, CERTIFIED PHARMACOTHERAPEUTICS TEST
BANK: 2025 REVIEW BASED ON ARCANGELO &
PETERSON
📘 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 APRN practices in a state where prescriptive authority
requires physician collaboration. Which action best
demonstrates compliance?
A. Prescribing Schedule II opioids independently
B. Ordering lab tests without notifying the collaborating
physician
C. Consulting the collaborating physician before initiating a
controlled substance
D. Delegating prescription writing to nursing staff
Answer: C
Rationale: APRNs in collaborative states must involve the
collaborator in controlled-substance decisions. A and B
violate scope; D is unsafe and unethical.
2. Which element is essential when verifying a patient’s
understanding before prescribing a new medication?
A. Providing written information only
B. Asking the patient to repeat back key points
C. Scheduling a follow-up visit in six months
D. Relying on patient’s nod of approval
Answer: B
Rationale: Teach-back confirms comprehension. A alone
may be misunderstood; C and D do not ensure immediate
understanding.
,3. An APP considers prescribing an off-label medication
supported by recent RCTs. Ethical prescribing dictates
that the provider should:
A. Prescribe immediately based on literature
B. Inform the patient of off-label use and evidence, and
document consent
C. Wait until FDA officially approves
D. Rely on patient’s internet research to guide consent
Answer: B
Rationale: Patients must be informed of off-label status
and underlying evidence. A skips consent; C delays
beneficial therapy; D is unreliable.
4. To minimize polypharmacy, the APRN reviews a patient’s
medication list. Which finding warrants priority action?
A. Two antihypertensives with complementary
mechanisms
B. Duplicate PPI prescriptions from different providers
C. Statin plus aspirin for cardiovascular risk
D. Vitamin D supplement and dietary sources
Answer: B
Rationale: Duplicate therapy increases adverse effects. A
is often appropriate; C is guideline-based; D is benign.
5. An elderly patient struggles with taking pills. Which
intervention most improves adherence?
, A. Advising use of a pillbox organizer
B. Instructing patient to take all meds at once
C. Writing separate instructions for each medication
D. Switching to a more frequent dosing schedule
Answer: A
Rationale: Pillboxes simplify regimens. B risks interactions;
C may confuse; D worsens adherence.
6. State law limits APRN prescriptive authority to non-
controlled substances without delegation. Which
prescription requires additional oversight?
A. Prescribing amoxicillin for otitis media
B. Renewing a patient’s SSRI
C. Ordering hydrocodone for acute pain
D. Starting metformin for new diabetes
Answer: C
Rationale: Hydrocodone is Schedule II–V and requires
delegation or physician involvement under many state
laws.
7. When encountering a language barrier, the APP should
first:
A. Speak slowly in English
B. Use a professional medical interpreter
C. Rely on a bilingual family member
D. Provide translated drug sheet only
, Answer: B
Rationale: Professional interpreters ensure accuracy and
confidentiality. A may still fail; C risks misinterpretation; D
alone is insufficient.
8. An APP wants to prescribe an experimental drug.
According to evidence-based practice, the best source is:
A. A case report in a blog
B. A single-center observational study
C. A systematic review of RCTs
D. Manufacturer’s press release
Answer: C
Rationale: Systematic reviews of RCTs provide highest
quality evidence. A and B are lower levels; D is biased.
9. A patient expresses concern about cost of a new
medication. The APRN’s best response is to:
A. Proceed without discussion
B. Switch to oldest available therapy
C. Explore patient assistance programs and generics
D. Advise the patient to skip doses to save money
Answer: C
Rationale: Discussing affordability fosters adherence. A
ignores barriers; B may be less effective; D is unsafe.
,10. Which scenario represents a breach of provider
accountability?
A. Documenting rationale for prescribing
B. Ignoring a lab result indicating toxicity
C. Following state prescription-monitoring program rules
D. Reporting adverse drug events as required
Answer: B
Rationale: Ignoring toxicity endangers patients and
violates accountability. A, C, and D are responsible
behaviors.
11. To respect cultural beliefs about injections, the APP
should first:
A. Insist on standard practice
B. Acknowledge beliefs and explore alternatives
C. Provide no explanation
D. Delegate injection teaching to staff
Answer: B
Rationale: Cultural competence begins with
acknowledgment and shared decision-making. A and C
disregard patient values; D may fragment communication.
12. An APP reviews Beers Criteria before prescribing to
an 80-year-old. This action best exemplifies:
A. Polypharmacy avoidance
B. Provider accountability
, C. Evidence-based dosing
D. Cultural competence
Answer: A
Rationale: Beers Criteria identifies potentially
inappropriate meds in elderly, reducing polypharmacy
risks.
13. Which factor most directly contributes to poor
adherence in low–health-literacy patients?
A. Complex dosing schedules
B. Once‐daily dosing
C. Affordable copayments
D. Clear pictogram instructions
Answer: A
Rationale: Complexity confuses low-literacy patients. B
and D promote adherence; C improves access but literacy
remains barrier.
14. When interpreting state law on prescriptive
authority, the APP should:
A. Rely on national guidelines only
B. Consult the state board of nursing regulations
C. Use federal DEA rules exclusively
D. Follow hospital policy regardless of law
Answer: B
Rationale: State boards define scope. National guidelines
BANK: 2025 REVIEW BASED ON ARCANGELO &
PETERSON
📘 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 APRN practices in a state where prescriptive authority
requires physician collaboration. Which action best
demonstrates compliance?
