NR565 MIDTERM STUDY GUIDE: KEY CONCEPTS IN PHARMACOLOGY
AND DRUG THERAPY | 2026 CORRECT QUESTIONS AND VERIFIED
ANSWERS ~ CHAMBERLAIN UNIVERSITY.
NR565 midterm study guide
Chapter 1 Prescriptive Authority
• State laws impact on prescriptive authority
o Determined by state law
o Determined by health professional board.
o The right to prescribe without limitation and the right to prescribe
independently.
• Full Practice Authority
o 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
• Role: Prescriptive Authority
o 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 board.
o Refers to the nurse practitioner’s authority to prescribe medications
independently and without limitations
Chapter 3 Promoting Positive Outcomes of Drug Therapy
• Generic vs Brand Name: Value of Knowing
o Both names should be included on prescription
• Duration of Therapy
o Knowing medication therapy being short time or long term
• Role of Formularies
o
• Blood Flow Impact on Absorption
o Rapidly absorbed where blood flow is high because blood containing
a newly absorbed drug will be replaced rapidly by drug-free blood.
,The greater the concentration gradient, the more rapid absorption will
be
,Chapter 4 Pharmacokinetics, Pharmacodynamics, and Drug Interactions
• Excretion Process
o Is the movement of drugs and their metabolites out of the body
• Metabolism Process
o Biotransformation is the enzymatically mediated alteration of drug
structure
o Most drugs metabolize in the liver and its performed by the hepatic
microsomal enzyme system
• Distribution Process
o Distribution is the movement of drugs from the systemic circulation
to the site of drug action
o
• Passage Across Membranes
o Channels or pores, passage with the aid of a transport system, direct
penetration of the membrane
o P-glycoprotein or multidrug transporter protein, transports a wide
variety of drugs out of cells
o Drugs must be lipid soluble to penetrate membranes
• Absorption Process
o Absorption is the movement of a drug from its site of administration
into the systemic circulation.
o The rate of absorption determines how soon effects will begin
o The amount of absorption helps determine how intense effects will
be
• Rate of Dissolution
o A drug must first dissolve. Hence the rate of dissolution helps
determine the rate of absorption
• Surface Area and Absorption
o The surface area is larger, absorption is faster.
• Multiple drugs on metabolic pathways
o When two drugs are metabolized by the same metabolic pathway, they
may compete with each other for metabolism and may thereby
decrease the rate at which one or both agents are metabolized. If
metabolism is depressed enough, a drug can accumulate to dangerous
levels.
, • Therapeutic Consequences
o Accelerated renal excretion of drugs
o Drug inactivation
o Increased therapeutic action
o Activation of prodrugs
o Increased toxicity
o Decreased toxicity
• Impact of drug selectivity on side effects
• Receptors and Selectivity of Drug Action
o The more selective a drug is, the fewer side effects.
o Receptors for each neurotransmitter, hormone, and other molecules
the body uses to regulate physiological processes
o
• Noncompetitive Antagonists
o Bind irreversibly to receptors
o The effect of irreversible binding is equivalent to reducing the total
number of receptors available for activation by an agonist
o Reduce the maximal response that an agonist can elicit
• Noncompetitive Antagonists Action
o
• Identifying Adverse Drug Reactions
o Did symptoms appear shortly after the drug was first used?
o Did symptoms abate when the drug was discontinued?
o Did symptoms reappear when the drug was reinstituted?
o Is the illness itself sufficient to explain the event?
o Are other drugs in the regimen sufficient to explain the event?
Chapter 5 Adverse Drug Reactions and Medication Errors
• FDA & QT Interval Drugs
o Prolong the QT interval and serious risks for dysrhythmias. Torsades
de pointes.
o FDA requires all new drugs be tested for the ability to cause QT
prolongation
• Boxed Warnings
AND DRUG THERAPY | 2026 CORRECT QUESTIONS AND VERIFIED
ANSWERS ~ CHAMBERLAIN UNIVERSITY.
NR565 midterm study guide
Chapter 1 Prescriptive Authority
• State laws impact on prescriptive authority
o Determined by state law
o Determined by health professional board.
o The right to prescribe without limitation and the right to prescribe
independently.
• Full Practice Authority
o 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
• Role: Prescriptive Authority
o 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 board.
o Refers to the nurse practitioner’s authority to prescribe medications
independently and without limitations
Chapter 3 Promoting Positive Outcomes of Drug Therapy
• Generic vs Brand Name: Value of Knowing
o Both names should be included on prescription
• Duration of Therapy
o Knowing medication therapy being short time or long term
• Role of Formularies
o
• Blood Flow Impact on Absorption
o Rapidly absorbed where blood flow is high because blood containing
a newly absorbed drug will be replaced rapidly by drug-free blood.
,The greater the concentration gradient, the more rapid absorption will
be
,Chapter 4 Pharmacokinetics, Pharmacodynamics, and Drug Interactions
• Excretion Process
o Is the movement of drugs and their metabolites out of the body
• Metabolism Process
o Biotransformation is the enzymatically mediated alteration of drug
structure
o Most drugs metabolize in the liver and its performed by the hepatic
microsomal enzyme system
• Distribution Process
o Distribution is the movement of drugs from the systemic circulation
to the site of drug action
o
• Passage Across Membranes
o Channels or pores, passage with the aid of a transport system, direct
penetration of the membrane
o P-glycoprotein or multidrug transporter protein, transports a wide
variety of drugs out of cells
o Drugs must be lipid soluble to penetrate membranes
• Absorption Process
o Absorption is the movement of a drug from its site of administration
into the systemic circulation.
o The rate of absorption determines how soon effects will begin
o The amount of absorption helps determine how intense effects will
be
• Rate of Dissolution
o A drug must first dissolve. Hence the rate of dissolution helps
determine the rate of absorption
• Surface Area and Absorption
o The surface area is larger, absorption is faster.
• Multiple drugs on metabolic pathways
o When two drugs are metabolized by the same metabolic pathway, they
may compete with each other for metabolism and may thereby
decrease the rate at which one or both agents are metabolized. If
metabolism is depressed enough, a drug can accumulate to dangerous
levels.
, • Therapeutic Consequences
o Accelerated renal excretion of drugs
o Drug inactivation
o Increased therapeutic action
o Activation of prodrugs
o Increased toxicity
o Decreased toxicity
• Impact of drug selectivity on side effects
• Receptors and Selectivity of Drug Action
o The more selective a drug is, the fewer side effects.
o Receptors for each neurotransmitter, hormone, and other molecules
the body uses to regulate physiological processes
o
• Noncompetitive Antagonists
o Bind irreversibly to receptors
o The effect of irreversible binding is equivalent to reducing the total
number of receptors available for activation by an agonist
o Reduce the maximal response that an agonist can elicit
• Noncompetitive Antagonists Action
o
• Identifying Adverse Drug Reactions
o Did symptoms appear shortly after the drug was first used?
o Did symptoms abate when the drug was discontinued?
o Did symptoms reappear when the drug was reinstituted?
o Is the illness itself sufficient to explain the event?
o Are other drugs in the regimen sufficient to explain the event?
Chapter 5 Adverse Drug Reactions and Medication Errors
• FDA & QT Interval Drugs
o Prolong the QT interval and serious risks for dysrhythmias. Torsades
de pointes.
o FDA requires all new drugs be tested for the ability to cause QT
prolongation
• Boxed Warnings
