Nr 565 Midterm Exam 2024 | NR565
Exam Latest 2024 Questions and Correct
Answers Rated A+
What are medication examples of Schedule II drugs? -ANSWER--
Ativan & Valium
-Fentanyl
-Oxycodone
-Methadone
What medications are Schedule III drugs? -ANSWER--Xanax
-Tramadol
-anabolic steroids
-<90mg of codeine
What medications are Schedule IV drugs? -ANSWER--Ativan
-Tramadol
-Methadone
-Adderall
Which schedule drugs can APRNs prescribe? -ANSWER-Schedule II
through Schedule IV
examples of reasons for medication non-adherence -ANSWER--too
busy
-too expensive
-ran out
-forgetting
-traveling & busy
Distribution in medication in elderly can be affected in what ways? -
ANSWER--decreased lean mass
-decreased albumin
-decreased body fat
-slower gastric acidity
,-slower absorption results in delayed response
In the elderly decrease albumin and decreased lean mass affects
medications how? -ANSWER-medication binds to protein so
decreased protein affects how medication is absorbed and distributed
In elderly decreased body fat affects medications how? -ANSWER-
need fat to transport medications and some drug metabolism is
dependent on body weight
When prescribing medication, we must understand that liver function
declines with age due to.... -ANSWER-decreased blood flow to the
liver, decreased hepatic enzymes
What is the most important cause of adverse drug reactions? -
ANSWER-***overprescribing/polypharmacy
***decreased renal excretion
-high drug dosages (start low & go slow)
-lack of monitoring medications
What can a poor metabolism phenotype do to a metabolism of a drug?
-ANSWER--slow or increase absorption
-slow the metabolism
-keep drug in body longer
-increase toxicity
How does poor metabolism affect a high or low therapeutic index? -
ANSWER--increase drug toxicity
(example plavix - clots & increased platelets)
Black box warning for Opioids -ANSWER-respiratory depression
Black box warning for Fentanyl -ANSWER-FATAL respiratory
depression
Black box warning for Methadone (NP cannot prescribe) -ANSWER-
QT interval prolongation
,Black box warning for Codeine -ANSWER--breastfeeding and infant
death can occur
-10% of dose converts to morphine
Black box warning for hydromorphone & oxymorphone (NP cannot
prescribe long acting hydromorphone and oxymorphone) -ANSWER--
risk for high abuse & overdose
-respiratory depression
Black box warning for oxycodone (NP need additional training to
prescribe for chronic pain) -ANSWER--HIGH potential for abuse
-respiratory depression
Meds that require special training for APNs to prescribe are... -
ANSWER--Opioids
-Fentanyl
-Methadone
-Codeine
-Hydromorphone & oxymorphone
-Oxycodone
What are therapeutic uses for morphine? -ANSWER-MODERATE TO
SEVERE PAIN
-acute pain
-post op/surgical pain
-end of life pain management
-MI
-labor & delivery
-cancer
What are therapeutic uses for Fentanyl? -ANSWER-
BREAKTHROUGH PAIN
surgical pain
severe pain
opioid tolerant patients
, What are therapeutic uses for codeine? -ANSWER-MILD TO
MODERATE PAIN
cough
What is MME and when to use it? -ANSWER-morphine milligram
equivalent
used for overdose(OD)
assess where patient is at in their pain management and monitor them
safely
What is the PDPM and when to use it? -ANSWER--database to
access to patient's prescription history of controlled substances used
to ensure safe prescribing to prevent overdosing and polypharmacy
-use prior to starting opioid therapy and during opioid therapy
Renal and hepatic insufficiencies with opioids
1)Codeine -ANSWER-stays in body longer & metabolism is effected
Renal and hepatic insufficiencies with opioids
2) Morphine -ANSWER-neurotoxicity
Renal and hepatic insufficiencies with opioids
3)Oxycodone -ANSWER-overdose
can use with extreme caution and reduction of dosage
Renal and hepatic insufficiencies with opioids
4)Fentanyl -ANSWER-monitor closely for sedation
Risk factors for Opioid Use Disorder (OUD) -ANSWER-family history
mental health disorder (anxiety, depression)
social factors
prior drug use
pain management
poly-substance abuse
prescribe post surgery for long period of time
