PREPARATION WITH COMPLETE QUESTIONS AND CORRECT ANSWERS
WITH RATIONALES | ADVANCED PHARMACOLOGY FOR NURSING
PRACTICE EXAM ALREADY GRADED A+|
|BRAND NEW VERSION!!
SECTION 1: CLINICAL JUDGMENT & PRESCRIBING PRINCIPLES (Q1 - Q30)
Q1. What factors are associated with clinical judgment when prescribing
medications?
A) Prescribing based solely on the cheapest available medication
B) Thorough assessment of the patient, patient's environment, alternative
therapies, drug knowledge, and disease process
C) Prescribing based only on the physician's preference
D) Using the same drug for all patients with similar symptoms
Ans: B
Rationale: Clinical judgment in prescribing is based on a thorough assessment of
the patient and the patient's environment. It includes the determination of
potential medical and nursing diagnoses, a review of potential alternative
therapies, specific knowledge about the drug chosen, and the disease process it is
going to treat. This is known as patient-centered care. The best therapy is usually
the least invasive, least expensive, and least likely to cause adverse reactions.
Q2. According to the WHO, what is the FIRST step in the prescribing process?
A) Choose which drug or treatment is needed
B) Define the patient's problem
C) Educate the patient
D) Monitor the treatment
Ans: B
Rationale: The World Health Organization (WHO) outlines a systematic approach
to prescribing. The first step is to define the patient's problem through a thorough
assessment. This establishes the foundation for all subsequent steps. The second
step is to specify the therapeutic objective, the third is to choose which drug or
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,treatment is needed, the fourth is to start the treatment, the fifth is to educate
the patient, and the sixth is to monitor the treatment.
Q3. According to the WHO, what is the SECOND step in the prescribing process?
A) Define the patient's problem
B) Start the treatment
C) Specify the therapeutic objective
D) Monitor the treatment
Ans: C
Rationale: After defining the patient's problem, the next step is to specify the
therapeutic objective. This involves identifying the desired outcome of
treatment—what the drug is expected to achieve in terms of symptom relief,
disease modification, or prevention. Clear therapeutic objectives guide drug
selection and evaluation of treatment effectiveness.
Q4. According to the WHO, what is the THIRD step in the prescribing process?
A) Educate the patient
B) Define the patient's problem
C) Choose which drug or treatment is needed
D) Monitor the treatment
Ans: C
Rationale: The third step in the WHO prescribing process is to choose which drug
or treatment is needed. This involves selecting the most appropriate
pharmacologic agent based on the therapeutic objective, patient characteristics,
drug efficacy, safety profile, cost, and evidence-based guidelines. This step
requires integration of pharmacology knowledge with clinical judgment.
Q5. According to the WHO, what is the FOURTH step in the prescribing process?
A) Start the treatment
B) Define the patient's problem
C) Specify the therapeutic objective
D) Choose which drug or treatment is needed
Ans: A
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,Rationale: The fourth step is to start the treatment. This involves writing the
prescription, including the correct drug, dose, route, frequency, and duration. It
also includes considering any necessary monitoring parameters and providing the
patient with clear instructions on how to take the medication.[reference:5]
Q6. According to the WHO, what is the FIFTH step in the prescribing process?
A) Start the treatment
B) Educate the patient
C) Monitor the treatment
D) Choose which drug or treatment is needed
Ans: B
Rationale: The fifth step is to educate the patient. This is a critical component of
safe prescribing. Patient education should include information about the drug's
purpose, how to take it, potential side effects, what to do if a dose is missed, drug
interactions, and when to seek medical attention. Informed patients are more
likely to adhere to treatment and recognize adverse effects early.
Q7. According to the WHO, what is the SIXTH step in the prescribing process?
A) Educate the patient
B) Start the treatment
C) Monitor the treatment
D) Choose which drug or treatment is needed
Ans: C
Rationale: The sixth and final step is to monitor the treatment. This involves
ongoing assessment of the patient's response to therapy, including therapeutic
effectiveness, adverse effects, and adherence. Monitoring may include laboratory
tests, physical examinations, and patient interviews. The results of monitoring
may lead to dosage adjustments, drug changes, or discontinuation of therapy.
Q8. What are the criteria for choosing an effective drug?
A) Choose the drug with the most side effects
B) Consult nationally recognized guidelines for disease management
C) Choose the most expensive drug
D) Choose the drug that is easiest to prescribe
Ans: B
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, Rationale: Multiple drugs may be able to treat a specific condition. To determine
the most effective drug, the prescriber must consult nationally recognized
guidelines for disease management. These guidelines are based on systematic
reviews of evidence and provide recommendations for optimal pharmacotherapy.
Following evidence-based guidelines improves patient outcomes and reduces
variability in care.
Q9. What is the best therapy according to patient-centered care principles?
A) The most invasive therapy
B) The most expensive therapy
C) The least invasive, least expensive, and least likely to cause adverse reactions
D) The newest therapy available
Ans: C
Rationale: Patient-centered care in prescribing emphasizes selecting the therapy
that is least invasive, least expensive, and least likely to cause adverse reactions.
This approach prioritizes patient safety, minimizes harm, and considers the
patient's values and preferences. It also considers cost-effectiveness and
accessibility, ensuring that the treatment is sustainable for the patient.
Q10. How does hypoalbuminemia affect the process of prescribing?
A) It has no effect on drug prescribing
B) It increases drug binding to albumin, decreasing free drug concentration
C) It decreases drug binding to albumin, increasing free drug concentration and
potential adverse effects
D) It increases drug metabolism
Ans: C
Rationale: Many drugs that carry an electric charge are bound to albumin in the
blood. Hypoalbuminemia (low albumin levels) results in more free (unbound)
drug because the drug cannot bind to albumin. This increases the concentration
of active drug available to target tissues, which can lead to increased therapeutic
effects and a higher risk of adverse effects. Dose adjustments may be necessary in
patients with hypoalbuminemia.
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