PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE 3RD EDITION..

TestBankforPharmacotherapeuticsforAdvancedPracticeA
yPracticalApproach5thEditionByVirginiaPooleArcangelo,
AndrewMPeterson,VeronicaWilbur,TepM.Kang/All
y y y y y y y y y




ChaptersCovered–LatestUpdate2024. y




Nursepractitionerprescriptiveauthorityisregulatedby:

1. TheNationalCouncilofStateBoardsofNursing

2. TheU.S.DrugEnforcement Administration v




3. TheStateBoardofNursingforeachstate

4. TheStateBoardofPharmacy - Correct Answer - 3. The State Board of Nursing for each state y v v v v v v v v v v v v




ThebenefitstothepatientofhavinganAdvancedPracticeRegisteredNurse(APRN)prescriberinclude: y y y




1. NursesknowmoreaboutPharmacologythanotherprescribersbecausetheytakeitbothintheirbasic
y y y y y y y y y




nursing program and in their APRN program.
y y y y y y y




2. Nursescareforthepatientfromaholisticapproachandincludethepatient indecisionmaking y y v y




regarding their care.
y y y




3. APRNsarelesslikelyto prescribenarcoticsandothercontrolledsubstances. y




4. APRNsareabletoprescribeindependentlyinallstates,whereasaphysician'sassistantneeds tohavea v y




physician supervising their practice. - Correct Answer - 2. Nurses care for the patient from a holistic
y y y y y v v v v v v v v v v v



approach and include the patient in decision making regarding their care.
v v v v v v v v v v v




Clinicaljudgmentinprescribingincludes:

1. Factoringinthecost tothepatientofthemedicationprescribed
y y y y




2. Alwaysprescribingthenewestmedication available for thediseaseprocess y y y




3. Handingout drugsamplesto poorpatients v y y




4. Prescribingallgenericmedicationsto cutcosts - Correct Answer - 1. Factoring in the cost to the y y v v v v v v v v v v vv


patient of the medication prescribed
v v v v




pg. 1
y

,Criteriaforchoosing aneffectivedrugforadisorderinclude: v




1. Askingthe patientwhatdrugthey thinkwouldworkbestforthem
y y y y y




2. Consultingnationallyrecognizedguidelinesfordiseasemanagement

3. Prescribingmedicationsthat areavailableas samples beforewritingaprescription y y y




4. FollowingU.S.DrugEnforcementAdministration guidelinesforprescribing - Correct Answer - 2. y y y v v v vv


Consulting nationally recognized guidelines for disease management
v v v v v v




Nursepractitionerpracticemay thriveunderhealth-carereformbecauseof: y




1. Thedemonstratedabilityofnursepractitionerstocontrolcostsandimprovepatientoutcomes y y




2. Thefactthatnursepractitionerswillbeabletopracticeindependently

3. The fact thatnursepractitionerswillhave full reimbursementunderhealth-carereform
y y y y




4. Theabilityto shiftaccountabilityforMedicaidtothestatelevel - Correct Answer - 1. The
y v y y y v v v v v



demonstrated ability of nurse practitioners to control costs and improve patient outcomes
y v v v v v v v v v v v




Apatient'snutritionalintake andlaboratoryresultsreflecthypoalbuminemia.This is v y y y




critical to prescribing because:
y y y y




1. Distributionofdrugsto target tissuemay beaffected. y y y y




2. Thesolubilityofthedrugwill notmatchthe siteof absorption. y y y




3. Therewillbeless freedrugavailableto generateaneffect. v v




4. Drugs boundtoalbuminarereadilyexcretedbythekidneys. -Correct Answer - 1. Distribution of drugs to
v y y y y v v v v v v v



target tissue may be affected.
v v v v v




Drugsthat haveasignificant first-pass effect:
y y y v




1. Mustbegivenbytheenteral(oral)routeonly

2. Bypassthehepaticcirculation y




3. Arerapidlymetabolizedby theliverandmayhavelittleifanydesiredaction y




pg. 2 y

,4. Areconvertedbythelivertomoreactiveandfat-solubleforms - Correct Answer - 3. Are rapidly v y v v v v v vv


metabolized by the liver and may have little if any desired action
v v v v v v v v v v v




Therouteofexcretionofavolatiledrugwilllikelybe the:
y y y y y y




1. Kidneys

2. Lungs

3. Bileandfeces y




4. Skin - Correct Answer - 2. Lungs
v v v v v v




Medroxyprogesterone(DepoProvera)isprescribedintramuscularly(IM)tocreateastoragereservoirofthe y




drug. Storage reservoirs:
y y y




1. Assurethatthedrugwillreach itsintendedtarget tissue y y y




2. Arethereasonforgivingloading doses y y




3. Increasethelengthoftime adrugis availableandactive y v




4. Aremostcommonincollagentissues- Correct Answer - 3. Increase the length of time a drug is y y y v v v v v v v v v v v v vv


available and active v v




TheNPchoosestogivecephalexinevery8hours basedonknowledgeofthedrug's: y y v




1. Propensitytogotothetargetreceptor y y




2. Biological half-life y




3. Pharmacodynamics

4. Safetyandsideeffects-Correct Answer - 2. Biological half-life v v v v v




Azithromycindosingrequires thatthefirstday'sdosagebetwicethoseoftheother 4days ofthe prescription. y y y y y y y y v y y




This is considered a loading dose. A loading dose:
y y y y y y y y y




1. Rapidly achievesdruglevels inthetherapeuticrange
y y




2. Requiresfour-to five-half-livestoattain v




3. Isinfluencedbyrenalfunction

4. Isdirectly relatedtothedrugcirculatingtothetargettissues - Correct Answer - 1. Rapidly achieves
y y y v v v v v vv


drug levels in the therapeutic range
v v v v v




pg. 3
y

, Thepointintimeonthedrugconcentrationcurvethatindicatesthefirstsignofatherapeuticeffectis the:
y y y y y y y y y y y y




1. Minimumadverse effectlevel y y y




2. Peak ofaction v




3. Onsetof action y




4. Therapeuticrange-Correct Answer - 3. Onset of action y v v v v v v




Phenytoinrequiresthatatroughlevel be drawn.Peakandtroughlevels are done: y y y y y




1. Whenthe drughas awide therapeuticrange
y y y y




2. Whenthe drugwillbeadministeredforashorttimeonly
v y y y y




3. Whenthereisahighcorrelation betweenthedoseandsaturationofreceptorsites
y y y y y y y




4. Todetermineifadrug isinthetherapeuticrange - Correct Answer - 4. To determine if a drug is in the
v y y v v v v v v v v v v v vv


therapeutic range v




Alaboratoryresultindicatesthatthepeaklevelforadrug is abovetheminimum toxicconcentration. Thismeans
y y y v y y y




thatthe:
y y




1. Concentrationwill produce therapeutic effects y y y




2. Concentrationwillproduceanadverseresponse

3. Timebetweendosesmustbeshortened

4. Durationofactionofthedrugistoolong- Correct Answer - 2. Concentration will produce an adverse y y y v v v v v v v v



response
y




Drugsthatarereceptoragonistsmaydemonstratewhatproperty?

1. Irreversiblebindingto thedrugreceptorsite y y




2. Upregulationwithchronicuse

3. Desensitizationordownregulation withcontinuous use y y y y y




4. Inverserelationshipbetweendrugconcentrationanddrugaction- Correct Answer - 3. Desensitization or y y v v v v v v



downregulation with continuous use
v v v v




pg. 4
y