Advanced Pharmacology – Midterm
Exam Questions & Answers.
Nurse practitioner prescriptive authority is regulated by:
a. The National Council of Sate Board of Nursing
b. The State Board of Nursing for each state
c. The U. S. Drug Enforcement Administration
d. The State Board of Pharmacy - ANSWER-b. The State Board of Nursing for each
state
Eight Information needed for the prescription - ANSWER-1. Date of prescribing;
2. Name of patient(s);
3. Prescriber's name;
4. Name, strength, and dosage of drug or device;
5. Number of refills, if applicable;
6. Quantity prescribed in weight, volume, or number of units;
7. An indication of whether generic substitution has been authorized by the prescriber;
8. Any change or alteration made to the prescription dispensed on contact with the
prescriber must show a clear audit trail.
Three additional required information for controlled substances - ANSWER-1. Address
of the prescriber and patient;
2. The prescriber's DEA number;
3 Controlled prescriptions shall also comply with all requirements of federal and state
controlled substance laws.
Who oversees the APRN's prescribing of controlled substances?
a. The pharmaceutical board of the state
b. The federal government (DEA)
c. The practice protocols of the hospital
d. Practice agreements - ANSWER-b. The federal government (DEA)
The USFDA regulates:
a. Prescribing of drugs by medical doctors and nurse practitioners
b. The official labeling for all prescription and over-the-counter drugs
c. Off-label recommendations for prescribing
d. Pharmaceutical educational offering - ANSWER-b. The official labeling for all
prescription and over-the-counter drugs
Medication agreements or "Pain Medication Contracts" are recommended to be used:
a. Universally for all prescribing for chronic pain
b. For patients who have repeated requests for pain medication
,c. When you suspect a patient is exhibiting drug-seeking behavior
d. For patients with pain associated with malignancy - ANSWER-a. Universally for all
prescribing for chronic pain
Anaphylactic shock is a:
a. Type I reaction, called immediate hypersensitivity reaction
b. Type II reaction, called cytotoxic hypersensitivity reaction
c. Type III reaction, called immune complex hypersensitivity
d. Type IV reaction, called delayed hypersensitivity reaction - ANSWER-a. Type I
reaction, called immediate hypersensitivity reaction
The role of the nurse practitioner with regards to herbal medication is to:
a. Maintain competence in the prescribing of common herbal remedies.
b. Recommend common over-the-counter herbs to patients.
c. Educate patients and guide them to appropriate sources of care.
d. Encourage patients to not use herbal therapy due to the documented dangers. -
ANSWER-c. Educate patients and guide them to appropriate sources of care.
Prescribing for women during their childbearing years requires constant awareness of
the possibility of:
a. High risk for developmental disorders in their infants
b. Decreased risk for abuse during this time
c. Possible unknown pregnancy
d. Possibility of drug allergies - ANSWER-c. Possible unknown pregnancy
Dysmenorrhea is one of the most common gynecological complaints in young women.
The first-line of drug treatment for this disorder is:
a. Oral contraceptive pills
b. Caffeine
c. NSAIDs
d. Aspirin - ANSWER-c. NSAIDs
A medication review of an elderly person's medications involves:
a. Asking the patient to bring a list of current prescription medications to the visit.
b. Having the patient bring all their prescription, over-the-counter, and herbal
medications to the visit.
c. Asking what other providers are writing prescriptions for them.
d. All of the above. - ANSWER-d. All of the above.
ACE-Is are the drug of choice in treating HTN in diabetic patient because they:
,a. improve insulin sensitivity
b. improve renal hemodynamics
c. reduce the production of angiotensin II
d. all of above - ANSWER-d. all of above
The NP orders a thyroid panel for a patient on amiodarone. The patient tells the NP that
he does not have thyroid disease and wants to know why the test has been ordered.
Which is the correct response?
a. Amiodarone inhibits an enzyme that is important in making thyroid hormone and can
cause hypothyroidism.
b. Amiodarone damages the thyroid gland and can result in inflammation of that gland,
causing hyperthyroidism
c. Amiodarone is a broad spectrum drug with many adverse effects, Many different tests
need to be done before it is given.
d. Amiodarone can cause corneal deposits in up to 25% of patients. - ANSWER-a.
Amiodarone inhibits an enzyme that is important in making thyroid hormone and can
cause hypothyroidism.