Exam Latest 2024 Questions and Correct
Answers Rated A+
What are medication examples of Schedule II drugs? -ANSWER--
Ativan & Valium
-Fentanyl
-Oxycodone
-Methadone
What medications are Schedule III drugs? -ANSWER--Xanax
-Tramadol
-anabolic steroids
-<90mg of codeine
What medications are Schedule IV drugs? -ANSWER--Ativan
-Tramadol
-Methadone
-Adderall
Which schedule drugs can APRNs prescribe? -ANSWER-Schedule II
through Schedule IV
examples of reasons for medication non-adherence -ANSWER--too
busy
-too expensive
-ran out
-forgetting
-traveling & busy
Distribution in medication in elderly can be affected in what ways? -
ANSWER--decreased lean mass
-decreased albumin
-decreased body fat
-slower gastric acidity
,-slower absorption results in delayed response
In the elderly decrease albumin and decreased lean mass affects
medications how? -ANSWER-medication binds to protein so
decreased protein affects how medication is absorbed and distributed
In elderly decreased body fat affects medications how? -ANSWER-
need fat to transport medications and some drug metabolism is
dependent on body weight
When prescribing medication, we must understand that liver function
declines with age due to.... -ANSWER-decreased blood flow to the
liver, decreased hepatic enzymes
What is the most important cause of adverse drug reactions? -
ANSWER-***overprescribing/polypharmacy
***decreased renal excretion
-high drug dosages (start low & go slow)
-lack of monitoring medications
What can a poor metabolism phenotype do to a metabolism of a drug?
-ANSWER--slow or increase absorption
-slow the metabolism
-keep drug in body longer
-increase toxicity
How does poor metabolism affect a high or low therapeutic index? -
ANSWER--increase drug toxicity
(example plavix - clots & increased platelets)
Black box warning for Opioids -ANSWER-respiratory depression
Black box warning for Fentanyl -ANSWER-FATAL respiratory
depression
Black box warning for Methadone (NP cannot prescribe) -ANSWER-
QT interval prolongation
,Black box warning for Codeine -ANSWER--breastfeeding and infant
death can occur
-10% of dose converts to morphine
Black box warning for hydromorphone & oxymorphone (NP cannot
prescribe long acting hydromorphone and oxymorphone) -ANSWER--
risk for high abuse & overdose
-respiratory depression
Black box warning for oxycodone (NP need additional training to
prescribe for chronic pain) -ANSWER--HIGH potential for abuse
-respiratory depression
Meds that require special training for APNs to prescribe are... -
ANSWER--Opioids
-Fentanyl
-Methadone
-Codeine
-Hydromorphone & oxymorphone
-Oxycodone
What are therapeutic uses for morphine? -ANSWER-MODERATE TO
SEVERE PAIN
-acute pain
-post op/surgical pain
-end of life pain management
-MI
-labor & delivery
-cancer
What are therapeutic uses for Fentanyl? -ANSWER-
BREAKTHROUGH PAIN
surgical pain
severe pain
opioid tolerant patients
, What are therapeutic uses for codeine? -ANSWER-MILD TO
MODERATE PAIN
cough
What is MME and when to use it? -ANSWER-morphine milligram
equivalent
used for overdose(OD)
assess where patient is at in their pain management and monitor them
safely
What is the PDPM and when to use it? -ANSWER--database to
access to patient's prescription history of controlled substances used
to ensure safe prescribing to prevent overdosing and polypharmacy
-use prior to starting opioid therapy and during opioid therapy
Renal and hepatic insufficiencies with opioids
1)Codeine -ANSWER-stays in body longer & metabolism is effected
Renal and hepatic insufficiencies with opioids
2) Morphine -ANSWER-neurotoxicity
Renal and hepatic insufficiencies with opioids
3)Oxycodone -ANSWER-overdose
can use with extreme caution and reduction of dosage
Renal and hepatic insufficiencies with opioids
4)Fentanyl -ANSWER-monitor closely for sedation
Risk factors for Opioid Use Disorder (OUD) -ANSWER-family history
mental health disorder (anxiety, depression)
social factors
prior drug use
pain management
poly-substance abuse
prescribe post surgery for long period of time
