Pharmacology midterm-questions and
answers
Which of the following has influenced an emphasis on primary care education in
medical schools? - ANS>>Changes in Medicare reimbursement methods recommended
in 1992
Which of the following statements is true about the prescribing practices of physicians?
- ANS>>The dominant form of drug information used by primary care physicians
continues to be that provided by pharmaceutical companies
As primary care nurse practitioners (NPs) continue to develop their role as prescribers
of medications, it will be important to: - ANS>>learn from the experiences of physicians
and develop expertise based on evidence-based practice.
A primary care NP will begin practicing in a state in which the governor has opted out of
the federal facility reimbursement requirement. The NP should be aware that this
defines how NPs may write prescriptions: - ANS>>as CRNAs without physician
supervision in a hospital setting.
CRNAs in most states: - ANS>>order and administer controlled substances but do not
have full prescriptive authority.
A CNM: - ANS>>has prescriptive authority in all 50 states.
In every state, prescriptive authority for NPs includes the ability to write prescriptions: -
ANS>>for specified classifications of medications.
The current trend toward transitioning NP programs to the doctoral level will mean that:
- ANS>>NPs will be better prepared to meet emerging health care needs of patients.
An important difference between physician assistants (PAs) and NPs is PAs: -
ANS>>always work under physician supervision.
To increase the likelihood of successful pharmacotherapy, when teaching a patient
about using a medication, the primary care nurse practitioner (NP) should: -
ANS>>encourage the patient to participate in the choice of the medication.
A patient has recurrent symptoms and tells the primary care NP that she can't
remember to take her medication all the time. The NP should: - ANS>>ask her about
her lifestyle, her schedule, and her understanding of her condition.
A primary care NP prepares to teach a patient about the management of a chronic
condition. The patient says, "I don't want to know all of that. Just tell me what to take
,and when." The NP should initially: - ANS>>give the patient basic written instructions
about medications, follow up visits, and symptoms.
A parent brings a child who has moderate-persistent asthma to the clinic and tells the
primary care NP that none of the child's medications are working. The parent says,
"Everybody tells me something different. I don't know what to do." The NP suspects that
the parent is not administering the medications appropriately. The NP should initially: -
ANS>>perform a careful history of the child's symptoms and the medications that are
given.
A primary care NP sees a 5-year-old child who is morbidly obese. The child has an
elevated hemoglobin A1c and increased lipid levels. Both of the child's parents are
overweight but not obese, and they tell the NP that they see nothing wrong with their
child. They both state that it is difficult to refuse their child's requests for soda or ice
cream. The NP should: - ANS>>initiate a dialogue with the parents about the
implications of the child's laboratory values.
A patient bursts into tears when the primary care NP diagnoses diabetes. The NP
should: - ANS>>ask the patient about past experiences with anyone who has this
diagnosis.
A primary care NP writes a prescription for an off-label use for a drug. To help ensure
compliance, the NP should: - ANS>>include information about the off-label use on the
E-script
The primary care nurse practitioner (NP) writes a prescription for an antibiotic using an
electronic drug prescription system. The pharmacist will fill this prescription when: -
ANS>>the electronic prescription is received.
When prescribing a medication for a chronic condition, the primary care NP should tell
the patient: - ANS>>about the frequency of clinic visits necessary for the number of
refills authorized.
The neighbor of a primary care NP asks the NP to write a prescription for an antibiotic.
The NP should tell the neighbor: - ANS>>that it is best if the neighbor sees a health
care provider before obtaining a prescription.
The primary care NP is prescribing a medication for an off-label use. To help prevent a
medication error, the NP should: - ANS>>write "off-label use" on the prescription and
provide a rationale.
The primary care NP sees a patient covered by Medicaid, writes a prescription for a
medication, and is informed by the pharmacist that the medication is "off-formulary."
The NP should: - ANS>>write the prescription for a generic drug if it meets the patient's
needs.
, A patient who has asthma and who is known to the primary care NP calls the NP after
hours and asks for a refill of an albuterol metered-dose inhaler. The patient has not
been seen in the clinic for more than a year. The NP should: - ANS>>refill the drug and
tell the patient that an office visit is necessary for further refills.