To reduce mortality, all patients with angina, regardless of class, should be on:
a. ASA 81 to 325 mg/day
b. Nitroglycerin sublingually for chest pain
c. ACE inhibitors or angiotensin receptor blockers
d. Dixoxin - ANSWER-a. ASA 81 to 325 mg/day
Beta-blockers are especially helpful for patients with exertional angina who also have:
a. arrhythmia
b. hypothyroidism
c. hyperthyroidism
d. atherosclerosis - ANSWER-a. arrhythmia
What assessment that can be done at home is the most reliable to use for making
decisions to change HF medications?
a. Weight
b. BP
c. HR
d. Serum glucose - ANSWER-a. Weight
What can chest x-rays contribute to the diagnosis and management of HF?
a. They have no role.
b. They can give very precise pictures of pulmonary fluid status.
c. They provide an idea of general cardiac size and pulmonary great vessel distribution.
, d. They can confirm the diagnosis. - ANSWER-c. They provide an idea of general
cardiac size and pulmonary great vessel distribution.
Jamie is a 34-year-old pregnant woman with familial hyperlipidemia and elevated LDL
levels. What is the appropriate treatment for a pregnant woman?
a. A statin
b. Niacin
c. Fibric acid derivative
d. Bile acid-binding resins - ANSWER-d. Bile acid-binding resins (same thing as bile
acid sequestrants)
Jose is a 12-year-old overweight child with a total cholesterol of 180 mg/dL and LDL of
125 mg/dL. Along with diet education and recommending increased physical activity, a
treatment plan for Jose would include _____ with a reevaluation in 6 months.
a. Statins
b. Niacin
c. Sterols
d. Bile acid-binding resins - ANSWER-Sterols
Which antihypertensive is safe to use in pregnancy?
a. ACE-Is
b. BBs
c. DRIs
d. ARBs - ANSWER-b. BBs
A potentially life-threatening adverse response to ACE-Is is angioedema. Which of the
following statements true about this adverse response?
a. Swelling of the tongue and hoarseness are the most common symptoms.
b. It appears to be related to the decrease in aldosterone production.
c. Presence of a dry, hacking cough indicates a high risk for this adverse response.
d. Because it takes time to build up a blood level, it occurs after being on the drug for
about one week. - ANSWER-a. Swelling of tongue and hoarseness are the most
common symptoms.
Appropriate treatment for impetigo is:
a. miconazole topical
b. mupirocin (Bactroban)
c. Keflex
d. Benadryl - ANSWER-b. mupirocin (Bactroban)
Exam Questions & Answers.
Nurse practitioner prescriptive authority is regulated by:
a. The National Council of Sate Board of Nursing
b. The State Board of Nursing for each state
c. The U. S. Drug Enforcement Administration
d. The State Board of Pharmacy - ANSWER-b. The State Board of Nursing for each
state
Eight Information needed for the prescription - ANSWER-1. Date of prescribing;
2. Name of patient(s);
3. Prescriber's name;
4. Name, strength, and dosage of drug or device;
5. Number of refills, if applicable;
6. Quantity prescribed in weight, volume, or number of units;
7. An indication of whether generic substitution has been authorized by the prescriber;
8. Any change or alteration made to the prescription dispensed on contact with the
prescriber must show a clear audit trail.
Three additional required information for controlled substances - ANSWER-1. Address
of the prescriber and patient;
2. The prescriber's DEA number;
3 Controlled prescriptions shall also comply with all requirements of federal and state
controlled substance laws.
Who oversees the APRN's prescribing of controlled substances?
a. The pharmaceutical board of the state
b. The federal government (DEA)
c. The practice protocols of the hospital
d. Practice agreements - ANSWER-b. The federal government (DEA)
The USFDA regulates:
a. Prescribing of drugs by medical doctors and nurse practitioners
b. The official labeling for all prescription and over-the-counter drugs
c. Off-label recommendations for prescribing
d. Pharmaceutical educational offering - ANSWER-b. The official labeling for all
prescription and over-the-counter drugs
Medication agreements or "Pain Medication Contracts" are recommended to be used:
a. Universally for all prescribing for chronic pain
b. For patients who have repeated requests for pain medication
,c. When you suspect a patient is exhibiting drug-seeking behavior
d. For patients with pain associated with malignancy - ANSWER-a. Universally for all
prescribing for chronic pain
Anaphylactic shock is a:
a. Type I reaction, called immediate hypersensitivity reaction
b. Type II reaction, called cytotoxic hypersensitivity reaction
c. Type III reaction, called immune complex hypersensitivity
d. Type IV reaction, called delayed hypersensitivity reaction - ANSWER-a. Type I
reaction, called immediate hypersensitivity reaction
The role of the nurse practitioner with regards to herbal medication is to:
a. Maintain competence in the prescribing of common herbal remedies.
b. Recommend common over-the-counter herbs to patients.
c. Educate patients and guide them to appropriate sources of care.
d. Encourage patients to not use herbal therapy due to the documented dangers. -
ANSWER-c. Educate patients and guide them to appropriate sources of care.
