TestBankforPharmacotherapeuticsforAdvancedPracticeA
PracticalApproach5thEditionByVirginiaPooleArcangelo,
B
B AndrewMPeterson,VeronicaWilbur, Tep M.Kang/All
B B B B B B B B
B ChaptersCovered–LatestUpdate2024.
Nursepractitionerprescriptiveauthorityisregulatedby:
1. TheNationalCouncilofStateBoardsofNursing
2. TheU.S.DrugEnforcement Administration v
3. TheStateBoardofNursingforeachstate
4. TheStateBoardofPharmacy - Correct Answer - 3. The State Board of Nursing for each state p v v v v v v v v v v v
ThebenefitstothepatientofhavinganAdvancedPracticeRegisteredNurse(APRN)prescriberinclude:
1. NursesknowmoreaboutPharmacologythanotherprescribersbecausetheytakeitbothintheirbasic
B B
nursing program and in their APRN program.
p p p p p p p
2. Nursescareforthepatientfromaholisticapproachandincludethepatientindecisionmaking p
regardingtheircare.
p
3. APRNsarelesslikelyto prescribenarcoticsandothercontrolledsubstances. p
4. APRNsareabletoprescribeindependentlyinallstates,whereasaphysician'sassistantneeds tohavea p
physiciansupervisingtheirpractice.- Correct Answer - 2. Nurses care for the patient from a holistic
p p p p p
v v v v v v v v v v v
approach and include the patient in decision making regarding their care.
v v v v v v v v v v v
Clinicaljudgmentinprescribingincludes:
1. Factoringi nthecosttothepatientofthemedicationprescribed
B p B
2. Alwaysprescribingthenewestmedicationavailable for thediseaseprocess p p
3. Handingoutdrugsamplestopoorpatients p
4. Prescribingallgenericmedicationstocutcosts - Correct Answer - 1. Factoring in the cost to the p p v v v v v v v v v vv
patient of the medication prescribed
v v v v
1
,Criteriaforchoosing aneffectivedrugforadisorderinclude:
p
1. Askingthepatientwhatdrugtheythinkwouldwork bestforthem p B
2. Consultingnationallyrecognizedguidelinesfordiseasemanagement
3. Prescribingmedicationsthat areavailableas samples beforewritingaprescription
p p p
4. FollowingU.S.DrugEnforcementAdministrationguidelinesforprescribing - Correct Answer - 2. p p p v v v vv
Consulting nationally recognized guidelines for disease management
v v v v v v
Nursepractitionerpracticemay thriveunderhealth-carereformbecauseof: p
1. Thedemonstratedabilityofnursepractitionerstocontrolcostsandimprovepatientoutcomes
2. Thefactthatnursepractitionerswillbeabletopracticeindependently
3. Thefact thatnursepractitionerswillhavefullreimbursementunderhealth-carereform
p p p
4.TheabilitytoshiftaccountabilityforMedicaidtothestatelevel -Correct Answer - 1. The
p p
p v v v v
Apatient'snutritionalintakeandlaboratoryresultsreflecthypoalbuminemia.Thisiscritical
p p p
toprescribingbecause:
p
1. Distributionofdrugstotarget tissuemaybeaffected. p
2. Thesolubilityofthedrugwill notmatchthe siteof absorption. p p p
3. Therewillbeless freedrugavailableto generateaneffect.
v p
4. Drugs boundtoalbuminarereadilyexcretedbythekidneys.-Correct Answer - 1. Distribution of drugs to
p v v v v v v v
target tissue may be affected.
