NR565 ADVANCED PHARM
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)
, Patient name, DOB, allergies
Medication name, indication, strength, dose, frequency, dispense quantity
and number of refills
May be telephone, written, e-script, or refill
-Schedule II cannot be prescribed or refilled by phone
-Written scripts must be legible, in ink, no abbreviations, and never sign a
blank script
-Not all DEA drugs can be e-prescribed
-With refills, consider monitoring needs
Pharmacokinetics - CORRECT ANSWERS-How the drug moves ("kinetic")
through the body (absorption, distribution, metabolism, excretion)
Absorption - Drug entering blood (ex. Absorbed from GI tract)
Distribution - Drug moving from blood to tissues/cells of liver, kidneys or
other site
Metabolism - Drug-structure altered by enzymes
Excretion - Drugs & their metabolites move out of the body via bile or urine
Pharmacodynamics - CORRECT ANSWERS-PharmacoDynamics
(What Drugs Do to the body)
MOA (interactions between drug and receptors or enzymes), dose, tolerance,
dependence, interactions, adverse effects; drugs affects individuals
differently
Relates to agonists, antagonists
Agonists & Antagonists - CORRECT ANSWERS-Agonists mimic the body's own
regulatory molecules and activate receptors. Ex. Dobutamine (drug) mimics
norepinephrine at receptors on the heart, allowing it to bind and cause the
heart rate to increase.
Antagonists block the actions of regulating molecules. They do not activate
receptors. Ex. Antihistamines suppress allergy symptoms by binding to the
receptors of histamine and preventing activation of these receptors by
histamine released in response to allergens.
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)
, Patient name, DOB, allergies
Medication name, indication, strength, dose, frequency, dispense quantity
and number of refills
May be telephone, written, e-script, or refill
-Schedule II cannot be prescribed or refilled by phone
-Written scripts must be legible, in ink, no abbreviations, and never sign a
blank script
-Not all DEA drugs can be e-prescribed
-With refills, consider monitoring needs
Pharmacokinetics - CORRECT ANSWERS-How the drug moves ("kinetic")
through the body (absorption, distribution, metabolism, excretion)
Absorption - Drug entering blood (ex. Absorbed from GI tract)
Distribution - Drug moving from blood to tissues/cells of liver, kidneys or
other site
Metabolism - Drug-structure altered by enzymes
Excretion - Drugs & their metabolites move out of the body via bile or urine
Pharmacodynamics - CORRECT ANSWERS-PharmacoDynamics
(What Drugs Do to the body)
MOA (interactions between drug and receptors or enzymes), dose, tolerance,
dependence, interactions, adverse effects; drugs affects individuals
differently
Relates to agonists, antagonists
Agonists & Antagonists - CORRECT ANSWERS-Agonists mimic the body's own
regulatory molecules and activate receptors. Ex. Dobutamine (drug) mimics
norepinephrine at receptors on the heart, allowing it to bind and cause the
heart rate to increase.
Antagonists block the actions of regulating molecules. They do not activate
receptors. Ex. Antihistamines suppress allergy symptoms by binding to the
receptors of histamine and preventing activation of these receptors by
histamine released in response to allergens.
