PHARMACOTHERAPEUTICShFORhADVANCEDhPRACTICEhNURSEhPRESCRIBE
RSh6THhEDITIONhWOOhROBINSONhTESThBANK
, PHARMACOTHERAPEUTICShFORhADVANCEDhPRACTICEhCAREGIVERhPRESCRIBERSh6T
HhEDITIONhWOOhROBINSONhTESThBANK
CHhh1.hThehRolehofhthehCaregiverhPractitionerh
Multiplehselection
Identifyhthehoptionhthathbesthcompleteshthehstatementhorhanswershthehquestion.
h 1.hNursehpractitionerhprescriptivehauthorityhishregulatedhby:
1. ThehNationalhCouncilhofhStatehBoardshofhNursing
2. ThehU.S.hMedicalhdrughEnforcementhAdministration
3. ThehStatehBoardhofhNursinghforheachhstate
4. ThehStatehBoardhofhPharmacy
h
2.hThehbenefitshtohthehhospitalhclienthofhhavinghanhAdvancedhPracticehRegisteredhCaregiverh(A
PRN)hprescriberhinclude:
1. CaregivershknowhmorehabouthPharmacologyhthanhotherhprescribershbecausehtheyht
akehithbothhinhtheirhbasichnursinghprogramhandhinhtheirhAPRNhprogram.
2. Caregivershcarehforhthehhospitalhclienthfromhahholistichapproachhandhincludeht
hehhospitalhclienthinhdecisionhmakinghregardinghtheirhcare.
3. APRNsharehlesshlikelyhtohprescribehnarcoticshandhotherhcontrolledhsubstances.
4. APRNsharehablehtohprescribehindependentlyhinhallhstates,hwhereashahphysician’s
hassistanthneedshtohhavehahphysicianhsupervisinghtheirhpractice.
h 3.hClinicalhjudgmenthinhprescribinghincludes:
1. Factoringhinhthehcosthtohthehhospitalhclienthofhthehmedicationhprescribed
2. Alwayshprescribinghthehnewesthmedicationhavailablehforhthehdiseasehprocess
3. Handinghouthmedicalhdrughsampleshtohpoorhhospitalhclients
4. Prescribinghallhgenerichmedicationshtohcuthcosts
h 4.hCriteriahforhchoosinghanheffectivehmedicalhdrughforhahdisorderhinclude:
1. Askinghthehhospitalhclienthwhathmedicalhdrughtheyhthinkhwouldhworkhbesthforhthem
2. Consultinghnationallyhrecognizedhguidelineshforhdiseasehmanagement
3. Prescribinghmedicationshthatharehavailablehashsampleshbeforehwritinghahprescription
4. FollowinghU.S.hDrughEnforcementhAdministrationhguidelineshforhprescribing
h 5.hCaregiverhpractitionerhpracticehmayhthrivehunderhhealth-carehreformhbecausehof:
1. Thehdemonstratedhabilityhofhcaregiverhpractitionershtohcontrolhcostshandhimprovehhos
pitalhclienthoutcomes
2. Thehfacththathcaregiverhpractitionershwillhbehablehtohpracticehindependently
3. Thehfacththathcaregiverhpractitionershwillhhavehfullhreimbursementhunderhhealth-
carehreform
4. ThehabilityhtohshifthaccountabilityhforhMedicaidhtohthehstatehlevel
,CHhh1.hThehRolehofhthehCaregiverhPractitionerh
AnswerhSection
MULTIPLEhSELECTION
1.hACCU 3 PTS: 1
RATEhAN
SWER:
2.hACCU 2 PTS: 1
RATEhAN
SWER:
3.hACCU 1 PTS: 1
RATEhAN
SWER:
4.hACCU 2 PTS: 1
RATEhAN
SWER:
5.hACCU 1 PTS: 1
RATEhAN
SWER:
CHhh2.hReviewhofhBasichPrincipleshofhPharmacology
Multiplehselection
Identifyhthehoptionhthathbesthcompleteshthehstatementhorhanswershthehquestion.
