TEST BANK FOR PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE A PRACTICAL APPROACH 5TH EDITION

TestBankforPharmacotherapeuticsforAdvancedPracticeA
PracticalApproach5thEditionByVirginiaPooleArcangelo,
B




B AndrewMPeterson,VeronicaWilbur, Tep M.Kang/All
B B B B B B B B




B ChaptersCovered–LatestUpdate2024.




Nursepractitionerprescriptiveauthorityisregulatedby:

1. TheNationalCouncilofStateBoardsofNursing

2. TheU.S.DrugEnforcement Administration v




3. TheStateBoardofNursingforeachstate

4. TheStateBoardofPharmacy - Correct Answer - 3. The State Board of Nursing for each state p v v v v v v v v v v v




ThebenefitstothepatientofhavinganAdvancedPracticeRegisteredNurse(APRN)prescriberinclude:



1. NursesknowmoreaboutPharmacologythanotherprescribersbecausetheytakeitbothintheirbasic
B B




nursing program and in their APRN program.
p p p p p p p




2. Nursescareforthepatientfromaholisticapproachandincludethepatientindecisionmaking p




regardingtheircare.
p




3. APRNsarelesslikelyto prescribenarcoticsandothercontrolledsubstances. p




4. APRNsareabletoprescribeindependentlyinallstates,whereasaphysician'sassistantneeds tohavea p




physiciansupervisingtheirpractice.- Correct Answer - 2. Nurses care for the patient from a holistic
p p p p p
v v v v v v v v v v v



approach and include the patient in decision making regarding their care.
v v v v v v v v v v v




Clinicaljudgmentinprescribingincludes:

1. Factoringi nthecosttothepatientofthemedicationprescribed
B p B




2. Alwaysprescribingthenewestmedicationavailable for thediseaseprocess p p




3. Handingoutdrugsamplestopoorpatients p




4. Prescribingallgenericmedicationstocutcosts - Correct Answer - 1. Factoring in the cost to the p p v v v v v v v v v vv


patient of the medication prescribed
v v v v


1

,Criteriaforchoosing aneffectivedrugforadisorderinclude:
p




1. Askingthepatientwhatdrugtheythinkwouldwork bestforthem p B




2. Consultingnationallyrecognizedguidelinesfordiseasemanagement

3. Prescribingmedicationsthat areavailableas samples beforewritingaprescription
p p p




4. FollowingU.S.DrugEnforcementAdministrationguidelinesforprescribing - Correct Answer - 2. p p p v v v vv


Consulting nationally recognized guidelines for disease management
v v v v v v




Nursepractitionerpracticemay thriveunderhealth-carereformbecauseof: p




1. Thedemonstratedabilityofnursepractitionerstocontrolcostsandimprovepatientoutcomes

2. Thefactthatnursepractitionerswillbeabletopracticeindependently

3. Thefact thatnursepractitionerswillhavefullreimbursementunderhealth-carereform
p p p




4.TheabilitytoshiftaccountabilityforMedicaidtothestatelevel -Correct Answer - 1. The
p p
p v v v v




Apatient'snutritionalintakeandlaboratoryresultsreflecthypoalbuminemia.Thisiscritical
p p p




toprescribingbecause:
p




1. Distributionofdrugstotarget tissuemaybeaffected. p




2. Thesolubilityofthedrugwill notmatchthe siteof absorption. p p p




3. Therewillbeless freedrugavailableto generateaneffect.
v p




4. Drugs boundtoalbuminarereadilyexcretedbythekidneys.-Correct Answer - 1. Distribution of drugs to
p v v v v v v v




target tissue may be affected.
v v v v v




Drugsthathaveasignificantfirst-pass effect: p




1. Mustbegivenbytheenteral(oral)routeonly

2. Bypassthehepaticcirculation

3. Arerapidlymetabolizedby theliverandmayhavelittleifanydesiredaction
p




2

,4. Areconvertedbythelivertomoreactiveandfat-solubleforms - Correct Answer - 3. Are rapidly p p p v v v v v vv


metabolized by the liver and may have little if any desired action
v v v v v v v v v v v




Therouteofexcretionofavolatiledrugwilllikelybethe:

1. Kidneys

2. Lungs

3. Bileandfeces

4. Skin - Correct Answer - 2. Lungs
v v v v v v




Medroxyprogesterone(DepoProvera)isprescribedintramuscularly(IM)tocreateastoragereservoirofthe
drug.Storagereservoirs:
p p p




1. Assurethatthedrugwillreach itsintendedtarget tissue p p




2. Arethereasonforgivingloadingdoses

3. Increasethelengthoftime adrugisavailableandactive p p




4. Aremostcommonincollagentissues- Correct Answer - 3. Increase the length of time a drug is B p v v v v v v v v v v v vv


available and active v v




TheNPchoosestogivecephalexinevery8hours basedonknowledgeofthedrug's: p




1. Propensitytogotothetargetreceptor

2. Biologicalhalf-life p




3. Pharmacodynamics

4. Safetyandsideeffects-Correct Answer - 2. Biological half-life v v v v v




Azithromycindosingrequiresthatthefirstday'sdosagebetwicethoseoftheother4daysoftheprescription. This p p p p




isconsidered a loadingdose. A loadingdose:
p p p p p p p




1. Rapidlyachievesdruglevelsinthetherapeuticrange p




2. Requiresfour-to five-half-livestoattain p




3. Isinfluencedbyrenalfunction

4. Isdirectlyrelatedtothedrugcirculatingtothetargettissues -Correct Answer - 1. Rapidly achieves
p p p v v v v v vv


drug levels in the therapeutic range
v v v v v




3

, Thepointintimeonthedrugconcentrationcurvethatindicatesthefirstsignofatherapeuticeffectisthe: B




1. Minimumadverseeffectlevel

2. Peakofaction

3. Onsetofaction

4. Therapeuticrange-Correct Answer - 3. Onset of action
v v v v v v




Phenytoinrequiresthatatroughlevelbe drawn.Peakandtroughlevels are done:
p p p




1. Whenthedrughasawidetherapeuticrange
B




2. Whenthedrugwillbeadministeredforashorttimeonly
p




3. Whenthereisahighcorrelationbetweenthedoseandsaturationofreceptorsites

4. Todetermineifadrug isinthetherapeuticrange -Correct Answer - 4. To determine if a drug is in the
p p p v v v v v v v v v v v vv


therapeutic range
v




Alaboratoryresultindicatesthatthepeaklevelfora drug is abovetheminimum toxicconcentration. Thismeans
B p B p p




thatthe:
p




1. Concentrationwillproducetherapeuticeffects
p




2. Concentrationwillproduceanadverseresponse

3. Timebetweendosesmustbeshortened

4. Durationofactionofthedrugistoolong- Correct Answer - 2. Concentration will produce an adverse
B v v v v v v v v



response
B




Drugsthatarereceptoragonistsmaydemonstratewhatproperty?

1. Irreversiblebindingto thedrugreceptorsite
p




2. Upregulationwithchronicuse

3. Desensitizationordownregulationwithcontinuoususe

4. Inverserelationshipbetweendrugconcentrationanddrugaction- Correct Answer - 3. Desensitization or p v v v v v



downregulation with continuous use
v v v v




pg.4