A patient who has chronic pain and who takes oxycodone (Percodan) calls the clinic to
ask for a refill of the medication. The primary care NP notes that the medication refill is
not due for 2 weeks. The patient tells the NP that the refill is needed because he is
going out of town. The NP should: - ANS>>review the patient's chart to see if this is a
one-time or repeat occurrence.
The primary care nurse practitioner (NP) is using critical thinking skills when: -
ANS>>analyzing current research and synthesizing new approaches to patient care.
The primary care NP has referred a child who has significant gastrointestinal reflux
disease to a specialist for consideration for a fundoplication and gastrostomy tube
placement. The child's weight is 80% of what is recommended for age, and a recent
swallow study revealed significant risk for aspiration. The child's parents do not want the
procedure. The NP should: - ANS>>initiate a discussion with the parents about the
potential outcomes of each possible action.
The primary care NP prescribes an inhaled corticosteroid for a patient who has asthma.
The third-party payer for this patient denies coverage for the brand that comes in the
specific strength the NP prescribes. The NP should: - ANS>>order the closest
formulary-approved approximation of the drug and monitor effectiveness.
A patient takes a cardiac medication that has a very narrow therapeutic range. The
primary care NP learns that the particular brand the patient is taking is no longer
covered by the patient's medical plan. The NP knows that the bioavailability of the drug
varies from brand to brand. The NP should: - ANS>>contact the insurance provider to
explain why this particular formulation is necessary.
A patient comes to the clinic reporting dizziness and fatigue associated with nausea and
vomiting. The primary care NP suspects anemia and orders a complete blood count.
The patient's hemoglobin is elevated. The NP correctly concludes that the patient is not
anemic. The NP has made an error in: - ANS>>hypothesis triggering and information
processing.
A patient comes to the clinic with a 2-day history of cough and wheezing. The patient
has no previous history of asthma. The patient reports having heartburn for several
months, which has worsened considerably. The primary care NP makes a diagnosis of
asthma and orders oral steroids and inhaled albuterol. The patient's condition worsens,
and a chest radiograph obtained 2 days later shows bilateral infiltrates. The NP has
failed to: - ANS>>confirm the diagnosis.
answers
Which of the following has influenced an emphasis on primary care education in
medical schools? - ANS>>Changes in Medicare reimbursement methods recommended
in 1992
Which of the following statements is true about the prescribing practices of physicians?
- ANS>>The dominant form of drug information used by primary care physicians
continues to be that provided by pharmaceutical companies
As primary care nurse practitioners (NPs) continue to develop their role as prescribers
of medications, it will be important to: - ANS>>learn from the experiences of physicians
and develop expertise based on evidence-based practice.
A primary care NP will begin practicing in a state in which the governor has opted out of
the federal facility reimbursement requirement. The NP should be aware that this
defines how NPs may write prescriptions: - ANS>>as CRNAs without physician
supervision in a hospital setting.
CRNAs in most states: - ANS>>order and administer controlled substances but do not
have full prescriptive authority.
A CNM: - ANS>>has prescriptive authority in all 50 states.
In every state, prescriptive authority for NPs includes the ability to write prescriptions: -
ANS>>for specified classifications of medications.
The current trend toward transitioning NP programs to the doctoral level will mean that:
- ANS>>NPs will be better prepared to meet emerging health care needs of patients.
An important difference between physician assistants (PAs) and NPs is PAs: -
ANS>>always work under physician supervision.
To increase the likelihood of successful pharmacotherapy, when teaching a patient
about using a medication, the primary care nurse practitioner (NP) should: -
ANS>>encourage the patient to participate in the choice of the medication.
A patient has recurrent symptoms and tells the primary care NP that she can't
remember to take her medication all the time. The NP should: - ANS>>ask her about
her lifestyle, her schedule, and her understanding of her condition.
A primary care NP prepares to teach a patient about the management of a chronic
condition. The patient says, "I don't want to know all of that. Just tell me what to take
,and when." The NP should initially: - ANS>>give the patient basic written instructions
about medications, follow up visits, and symptoms.
A parent brings a child who has moderate-persistent asthma to the clinic and tells the
primary care NP that none of the child's medications are working. The parent says,
"Everybody tells me something different. I don't know what to do." The NP suspects that
the parent is not administering the medications appropriately. The NP should initially: -
ANS>>perform a careful history of the child's symptoms and the medications that are
given.
