NR565 Midterm Study Questions And
Answers Graded A+.
APRNjprescribingjrolej-
jcorrectjanswer.jjjjPrescriptive jauthorityjforjnursejpractitionersjalsojregulatesjprescribingjrigh
tsjbeyondjmedicationsjandjcontrolledjsubstances.jThesejrightsjincludejtherapeuticjdevicesj
andjservicesjandjarejoutlinedjinjstatejpracticejlawsjandjregulationsjandjincludejDurablejMed
icaljEquipmentj(DME)jsuchjasjwheelchairs,jpowerjscooters,jhospitaljbeds,jportablejoxygenj
equipment,jhandicapjplacards,jetc.jandjmedicaljservicesjsuchjasjPhysicaljTherapyj(PT),jOc
cupationaljTherapyj(OT),jhomejhealthjservices,jetc.jPrescriptivejauthorityjencompassesjm
orejthanjwritingjajprescriptionjcorrectly.jItjrequiresjadherencejtojethicaljguidelinesjtojensurejt
hatjpatientsjarejsafeguardedjfromjharm.jEthicaljprescribingjstartsjwithjbeingjwell-
informedjaboutjmedications.jMechanismjofjaction,jefficacy,jandjsafetyjarejimportantjconsid
erations,jasjarejajpatient'sjdistinctjneedsjandjcircumstances,jincludingjthejnumberjofjmedica
tionsjprescribedj(Mitchellj&jOliphant,j2016).jMostjpatientsjreceivingjajprescriptionjarejtakingj
otherjmedications,jwhetherjprescriptionjorjover-the-
counter.jAppropriatejselection,jdosing,jandjdurationjofjpharmaceuticaljagentsjarejkeyjtojma
ximizingjoutcomesjandjminimizingjadversejeffects
benefitsjofjfulljpracticejauthorityj-
jcorrectjanswer.jjjjNursejpractitionersjhave jthejautonomyjtojevaluatejpatients,jdiagnose,jord
erjandjinterpretjtests,jinitiatejandjmanagejtreatmentsjandjprescribejmedications,jincludingjc
ontrolledjsubstancesjwithoutjphysicianjoversight
promotingjpositivejoutcomesjthroughjprudentjprescribingjpracticesj-
jcorrectjanswer.jjjjAdministeringjmedicationsjandjprescribingjmedicationsjarejtwo jdistinctjpro
cesses.jPrescriptionjwritingjrequiresjprudentjandjdeliberatejdecision-
makingjprocessesjtojmaintainjpatientjsafetyjandjreducejliability,jincluding:
*documentationjofjajprovider-
patientjrelationshipjforjthejrecipientjofjthejprescribedjmedications
*documentationjofjajthoroughjhistoryjandjphysicaljexaminationjforjthejrecipient
*documentationjofjdiscussionsjregardingjriskjfactors,jsidejeffects,jorjtherapyjoptions
, *documentationjofjdrugjmonitoringjorjtitrationjplan,jifjapplicable
*documentationjofjconsultations,jifjany
avoidancejofjprescribingjmedicationsjforjself,jfamily,jorjfriends
Rationaljdrugjselectionjrequiresjajlogicaljapproachjthatjincludesjthejformulationjofjajdiagnos
isjbasedjonjclinicaljreasoningjandjthejselectionjandjmonitoringjofjthejmostjappropriatejphar
macologicaljtreatmentj
Considerationsjinclude:jCost,jguidelines,javailability,jinteractions,jsidejeffects,jallergies,jhe
patic/renaljfunctions,jneedjforjmonitoring,j&jspecialjpopulations
Beer'sjCriteriaj-
jcorrectjanswer.jjjjidentifiesjdrugsjwithjajhighjlikelihoodjofjcausingjadversejeffectsjinjolderjadu
lts.jAccordingly,jdrugsjonjthisjlistjshouldjgenerallyjbejavoidedjinjadultsjolderjthanj65jyearsjex
ceptjwhenjthejbenefitsjarejsignificantlyjgreaterjthanjthejrisks.
