NR 565 ADVANCED PHARMACOLOGY MIDTERM EXAM
2026/2027 QUESTIONS AND SOLUTIONS RATED A+
✔✔How can healthcare providers decrease likelihood of an elderly patient experiencing
an adverse drug reaction? - ✔✔obtaining a thorough drug history that includes over-the-
counter medications
considering pharmacokinetic and pharmacodynamics changes due to age
monitoring the patient's clinical response and plasma drug levels
using the simplest regimen possible
monitoring for drug-drug interactions and iatrogenic illness
periodically reviewing the need for continued drug therapy
encouraging the patient to dispose of old medications
taking steps to promote adherence and to avoid drugs on the Beers list
✔✔How can we promote medication adherence with elderly patients? - ✔✔simplifying
drug regimens
providing clear and concise verbal and written instructions
using an appropriate dosage form
clearly labeling and dispensing easy-to-open containers
developing daily reminders
monitoring frequently
affordability of drugs
support systems
✔✔Why do nitrates need to be taken no later than 4 PM? - ✔✔Need nitrate free interval
so tolerance doesn't develop
✔✔Nine factors that impact outcome of medication? - ✔✔Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight
✔✔Do you need informed consent for genetic testing? - ✔✔yes
✔✔What is the purpose of the Genetic Information Non-Discriminatory Act? -
✔✔Protects patients from discrimination by employers and insurance providers based
on genetic information
✔✔Difference between practice authority and prescriptive authority? - ✔✔Practice
authority refers to the nurse practitioner's ability to practice without physician oversight,
,whereas prescriptive authority refers to the nurse practitioner's authority to prescribe
medications independently and without limitations.
✔✔Who regulates prescriptive authority? - ✔✔the jurisdiction of a health professional
board. This may be the State Board of Nursing, the State Board of Medicine, or the
State Board of Pharmacy, as determined by each state.
✔✔What is scope of practice determined by? - ✔✔is determined by state practice and
licensure laws.
✔✔What is full practice authority? - ✔✔Nurse practitioners have the autonomy to
evaluate patients, diagnose, order and interpret tests, initiate and manage treatments
and prescribe medications, including controlled substances without physician oversight.
✔✔What is reduced practice authority? - ✔✔Nurse practitioners are limited in at least
one element of practice. The state requires a formal collaborative agreement with an
outside health discipline for the nurse practitioner to provide patient care. ex/ physician
involvement for 5 yrs than independent
✔✔What is restricted practice authority? - ✔✔Nurse practitioners are limited in at least
one element of practice by requiring supervision, delegation, or team management by
an outside health discipline for the nurse practitioner to provide patient care.- typically
doctor on site
✔✔What are components of Rx? - ✔✔Prescriber Contact info
Prescribers name
NPI
DEA
Patient name
DOB
Date
Allergies
Medication name
Strength
Quantity
Indication for use
Direction for use
Refills
Signature
✔✔What are some potential problems that arise with written prescriptions? - ✔✔Must
contain all elements
May have pre-populated information
Write legibly
Avoid error prone abbreviations
, Tamper resistant scripts are often required
✔✔Reasons for monitoring drug therapy - ✔✔determining therapeutic dosage
evaluating medication adequacy
identifying adverse effects
serious or life-threatening risks.
✔✔Which schedules of drugs can APRNs prescribe? - ✔✔depends on state - most II-V
✔✔How does limited prescriptive authority impact patients within the healthcare
system? - ✔✔longer wait times to sign a prescription
limits practitioners that are needed in rural areas
unequal relationships between providers. Ex. one has more power
high need for providers due to lack of providers and high amounts of patients.
Independent practitioners= more patients being seen= lessens the patient/provider load
✔✔Provider key responsibilities when prescribing? - ✔✔safe and competent practice
understanding of the drugs, reactions, and pharmacology
Be aware of the age group you are prescribing to
Ex. Children vs older adults
✔✔What should be used to make prescribing decisions? - ✔✔documented provider-
patient relationship, not prescribing for family or friends, documenting a thorough H&P,
including discussions with the patient, drug monitoring/titrating.
