1
WGU D116 ADVANCED PHARMACOLOGY OA AND
PRE ASSESSMENT EXAM ACTUAL EXAM
COMPLETE QUESTIONS WITH DETAILED
VERIFIED ANSWERS AND RATIONALES
||COMPLETE A+ GUIDE
1. Which factors could be attributed to limited prescriptive authority
forAPRNs?Select all that apply.: Inaccessibility of patient care
Feedback: Limiting prescriptive authority for APRNs can create barriers to
quality, affordable, and accessible patient care. It may also lead to poor
collaboration amongproviders and higher health care costs. It would not directly
impact patient's healthliteracy.
Higher health care costs
Feedback: Limiting prescriptive authority for APRNs can create barriers to
quality, affordable, and accessible patient care. It may also lead to poor
collaboration amongproviders and higher health care costs. It would not directly
impact patient's healthliteracy.
2. A patient reports that a medication prescribed for recurrent migraine
headaches is not working. Which action should be taken first?: Ask the
patientabout the number and frequency of tablets taken
Feedback: using the drug as ordered. Asking the patient to tell the nurse how
,2 manytablets are taken and how often helps the nurse determine compliance.
Assessingcurrent pain does not yield information about how well the medication
is working unless the patient is currently taking it. The nurse should gather as
much informationabout compliance, symptoms, and drug effectiveness as
possible before contactingthe prescriber. Biofeedback may be an effective
adjunct to treatment, but it should not be recommended without complete
information about drug effectiveness
3. A patient is receiving intravenous gentamicin. A serum drug test reveals
tox-ic levels. The dosing is correct, and this medication has been tolerated
bythispatient inthe past. Which could be a probable cause of the test
result?: The patient is taking another medication that binds to serum albumin
Feedback: Gentamicin binds to albumin, but only weakly, and in the presence of
another drug that binds to albumin, it can rise to toxic levels in blood serum. A
loadingdose increases the initial amount ofa drug and is used to bring drug levels
to the desired plateau more quickly. A drug that is not completely dissolved
carries a riskof causing embolism. A drug given at a frequency longer than the
drug half-life willlikely be at subtherapeutic levels and not at toxic levels
4. The nurse is administering morning medications. The nurse gives a
patientmultiple medications, two of which compete for plasma albumin
receptor sites.As a result of this concurrent administration, the nurse can
anticipate that what might occur? Select all that apply: Binding of one or
both agents will be reduced
Plasma levels of free drug will rise
,3 The increase in free drug will intensify effects
Feedback: When two drugs bind to the same site on plasma albumin,
coadministration of those drugs produces competition for binding. As a result,
binding of one or both agents is reduced, causing plasma levels of free drug to
rise. The increase in free drug can intensify the effect, but it usually undergoes
rapid elimination. Theincrease in plasma levels of free drug is rarely sustained.
, 4
5. Which patients are at increased risk for adverse drug events? Select all
that apply: A 2-month-old infant taking a medication for gastroesophageal reflux
disease
A 40-year-old male who is intubated in the intensive care unit and taking
antibioticsand cardiac medications
A 7-year-old female receiving insulin for
diabetes
An 80-year-old male taking medications for
COPD
Feedback: Patients at increased risk for adverse drug events include the very
young,the very old, and those who have serious illnesses. Females, children, and
young adults taking single medications do not have increased risk for adverse
events.