A. Prescribing Schedule II opioids independently
B. Ordering lab tests without notifying the collaborating
physician
C. Consulting the collaborating physician before initiating a
controlled substance
D. Delegating prescription writing to nursing staff
Answer: C
Rationale: APRNs in collaborative states must involve the
collaborator in controlled-substance decisions. A and B
violate scope; D is unsafe and unethical.
2. Which element is essential when verifying a patient’s
understanding before prescribing a new medication?
A. Providing written information only
B. Asking the patient to repeat back key points
C. Scheduling a follow-up visit in six months
D. Relying on patient’s nod of approval
Answer: B
Rationale: Teach-back confirms comprehension. A alone
may be misunderstood; C and D do not ensure immediate
understanding.
,3. An APP considers prescribing an off-label medication
supported by recent RCTs. Ethical prescribing dictates
that the provider should:
A. Prescribe immediately based on literature
B. Inform the patient of off-label use and evidence, and
document consent
C. Wait until FDA officially approves
D. Rely on patient’s internet research to guide consent
Answer: B
Rationale: Patients must be informed of off-label status
and underlying evidence. A skips consent; C delays
beneficial therapy; D is unreliable.
4. To minimize polypharmacy, the APRN reviews a patient’s
medication list. Which finding warrants priority action?
A. Two antihypertensives with complementary
mechanisms
B. Duplicate PPI prescriptions from different providers
C. Statin plus aspirin for cardiovascular risk
D. Vitamin D supplement and dietary sources
Answer: B
Rationale: Duplicate therapy increases adverse effects. A
is often appropriate; C is guideline-based; D is benign.
5. An elderly patient struggles with taking pills. Which
intervention most improves adherence?
, A. Advising use of a pillbox organizer
B. Instructing patient to take all meds at once
C. Writing separate instructions for each medication
D. Switching to a more frequent dosing schedule
Answer: A
Rationale: Pillboxes simplify regimens. B risks interactions;
C may confuse; D worsens adherence.
6. State law limits APRN prescriptive authority to non-
controlled substances without delegation. Which
prescription requires additional oversight?
A. Prescribing amoxicillin for otitis media
B. Renewing a patient’s SSRI
C. Ordering hydrocodone for acute pain
D. Starting metformin for new diabetes
Answer: C
Rationale: Hydrocodone is Schedule II–V and requires
delegation or physician involvement under many state
laws.
7. When encountering a language barrier, the APP should
first:
A. Speak slowly in English
B. Use a professional medical interpreter
C. Rely on a bilingual family member
D. Provide translated drug sheet only
, Answer: B
Rationale: Professional interpreters ensure accuracy and
confidentiality. A may still fail; C risks misinterpretation; D
alone is insufficient.
8. An APP wants to prescribe an experimental drug.
According to evidence-based practice, the best source is:
A. A case report in a blog
B. A single-center observational study
C. A systematic review of RCTs
D. Manufacturer’s press release
Answer: C
Rationale: Systematic reviews of RCTs provide highest
quality evidence. A and B are lower levels; D is biased.
9. A patient expresses concern about cost of a new
medication. The APRN’s best response is to:
A. Proceed without discussion
B. Switch to oldest available therapy
C. Explore patient assistance programs and generics
D. Advise the patient to skip doses to save money
Answer: C
Rationale: Discussing affordability fosters adherence. A
ignores barriers; B may be less effective; D is unsafe.
,10. Which scenario represents a breach of provider
accountability?
A. Documenting rationale for prescribing
B. Ignoring a lab result indicating toxicity
C. Following state prescription-monitoring program rules
D. Reporting adverse drug events as required
Answer: B
Rationale: Ignoring toxicity endangers patients and
violates accountability. A, C, and D are responsible
behaviors.
11. To respect cultural beliefs about injections, the APP
should first:
A. Insist on standard practice
B. Acknowledge beliefs and explore alternatives
C. Provide no explanation
D. Delegate injection teaching to staff
Answer: B
Rationale: Cultural competence begins with
acknowledgment and shared decision-making. A and C
disregard patient values; D may fragment communication.
12. An APP reviews Beers Criteria before prescribing to
an 80-year-old. This action best exemplifies:
A. Polypharmacy avoidance
B. Provider accountability
, C. Evidence-based dosing
D. Cultural competence
Answer: A
Rationale: Beers Criteria identifies potentially
inappropriate meds in elderly, reducing polypharmacy
risks.
13. Which factor most directly contributes to poor
adherence in low–health-literacy patients?
A. Complex dosing schedules
B. Once‐daily dosing
C. Affordable copayments
D. Clear pictogram instructions
Answer: A
Rationale: Complexity confuses low-literacy patients. B
and D promote adherence; C improves access but literacy
remains barrier.
14. When interpreting state law on prescriptive
authority, the APP should:
A. Rely on national guidelines only
B. Consult the state board of nursing regulations
C. Use federal DEA rules exclusively
D. Follow hospital policy regardless of law
Answer: B
Rationale: State boards define scope. National guidelines