v v v v v
Drugsthathaveasignificantfirst-pass effect: p
1. Mustbegivenbytheenteral(oral)routeonly
2. Bypassthehepaticcirculation
3. Arerapidlymetabolizedby theliverandmayhavelittleifanydesiredaction
p
2
,4. Areconvertedbythelivertomoreactiveandfat-solubleforms - Correct Answer - 3. Are rapidly p p p v v v v v vv
metabolized by the liver and may have little if any desired action
v v v v v v v v v v v
Therouteofexcretionofavolatiledrugwilllikelybethe:
1. Kidneys
2. Lungs
3. Bileandfeces
4. Skin - Correct Answer - 2. Lungs
v v v v v v
Medroxyprogesterone(DepoProvera)isprescribedintramuscularly(IM)tocreateastoragereservoirofthe
drug.Storagereservoirs:
p p p
1. Assurethatthedrugwillreach itsintendedtarget tissue p p
2. Arethereasonforgivingloadingdoses
3. Increasethelengthoftime adrugisavailableandactive p p
4. Aremostcommonincollagentissues- Correct Answer - 3. Increase the length of time a drug is B p v v v v v v v v v v v vv
available and active v v
TheNPchoosestogivecephalexinevery8hours basedonknowledgeofthedrug's: p
1. Propensitytogotothetargetreceptor
2. Biologicalhalf-life p
3. Pharmacodynamics
4. Safetyandsideeffects-Correct Answer - 2. Biological half-life v v v v v
Azithromycindosingrequiresthatthefirstday'sdosagebetwicethoseoftheother4daysoftheprescription. This p p p p
isconsidered a loadingdose. A loadingdose:
p p p p p p p
1. Rapidlyachievesdruglevelsinthetherapeuticrange p
2. Requiresfour-to five-half-livestoattain p
3. Isinfluencedbyrenalfunction
4. Isdirectlyrelatedtothedrugcirculatingtothetargettissues -Correct Answer - 1. Rapidly achieves
p p p v v v v v vv
drug levels in the therapeutic range
v v v v v
3
, Thepointintimeonthedrugconcentrationcurvethatindicatesthefirstsignofatherapeuticeffectisthe: B
1. Minimumadverseeffectlevel
2. Peakofaction
3. Onsetofaction
4. Therapeuticrange-Correct Answer - 3. Onset of action
v v v v v v
Phenytoinrequiresthatatroughlevelbe drawn.Peakandtroughlevels are done:
p p p
1. Whenthedrughasawidetherapeuticrange
B
2. Whenthedrugwillbeadministeredforashorttimeonly
p
3. Whenthereisahighcorrelationbetweenthedoseandsaturationofreceptorsites
4. Todetermineifadrug isinthetherapeuticrange -Correct Answer - 4. To determine if a drug is in the
p p p v v v v v v v v v v v vv
therapeutic range
v
Alaboratoryresultindicatesthatthepeaklevelfora drug is abovetheminimum toxicconcentration. Thismeans
B p B p p
thatthe:
p
1. Concentrationwillproducetherapeuticeffects
p
2. Concentrationwillproduceanadverseresponse
3. Timebetweendosesmustbeshortened
4. Durationofactionofthedrugistoolong- Correct Answer - 2. Concentration will produce an adverse
B v v v v v v v v
response
B
Drugsthatarereceptoragonistsmaydemonstratewhatproperty?
1. Irreversiblebindingto thedrugreceptorsite
p
2. Upregulationwithchronicuse
3. Desensitizationordownregulationwithcontinuoususe
4. Inverserelationshipbetweendrugconcentrationanddrugaction- Correct Answer - 3. Desensitization or p v v v v v
downregulation with continuous use
v v v v
pg.4
PracticalApproach5thEditionByVirginiaPooleArcangelo,
B
B AndrewMPeterson,VeronicaWilbur, Tep M.Kang/All
B B B B B B B B
B ChaptersCovered–LatestUpdate2024.
Nursepractitionerprescriptiveauthorityisregulatedby:
1. TheNationalCouncilofStateBoardsofNursing
2. TheU.S.DrugEnforcement Administration v
3. TheStateBoardofNursingforeachstate
4. TheStateBoardofPharmacy - Correct Answer - 3. The State Board of Nursing for each state p v v v v v v v v v v v
ThebenefitstothepatientofhavinganAdvancedPracticeRegisteredNurse(APRN)prescriberinclude:
1. NursesknowmoreaboutPharmacologythanotherprescribersbecausetheytakeitbothintheirbasic
B B
nursing program and in their APRN program.
p p p p p p p
2. Nursescareforthepatientfromaholisticapproachandincludethepatientindecisionmaking p
regardingtheircare.
p
3. APRNsarelesslikelyto prescribenarcoticsandothercontrolledsubstances. p
4. APRNsareabletoprescribeindependentlyinallstates,whereasaphysician'sassistantneeds tohavea p
physiciansupervisingtheirpractice.- Correct Answer - 2. Nurses care for the patient from a holistic
p p p p p
v v v v v v v v v v v
approach and include the patient in decision making regarding their care.
v v v v v v v v v v v
Clinicaljudgmentinprescribingincludes:
1. Factoringi nthecosttothepatientofthemedicationprescribed
B p B
2. Alwaysprescribingthenewestmedicationavailable for thediseaseprocess p p
3. Handingoutdrugsamplestopoorpatients p
4. Prescribingallgenericmedicationstocutcosts - Correct Answer - 1. Factoring in the cost to the p p v v v v v v v v v vv
patient of the medication prescribed
v v v v
1
,Criteriaforchoosing aneffectivedrugforadisorderinclude:
p
1. Askingthepatientwhatdrugtheythinkwouldwork bestforthem p B
2. Consultingnationallyrecognizedguidelinesfordiseasemanagement
3. Prescribingmedicationsthat areavailableas samples beforewritingaprescription
p p p
4. FollowingU.S.DrugEnforcementAdministrationguidelinesforprescribing - Correct Answer - 2. p p p v v v vv
Consulting nationally recognized guidelines for disease management
v v v v v v
Nursepractitionerpracticemay thriveunderhealth-carereformbecauseof: p
1. Thedemonstratedabilityofnursepractitionerstocontrolcostsandimprovepatientoutcomes
2. Thefactthatnursepractitionerswillbeabletopracticeindependently
3. Thefact thatnursepractitionerswillhavefullreimbursementunderhealth-carereform
p p p
4.TheabilitytoshiftaccountabilityforMedicaidtothestatelevel -Correct Answer - 1. The
p p
p v v v v
Apatient'snutritionalintakeandlaboratoryresultsreflecthypoalbuminemia.Thisiscritical
p p p
toprescribingbecause:
p
1. Distributionofdrugstotarget tissuemaybeaffected. p
2. Thesolubilityofthedrugwill notmatchthe siteof absorption. p p p
3. Therewillbeless freedrugavailableto generateaneffect.
v p
4. Drugs boundtoalbuminarereadilyexcretedbythekidneys.-Correct Answer - 1. Distribution of drugs to
p v v v v v v v
target tissue may be affected.
v v v v v
Drugsthathaveasignificantfirst-pass effect: p
1. Mustbegivenbytheenteral(oral)routeonly
2. Bypassthehepaticcirculation
3. Arerapidlymetabolizedby theliverandmayhavelittleifanydesiredaction
p
2
,4. Areconvertedbythelivertomoreactiveandfat-solubleforms - Correct Answer - 3. Are rapidly p p p v v v v v vv
metabolized by the liver and may have little if any desired action
v v v v v v v v v v v
Therouteofexcretionofavolatiledrugwilllikelybethe:
1. Kidneys
2. Lungs
3. Bileandfeces
4. Skin - Correct Answer - 2. Lungs
v v v v v v
Medroxyprogesterone(DepoProvera)isprescribedintramuscularly(IM)tocreateastoragereservoirofthe
drug.Storagereservoirs:
p p p
1. Assurethatthedrugwillreach itsintendedtarget tissue p p
2. Arethereasonforgivingloadingdoses
3. Increasethelengthoftime adrugisavailableandactive p p
4. Aremostcommonincollagentissues- Correct Answer - 3. Increase the length of time a drug is B p v v v v v v v v v v v vv
available and active v v
TheNPchoosestogivecephalexinevery8hours basedonknowledgeofthedrug's: p
1. Propensitytogotothetargetreceptor
2. Biologicalhalf-life p
3. Pharmacodynamics
4. Safetyandsideeffects-Correct Answer - 2. Biological half-life v v v v v
Azithromycindosingrequiresthatthefirstday'sdosagebetwicethoseoftheother4daysoftheprescription. This p p p p
isconsidered a loadingdose. A loadingdose:
p p p p p p p
1. Rapidlyachievesdruglevelsinthetherapeuticrange p
2. Requiresfour-to five-half-livestoattain p
3. Isinfluencedbyrenalfunction
4. Isdirectlyrelatedtothedrugcirculatingtothetargettissues -Correct Answer - 1. Rapidly achieves
p p p v v v v v vv
drug levels in the therapeutic range
v v v v v
3
, Thepointintimeonthedrugconcentrationcurvethatindicatesthefirstsignofatherapeuticeffectisthe: B
1. Minimumadverseeffectlevel
2. Peakofaction
3. Onsetofaction
4. Therapeuticrange-Correct Answer - 3. Onset of action
v v v v v v
Phenytoinrequiresthatatroughlevelbe drawn.Peakandtroughlevels are done:
p p p
1. Whenthedrughasawidetherapeuticrange
B
2. Whenthedrugwillbeadministeredforashorttimeonly
p
3. Whenthereisahighcorrelationbetweenthedoseandsaturationofreceptorsites
4. Todetermineifadrug isinthetherapeuticrange -Correct Answer - 4. To determine if a drug is in the
p p p v v v v v v v v v v v vv
therapeutic range
v
Alaboratoryresultindicatesthatthepeaklevelfora drug is abovetheminimum toxicconcentration. Thismeans
B p B p p
thatthe:
p
1. Concentrationwillproducetherapeuticeffects
p
2. Concentrationwillproduceanadverseresponse
3. Timebetweendosesmustbeshortened
4. Durationofactionofthedrugistoolong- Correct Answer - 2. Concentration will produce an adverse
B v v v v v v v v
response
B
Drugsthatarereceptoragonistsmaydemonstratewhatproperty?
1. Irreversiblebindingto thedrugreceptorsite
p
2. Upregulationwithchronicuse
3. Desensitizationordownregulationwithcontinuoususe
4. Inverserelationshipbetweendrugconcentrationanddrugaction- Correct Answer - 3. Desensitization or p v v v v v
downregulation with continuous use
v v v v
pg.4
