NR 565 ADVANCED
PHARMACOLOGY FUNDAMENTALS
WEEK 2 2026 EXAM SCRIPT SOLVED
QUESTIONS SET
◉ Which schedule drugs can APRNs prescribe?
Answer: DEA license will allow for prescribing of Schedules 2-5. There
can be restrictions as noted in collaborative agreement. May be
facility/state dependent.
◉ Who determines and regulates prescriptive authority?
Answer: Determines: Also known as independent prescribing. APRNS
can prescribe without limitation and is state dependent. Includes
"legend" (prescription) and controlled drugs, health/medical services,
DME, etc.
Regulates: State board of nursing, regulated by health professional
board. Federal government controls drug regulations but has no control
over prescriptive authority.
◉ How does limited prescriptive authority impact patients within the
healthcare system?
Answer: Limited prescriptive authority creates numerous barriers to
quality, affordable, and accessible patient care. For example, restrictions
on the distance of the APRN or PA from the physician providing
supervision or collaboration may prevent outreach to area of greatest
need. An increase in patient waits.
,◉ What are the key responsibilities of prescribing?
Answer: The ability to prescribe medications is both a privilege and a
burden. Have a documented provider-patient relationship, do not
prescribe medications to family or friends or yourself, Document a
thorough history and physical examination, include any discussions you
have with the patient about risk factors, side effects, or therapy options,
have documented plan regarding drug monitoring or titration, if you
consult additional providers not that you did so. Use the references
provided in the following boxes to assist in safely and rationally
choosing one medication over another.
Be sensible, accept responsibility, do not fear it, know constraints and
limitations, always learn and update, keep Rx pads in safe place, confirm
allergies, verify medication list with patient, do not let insurance dictate
quantity of Rx, Charting is key (particularly with off label use), Provide
use and rationale.
◉ What should be used to make prescribing decisions?
Answer: The best way to keep your patients (and yourself) safe is to be
prudent and deliberate in your decision-making process. Cost,
availability, current practice guidelines, medication interactions
including interactions with food, side effects, need for monitoring, how
drug is metabolized (hepatic or renal), special populations (pregnancy,
nursing, older adults)
◉ Be familiar with pharmacokinetic and pharmacodynamic changes of
older adults and how that would translate to baseline information needed
to prescribe
Answer: Pharmacokinetic is the study of drug absorption, distribution,
metabolism, and excretion in the body. The ability of older adults to
,metabolize drugs is commonly decreased. Drug dosages may need to be
reduced to prevent drug toxicity.
◉ Beer's criteria
Answer: Guidelines for prescribing medications to patients 65 & older.
Drugs on the list should be avoided in patients over 65 expect when the
benefits significantly outweigh the risks. The Beers Criteria includes
five lists that describe certain medications and situations and include:
potentially inappropriate medication (PIM) us in older adults, PIM use in
older adults due to medication-disease or medication-syndrome
interactions that may exacerbate the disease or syndrome, medications to
be used cautiously in older adults, clinically significant drug interactions
that should be avoided in older adults, medications to be avoided or
dosage decreased in the presence of impaired kidney function in older
adults.
◉ Why is Beer's criteria important?
Answer: It provides a list of medications that are potentially harmful in
elderly. List that identifies drugs with a high likelihood of causing
adverse effects in older adults. Beers Criteria are recommendations;
ultimately prescribers must determine whether a medication is
appropriate for use or not. These guidelines are not intended to limit the
use of medications or apply to all older adults. Safe and judicious
prescribing is crucial in the older adult to optimize pharmacotherapy.
◉ Impacts/outcomes of polypharmacy
Answer: Polypharmacy greatly increases the risk for interactions. Drug
interactions with mild side effects to life-threatening consequences.
, Elderly is at a higher risk of polypharmacy due to taking five or more
medications daily.
◉ CYP450
Answer: metabolic pathway, involved in metabolism of drugs in the
liver. Metabolism can be inhibited or induced by drugs and once this
happens drug-drug interaction can occur.
◉ What are the CYP450 inhibitors?
Answer: Liver enzymes. It's not just a single molecular entity but rather
a group of 12 closely related enzyme families.
Examples: Valproate, Isoniazid, Sulfonamides, Amiodarone,
Chloramphenicol, Ketoconazole, Grapefruit juice, Quinidine
What do they do? Slows down metabolism of medications. Inhibitors are
medications that inhibit activity of one or more of the CYP450 enzymes.
Medications that inhibit an enzyme can potentially slow that enzymes
activity required for metabolism of other medications, thereby increasing
the levels of medications dependent on that particular enzyme for
biotransformation. This inhibition prolongs the pharmacalogical effects,
which may result in toxicity. Factors that affect the inhibition include the
dose and the capacity to bind to the enzyme
◉ What do they cause if not used correctly (CYP450)?(aka:What would
the patient experience?)
