, ARCANGELO & PETERSON’S
PHARMACOTHERAPEUTICS TEST PREP: 2025
CERTIFIED REVIEW & QUESTIONS
📘 Verified | Detailed Rationales | 1,120 Questions | Designed for Guaranteed Clinical
Competency
Table of Contents
1. Issues for the Practitioner in Drug Therapy
2. Pharmacokinetic Basis of Therapeutics and Pharmacodynamic Principles
3. Impact of Drug Interactions and Adverse Events on Therapeutics
4. Principles of Pharmacotherapy in Pediatrics, Pregnancy and Lactation
5. Pharmacotherapy Principles in Older Adults
6. Principles of Antimicrobial Therapy
7. Pharmacogenomics
8. The Economics of Pharmacotherapeutics
9. Principles of Pharmacology in Pain Management
10. Pain Management in Opioid Use Disorder (OUD) Patients
11. Cannabis and Pain Management
12. Dermatitis
13. Bacterial, Fungal, and Viral Infections of the Skin
14. Psoriasis
15. Acne Vulgaris and Rosacea
16. Ophthalmic Disorders
17. Otitis Media and Otitis Externa
18. Hypertension
19. Hyperlipidemia
20. Chronic Stable Angina and Myocardial Infarction
,21. Heart Failure
22. Arrhythmias
23. Respiratory Infections
24. Asthma and Chronic Obstructive Pulmonary Disease
25. Gastric, Functional and Inflammatory Bowel Disorders
26. Gastroesophageal Reflux Disease and Peptic Ulcer Disease
27. Liver Diseases
28. Urinary Tract Infection
29. Prostatic Disorders and Erectile Dysfunction
30. Overactive Bladder
31. Sexually Transmitted Infections
32. Osteoarthritis and Gout
33. Osteoporosis
34. Rheumatoid Arthritis
35. Headaches
36. Seizure Disorders
37. Alzheimer’s Disease
38. Parkinson Disease
39. Major Depressive Disorder and Bipolar Disorders
40. Anxiety Disorders
41. Sleep Disorders
42. Attention Deficit Hyperactivity Disorder
43. Substance Use Disorders
44. Diabetes Mellitus
45. Thyroid and Parathyroid Disorders
46. Allergies and Allergic Reactions
47. Human Immunodeficiency Virus
,48. Organ Transplantation
49. Pharmacotherapy for Select Thromboembolic Disorders
50. Anemias
51. Immunizations
52. Smoking Cessation
53. Weight Loss
54. Contraception
55. Menopause
56. Vaginitis
, 1. An NP licensed in State A prescribes a Schedule II opioid
without collaborative agreement. Which action is most
appropriate?
A. Document patient consent and proceed
B. Halt the prescription and contact the state board
C. Delegate prescribing to a registered nurse
D. Prescribe a non-controlled alternative
Answer: B
Rationale: Without legal authority (collaborative agreement),
prescribing Schedule II is out of scope; contact the board to
clarify scope. A is incorrect (insufficient), C is illegal delegation,
D avoids controlled but doesn’t address scope issue.
2. Which statement best reflects ethical prescribing?
A. Choosing the newest drug for better marketing
B. Prioritizing patient need over pharmaceutical incentives
C. Selecting medications based on prescriber familiarity
D. Basing choices on patient’s ability to pay only
Answer: B
Rationale: Ethical prescribing emphasizes patient welfare
above conflicts of interest. A & C reflect bias, D ignores clinical
appropriateness.
3. An APP reviews an elderly patient’s medications and
notes five daily prescriptions. What’s the priority?
A. Discontinue all but two drugs immediately
B. Assess for indications and deprescribe unnecessary
meds
, C. Increase dosing intervals
D. Add a medication reconciliation service referral
Answer: B
Rationale: Polypharmacy avoidance requires systematic review
and deprescribing when no indication. A is too abrupt, C
doesn’t reduce count, D is supportive but secondary.
4. To enhance adherence, which strategy is most evidence-
based?