h
1.hAhhospitalhclient’shnutritionalhintakehandhlaboratoryhresultshreflecthhypoalbuminemia.hThishis
hcriticalhtohprescribinghbecause:
1. Distributionhofhmedicalhdrugshtohtargethtissuehmayhbehaffected.
2. Thehsolubilityhofhthehmedicalhdrughwillhnothmatchhthehsitehofhabsorption.
3. Therehwillhbehlesshfreehmedicalhdrughavailablehtohgeneratehanheffect.
4. Medicalhdrugshboundhtohalbuminharehreadilyhexcretedhbyhthehkidneys.
h 2.hMedicalhdrugshthathhavehahsignificanthfirst-passheffect:
1. Musthbehgivenhbyhthehenteralh(oral)hroutehonly
2. Bypasshthehhepatichcirculation
3. Arehrapidlyhmetabolizedhbyhthehliverhandhmayhhavehlittlehifhanyhdesiredhaction
4. Arehconvertedhbyhthehliverhtohmorehactivehandhfat-solublehforms
h 3.hThehroutehofhexcretionhofhahvolatilehmedicalhdrughwillhlikelyhbehthe:
1. Kidneys
2. Lungs
3. Bilehandhfeces
4. Skin
h
4.hMedroxyprogesteroneh(DepohProvera)hishprescribedhintramuscularlyh(IM)htohcreatehahst
oragehreservoirhofhthehmedicalhdrug.hStoragehreservoirs:
1. Assurehthaththehmedicalhdrughwillhreachhitshintendedhtargethtissue
2. Arehthehreasonhforhgivinghloadinghdoses
3. Increasehthehlengthhofhtimehahmedicalhdrughishavailablehandhactive
4. Arehmosthcommonhinhcollagenhtissues
, h 5.hThehNPhchooseshtohgivehcephalexinheveryh8hhourshbasedhonhknowledgehofhthehmedicalhdrug’s:
1. Propensityhtohgohtohthehtargethreceptor
2. Biologicalhhalf-life
3. Pharmacodynamics
4. Safetyhandhsideheffects
6.hAzithromycinhdosinghrequireshthaththehfirsthday’shdosagehbehtwicehthosehofhthehotherh4hdaysh
ofhthehprescription.hThishishconsideredhahloadinghdose.hAhloadinghdose:
1. Rapidlyhachieveshmedicalhdrughlevelshinhthehtherapeutichrange
2. Requireshfour-htohfive-half-liveshtohattain
3. Ishinfluencedhbyhrenalhfunction
4. Ishdirectlyhrelatedhtohthehmedicalhdrughcirculatinghtohthehtargethtissues
h
7.hThehpointhinhtimehonhthehmedicalhdrughconcentrationhcurvehthathindicateshthehfirsthsignhofhahther
apeuticheffecthishthe:
1. Minimumhadverseheffecthlevel
2. Peakhofhaction
3. Onsethofhaction
4. Therapeutichrange
h 8.hPhenytoinhrequireshthathahtroughhlevelhbehdrawn.hPeakhandhtroughhlevelsharehdone:
1. Whenhthehmedicalhdrughhashahwidehtherapeutichrange
2. Whenhthehmedicalhdrughwillhbehadministeredhforhahshorthtimehonly
3. Whenhtherehishahhighhcorrelationhbetweenhthehdosehandhsaturationhofhreceptorhsites
4. Tohdeterminehifhahmedicalhdrughishinhthehtherapeutichrange
h
9.hAhlaboratoryhresulthindicateshthaththehpeakhlevelhforhahmedicalhdrughishabovehthehminimumhtoxichconcentrati
on.
Thishmeanshthaththe:
1. Concentrationhwillhproducehtherapeuticheffects
2. Concentrationhwillhproducehanhadversehresponse
3. Timehbetweenhdoseshmusthbehshortened
4. Durationhofhactionhofhthehmedicalhdrughishtoohlong
h hh10.hMedicalhdrugshthatharehreceptorhagonistshmayhdemonstratehwhathproperty?
1. Irreversiblehbindinghtohthehmedicalhdrughreceptorhsite
2. Upregulationhwithhchronichuse
3. Desensitizationhorhdownregulationhwithhcontinuoushuse
4. Inversehrelationshiphbetweenhmedicalhdrughconcentrationhandhmedicalhdrughaction
h hh11.hMedicalhdrugshthatharehreceptorhantagonists,hsuchhashbetahblockers,hmayhcause:
1. Downregulationhofhthehmedicalhdrughreceptor
2. Anhexaggeratedhresponsehifhabruptlyhdiscontinued
3. Partialhblockadehofhtheheffectshofhagonisthmedicalhdrugs
4. Anhexaggeratedhresponsehtohcompetitivehmedicalhdrughagonists
h hh12.hFactorshthathaffecthgastrichmedicalhdrughabsorptionhinclude:
1. Liverhenzymehactivity
2. Protein-bindinghpropertieshofhthehmedicalhdrughmolecule
3. Lipidhsolubilityhofhthehmedicalhdrug
4. Abilityhtohchewhandhswallow
RSh6THhEDITIONhWOOhROBINSONhTESThBANK
, PHARMACOTHERAPEUTICShFORhADVANCEDhPRACTICEhCAREGIVERhPRESCRIBERSh6T
HhEDITIONhWOOhROBINSONhTESThBANK
CHhh1.hThehRolehofhthehCaregiverhPractitionerh
Multiplehselection
Identifyhthehoptionhthathbesthcompleteshthehstatementhorhanswershthehquestion.
