NR565 MIDTERM STUDY QUESTIONS
AND ANSWERS
APRN65prescribing65role65-65answer--
Prescriptive65authority65for65nurse65practitioners65also65regulates65prescribing65rights65b
eyond65medications65and65controlled65substances.65These65rights65include65therapeutic
65devices65and65services65and65are65outlined65in65state65practice65laws65and65regulation
s65and65include65Durable65Medical65Equipment65(DME)65such65as65wheelchairs,65power
65scooters,65hospital65beds,65portable65oxygen65equipment,65handicap65placards,65etc.65
and65medical65services65such65as65Physical65Therapy65(PT),65Occupational65Therapy65(
OT),65home65health65services,65etc.65Prescriptive65authority65encompasses65more65than
65writing65a65prescription65correctly.65It65requires65adherence65to65ethical65guidelines65to
65ensure65that65patients65are65safeguarded65from65harm.65Ethical65prescribing65starts65
with65being65well-
informed65about65medications.65Mechanism65of65action,65efficacy,65and65safety65are65im
portant65considerations,65as65are65a65patient's65distinct65needs65and65circumstances,65in
cluding65the65number65of65medications65prescribed65(Mitchell65&65Oliphant,652016).65Mo
st65patients65receiving65a65prescription65are65taking65other65medications,65whether65pres
cription65or65over-the-
counter.65Appropriate65selection,65dosing,65and65duration65of65pharmaceutical65agents65
are65key65to65maximizing65outcomes65and65minimizing65adverse65effects
benefits65of65full65practice65authority65-65answer--
Nurse65practitioners65have65the65autonomy65to65evaluate65patients,65diagnose,65order65
and65interpret65tests,65initiate65and65manage65treatments65and65prescribe65medications,
65including65controlled65substances65without65physician65oversight
promoting65positive65outcomes65through65prudent65prescribing65practices65-65answer--
Administering65medications65and65prescribing65medications65are65two65distinct65process
es.65Prescription65writing65requires65prudent65and65deliberate65decision-
making65processes65to65maintain65patient65safety65and65reduce65liability,65including:
*documentation65of65a65provider-
patient65relationship65for65the65recipient65of65the65prescribed65medications
*documentation65of65a65thorough65history65and65physical65examination65for65the65recipie
nt
, *documentation65of65discussions65regarding65risk65factors,65side65effects,65or65therapy65
options
*documentation65of65drug65monitoring65or65titration65plan,65if65applicable
*documentation65of65consultations,65if65any
avoidance65of65prescribing65medications65for65self,65family,65or65friends
Rational65drug65selection65requires65a65logical65approach65that65includes65the65formulati
on65of65a65diagnosis65based65on65clinical65reasoning65and65the65selection65and65monitor
ing65of65the65most65appropriate65pharmacological65treatment65
Considerations65include:65Cost,65guidelines,65availability,65interactions,65side65effects,65
allergies,65hepatic/renal65functions,65need65for65monitoring,65&65special65populations
Beer's65Criteria65-65answer--
identifies65drugs65with65a65high65likelihood65of65causing65adverse65effects65in65older65ad
ults.65Accordingly,65drugs65on65this65list65should65generally65be65avoided65in65adults65old
er65than656565years65except65when65the65benefits65are65significantly65greater65than65the
65risks.
Pharmacodynamics65-65answer--
the65study65of65the65biochemical65and65physiologic65effects65of65drugs65on65the65body65
and65the65molecular65mechanisms65by65which65those65effects65are65produced
Pharmacokinetics65-65answer--the65study65of65drug65movement65throughout65the65body
Pharmacogenomics65-65answer--
the65study65of65how65genes65affect65a65person's65response65to65drugs.65The65purpose65
of65this65is65to65combine65the65sciences65of65genomics65and65pharmacology65to65provid
e65individualized,65targeted,65safe65drug65therapies65to65patients
CYP45065inducers65-65answer--
Inducers65are65xenobiotics65(medications65and65environmental65agents)65that65elevate65
CYP45065enzyme65activity65by65increasing65enzyme65synthesis.65This65action65leads65t
o65additional65sites65available65for65biotransformation.65The65increased65number65of65sit
es65enhances65medication65metabolism,65decreasing65the65concentration65of65the65"par
ent65drug"65while65increasing65metabolite65production.
Inducers65=65Increase65medication65metabolism65
(Carbamazepine,65Rifampin,65Alcohol,65Phenytoin,65Griseofulvin,65Phenobarbital,65Sulfo
nylureas)
CYP45065inhibitors65-65answer--
Inhibitors65are65medications65that65inhibit65the65metabolic65activity65of65one65or65more65o
AND ANSWERS
APRN65prescribing65role65-65answer--
Prescriptive65authority65for65nurse65practitioners65also65regulates65prescribing65rights65b
eyond65medications65and65controlled65substances.65These65rights65include65therapeutic
65devices65and65services65and65are65outlined65in65state65practice65laws65and65regulation
s65and65include65Durable65Medical65Equipment65(DME)65such65as65wheelchairs,65power
65scooters,65hospital65beds,65portable65oxygen65equipment,65handicap65placards,65etc.65
and65medical65services65such65as65Physical65Therapy65(PT),65Occupational65Therapy65(
OT),65home65health65services,65etc.65Prescriptive65authority65encompasses65more65than
65writing65a65prescription65correctly.65It65requires65adherence65to65ethical65guidelines65to
65ensure65that65patients65are65safeguarded65from65harm.65Ethical65prescribing65starts65
with65being65well-
informed65about65medications.65Mechanism65of65action,65efficacy,65and65safety65are65im
portant65considerations,65as65are65a65patient's65distinct65needs65and65circumstances,65in
cluding65the65number65of65medications65prescribed65(Mitchell65&65Oliphant,652016).65Mo
st65patients65receiving65a65prescription65are65taking65other65medications,65whether65pres
cription65or65over-the-
counter.65Appropriate65selection,65dosing,65and65duration65of65pharmaceutical65agents65
are65key65to65maximizing65outcomes65and65minimizing65adverse65effects
benefits65of65full65practice65authority65-65answer--
Nurse65practitioners65have65the65autonomy65to65evaluate65patients,65diagnose,65order65
and65interpret65tests,65initiate65and65manage65treatments65and65prescribe65medications,
65including65controlled65substances65without65physician65oversight
promoting65positive65outcomes65through65prudent65prescribing65practices65-65answer--
Administering65medications65and65prescribing65medications65are65two65distinct65process
es.65Prescription65writing65requires65prudent65and65deliberate65decision-
making65processes65to65maintain65patient65safety65and65reduce65liability,65including:
*documentation65of65a65provider-
patient65relationship65for65the65recipient65of65the65prescribed65medications
*documentation65of65a65thorough65history65and65physical65examination65for65the65recipie
nt
, *documentation65of65discussions65regarding65risk65factors,65side65effects,65or65therapy65
options
*documentation65of65drug65monitoring65or65titration65plan,65if65applicable
*documentation65of65consultations,65if65any
avoidance65of65prescribing65medications65for65self,65family,65or65friends
Rational65drug65selection65requires65a65logical65approach65that65includes65the65formulati
on65of65a65diagnosis65based65on65clinical65reasoning65and65the65selection65and65monitor
ing65of65the65most65appropriate65pharmacological65treatment65
Considerations65include:65Cost,65guidelines,65availability,65interactions,65side65effects,65
allergies,65hepatic/renal65functions,65need65for65monitoring,65&65special65populations
Beer's65Criteria65-65answer--
identifies65drugs65with65a65high65likelihood65of65causing65adverse65effects65in65older65ad
ults.65Accordingly,65drugs65on65this65list65should65generally65be65avoided65in65adults65old
er65than656565years65except65when65the65benefits65are65significantly65greater65than65the
65risks.
Pharmacodynamics65-65answer--
the65study65of65the65biochemical65and65physiologic65effects65of65drugs65on65the65body65
and65the65molecular65mechanisms65by65which65those65effects65are65produced
Pharmacokinetics65-65answer--the65study65of65drug65movement65throughout65the65body
Pharmacogenomics65-65answer--
the65study65of65how65genes65affect65a65person's65response65to65drugs.65The65purpose65
of65this65is65to65combine65the65sciences65of65genomics65and65pharmacology65to65provid
e65individualized,65targeted,65safe65drug65therapies65to65patients
CYP45065inducers65-65answer--
Inducers65are65xenobiotics65(medications65and65environmental65agents)65that65elevate65
CYP45065enzyme65activity65by65increasing65enzyme65synthesis.65This65action65leads65t
o65additional65sites65available65for65biotransformation.65The65increased65number65of65sit
es65enhances65medication65metabolism,65decreasing65the65concentration65of65the65"par
ent65drug"65while65increasing65metabolite65production.
Inducers65=65Increase65medication65metabolism65
(Carbamazepine,65Rifampin,65Alcohol,65Phenytoin,65Griseofulvin,65Phenobarbital,65Sulfo
nylureas)
CYP45065inhibitors65-65answer--
Inhibitors65are65medications65that65inhibit65the65metabolic65activity65of65one65or65more65o