6. A patient asks a nurse why a friend who is taking the same drug responds
differently to that drug. The nurse knows that the most common variation
in drug response is due to differences in each patient's:: metabolism of drugs
Feedback: The most common source of genetic variation in drug response is
relatedto alterations in drug metabolism and is determined by genetic codes for
various drug-metabolizing isoenzymes. There are known genetic differences in
codes for drug target sites, but these are not as numerous as those for metabolic
isoenzymes.Hypersensitivity potential is also genetically determined, but
variations produce differences in adverse reactions to drugs and not in drug
WGU D116 ADVANCED PHARMACOLOGY OA AND
PRE ASSESSMENT EXAM ACTUAL EXAM
COMPLETE QUESTIONS WITH DETAILED
VERIFIED ANSWERS AND RATIONALES
||COMPLETE A+ GUIDE
1. Which factors could be attributed to limited prescriptive authority
forAPRNs?Select all that apply.: Inaccessibility of patient care
Feedback: Limiting prescriptive authority for APRNs can create barriers to
quality, affordable, and accessible patient care. It may also lead to poor
collaboration amongproviders and higher health care costs. It would not directly
impact patient's healthliteracy.
Higher health care costs
Feedback: Limiting prescriptive authority for APRNs can create barriers to
quality, affordable, and accessible patient care. It may also lead to poor
collaboration amongproviders and higher health care costs. It would not directly
impact patient's healthliteracy.
2. A patient reports that a medication prescribed for recurrent migraine
headaches is not working. Which action should be taken first?: Ask the
patientabout the number and frequency of tablets taken
Feedback: using the drug as ordered. Asking the patient to tell the nurse how
,2 manytablets are taken and how often helps the nurse determine compliance.
Assessingcurrent pain does not yield information about how well the medication
is working unless the patient is currently taking it. The nurse should gather as
much informationabout compliance, symptoms, and drug effectiveness as
possible before contactingthe prescriber. Biofeedback may be an effective
adjunct to treatment, but it should not be recommended without complete
information about drug effectiveness
3. A patient is receiving intravenous gentamicin. A serum drug test reveals
tox-ic levels. The dosing is correct, and this medication has been tolerated
bythispatient inthe past. Which could be a probable cause of the test
result?: The patient is taking another medication that binds to serum albumin
Feedback: Gentamicin binds to albumin, but only weakly, and in the presence of
another drug that binds to albumin, it can rise to toxic levels in blood serum. A
loadingdose increases the initial amount ofa drug and is used to bring drug levels
to the desired plateau more quickly. A drug that is not completely dissolved
carries a riskof causing embolism. A drug given at a frequency longer than the
drug half-life willlikely be at subtherapeutic levels and not at toxic levels
4. The nurse is administering morning medications. The nurse gives a
patientmultiple medications, two of which compete for plasma albumin
receptor sites.As a result of this concurrent administration, the nurse can
anticipate that what might occur? Select all that apply: Binding of one or
both agents will be reduced
Plasma levels of free drug will rise
,3 The increase in free drug will intensify effects
Feedback: When two drugs bind to the same site on plasma albumin,
coadministration of those drugs produces competition for binding. As a result,
binding of one or both agents is reduced, causing plasma levels of free drug to
rise. The increase in free drug can intensify the effect, but it usually undergoes
rapid elimination. Theincrease in plasma levels of free drug is rarely sustained.
, 4
5. Which patients are at increased risk for adverse drug events? Select all
that apply: A 2-month-old infant taking a medication for gastroesophageal reflux
disease
A 40-year-old male who is intubated in the intensive care unit and taking
antibioticsand cardiac medications
A 7-year-old female receiving insulin for
diabetes
An 80-year-old male taking medications for
COPD
Feedback: Patients at increased risk for adverse drug events include the very
young,the very old, and those who have serious illnesses. Females, children, and
young adults taking single medications do not have increased risk for adverse
events.
6. A patient asks a nurse why a friend who is taking the same drug responds
differently to that drug. The nurse knows that the most common variation
in drug response is due to differences in each patient's:: metabolism of drugs
Feedback: The most common source of genetic variation in drug response is
relatedto alterations in drug metabolism and is determined by genetic codes for
various drug-metabolizing isoenzymes. There are known genetic differences in
codes for drug target sites, but these are not as numerous as those for metabolic
isoenzymes.Hypersensitivity potential is also genetically determined, but
variations produce differences in adverse reactions to drugs and not in drug