A. Prescribing monotherapy always
B. Using pill organizers and teach-back
C. Assuming patients will ask if confused
D. Writing “take as directed” only
Answer: B
Rationale: Pill organizers plus teach-back improve
understanding and adherence. A oversimplifies, C is passive, D
is vague.
5. When an APP encounters a patient with low health
literacy, the best approach is to:
A. Provide detailed written instructions only
B. Use medical jargon to educate
C. Employ simple language and visuals
D. Refer immediately to a specialist
Answer: C
Rationale: Simple language plus visuals tailor to low literacy. A
is insufficient, B worsens confusion, D bypasses provider role.
, 6. A patient declines statin therapy despite high CV risk. The
APP should:
A. Insist on starting therapy immediately
B. Document refusal and move on
C. Explore concerns and engage shared decision-making
D. Switch to an alternative cholesterol agent without
discussion
Answer: C
Rationale: Shared decision-making uncovers barriers and
fosters adherence. A is coercive, B neglects patient autonomy,
D avoids core issue.
7. Which scenario best illustrates liability for negligent
prescribing?
A. Following all guidelines but monitoring labs
B. Prescribing without checking allergies
C. Consulting a drug database before prescribing
D. Referring care when beyond expertise
Answer: B
Rationale: Ignoring allergy history falls below standard, risking
harm. Others reflect due diligence.
8. State B requires physician oversight for opioid scripts. An
APP writes one independently. This is:
A. Within scope under DEA rules
B. Unlawful and subject to disciplinary action
C. Permissible if patient consents
D. Allowed during emergencies only
,Answer: B
Rationale: Overriding state scope is illegal regardless of patient
consent or DEA; emergencies have specific protocols.
9. Which is a key element of evidence-based prescribing?
A. Relying solely on personal experience
B. Incorporating clinical guidelines and patient context
C. Preferring brand-name over generics
D. Using peer anecdotes to guide therapy
Answer: B
Rationale: Evidence-based practice integrates best evidence
plus clinical judgment and patient values. Others overvalue
anecdote or cost.
10. An APP wants to reduce medication errors. Which
tool is most effective?
A. Handwritten orders
B. Barcode-scanning at administration
C. Verbal orders via phone
D. Limiting drug formulary to two agents
Answer: B
Rationale: Barcode scanning verifies patient and drug match,
reducing errors. Handwritten/phone orders increase risk;
formulary limitation may not suit all.
11. Which action promotes cultural competence in
prescribing?
, A. Ignoring cultural beliefs if they conflict with guidelines
B. Asking about traditional remedies and integrating safely
C. Mandating Western medicine only
D. Relying on interpreter family member only
Answer: B
Rationale: Inquiring about and respecting traditional practices
builds trust and safety. A & C dismiss culture; D risks
miscommunication.
12. An APP prescribes off-label chemotherapy. What
must they document?
A. No documentation needed for APPs
B. Evidence supporting off-label use and informed consent
C. Only dosage schedule
D. That patient requested the treatment
Answer: B
Rationale: Off-label prescribing requires justification and
patient consent. Others omit key legal/ethical requirements.
13. To avoid polypharmacy, an APP should:
A. Never add a drug for side-effect management
B. Prioritize nonpharmacologic interventions first
C. Rotate all drugs monthly
D. Prescribe lowest price drugs only
Answer: B
Rationale: Non-drug therapies can reduce need for additional
, meds. A may neglect necessary therapy, C is arbitrary, D ignores
appropriateness.
14. Which communication technique supports health
literacy?
A. “How well do you understand this?”
B. Speak slowly and use teach-back
C. Provide pamphlets with small print
D. “You’ll be fine” assurances
Answer: B
Rationale: Teach-back confirms comprehension and tailoring
pace. A may embarrass, C is unreadable, D is dismissive.
15. An APP supervising an unlicensed assistive
personnel (UAP) must:
A. Delegate medication prescribing
B. Ensure UAP documents administration per protocol
C. Allow UAP to adjust doses
D. Transfer prescribing authority entirely
Answer: B
Rationale: UAP can document per standing orders;
prescribing/dose adjustment is prescriber’s role.
16. Which factor is most important when choosing
between two equivalent medications?
