Pharmacotherapeutics for
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. Lifestyle modification alone is
unlikely to achieve the patient's blood pressure goal. Before issuing the
first prescription, the APRN reviews the patient's medical history,
allergies, current medications, renal function, and recent laboratory
results. Which prescribing principle is BEST demonstrated by this
approach?
A. Selecting the least expensive medication before assessing clinical
factors
B. Performing an individualized benefit-risk assessment to support safe
prescribing
C. Avoiding laboratory evaluation until medication effectiveness is
determined
D. Delegating medication selection to the dispensing pharmacist
Correct Answer: B
Rationale:
Safe prescribing begins with a comprehensive patient assessment that
identifies factors influencing medication efficacy and safety, including
comorbidities, allergies, organ function, concurrent medications, and
potential contraindications. Individualized benefit-risk evaluation helps
minimize adverse drug events and optimize therapeutic outcomes.
Option A overlooks important clinical considerations. Option C may
delay identification of contraindications or necessary dose adjustments.
Option D is inappropriate because medication selection is the
prescriber's professional responsibility.
,Question 2
An APRN is preparing to prescribe trimethoprim-sulfamethoxazole for a
patient with an uncomplicated urinary tract infection. During
medication reconciliation, the patient reports taking warfarin for atrial
fibrillation. What is the MOST appropriate next step?
A. Prescribe the antibiotic without further evaluation because the
treatment course is brief.
B. Assess for a clinically significant drug interaction and modify therapy
or monitoring as appropriate.
C. Instruct the patient to discontinue warfarin while taking the
antibiotic.
D. Reduce the antibiotic dose by half regardless of kidney function.
Correct Answer: B
Rationale:
Medication reconciliation includes evaluating clinically important drug-
drug interactions before prescribing. Trimethoprim-sulfamethoxazole
can significantly increase warfarin's anticoagulant effect, increasing
bleeding risk. The prescriber should consider an alternative antibiotic or
arrange closer INR monitoring and possible warfarin dose adjustment.
Option A ignores a potentially serious interaction. Option C
unnecessarily exposes the patient to thromboembolic risk. Option D
does not address the interaction and renal dosing should be based on
kidney function rather than a routine dose reduction.
Question 3
, A 74-year-old woman with chronic kidney disease presents with
cellulitis requiring oral antibiotic therapy. Her estimated glomerular
filtration rate (eGFR) is 28 mL/min/1.73 m². Which prescribing action
BEST reflects appropriate clinical decision-making?
A. Prescribe the standard adult dose because age alone does not affect
drug therapy.
B. Consider renal function when selecting and dosing the medication to
reduce toxicity risk.
C. Double the loading dose to achieve therapeutic concentrations more
rapidly.
D. Avoid all antimicrobial therapy because adverse effects are more
common in older adults.
Correct Answer: B
Rationale:
Reduced renal function may decrease drug clearance, increasing the
risk of accumulation and toxicity. APRNs should evaluate renal function
before prescribing medications that are renally eliminated and adjust
dosing or select an alternative agent when appropriate. Option A
ignores impaired renal clearance. Option C may increase toxicity.
Option D is inappropriate because infections should still be treated
while selecting the safest effective regimen.
Question 4
An APRN prescribes a newly initiated antihypertensive medication.
Which patient counseling statement is MOST likely to improve
medication safety and adherence?
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. Lifestyle modification alone is
unlikely to achieve the patient's blood pressure goal. Before issuing the
first prescription, the APRN reviews the patient's medical history,
allergies, current medications, renal function, and recent laboratory
results. Which prescribing principle is BEST demonstrated by this
approach?
A. Selecting the least expensive medication before assessing clinical
factors
B. Performing an individualized benefit-risk assessment to support safe
prescribing
C. Avoiding laboratory evaluation until medication effectiveness is
determined
D. Delegating medication selection to the dispensing pharmacist
Correct Answer: B
Rationale:
Safe prescribing begins with a comprehensive patient assessment that
identifies factors influencing medication efficacy and safety, including
comorbidities, allergies, organ function, concurrent medications, and
potential contraindications. Individualized benefit-risk evaluation helps
minimize adverse drug events and optimize therapeutic outcomes.
Option A overlooks important clinical considerations. Option C may
delay identification of contraindications or necessary dose adjustments.
Option D is inappropriate because medication selection is the
prescriber's professional responsibility.
,Question 2
An APRN is preparing to prescribe trimethoprim-sulfamethoxazole for a
patient with an uncomplicated urinary tract infection. During
medication reconciliation, the patient reports taking warfarin for atrial
fibrillation. What is the MOST appropriate next step?
A. Prescribe the antibiotic without further evaluation because the
treatment course is brief.
B. Assess for a clinically significant drug interaction and modify therapy
or monitoring as appropriate.
C. Instruct the patient to discontinue warfarin while taking the
antibiotic.
D. Reduce the antibiotic dose by half regardless of kidney function.
Correct Answer: B
Rationale:
Medication reconciliation includes evaluating clinically important drug-
drug interactions before prescribing. Trimethoprim-sulfamethoxazole
can significantly increase warfarin's anticoagulant effect, increasing
bleeding risk. The prescriber should consider an alternative antibiotic or
arrange closer INR monitoring and possible warfarin dose adjustment.
Option A ignores a potentially serious interaction. Option C
unnecessarily exposes the patient to thromboembolic risk. Option D
does not address the interaction and renal dosing should be based on
kidney function rather than a routine dose reduction.
Question 3
, A 74-year-old woman with chronic kidney disease presents with
cellulitis requiring oral antibiotic therapy. Her estimated glomerular
filtration rate (eGFR) is 28 mL/min/1.73 m². Which prescribing action
BEST reflects appropriate clinical decision-making?
A. Prescribe the standard adult dose because age alone does not affect
drug therapy.
B. Consider renal function when selecting and dosing the medication to
reduce toxicity risk.
C. Double the loading dose to achieve therapeutic concentrations more
rapidly.
D. Avoid all antimicrobial therapy because adverse effects are more
common in older adults.
Correct Answer: B
Rationale:
Reduced renal function may decrease drug clearance, increasing the
risk of accumulation and toxicity. APRNs should evaluate renal function
before prescribing medications that are renally eliminated and adjust
dosing or select an alternative agent when appropriate. Option A
ignores impaired renal clearance. Option C may increase toxicity.
Option D is inappropriate because infections should still be treated
while selecting the safest effective regimen.
Question 4
An APRN prescribes a newly initiated antihypertensive medication.
Which patient counseling statement is MOST likely to improve
medication safety and adherence?