h 1.hNursehpractitionerhprescriptivehauthorityhishregulatedhby:
1. ThehNationalhCouncilhofhStatehBoardshofhNursing
2. ThehU.S.hMedicalhdrughEnforcementhAdministration
3. ThehStatehBoardhofhNursinghforheachhstate
4. ThehStatehBoardhofhPharmacy
h
2.hThehbenefitshtohthehhospitalhclienthofhhavinghanhAdvancedhPracticehRegisteredhCaregiverh(A
PRN)hprescriberhinclude:
1. CaregivershknowhmorehabouthPharmacologyhthanhotherhprescribershbecausehtheyht
akehithbothhinhtheirhbasichnursinghprogramhandhinhtheirhAPRNhprogram.
2. Caregivershcarehforhthehhospitalhclienthfromhahholistichapproachhandhincludeht
hehhospitalhclienthinhdecisionhmakinghregardinghtheirhcare.
3. APRNsharehlesshlikelyhtohprescribehnarcoticshandhotherhcontrolledhsubstances.
4. APRNsharehablehtohprescribehindependentlyhinhallhstates,hwhereashahphysician’s
hassistanthneedshtohhavehahphysicianhsupervisinghtheirhpractice.
h 3.hClinicalhjudgmenthinhprescribinghincludes:
1. Factoringhinhthehcosthtohthehhospitalhclienthofhthehmedicationhprescribed
2. Alwayshprescribinghthehnewesthmedicationhavailablehforhthehdiseasehprocess
3. Handinghouthmedicalhdrughsampleshtohpoorhhospitalhclients
4. Prescribinghallhgenerichmedicationshtohcuthcosts
h 4.hCriteriahforhchoosinghanheffectivehmedicalhdrughforhahdisorderhinclude:
1. Askinghthehhospitalhclienthwhathmedicalhdrughtheyhthinkhwouldhworkhbesthforhthem
2. Consultinghnationallyhrecognizedhguidelineshforhdiseasehmanagement
3. Prescribinghmedicationshthatharehavailablehashsampleshbeforehwritinghahprescription
4. FollowinghU.S.hDrughEnforcementhAdministrationhguidelineshforhprescribing
h 5.hCaregiverhpractitionerhpracticehmayhthrivehunderhhealth-carehreformhbecausehof:
1. Thehdemonstratedhabilityhofhcaregiverhpractitionershtohcontrolhcostshandhimprovehhos
pitalhclienthoutcomes
2. Thehfacththathcaregiverhpractitionershwillhbehablehtohpracticehindependently
3. Thehfacththathcaregiverhpractitionershwillhhavehfullhreimbursementhunderhhealth-
carehreform
4. ThehabilityhtohshifthaccountabilityhforhMedicaidhtohthehstatehlevel
,CHhh1.hThehRolehofhthehCaregiverhPractitionerh
AnswerhSection
MULTIPLEhSELECTION
1.hACCU 3 PTS: 1
RATEhAN
SWER:
2.hACCU 2 PTS: 1
RATEhAN
SWER:
3.hACCU 1 PTS: 1
RATEhAN
SWER:
4.hACCU 2 PTS: 1
RATEhAN
SWER:
5.hACCU 1 PTS: 1
RATEhAN
SWER:
CHhh2.hReviewhofhBasichPrincipleshofhPharmacology
Multiplehselection
Identifyhthehoptionhthathbesthcompleteshthehstatementhorhanswershthehquestion.