A. Marketing support
B. Patient’s insurance coverage
PHARMACOTHERAPEUTICS TEST PREP: 2025
CERTIFIED REVIEW & QUESTIONS
📘 Verified | Detailed Rationales | 1,120 Questions | Designed for Guaranteed Clinical
Competency
Table of Contents
1. Issues for the Practitioner in Drug Therapy
2. Pharmacokinetic Basis of Therapeutics and Pharmacodynamic Principles
3. Impact of Drug Interactions and Adverse Events on Therapeutics
4. Principles of Pharmacotherapy in Pediatrics, Pregnancy and Lactation
5. Pharmacotherapy Principles in Older Adults
6. Principles of Antimicrobial Therapy
7. Pharmacogenomics
8. The Economics of Pharmacotherapeutics
9. Principles of Pharmacology in Pain Management
10. Pain Management in Opioid Use Disorder (OUD) Patients
11. Cannabis and Pain Management
12. Dermatitis
13. Bacterial, Fungal, and Viral Infections of the Skin
14. Psoriasis
15. Acne Vulgaris and Rosacea
16. Ophthalmic Disorders
17. Otitis Media and Otitis Externa
18. Hypertension
19. Hyperlipidemia
20. Chronic Stable Angina and Myocardial Infarction
,21. Heart Failure
22. Arrhythmias
23. Respiratory Infections
24. Asthma and Chronic Obstructive Pulmonary Disease
25. Gastric, Functional and Inflammatory Bowel Disorders
26. Gastroesophageal Reflux Disease and Peptic Ulcer Disease
27. Liver Diseases
28. Urinary Tract Infection
29. Prostatic Disorders and Erectile Dysfunction
30. Overactive Bladder
31. Sexually Transmitted Infections
32. Osteoarthritis and Gout
33. Osteoporosis
34. Rheumatoid Arthritis
35. Headaches
36. Seizure Disorders
37. Alzheimer’s Disease
38. Parkinson Disease
39. Major Depressive Disorder and Bipolar Disorders
40. Anxiety Disorders
41. Sleep Disorders
42. Attention Deficit Hyperactivity Disorder
43. Substance Use Disorders
44. Diabetes Mellitus
45. Thyroid and Parathyroid Disorders
46. Allergies and Allergic Reactions
47. Human Immunodeficiency Virus
,48. Organ Transplantation
49. Pharmacotherapy for Select Thromboembolic Disorders
50. Anemias
51. Immunizations
52. Smoking Cessation
53. Weight Loss
54. Contraception
55. Menopause
56. Vaginitis
, 1. An NP licensed in State A prescribes a Schedule II opioid
without collaborative agreement. Which action is most
appropriate?
A. Document patient consent and proceed
B. Halt the prescription and contact the state board
C. Delegate prescribing to a registered nurse
D. Prescribe a non-controlled alternative
Answer: B
Rationale: Without legal authority (collaborative agreement),
prescribing Schedule II is out of scope; contact the board to
clarify scope. A is incorrect (insufficient), C is illegal delegation,
D avoids controlled but doesn’t address scope issue.
2. Which statement best reflects ethical prescribing?
A. Choosing the newest drug for better marketing
B. Prioritizing patient need over pharmaceutical incentives
C. Selecting medications based on prescriber familiarity
D. Basing choices on patient’s ability to pay only
Answer: B
Rationale: Ethical prescribing emphasizes patient welfare
above conflicts of interest. A & C reflect bias, D ignores clinical
appropriateness.
3. An APP reviews an elderly patient’s medications and
notes five daily prescriptions. What’s the priority?
A. Discontinue all but two drugs immediately
B. Assess for indications and deprescribe unnecessary
meds
, C. Increase dosing intervals
D. Add a medication reconciliation service referral
Answer: B
Rationale: Polypharmacy avoidance requires systematic review
and deprescribing when no indication. A is too abrupt, C
doesn’t reduce count, D is supportive but secondary.
4. To enhance adherence, which strategy is most evidence-
based?
A. Prescribing monotherapy always
B. Using pill organizers and teach-back
C. Assuming patients will ask if confused
D. Writing “take as directed” only
Answer: B
Rationale: Pill organizers plus teach-back improve
understanding and adherence. A oversimplifies, C is passive, D
is vague.