A primary care NP sees a 5-year-old child who is morbidly obese. The child has an
elevated hemoglobin A1c and increased lipid levels. Both of the child's parents are
overweight but not obese, and they tell the NP that they see nothing wrong with their
child. They both state that it is difficult to refuse their child's requests for soda or ice
cream. The NP should: - ANS>>initiate a dialogue with the parents about the
implications of the child's laboratory values.
A patient bursts into tears when the primary care NP diagnoses diabetes. The NP
should: - ANS>>ask the patient about past experiences with anyone who has this
diagnosis.
A primary care NP writes a prescription for an off-label use for a drug. To help ensure
compliance, the NP should: - ANS>>include information about the off-label use on the
E-script
The primary care nurse practitioner (NP) writes a prescription for an antibiotic using an
electronic drug prescription system. The pharmacist will fill this prescription when: -
ANS>>the electronic prescription is received.
When prescribing a medication for a chronic condition, the primary care NP should tell
the patient: - ANS>>about the frequency of clinic visits necessary for the number of
refills authorized.
The neighbor of a primary care NP asks the NP to write a prescription for an antibiotic.
The NP should tell the neighbor: - ANS>>that it is best if the neighbor sees a health
care provider before obtaining a prescription.
The primary care NP is prescribing a medication for an off-label use. To help prevent a
medication error, the NP should: - ANS>>write "off-label use" on the prescription and
provide a rationale.
The primary care NP sees a patient covered by Medicaid, writes a prescription for a
medication, and is informed by the pharmacist that the medication is "off-formulary."
The NP should: - ANS>>write the prescription for a generic drug if it meets the patient's
needs.
, A patient who has asthma and who is known to the primary care NP calls the NP after
hours and asks for a refill of an albuterol metered-dose inhaler. The patient has not
been seen in the clinic for more than a year. The NP should: - ANS>>refill the drug and
tell the patient that an office visit is necessary for further refills.
A patient who has chronic pain and who takes oxycodone (Percodan) calls the clinic to
ask for a refill of the medication. The primary care NP notes that the medication refill is
not due for 2 weeks. The patient tells the NP that the refill is needed because he is
going out of town. The NP should: - ANS>>review the patient's chart to see if this is a
one-time or repeat occurrence.
The primary care nurse practitioner (NP) is using critical thinking skills when: -
ANS>>analyzing current research and synthesizing new approaches to patient care.
The primary care NP has referred a child who has significant gastrointestinal reflux
disease to a specialist for consideration for a fundoplication and gastrostomy tube
placement. The child's weight is 80% of what is recommended for age, and a recent
swallow study revealed significant risk for aspiration. The child's parents do not want the
procedure. The NP should: - ANS>>initiate a discussion with the parents about the
potential outcomes of each possible action.
The primary care NP prescribes an inhaled corticosteroid for a patient who has asthma.
The third-party payer for this patient denies coverage for the brand that comes in the
specific strength the NP prescribes. The NP should: - ANS>>order the closest
formulary-approved approximation of the drug and monitor effectiveness.
A patient takes a cardiac medication that has a very narrow therapeutic range. The
primary care NP learns that the particular brand the patient is taking is no longer
covered by the patient's medical plan. The NP knows that the bioavailability of the drug
varies from brand to brand. The NP should: - ANS>>contact the insurance provider to
explain why this particular formulation is necessary.
A patient comes to the clinic reporting dizziness and fatigue associated with nausea and
vomiting. The primary care NP suspects anemia and orders a complete blood count.
The patient's hemoglobin is elevated. The NP correctly concludes that the patient is not
anemic. The NP has made an error in: - ANS>>hypothesis triggering and information
processing.
A patient comes to the clinic with a 2-day history of cough and wheezing. The patient
has no previous history of asthma. The patient reports having heartburn for several
months, which has worsened considerably. The primary care NP makes a diagnosis of
asthma and orders oral steroids and inhaled albuterol. The patient's condition worsens,
and a chest radiograph obtained 2 days later shows bilateral infiltrates. The NP has
failed to: - ANS>>confirm the diagnosis.
