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) evaluates a 58-year-old man with
newly diagnosed stage 2 hypertension. The patient requests medication
immediately but reports taking several herbal supplements purchased
online. Before selecting pharmacotherapy, which action best reflects
the advanced practice nurse's role as a safe prescriber?
A. Prescribe the antihypertensive and review the supplements at the
next visit.
B. Obtain a complete medication history, including prescription drugs,
over-the-counter medications, herbal supplements, and recreational
substances before prescribing.
C. Advise the patient to discontinue all supplements permanently
regardless of their purpose.
D. Delay all treatment until the patient provides written documentation
of every supplement used.
Correct Answer: B
Rationale:
Safe prescribing begins with obtaining a comprehensive medication
history, including prescription medications, OTC products, dietary
supplements, herbal products, and recreational substances. This
assessment helps identify potential drug-drug and drug-supplement
interactions, duplicate therapies, contraindications, and adherence
issues before initiating treatment. Current U.S. prescribing standards
emphasize medication reconciliation as a fundamental patient safety
strategy.
, • A: Initiating therapy without a complete medication review may
expose the patient to preventable adverse interactions.
• C: Not all supplements require discontinuation; recommendations
should be individualized.
• D: Treatment should not be unnecessarily delayed if clinically
indicated, provided an adequate medication history can be
obtained.
Question 2
A nurse practitioner is preparing to prescribe a newly approved
medication for type 2 diabetes. The patient asks why the NP discusses
both expected benefits and potential risks before writing the
prescription.
Which ethical prescribing principle is being demonstrated?
A. Beneficence balanced with informed shared decision-making
B. Provider autonomy over patient preferences
C. Defensive medicine to reduce malpractice risk
D. Cost containment as the primary prescribing goal
Correct Answer: A
Rationale:
Advanced practice prescribers are expected to engage patients in
shared decision-making by discussing expected benefits, risks,
alternatives, and patient preferences. This approach supports informed
consent, promotes adherence, and aligns treatment decisions with the
patient's goals and values while maximizing benefit and minimizing
harm.
, • B: Ethical prescribing emphasizes collaboration rather than
unilateral provider decisions.
• C: Defensive medicine is not the primary objective of evidence-
based prescribing.
• D: Cost is important but should not supersede patient-centered
clinical decision-making.
Question 3
A 76-year-old woman with chronic kidney disease receives a
prescription for an antibiotic that is primarily eliminated by the kidneys.
Before finalizing the prescription, which factor should most directly
influence dose selection?
A. Patient's preferred pharmacy
B. Estimated renal function
C. Time since last primary care visit
D. Number of previous antibiotic prescriptions
Correct Answer: B
Rationale:
Renal function is a critical determinant of medication dosing for drugs
eliminated through the kidneys. Failure to adjust therapy appropriately
may result in drug accumulation, toxicity, or adverse drug events.
Advanced practice prescribers should evaluate renal function before
initiating medications requiring renal dose adjustment.
• A: Pharmacy preference does not influence pharmacokinetic
dosing.