Prescribing for women during their childbearing years requires constant awareness of
the possibility of:
a. High risk for developmental disorders in their infants
b. Decreased risk for abuse during this time
c. Possible unknown pregnancy
d. Possibility of drug allergies - ANSWER-c. Possible unknown pregnancy
Dysmenorrhea is one of the most common gynecological complaints in young women.
The first-line of drug treatment for this disorder is:
a. Oral contraceptive pills
b. Caffeine
c. NSAIDs
d. Aspirin - ANSWER-c. NSAIDs
A medication review of an elderly person's medications involves:
a. Asking the patient to bring a list of current prescription medications to the visit.
b. Having the patient bring all their prescription, over-the-counter, and herbal
medications to the visit.
c. Asking what other providers are writing prescriptions for them.
d. All of the above. - ANSWER-d. All of the above.
ACE-Is are the drug of choice in treating HTN in diabetic patient because they:
,a. improve insulin sensitivity
b. improve renal hemodynamics
c. reduce the production of angiotensin II
d. all of above - ANSWER-d. all of above
The NP orders a thyroid panel for a patient on amiodarone. The patient tells the NP that
he does not have thyroid disease and wants to know why the test has been ordered.
Which is the correct response?
a. Amiodarone inhibits an enzyme that is important in making thyroid hormone and can
cause hypothyroidism.
b. Amiodarone damages the thyroid gland and can result in inflammation of that gland,
causing hyperthyroidism
c. Amiodarone is a broad spectrum drug with many adverse effects, Many different tests
need to be done before it is given.
d. Amiodarone can cause corneal deposits in up to 25% of patients. - ANSWER-a.
Amiodarone inhibits an enzyme that is important in making thyroid hormone and can
cause hypothyroidism.
To reduce mortality, all patients with angina, regardless of class, should be on:
a. ASA 81 to 325 mg/day
b. Nitroglycerin sublingually for chest pain
c. ACE inhibitors or angiotensin receptor blockers
d. Dixoxin - ANSWER-a. ASA 81 to 325 mg/day
Beta-blockers are especially helpful for patients with exertional angina who also have:
a. arrhythmia
b. hypothyroidism
c. hyperthyroidism
d. atherosclerosis - ANSWER-a. arrhythmia
What assessment that can be done at home is the most reliable to use for making
decisions to change HF medications?
a. Weight
b. BP
c. HR
d. Serum glucose - ANSWER-a. Weight
What can chest x-rays contribute to the diagnosis and management of HF?
a. They have no role.
b. They can give very precise pictures of pulmonary fluid status.
c. They provide an idea of general cardiac size and pulmonary great vessel distribution.
, d. They can confirm the diagnosis. - ANSWER-c. They provide an idea of general
cardiac size and pulmonary great vessel distribution.
Jamie is a 34-year-old pregnant woman with familial hyperlipidemia and elevated LDL
levels. What is the appropriate treatment for a pregnant woman?
a. A statin
b. Niacin
c. Fibric acid derivative
d. Bile acid-binding resins - ANSWER-d. Bile acid-binding resins (same thing as bile
acid sequestrants)
Jose is a 12-year-old overweight child with a total cholesterol of 180 mg/dL and LDL of
125 mg/dL. Along with diet education and recommending increased physical activity, a
treatment plan for Jose would include _____ with a reevaluation in 6 months.
a. Statins
b. Niacin
c. Sterols
d. Bile acid-binding resins - ANSWER-Sterols
Which antihypertensive is safe to use in pregnancy?
a. ACE-Is
b. BBs
c. DRIs
d. ARBs - ANSWER-b. BBs
A potentially life-threatening adverse response to ACE-Is is angioedema. Which of the
following statements true about this adverse response?
a. Swelling of the tongue and hoarseness are the most common symptoms.
b. It appears to be related to the decrease in aldosterone production.
c. Presence of a dry, hacking cough indicates a high risk for this adverse response.
d. Because it takes time to build up a blood level, it occurs after being on the drug for
about one week. - ANSWER-a. Swelling of tongue and hoarseness are the most
common symptoms.
Appropriate treatment for impetigo is:
a. miconazole topical
b. mupirocin (Bactroban)
c. Keflex
d. Benadryl - ANSWER-b. mupirocin (Bactroban)
