MIDTERM EXAM WITH
CORRECT ANSWERS
What are the key responsibilities of prescribing? - CORRECT
ANSWERS-Protect patients from harm
Know MOA, safety, efficacy, and select right med/dose to maximize
outcome and minimize adverse effects
What should be used to make prescribing decisions? - CORRECT
ANSWERS-- Have a documented provider-patient relationship
- Document H&P
- Discuss & document risk factors, side effects, and therapy options
- Document plan for monitoring and/or titration
- Consider cost, drug availability, and clinical practice guidelines
- Consider side effects, allergies, hepatic/renal function, need for
monitoring, and lifespan considerations
Calcium supplementation varies with age. Current recommendations
include
- CORRECT ANSWERS-adolescents 1300 mg daily; young adults
1000 mg daily; older adults 1200 mg daily
Alendronate is prescribed for Loretta who has postmenopausal
osteoporosis. What patient education information is important to
share with Loretta? - CORRECT ANSWERS-take the medication with
plenty of water and remain upright for at least 30 minutes
Marta is postmenopausal and has a family history of breast cancer
develops. At her annual visit, it is determined that Marta has
osteoporosis. Which of the following medications is the best
treatment for Marta? - CORRECT ANSWERS-raloxifene
Use caution when combining ACEIs with potassium-sparing
diuretics due to - CORRECT ANSWERS-increased risk of
hyperkalemia
ACEIs and ARBS will precipitate acute renal failure when -
CORRECT ANSWERS-bilateral renal artery stenosis is present
,Women who have both HTN and osteopenia/osteoporosis should
take - CORRECT ANSWERS-thiazides to help slow calcium loss,
stimulate osteoclasts, and reduce bone loss
Patients on simvastatin and lovastatin should avoid - CORRECT
ANSWERS-grapefruit juice and macrolides
NSAIDs may damage the GI tract by - CORRECT ANSWERS-
inhibiting the action of cyclooxygenases (COX)-1 and -2, thereby
decreasing prostaglandins that protect the stomach lining and
promote clotting
Colchicine is used to treat gout but may cause - CORRECT
ANSWERS-GI effects (abdominal pain, diarrhea). Stop
medication if GI effects occur.
Methotrexate is contraindicated in - CORRECT ANSWERS-pregnancy
Which schedule drugs can APRNs prescribe? - CORRECT
ANSWERS-Schedule II-V
Prescriptive authority - CORRECT ANSWERS-2 components
(1) the right to prescribe independently
(2) the right to prescribe without limitation
Physicians have full prescriptive authority. APPs are limited
depending on state laws
Who determines and regulates prescriptive authority? - CORRECT
ANSWERS-State laws & State Board of Nursing
How does limited prescriptive authority impact patients within the
healthcare system? - CORRECT ANSWERS-Limited prescriptive
authority creates barriers to quality, affordable and accessible
healthcare
Ex. Restrictions on the distance of the APP from the MD providing
supervision/collaboration can prevent outreach to areas of greatest
need
Ex. Needing a MD co-signature can cause delays in care.
Ex. Currently we have a physician shortage, so less are able to
oversee APPs
Elements of a prescription - CORRECT ANSWERS-Prescriber name,
, license, contact info, and DEA (if applicable)