5. When an APP encounters a patient with low health
literacy, the best approach is to:
A. Provide detailed written instructions only
B. Use medical jargon to educate
C. Employ simple language and visuals
D. Refer immediately to a specialist
Answer: C
Rationale: Simple language plus visuals tailor to low literacy. A
is insufficient, B worsens confusion, D bypasses provider role.
, 6. A patient declines statin therapy despite high CV risk. The
APP should:
A. Insist on starting therapy immediately
B. Document refusal and move on
C. Explore concerns and engage shared decision-making
D. Switch to an alternative cholesterol agent without
discussion
Answer: C
Rationale: Shared decision-making uncovers barriers and
fosters adherence. A is coercive, B neglects patient autonomy,
D avoids core issue.
7. Which scenario best illustrates liability for negligent
prescribing?
A. Following all guidelines but monitoring labs
B. Prescribing without checking allergies
C. Consulting a drug database before prescribing
D. Referring care when beyond expertise
Answer: B
Rationale: Ignoring allergy history falls below standard, risking
harm. Others reflect due diligence.
8. State B requires physician oversight for opioid scripts. An
APP writes one independently. This is:
A. Within scope under DEA rules
B. Unlawful and subject to disciplinary action
C. Permissible if patient consents
D. Allowed during emergencies only
,Answer: B
Rationale: Overriding state scope is illegal regardless of patient
consent or DEA; emergencies have specific protocols.
9. Which is a key element of evidence-based prescribing?
A. Relying solely on personal experience
B. Incorporating clinical guidelines and patient context
C. Preferring brand-name over generics
D. Using peer anecdotes to guide therapy
Answer: B
Rationale: Evidence-based practice integrates best evidence
plus clinical judgment and patient values. Others overvalue
anecdote or cost.
10. An APP wants to reduce medication errors. Which
tool is most effective?
A. Handwritten orders
B. Barcode-scanning at administration
C. Verbal orders via phone
D. Limiting drug formulary to two agents
Answer: B
Rationale: Barcode scanning verifies patient and drug match,
reducing errors. Handwritten/phone orders increase risk;
formulary limitation may not suit all.
11. Which action promotes cultural competence in
prescribing?
, A. Ignoring cultural beliefs if they conflict with guidelines
B. Asking about traditional remedies and integrating safely
C. Mandating Western medicine only
D. Relying on interpreter family member only
Answer: B
Rationale: Inquiring about and respecting traditional practices
builds trust and safety. A & C dismiss culture; D risks
miscommunication.
12. An APP prescribes off-label chemotherapy. What
must they document?
A. No documentation needed for APPs
B. Evidence supporting off-label use and informed consent
C. Only dosage schedule
D. That patient requested the treatment
Answer: B
Rationale: Off-label prescribing requires justification and
patient consent. Others omit key legal/ethical requirements.
13. To avoid polypharmacy, an APP should:
A. Never add a drug for side-effect management
B. Prioritize nonpharmacologic interventions first
C. Rotate all drugs monthly
D. Prescribe lowest price drugs only
Answer: B
Rationale: Non-drug therapies can reduce need for additional
, meds. A may neglect necessary therapy, C is arbitrary, D ignores
appropriateness.
14. Which communication technique supports health
literacy?
A. “How well do you understand this?”
B. Speak slowly and use teach-back
C. Provide pamphlets with small print
D. “You’ll be fine” assurances
Answer: B
Rationale: Teach-back confirms comprehension and tailoring
pace. A may embarrass, C is unreadable, D is dismissive.
15. An APP supervising an unlicensed assistive
personnel (UAP) must:
A. Delegate medication prescribing
B. Ensure UAP documents administration per protocol
C. Allow UAP to adjust doses
D. Transfer prescribing authority entirely
Answer: B
Rationale: UAP can document per standing orders;
prescribing/dose adjustment is prescriber’s role.
16. Which factor is most important when choosing
between two equivalent medications?
A. Marketing support
B. Patient’s insurance coverage
