Advanced Practice Nurse
Prescribers with Davis Edge
6th Edition
• Author(s)Teri Moser Woo; Wendy
L. Wright
TEST BANK
▪ The Foundation
▪ Pharmacotherapeutics with Single Drugs
▪ Pharmacotherapeutics with Multiple Drugs
▪ Special Drug Treatment Considerations
,Question 1
A family nurse practitioner (FNP) begins practicing in a state that grants
full practice authority. A 58-year-old patient with newly diagnosed
hypertension requests medication initiation during the first visit. Which
action best reflects the APRN's role as an independent prescriber?
A. Prescribe an antihypertensive solely based on the patient's request
to improve satisfaction.
B. Perform a comprehensive assessment, confirm the diagnosis, discuss
therapeutic options, consider patient-specific factors, and prescribe an
evidence-based medication with an appropriate follow-up plan.
C. Refer every newly diagnosed patient to a physician before initiating
any prescription medication.
D. Delay treatment until laboratory results from every possible
secondary cause of hypertension are available.
Correct Answer: B
Rationale:
Advanced practice prescribers are expected to integrate history,
physical examination, diagnostic findings, evidence-based guidelines,
patient preferences, comorbidities, medication safety, and shared
decision-making before initiating pharmacotherapy. Appropriate
follow-up is part of responsible prescribing.
• A: Patient satisfaction should never replace clinical judgment.
• C: Referral is appropriate only when clinically indicated, not
routinely.
• D: Necessary baseline studies should be obtained, but treatment
should not be unnecessarily delayed when the diagnosis is
established and no contraindications exist.
,Question 2
A 74-year-old woman with chronic kidney disease, osteoarthritis,
hypertension, and type 2 diabetes takes eight prescription medications
and several over-the-counter supplements. Before prescribing a new
medication for neuropathic pain, which action is the APRN's highest
priority?
A. Select the newest medication available because newer agents are
generally safer.
B. Review all prescription medications, nonprescription drugs, herbal
supplements, allergies, renal function, and potential drug-drug
interactions.
C. Prescribe the standard adult dose because age alone does not
require dose modification.
D. Recommend discontinuing all supplements before considering
additional therapy.
Correct Answer: B
Rationale:
Medication reconciliation is a fundamental responsibility of APRN
prescribers. Older adults with polypharmacy are at increased risk for
adverse drug events, drug-drug interactions, drug-disease interactions,
and dosing errors. Evaluating renal function, hepatic function when
appropriate, allergies, and all medications before prescribing promotes
safe pharmacotherapy.
• A: Newer medications are not inherently safer.
• C: Older adults frequently require individualized dosing because
of physiologic changes.
, • D: Some supplements may be appropriate; individualized
evaluation is necessary.
Question 3
A nurse practitioner is prescribing an oral antibiotic for a patient with
community-acquired pneumonia. During counseling, the patient states,
"If I start feeling better after two days, I'll stop taking it." Which
response best demonstrates effective patient-centered prescribing?
A. "Stopping early is acceptable if your symptoms completely resolve."
B. "You should complete the prescribed course unless a clinician
instructs you otherwise because stopping early may increase treatment
failure and recurrence."
C. "Double the dose if you miss a dose to finish the medication faster."
D. "Only continue the medication if you develop a fever again."
Correct Answer: B
Rationale:
Safe prescribing extends beyond writing a prescription. Effective
counseling includes explaining the expected benefits, potential adverse
effects, adherence, follow-up, and when to seek medical attention.
Completing therapy as prescribed improves treatment success and
reduces the risk of incomplete eradication of infection.
• A: Premature discontinuation may result in inadequate treatment.
• C: Doubling doses may increase toxicity.
• D: Waiting for symptom recurrence is inappropriate and may
delay necessary treatment.