Pharmacodynamicsj-
jcorrectjanswer.jjjjthe jstudyjofjthejbiochemicaljandjphysiologicjeffectsjofjdrugsjonjthejbodyjan
djthejmolecularjmechanismsjbyjwhichjthosejeffectsjarejproduced
Pharmacokineticsj-jcorrectjanswer.jjjjthejstudyjofjdrugjmovementjthroughoutjthejbody
Pharmacogenomicsj-
jcorrectjanswer.jjjjthe jstudyjofjhowjgenesjaffectjajperson'sjresponsejtojdrugs.jThejpurposejofjt
hisjisjtojcombinejthejsciencesjofjgenomicsjandjpharmacologyjtojprovidejindividualized,jtarg
eted,jsafejdrugjtherapiesjtojpatients
CYP450jinducersj-
jcorrectjanswer.jjjjInducersjarejxenobioticsj(medicationsjandjenvironmentaljagents)jthatjelev
atejCYP450jenzymejactivityjbyjincreasingjenzymejsynthesis.jThisjactionjleadsjtojadditionalj
sitesjavailablejforjbiotransformation.jThejincreasedjnumberjofjsitesjenhancesjmedicationjm
etabolism,jdecreasingjthejconcentrationjofjthej"parentjdrug"jwhilejincreasingjmetabolitejpro
duction.
Inducersj=jIncreasejmedicationjmetabolismj
(Carbamazepine,jRifampin,jAlcohol,jPhenytoin,jGriseofulvin,jPhenobarbital,jSulfonylureas
)
CYP450jinhibitorsj-
jcorrectjanswer.jjjjInhibitorsjarejmedicationsjthatjinhibitjthejmetabolicjactivityjofjonejorjmorejof
jthejCYP450jenzymes.jMedicationsjthatjinhibitjanjenzymejpotentiallyjslowsjthatjenzyme'sjac
tivityjorjblocksjthejactivityjrequiredjforjthejmetabolismjofjotherjmedications,jtherebyjincreasi
ngjthejlevelsjofjmedicationsjdependentjonjthatjparticularjenzymejforjbiotransformation.jInhi
Answers Graded A+.
APRNjprescribingjrolej-
jcorrectjanswer.jjjjPrescriptive jauthorityjforjnursejpractitionersjalsojregulatesjprescribingjrigh
tsjbeyondjmedicationsjandjcontrolledjsubstances.jThesejrightsjincludejtherapeuticjdevicesj
andjservicesjandjarejoutlinedjinjstatejpracticejlawsjandjregulationsjandjincludejDurablejMed
icaljEquipmentj(DME)jsuchjasjwheelchairs,jpowerjscooters,jhospitaljbeds,jportablejoxygenj
equipment,jhandicapjplacards,jetc.jandjmedicaljservicesjsuchjasjPhysicaljTherapyj(PT),jOc
cupationaljTherapyj(OT),jhomejhealthjservices,jetc.jPrescriptivejauthorityjencompassesjm
orejthanjwritingjajprescriptionjcorrectly.jItjrequiresjadherencejtojethicaljguidelinesjtojensurejt
hatjpatientsjarejsafeguardedjfromjharm.jEthicaljprescribingjstartsjwithjbeingjwell-
informedjaboutjmedications.jMechanismjofjaction,jefficacy,jandjsafetyjarejimportantjconsid
erations,jasjarejajpatient'sjdistinctjneedsjandjcircumstances,jincludingjthejnumberjofjmedica
tionsjprescribedj(Mitchellj&jOliphant,j2016).jMostjpatientsjreceivingjajprescriptionjarejtakingj
otherjmedications,jwhetherjprescriptionjorjover-the-
counter.jAppropriatejselection,jdosing,jandjdurationjofjpharmaceuticaljagentsjarejkeyjtojma
ximizingjoutcomesjandjminimizingjadversejeffects
benefitsjofjfulljpracticejauthorityj-
jcorrectjanswer.jjjjNursejpractitionersjhave jthejautonomyjtojevaluatejpatients,jdiagnose,jord
erjandjinterpretjtests,jinitiatejandjmanagejtreatmentsjandjprescribejmedications,jincludingjc
