1|Page
NR508 WEEK 4-MIDTERM EXAM |
COMPREHENSIVE Q&A FOR GUARANTEED
SUCCESS
Roles and Responsibilities of APRN -correct-answer-1. All states have title
protection for NP
2. All but 5 states stat's board of nursing control practice and licensure.
3. Scope of practice determined by individual NP license of licensing jurisdiction
New prescribers must know the rules
4. in 17 states, NPs have independent scope of practice and prescriptive authority.
5.6 states have full autonomous practice and prescriptive authority.
Clinical Judgement in prescribing -correct-answer-1. Best therapy
2. Least expensive
3. Least likely to cause ADR
4. Clear indication for drug?
5. Are drugs effective in treating disorder?
6. What is goal of therapy?
7. Under what conditions is it determined that drug is not meeting goal and
change should be made?
8. Unnecessary duplications?
9. OTC be just as useful?
,2|Page
10. Cost?
Collaboration with other prescribers -correct-answer-1. Physician: can offer
insight
2. Pharmacists: pharm knowledge
3. Other APRNs: clinical experience shared and collaboration
4. PAs
5. RNs.
Autonomy and prescriptive authority -correct-answer-1. More states are
broadening and expanding legal, reimbursement, and prescriptive authority.
2. Gains can be reversed, so address concerns.
3. Some push for physician control.
Alpha2Agonists: MOA -correct-answer-1. Activation of central alpha 2 receptors
results in inhibition of cardioacceleration and vasoconstriction centers in brain.
2. Lead to decrease in peripheral outflow of norepinephrine which leads to
decrease in:
a. peripheral resistance
b. renal vascular resistance
c. heart rate
,3|Page
d. blood pressure
3. Decrease in BP is due to sympathetic function therefore sodium retention and
increased blood volume may occur: give with diuretic.
4. Second or third line HTN drug treatment.
Alpha2Agonists: Drugs in class -correct-answer-1. Clonidine
2. guanabenz
3. guanfacine
4. methyldopa.
Alpha2Agonists: Clonidine, off-label use -correct-answer-Tx of withdrawal d/t
ability to lower adrenergic stimulation associated with withdrawal.
Alpha2Agonists: ADRs -correct-answer-Oral and transdermal doses:
bradycardia, AV block, palpitations, tachycardia, hallucinations, sleep disorders,
contact dermatitis, dry mouth, orthostatic hypotension, constipation, nausea,
urinary retention, decreased sexual activity, weight gain, leg gramps, and
thrombocytopenia.
MOST COMMON: dry mouth
, 4|Page
Alpha2Agonists: Discontinue instructions -correct-answer-Do not stop abruptly
d/t lack of alpha 2 receptors impair homeostatic balance that regulates SNS:
Gradual taper over 4 days.
Alpha2Agonists: Guanabenz and guanfacine -correct-answer-1. Used to treat HTN.
2. EXR guanfacine: ADHD
Alpha2Agonists: Methyldopa -correct-answer-1. Parallels synthesis of
norepinephrine (NE)
2. Stimulation by this metabolite: decrease in sympathetic outflow to the heart,
kidneys, and blood vessels.
3. End result: decreased in BP, peripheral resistance, HR, sl. decrease in CO.
Produces renal vascular resistance.
4. Positive coombs test
5. Rarely hemolytic anemia.
Beta-adrenergic antagonists: affects on body systems -correct-answer-1. Heart:
Highest # of receptors are in heart: decreased HR in rapid rhythms, angina, BP,
reflex orthostatic tachycardia.
2. Renal: Receptors in juxtaglomerular apparatus of kidney reduces release of
renin. Decrease in BP.
NR508 WEEK 4-MIDTERM EXAM |
COMPREHENSIVE Q&A FOR GUARANTEED
SUCCESS
Roles and Responsibilities of APRN -correct-answer-1. All states have title
protection for NP
2. All but 5 states stat's board of nursing control practice and licensure.
3. Scope of practice determined by individual NP license of licensing jurisdiction
New prescribers must know the rules
4. in 17 states, NPs have independent scope of practice and prescriptive authority.
5.6 states have full autonomous practice and prescriptive authority.
Clinical Judgement in prescribing -correct-answer-1. Best therapy
2. Least expensive
3. Least likely to cause ADR
4. Clear indication for drug?
5. Are drugs effective in treating disorder?
6. What is goal of therapy?
7. Under what conditions is it determined that drug is not meeting goal and
change should be made?
8. Unnecessary duplications?
9. OTC be just as useful?
,2|Page
10. Cost?
Collaboration with other prescribers -correct-answer-1. Physician: can offer
insight
2. Pharmacists: pharm knowledge
3. Other APRNs: clinical experience shared and collaboration
4. PAs
5. RNs.
Autonomy and prescriptive authority -correct-answer-1. More states are
broadening and expanding legal, reimbursement, and prescriptive authority.
2. Gains can be reversed, so address concerns.
3. Some push for physician control.
Alpha2Agonists: MOA -correct-answer-1. Activation of central alpha 2 receptors
results in inhibition of cardioacceleration and vasoconstriction centers in brain.
2. Lead to decrease in peripheral outflow of norepinephrine which leads to
decrease in:
a. peripheral resistance
b. renal vascular resistance
c. heart rate
,3|Page
d. blood pressure
3. Decrease in BP is due to sympathetic function therefore sodium retention and
increased blood volume may occur: give with diuretic.
4. Second or third line HTN drug treatment.
Alpha2Agonists: Drugs in class -correct-answer-1. Clonidine
2. guanabenz
3. guanfacine
4. methyldopa.
Alpha2Agonists: Clonidine, off-label use -correct-answer-Tx of withdrawal d/t
ability to lower adrenergic stimulation associated with withdrawal.
Alpha2Agonists: ADRs -correct-answer-Oral and transdermal doses:
bradycardia, AV block, palpitations, tachycardia, hallucinations, sleep disorders,
contact dermatitis, dry mouth, orthostatic hypotension, constipation, nausea,
urinary retention, decreased sexual activity, weight gain, leg gramps, and
thrombocytopenia.
MOST COMMON: dry mouth
, 4|Page
Alpha2Agonists: Discontinue instructions -correct-answer-Do not stop abruptly
d/t lack of alpha 2 receptors impair homeostatic balance that regulates SNS:
Gradual taper over 4 days.
Alpha2Agonists: Guanabenz and guanfacine -correct-answer-1. Used to treat HTN.
2. EXR guanfacine: ADHD
Alpha2Agonists: Methyldopa -correct-answer-1. Parallels synthesis of
norepinephrine (NE)
2. Stimulation by this metabolite: decrease in sympathetic outflow to the heart,
kidneys, and blood vessels.
3. End result: decreased in BP, peripheral resistance, HR, sl. decrease in CO.
Produces renal vascular resistance.
4. Positive coombs test
5. Rarely hemolytic anemia.
Beta-adrenergic antagonists: affects on body systems -correct-answer-1. Heart:
Highest # of receptors are in heart: decreased HR in rapid rhythms, angina, BP,
reflex orthostatic tachycardia.
2. Renal: Receptors in juxtaglomerular apparatus of kidney reduces release of
renin. Decrease in BP.
