NR 565 Midterm Exam Questions with
Answers (2025 -2026) (Verified Answers)
Distribution in medication in elderly can be affected in what ways? - ANSWER--
decreased lean mass
-decreased albumin
-decreased body fat
-slower gastric acidity
-slower absorption results in delayed response
In the elderly decrease albumin and decreased lean mass affects medications how? -
ANSWER-medication binds to protein so decreased protein affects how medication is
absorbed and distributed
In elderly decreased body fat affects medications how? - ANSWER-need fat to transport
medications and some drug metabolism is dependent on body weight
When prescribing medication, we must understand that liver function declines with age
due to.... - ANSWER-decreased blood flow to the liver, decreased hepatic enzymes
What is the most important cause of adverse drug reactions? - ANSWER-
***overprescribing/polypharmacy
***decreased renal excretion
-high drug dosages (start low & go slow)
-lack of monitoring medications
What can a poor metabolism phenotype do to a metabolism of a drug? - ANSWER--
slow or increase absorption
-slow the metabolism
-keep drug in body longer
-increase toxicity
How does poor metabolism affect a high or low therapeutic index? - ANSWER--increase
drug toxicity
(example plavix - clots & increased platelets)
Black box warning for Opioids - ANSWER-respiratory depression
Black box warning for Fentanyl - ANSWER-FATAL respiratory depression
Black box warning for Methadone (NP cannot prescribe) - ANSWER-QT interval
prolongation
Black box warning for Codeine - ANSWER--breastfeeding and infant death can occur
, -10% of dose converts to morphine
Black box warning for hydromorphone & oxymorphone (NP cannot prescribe long acting
hydromorphone and oxymorphone) - ANSWER--risk for high abuse & overdose
-respiratory depression
Black box warning for oxycodone (NP need additional training to prescribe for chronic
pain) - ANSWER--HIGH potential for abuse
-respiratory depression
Meds that require special training for APNs to prescribe are... - ANSWER--Opioids
-Fentanyl
-Methadone
-Codeine
-Hydromorphone & oxymorphone
-Oxycodone
What are therapeutic uses for morphine? - ANSWER-MODERATE TO SEVERE PAIN
-acute pain
-post op/surgical pain
-end of life pain management
-MI
-labor & delivery
-cancer
What are therapeutic uses for Fentanyl? - ANSWER-BREAKTHROUGH PAIN
surgical pain
What are medication examples of Schedule II drugs? - ANSWER--Ativan & Valium
-Fentanyl
-Oxycodone
-Methadone
What medications are Schedule III drugs? - ANSWER--Xanax
-Tramadol
-anabolic steroids
-<90mg of codeine
What medications are Schedule IV drugs? - ANSWER--Ativan
-Tramadol
-Methadone
-Adderall
Which schedule drugs can APRNs prescribe? - ANSWER-Schedule II through Schedule
IV
Answers (2025 -2026) (Verified Answers)
Distribution in medication in elderly can be affected in what ways? - ANSWER--
decreased lean mass
-decreased albumin
-decreased body fat
-slower gastric acidity
-slower absorption results in delayed response
In the elderly decrease albumin and decreased lean mass affects medications how? -
ANSWER-medication binds to protein so decreased protein affects how medication is
absorbed and distributed
In elderly decreased body fat affects medications how? - ANSWER-need fat to transport
medications and some drug metabolism is dependent on body weight
When prescribing medication, we must understand that liver function declines with age
due to.... - ANSWER-decreased blood flow to the liver, decreased hepatic enzymes
What is the most important cause of adverse drug reactions? - ANSWER-
***overprescribing/polypharmacy
***decreased renal excretion
-high drug dosages (start low & go slow)
-lack of monitoring medications
What can a poor metabolism phenotype do to a metabolism of a drug? - ANSWER--
slow or increase absorption
-slow the metabolism
-keep drug in body longer
-increase toxicity
How does poor metabolism affect a high or low therapeutic index? - ANSWER--increase
drug toxicity
(example plavix - clots & increased platelets)
Black box warning for Opioids - ANSWER-respiratory depression
Black box warning for Fentanyl - ANSWER-FATAL respiratory depression
Black box warning for Methadone (NP cannot prescribe) - ANSWER-QT interval
prolongation
Black box warning for Codeine - ANSWER--breastfeeding and infant death can occur
, -10% of dose converts to morphine
Black box warning for hydromorphone & oxymorphone (NP cannot prescribe long acting
hydromorphone and oxymorphone) - ANSWER--risk for high abuse & overdose
-respiratory depression
Black box warning for oxycodone (NP need additional training to prescribe for chronic
pain) - ANSWER--HIGH potential for abuse
-respiratory depression
Meds that require special training for APNs to prescribe are... - ANSWER--Opioids
-Fentanyl
-Methadone
-Codeine
-Hydromorphone & oxymorphone
-Oxycodone
What are therapeutic uses for morphine? - ANSWER-MODERATE TO SEVERE PAIN
-acute pain
-post op/surgical pain
-end of life pain management
-MI
-labor & delivery
-cancer
What are therapeutic uses for Fentanyl? - ANSWER-BREAKTHROUGH PAIN
surgical pain
What are medication examples of Schedule II drugs? - ANSWER--Ativan & Valium
-Fentanyl
-Oxycodone
-Methadone
What medications are Schedule III drugs? - ANSWER--Xanax
-Tramadol
-anabolic steroids
-<90mg of codeine
What medications are Schedule IV drugs? - ANSWER--Ativan
-Tramadol
-Methadone
-Adderall
Which schedule drugs can APRNs prescribe? - ANSWER-Schedule II through Schedule
IV
