to a collaborating
physician
D. Issue a paper prescription with the physician’s signature
on behalf of the APP
Answer: B
Rationale: Only e-prescribing systems recognized by State
X link APP credentials to prescribing authority; verbal
orders (A) are disallowed for Schedule II, delegation (C) is
impermissible, and signing for a physician (D) violates
scope.
2. A nurse practitioner moves from State A to State B.
Which step is most critical before writing medication
orders in State B?
A. Notify former state board of relocation
B. Verify prescriptive authority under State B’s statutes
C. Review federal Controlled Substances Act
, D. Establish a collaborative agreement remotely
Answer: B
Rationale: APP must confirm State B’s legal scope;
notifying (A) and federal knowledge (C) don’t grant
authority, and a collaborative agreement (D) requires local
statutes first.
3. Under a collaborative practice agreement, the APP can
independently initiate which class of medication?
A. Antihypertensives, if protocols specify dosage ranges
B. Chemotherapy agents without physician signature
C. Schedule I controlled substances
D. Biologics not listed in the agreement
Answer: A
Rationale: Protocol-based antihypertensive initiation is
allowed; chemotherapy (B), Schedule I (C), and non-
protocol biologics (D) exceed typical agreement scope.
4. Which documentation demonstrates that an APP is
practicing within state-prescribed authority?
A. Inclusion of supervising physician name on all
prescriptions
B. Reference to state protocol number in the medical
record
C. Use of APP credentials in all drug orders
D. Notation of collaborative agreement date in chart
Answer: D
Rationale: Documenting the active collaborative
, agreement evidences legal scope; credential use (C) alone
insufficient, protocol number (B) not always required, and
physician name (A) may mislead.
5. An APP prescribes a new antidepressant. Which
requirement is mandated by most state laws?
A. Co-signature by physician on first prescription
B. Completion of a risk-management training program
C. Documentation of patient education on side effects
D. Reporting to the state prescription monitoring program
Answer: D
Rationale: Reporting controlled prescriptions is mandated;
co-signature (A) and training (B) vary by state, and patient
education (C) is standard but not always legally required.
6. Which scenario exemplifies practicing beyond scope?
A. Ordering diagnostic labs before initiating a medication
B. Adjusting insulin dosage per protocol
C. Prescribing off-label chemotherapy without specialist
oversight
D. Counseling on diet and exercise with weight-loss agents
Answer: C
Rationale: Off-label chemo requires oncology oversight;
labs (A), insulin per protocol (B), and counseling (D) fall
within typical NP scope.
7. State law permits a clinical nurse specialist (CNS) to
prescribe under which condition?
A. CNS holds national certification only
, B. CNS signs a collaborative agreement with a physician
C. CNS has five years’ clinical experience
D. CNS prescribes only over-the-counter drugs
Answer: B
Rationale: Collaborative agreement grants prescriptive
authority; certification (A) and experience (C) alone are
insufficient, and OTC prescribing (D) does not require CNS
authority.
8. Which document should an APP consult to verify federal
controlled substance regulations?
A. State nurse practice act
B. Federal Register
C. Institutional policy manual
D. Collaborative practice agreement
Answer: B
Rationale: The Federal Register publishes DEA regulations;
state acts (A) and policies (C) refer to but don’t replace
federal law, and agreements (D) are state-level.
9. In states with full practice authority, APPs can do all
except:
A. Prescribe controlled substances independently
B. Sign death certificates
C. Practice without physician supervision
D. Open independent clinics
Answer: B
, Rationale: Death certificates often require physician
signature; the rest are allowed under full practice.
10. Which factor most influences an APP’s legal
prescribing scope?
A. Years of experience
B. Specialty certification
C. State statutes and regulations
D. Employer preference
Answer: C
Rationale: State laws define scope; experience (A),
certification (B), and employer rules (D) cannot override
statutes.
Focus Area 2: Ethical Prescribing and Provider Accountability
11. An APP is asked by a pharmaceutical rep to write
samples for a new drug. Ethically, the APP should:
A. Accept all samples to promote patient access
B. Refuse if samples bias prescribing patterns
C. Prescribe only well-known medications
D. Provide samples only when insurance denies coverage
Answer: B
Rationale: Rejecting biased promotions aligns with ethical
standards; accepting unrestricted (A) risks bias, prescribing
known meds (C) ignores need, and offering only on denial
(D) is reactive.
, 12. If an APP discovers a medication error they made,
the first action is to:
A. Document in patient record without notification
B. Notify the patient and supervising provider immediately
C. Correct the order and continue care silently
D. Contact pharmacy and ask them not to report it
Answer: B
Rationale: Transparency and patient safety require
notification; silent correction (C) hides error, nondisclosure
(A) breaches ethics, and silencing pharmacy (D) is
unethical.
13. Which principle supports refusing to prescribe an
antibiotic for viral infection?
A. Beneficence
B. Autonomy
C. Justice
D. Nonmaleficence
Answer: D
Rationale: Avoiding harm from resistance reflects
nonmaleficence; beneficence (A) is doing good, autonomy
(B) is patient choice, and justice (C) is resource fairness.
14. An APP prescribes a costly brand drug when an
equally effective generic is available. Which ethical
concern arises?
A. Justice in resource allocation
B. Autonomy infringement