Answer: Toxicity. drug build up
PHARMACOLOGY FUNDAMENTALS
WEEK 2 2026 EXAM SCRIPT SOLVED
QUESTIONS SET
◉ Which schedule drugs can APRNs prescribe?
Answer: DEA license will allow for prescribing of Schedules 2-5. There
can be restrictions as noted in collaborative agreement. May be
facility/state dependent.
◉ Who determines and regulates prescriptive authority?
Answer: Determines: Also known as independent prescribing. APRNS
can prescribe without limitation and is state dependent. Includes
"legend" (prescription) and controlled drugs, health/medical services,
DME, etc.
Regulates: State board of nursing, regulated by health professional
board. Federal government controls drug regulations but has no control
over prescriptive authority.
◉ How does limited prescriptive authority impact patients within the
healthcare system?
Answer: Limited prescriptive authority creates numerous barriers to
quality, affordable, and accessible patient care. For example, restrictions
on the distance of the APRN or PA from the physician providing
supervision or collaboration may prevent outreach to area of greatest
need. An increase in patient waits.
,◉ What are the key responsibilities of prescribing?
Answer: The ability to prescribe medications is both a privilege and a
burden. Have a documented provider-patient relationship, do not
prescribe medications to family or friends or yourself, Document a
thorough history and physical examination, include any discussions you
have with the patient about risk factors, side effects, or therapy options,
have documented plan regarding drug monitoring or titration, if you
consult additional providers not that you did so. Use the references
provided in the following boxes to assist in safely and rationally
choosing one medication over another.
Be sensible, accept responsibility, do not fear it, know constraints and
limitations, always learn and update, keep Rx pads in safe place, confirm
allergies, verify medication list with patient, do not let insurance dictate
quantity of Rx, Charting is key (particularly with off label use), Provide
use and rationale.
◉ What should be used to make prescribing decisions?
Answer: The best way to keep your patients (and yourself) safe is to be
prudent and deliberate in your decision-making process. Cost,
availability, current practice guidelines, medication interactions
including interactions with food, side effects, need for monitoring, how
drug is metabolized (hepatic or renal), special populations (pregnancy,
nursing, older adults)
◉ Be familiar with pharmacokinetic and pharmacodynamic changes of
older adults and how that would translate to baseline information needed
to prescribe
Answer: Pharmacokinetic is the study of drug absorption, distribution,
metabolism, and excretion in the body. The ability of older adults to
,metabolize drugs is commonly decreased. Drug dosages may need to be
reduced to prevent drug toxicity.
◉ Beer's criteria
Answer: Guidelines for prescribing medications to patients 65 & older.
Drugs on the list should be avoided in patients over 65 expect when the
benefits significantly outweigh the risks. The Beers Criteria includes
five lists that describe certain medications and situations and include:
potentially inappropriate medication (PIM) us in older adults, PIM use in
older adults due to medication-disease or medication-syndrome
interactions that may exacerbate the disease or syndrome, medications to
be used cautiously in older adults, clinically significant drug interactions
that should be avoided in older adults, medications to be avoided or
dosage decreased in the presence of impaired kidney function in older
adults.
◉ Why is Beer's criteria important?
Answer: It provides a list of medications that are potentially harmful in
elderly. List that identifies drugs with a high likelihood of causing
adverse effects in older adults. Beers Criteria are recommendations;
ultimately prescribers must determine whether a medication is
appropriate for use or not. These guidelines are not intended to limit the
use of medications or apply to all older adults. Safe and judicious
prescribing is crucial in the older adult to optimize pharmacotherapy.
◉ Impacts/outcomes of polypharmacy
Answer: Polypharmacy greatly increases the risk for interactions. Drug
interactions with mild side effects to life-threatening consequences.
, Elderly is at a higher risk of polypharmacy due to taking five or more
medications daily.
◉ CYP450
Answer: metabolic pathway, involved in metabolism of drugs in the
liver. Metabolism can be inhibited or induced by drugs and once this
happens drug-drug interaction can occur.
◉ What are the CYP450 inhibitors?
Answer: Liver enzymes. It's not just a single molecular entity but rather
a group of 12 closely related enzyme families.
Examples: Valproate, Isoniazid, Sulfonamides, Amiodarone,
Chloramphenicol, Ketoconazole, Grapefruit juice, Quinidine
What do they do? Slows down metabolism of medications. Inhibitors are
medications that inhibit activity of one or more of the CYP450 enzymes.
Medications that inhibit an enzyme can potentially slow that enzymes
activity required for metabolism of other medications, thereby increasing
the levels of medications dependent on that particular enzyme for
biotransformation. This inhibition prolongs the pharmacalogical effects,
which may result in toxicity. Factors that affect the inhibition include the
dose and the capacity to bind to the enzyme
◉ What do they cause if not used correctly (CYP450)?(aka:What would
the patient experience?)
Answer: Toxicity. drug build up