cost, guidelines, availability, interactions, side effects, allergies, hepatic and renal
function, need for monitoring, and special populations
✔✔What happens when someone has a poor metabolism phenotype? - ✔✔medications
metabolized slower, medication might not work or put them at risk for side-effects
✔✔What does the US food and drug administration regulate when it comes to
medications? - ✔✔Whether the drug is safe, effective, and benefits of a drug outweigh
the risks
✔✔reasons for medication non-adherence - ✔✔patients never filling/refilling
prescriptions (resulting in therapeutic failure)
multiple chronic disorders
multiple prescription medications
multiple doses per day for each medication
drug packaging that is difficult to open
multiple prescribers
changes in the regimen (adding meds, changes in dose or timing)
cognitive or physical impairment (reduction in memory, hearing, visual, color, or manual
dexterity)
living alone
2026/2027 QUESTIONS AND SOLUTIONS RATED A+
✔✔How can healthcare providers decrease likelihood of an elderly patient experiencing
an adverse drug reaction? - ✔✔obtaining a thorough drug history that includes over-the-
counter medications
considering pharmacokinetic and pharmacodynamics changes due to age
monitoring the patient's clinical response and plasma drug levels
using the simplest regimen possible
monitoring for drug-drug interactions and iatrogenic illness
periodically reviewing the need for continued drug therapy
encouraging the patient to dispose of old medications
taking steps to promote adherence and to avoid drugs on the Beers list
✔✔How can we promote medication adherence with elderly patients? - ✔✔simplifying
drug regimens
providing clear and concise verbal and written instructions
using an appropriate dosage form
clearly labeling and dispensing easy-to-open containers
developing daily reminders
monitoring frequently
affordability of drugs
support systems
✔✔Why do nitrates need to be taken no later than 4 PM? - ✔✔Need nitrate free interval
so tolerance doesn't develop
✔✔Nine factors that impact outcome of medication? - ✔✔Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight
✔✔Do you need informed consent for genetic testing? - ✔✔yes
✔✔What is the purpose of the Genetic Information Non-Discriminatory Act? -
✔✔Protects patients from discrimination by employers and insurance providers based
on genetic information
✔✔Difference between practice authority and prescriptive authority? - ✔✔Practice
authority refers to the nurse practitioner's ability to practice without physician oversight,
,whereas prescriptive authority refers to the nurse practitioner's authority to prescribe
medications independently and without limitations.
✔✔Who regulates prescriptive authority? - ✔✔the jurisdiction of a health professional
board. This may be the State Board of Nursing, the State Board of Medicine, or the
State Board of Pharmacy, as determined by each state.
✔✔What is scope of practice determined by? - ✔✔is determined by state practice and
licensure laws.
✔✔What is full practice authority? - ✔✔Nurse practitioners have the autonomy to
evaluate patients, diagnose, order and interpret tests, initiate and manage treatments
and prescribe medications, including controlled substances without physician oversight.
✔✔What is reduced practice authority? - ✔✔Nurse practitioners are limited in at least
one element of practice. The state requires a formal collaborative agreement with an
outside health discipline for the nurse practitioner to provide patient care. ex/ physician
involvement for 5 yrs than independent
✔✔What is restricted practice authority? - ✔✔Nurse practitioners are limited in at least
one element of practice by requiring supervision, delegation, or team management by
an outside health discipline for the nurse practitioner to provide patient care.- typically
doctor on site
✔✔What are components of Rx? - ✔✔Prescriber Contact info
Prescribers name
NPI
DEA
Patient name
DOB
Date
Allergies
Medication name
Strength
Quantity
Indication for use
Direction for use
Refills
Signature
✔✔What are some potential problems that arise with written prescriptions? - ✔✔Must
contain all elements
May have pre-populated information
Write legibly
Avoid error prone abbreviations
, Tamper resistant scripts are often required
✔✔Reasons for monitoring drug therapy - ✔✔determining therapeutic dosage
evaluating medication adequacy
identifying adverse effects
serious or life-threatening risks.
✔✔Which schedules of drugs can APRNs prescribe? - ✔✔depends on state - most II-V
✔✔How does limited prescriptive authority impact patients within the healthcare
system? - ✔✔longer wait times to sign a prescription
limits practitioners that are needed in rural areas
unequal relationships between providers. Ex. one has more power
high need for providers due to lack of providers and high amounts of patients.
Independent practitioners= more patients being seen= lessens the patient/provider load
✔✔Provider key responsibilities when prescribing? - ✔✔safe and competent practice
understanding of the drugs, reactions, and pharmacology
Be aware of the age group you are prescribing to
Ex. Children vs older adults
✔✔What should be used to make prescribing decisions? - ✔✔documented provider-
patient relationship, not prescribing for family or friends, documenting a thorough H&P,
including discussions with the patient, drug monitoring/titrating.
cost, guidelines, availability, interactions, side effects, allergies, hepatic and renal
function, need for monitoring, and special populations
✔✔What happens when someone has a poor metabolism phenotype? - ✔✔medications
metabolized slower, medication might not work or put them at risk for side-effects
✔✔What does the US food and drug administration regulate when it comes to
medications? - ✔✔Whether the drug is safe, effective, and benefits of a drug outweigh
the risks
✔✔reasons for medication non-adherence - ✔✔patients never filling/refilling
prescriptions (resulting in therapeutic failure)
multiple chronic disorders
multiple prescription medications
multiple doses per day for each medication
drug packaging that is difficult to open
multiple prescribers
changes in the regimen (adding meds, changes in dose or timing)
cognitive or physical impairment (reduction in memory, hearing, visual, color, or manual
dexterity)
living alone