ontrolledjsubstancesjwithoutjphysicianjoversight
promotingjpositivejoutcomesjthroughjprudentjprescribingjpracticesj-
jcorrectjanswer.jjjjAdministeringjmedicationsjandjprescribingjmedicationsjarejtwo jdistinctjpro
cesses.jPrescriptionjwritingjrequiresjprudentjandjdeliberatejdecision-
makingjprocessesjtojmaintainjpatientjsafetyjandjreducejliability,jincluding:
*documentationjofjajprovider-
patientjrelationshipjforjthejrecipientjofjthejprescribedjmedications
*documentationjofjajthoroughjhistoryjandjphysicaljexaminationjforjthejrecipient
*documentationjofjdiscussionsjregardingjriskjfactors,jsidejeffects,jorjtherapyjoptions
, *documentationjofjdrugjmonitoringjorjtitrationjplan,jifjapplicable
*documentationjofjconsultations,jifjany
avoidancejofjprescribingjmedicationsjforjself,jfamily,jorjfriends
Rationaljdrugjselectionjrequiresjajlogicaljapproachjthatjincludesjthejformulationjofjajdiagnos
isjbasedjonjclinicaljreasoningjandjthejselectionjandjmonitoringjofjthejmostjappropriatejphar
macologicaljtreatmentj
Considerationsjinclude:jCost,jguidelines,javailability,jinteractions,jsidejeffects,jallergies,jhe
patic/renaljfunctions,jneedjforjmonitoring,j&jspecialjpopulations
Beer'sjCriteriaj-
jcorrectjanswer.jjjjidentifiesjdrugsjwithjajhighjlikelihoodjofjcausingjadversejeffectsjinjolderjadu
lts.jAccordingly,jdrugsjonjthisjlistjshouldjgenerallyjbejavoidedjinjadultsjolderjthanj65jyearsjex
ceptjwhenjthejbenefitsjarejsignificantlyjgreaterjthanjthejrisks.
Pharmacodynamicsj-
jcorrectjanswer.jjjjthe jstudyjofjthejbiochemicaljandjphysiologicjeffectsjofjdrugsjonjthejbodyjan
djthejmolecularjmechanismsjbyjwhichjthosejeffectsjarejproduced
Pharmacokineticsj-jcorrectjanswer.jjjjthejstudyjofjdrugjmovementjthroughoutjthejbody
Pharmacogenomicsj-
jcorrectjanswer.jjjjthe jstudyjofjhowjgenesjaffectjajperson'sjresponsejtojdrugs.jThejpurposejofjt
hisjisjtojcombinejthejsciencesjofjgenomicsjandjpharmacologyjtojprovidejindividualized,jtarg
eted,jsafejdrugjtherapiesjtojpatients
CYP450jinducersj-
jcorrectjanswer.jjjjInducersjarejxenobioticsj(medicationsjandjenvironmentaljagents)jthatjelev
atejCYP450jenzymejactivityjbyjincreasingjenzymejsynthesis.jThisjactionjleadsjtojadditionalj
sitesjavailablejforjbiotransformation.jThejincreasedjnumberjofjsitesjenhancesjmedicationjm
etabolism,jdecreasingjthejconcentrationjofjthej"parentjdrug"jwhilejincreasingjmetabolitejpro
duction.
Inducersj=jIncreasejmedicationjmetabolismj
(Carbamazepine,jRifampin,jAlcohol,jPhenytoin,jGriseofulvin,jPhenobarbital,jSulfonylureas
)
CYP450jinhibitorsj-
jcorrectjanswer.jjjjInhibitorsjarejmedicationsjthatjinhibitjthejmetabolicjactivityjofjonejorjmorejof
jthejCYP450jenzymes.jMedicationsjthatjinhibitjanjenzymejpotentiallyjslowsjthatjenzyme'sjac
tivityjorjblocksjthejactivityjrequiredjforjthejmetabolismjofjotherjmedications,jtherebyjincreasi
ngjthejlevelsjofjmedicationsjdependentjonjthatjparticularjenzymejforjbiotransformation.jInhi