h
1.hAhhospitalhclient’shnutritionalhintakehandhlaboratoryhresultshreflecthhypoalbuminemia.hThishis
hcriticalhtohprescribinghbecause:
1. Distributionhofhmedicalhdrugshtohtargethtissuehmayhbehaffected.
2. Thehsolubilityhofhthehmedicalhdrughwillhnothmatchhthehsitehofhabsorption.
3. Therehwillhbehlesshfreehmedicalhdrughavailablehtohgeneratehanheffect.
4. Medicalhdrugshboundhtohalbuminharehreadilyhexcretedhbyhthehkidneys.
h 2.hMedicalhdrugshthathhavehahsignificanthfirst-passheffect:
1. Musthbehgivenhbyhthehenteralh(oral)hroutehonly
2. Bypasshthehhepatichcirculation
3. Arehrapidlyhmetabolizedhbyhthehliverhandhmayhhavehlittlehifhanyhdesiredhaction
4. Arehconvertedhbyhthehliverhtohmorehactivehandhfat-solublehforms
h 3.hThehroutehofhexcretionhofhahvolatilehmedicalhdrughwillhlikelyhbehthe:
1. Kidneys
2. Lungs
3. Bilehandhfeces
4. Skin
h
4.hMedroxyprogesteroneh(DepohProvera)hishprescribedhintramuscularlyh(IM)htohcreatehahst
oragehreservoirhofhthehmedicalhdrug.hStoragehreservoirs:
1. Assurehthaththehmedicalhdrughwillhreachhitshintendedhtargethtissue
2. Arehthehreasonhforhgivinghloadinghdoses
3. Increasehthehlengthhofhtimehahmedicalhdrughishavailablehandhactive
4. Arehmosthcommonhinhcollagenhtissues
, h 5.hThehNPhchooseshtohgivehcephalexinheveryh8hhourshbasedhonhknowledgehofhthehmedicalhdrug’s:
1. Propensityhtohgohtohthehtargethreceptor
2. Biologicalhhalf-life
3. Pharmacodynamics
4. Safetyhandhsideheffects
6.hAzithromycinhdosinghrequireshthaththehfirsthday’shdosagehbehtwicehthosehofhthehotherh4hdaysh
ofhthehprescription.hThishishconsideredhahloadinghdose.hAhloadinghdose:
1. Rapidlyhachieveshmedicalhdrughlevelshinhthehtherapeutichrange
2. Requireshfour-htohfive-half-liveshtohattain
3. Ishinfluencedhbyhrenalhfunction
4. Ishdirectlyhrelatedhtohthehmedicalhdrughcirculatinghtohthehtargethtissues
h
7.hThehpointhinhtimehonhthehmedicalhdrughconcentrationhcurvehthathindicateshthehfirsthsignhofhahther
apeuticheffecthishthe:
1. Minimumhadverseheffecthlevel
2. Peakhofhaction
3. Onsethofhaction
4. Therapeutichrange
h 8.hPhenytoinhrequireshthathahtroughhlevelhbehdrawn.hPeakhandhtroughhlevelsharehdone:
1. Whenhthehmedicalhdrughhashahwidehtherapeutichrange
2. Whenhthehmedicalhdrughwillhbehadministeredhforhahshorthtimehonly
3. Whenhtherehishahhighhcorrelationhbetweenhthehdosehandhsaturationhofhreceptorhsites
4. Tohdeterminehifhahmedicalhdrughishinhthehtherapeutichrange
h
9.hAhlaboratoryhresulthindicateshthaththehpeakhlevelhforhahmedicalhdrughishabovehthehminimumhtoxichconcentrati
on.
Thishmeanshthaththe:
1. Concentrationhwillhproducehtherapeuticheffects
2. Concentrationhwillhproducehanhadversehresponse
3. Timehbetweenhdoseshmusthbehshortened
4. Durationhofhactionhofhthehmedicalhdrughishtoohlong
h hh10.hMedicalhdrugshthatharehreceptorhagonistshmayhdemonstratehwhathproperty?
1. Irreversiblehbindinghtohthehmedicalhdrughreceptorhsite
2. Upregulationhwithhchronichuse
3. Desensitizationhorhdownregulationhwithhcontinuoushuse
4. Inversehrelationshiphbetweenhmedicalhdrughconcentrationhandhmedicalhdrughaction
h hh11.hMedicalhdrugshthatharehreceptorhantagonists,hsuchhashbetahblockers,hmayhcause:
1. Downregulationhofhthehmedicalhdrughreceptor
2. Anhexaggeratedhresponsehifhabruptlyhdiscontinued
3. Partialhblockadehofhtheheffectshofhagonisthmedicalhdrugs
4. Anhexaggeratedhresponsehtohcompetitivehmedicalhdrughagonists
h hh12.hFactorshthathaffecthgastrichmedicalhdrughabsorptionhinclude:
1. Liverhenzymehactivity
2. Protein-bindinghpropertieshofhthehmedicalhdrughmolecule
3. Lipidhsolubilityhofhthehmedicalhdrug
4. Abilityhtohchewhandhswallow
