NR 574 ACUTE CARE PRACTICUM MIDTERM
EXAM 2026 WEEK 1 TO 4 PRACTICE
QUESTIONS AND ANSWERS DETAILED REVIEW
◉ benefits of full practice authority. Answer: 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
◉ promoting positive outcomes through prudent prescribing practices.
Answer: Administering medications and prescribing medications are two
distinct processes. Prescription writing requires prudent and deliberate
decision-making processes to maintain patient safety and reduce
liability, including:
*documentation of a provider-patient relationship for the recipient of the
prescribed medications
*documentation of a thorough history and physical examination for the
recipient
*documentation of discussions regarding risk factors, side effects, or
therapy options
*documentation of drug monitoring or titration plan, if applicable
,*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the
formulation of a diagnosis based on clinical reasoning and the selection
and monitoring of the most appropriate pharmacological treatment
Considerations include: Cost, guidelines, availability, interactions, side
effects, allergies, hepatic/renal functions, need for monitoring, & special
populations
◉ Beer's Criteria. Answer: identifies drugs with a high likelihood of
causing adverse effects in older adults. Accordingly, drugs on this list
should generally be avoided in adults older than 65 years except when
the benefits are significantly greater than the risks.
◉ Pharmacodynamics. Answer: the study of the biochemical and
physiologic effects of drugs on the body and the molecular mechanisms
by which those effects are produced
◉ Pharmacokinetics. Answer: the study of drug movement throughout
the body
,◉ Pharmacogenomics. Answer: the study of how genes affect a person's
response to drugs. The purpose of this is to combine the sciences of
genomics and pharmacology to provide individualized, targeted, safe
drug therapies to patients
◉ CYP450 inducers. Answer: Inducers are xenobiotics (medications and
environmental agents) that elevate CYP450 enzyme activity by
increasing enzyme synthesis. This action leads to additional sites
available for biotransformation. The increased number of sites enhances
medication metabolism, decreasing the concentration of the "parent
drug" while increasing metabolite production.
Inducers = Increase medication metabolism
(Carbamazepine, Rifampin, Alcohol, Phenytoin, Griseofulvin,
Phenobarbital, Sulfonylureas)
◉ CYP450 inhibitors. Answer: Inhibitors are medications that inhibit the
metabolic activity of one or more of the CYP450 enzymes. Medications
that inhibit an enzyme potentially slows that enzyme's activity or blocks
the activity required for the metabolism of other medications, thereby
increasing the levels of medications dependent on that particular enzyme
for biotransformation. Inhibitors = decrease medication metabolism
(Valproate, Isoniazid, Sulfonamides, Amiodarone, Chloramphenicol,
Ketoconazole, Grapefruit Juice, Quinidine)
, ◉ cultural influences in prescribing. Answer: The greatest concern
surrounding race-based therapy has to do with genetic variability. We
know there is great diversity within and among racial groups; therefore,
a "one fits all" approach based on race is unwise. Still, we can use
known associations to guide choices. For example, differences in
metabolism between people with East Asian and European heritage are
common. The provider can use this knowledge to guide initial dosing
(with adjustment, as indicated based on response) if genetic testing is not
feasible or warranted
◉ Polypharmacy: Definition, challenges, and outcomes. Answer:
treatment with multiple drugs
greatly increases the risk for interactions. Some of these interactions are
negligible, but some can have life-threatening consequences. It is of
crucial importance to ask the patient about all current drugs, including
over-the-counter (OTC) medications and other herbal preparations.
Many patients do not consider OTC or alternative pharmaceuticals as
"medications" and may not mention them unless you ask specifically.
◉ Acute Pain Management. Answer:
◉ Chronic Pain Management. Answer:
◉ Opioid Management. Answer:
EXAM 2026 WEEK 1 TO 4 PRACTICE
QUESTIONS AND ANSWERS DETAILED REVIEW
◉ benefits of full practice authority. Answer: 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
◉ promoting positive outcomes through prudent prescribing practices.
Answer: Administering medications and prescribing medications are two
distinct processes. Prescription writing requires prudent and deliberate
decision-making processes to maintain patient safety and reduce
liability, including:
*documentation of a provider-patient relationship for the recipient of the
prescribed medications
*documentation of a thorough history and physical examination for the
recipient
*documentation of discussions regarding risk factors, side effects, or
therapy options
*documentation of drug monitoring or titration plan, if applicable
,*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the
formulation of a diagnosis based on clinical reasoning and the selection
and monitoring of the most appropriate pharmacological treatment
Considerations include: Cost, guidelines, availability, interactions, side
effects, allergies, hepatic/renal functions, need for monitoring, & special
populations
◉ Beer's Criteria. Answer: identifies drugs with a high likelihood of
causing adverse effects in older adults. Accordingly, drugs on this list
should generally be avoided in adults older than 65 years except when
the benefits are significantly greater than the risks.
◉ Pharmacodynamics. Answer: the study of the biochemical and
physiologic effects of drugs on the body and the molecular mechanisms
by which those effects are produced
◉ Pharmacokinetics. Answer: the study of drug movement throughout
the body
,◉ Pharmacogenomics. Answer: the study of how genes affect a person's
response to drugs. The purpose of this is to combine the sciences of
genomics and pharmacology to provide individualized, targeted, safe
drug therapies to patients
◉ CYP450 inducers. Answer: Inducers are xenobiotics (medications and
environmental agents) that elevate CYP450 enzyme activity by
increasing enzyme synthesis. This action leads to additional sites
available for biotransformation. The increased number of sites enhances
medication metabolism, decreasing the concentration of the "parent
drug" while increasing metabolite production.
Inducers = Increase medication metabolism
(Carbamazepine, Rifampin, Alcohol, Phenytoin, Griseofulvin,
Phenobarbital, Sulfonylureas)
◉ CYP450 inhibitors. Answer: Inhibitors are medications that inhibit the
metabolic activity of one or more of the CYP450 enzymes. Medications
that inhibit an enzyme potentially slows that enzyme's activity or blocks
the activity required for the metabolism of other medications, thereby
increasing the levels of medications dependent on that particular enzyme
for biotransformation. Inhibitors = decrease medication metabolism
(Valproate, Isoniazid, Sulfonamides, Amiodarone, Chloramphenicol,
Ketoconazole, Grapefruit Juice, Quinidine)
, ◉ cultural influences in prescribing. Answer: The greatest concern
surrounding race-based therapy has to do with genetic variability. We
know there is great diversity within and among racial groups; therefore,
a "one fits all" approach based on race is unwise. Still, we can use
known associations to guide choices. For example, differences in
metabolism between people with East Asian and European heritage are
common. The provider can use this knowledge to guide initial dosing
(with adjustment, as indicated based on response) if genetic testing is not
feasible or warranted
◉ Polypharmacy: Definition, challenges, and outcomes. Answer:
treatment with multiple drugs
greatly increases the risk for interactions. Some of these interactions are
negligible, but some can have life-threatening consequences. It is of
crucial importance to ask the patient about all current drugs, including
over-the-counter (OTC) medications and other herbal preparations.
Many patients do not consider OTC or alternative pharmaceuticals as
"medications" and may not mention them unless you ask specifically.
◉ Acute Pain Management. Answer:
◉ Chronic Pain Management. Answer:
◉ Opioid Management. Answer:
