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 j 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.
j j j j j j j
2. Nursescareforthepatientfromaholisticapproachandincludethepatientindecisionmaking j
regardingtheircare.
j
3. APRNsarelesslikelyto prescribenarcoticsandothercontrolledsubstances.
j
4. APRNsareabletoprescribeindependentlyinallstates,whereasaphysician'sassistantneeds tohavea j
physiciansupervising their practice. - Correct Answer - 2. Nurses care for the patient from a holistic
j j j j j 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 j B
2. Alwaysprescribingthenewestmedicationavailable for thediseaseprocess j j
3. Handingoutdrugsamplestopoorpatients j
4. Prescribingallgenericmedicationstocutcosts - Correct Answer - 1. Factoring in the cost to the j j v v v v v v v v v vv
patient of the medication prescribed
v v v v
1
,Criteriaforchoosing aneffectivedrugforadisorderinclude:
j
1. Askingthepatientwhatdrugtheythinkwouldwork bestforthem j B
2. Consultingnationallyrecognizedguidelinesfordiseasemanagement
3. Prescribingmedicationsthat areavailableas samples beforewritingaprescription
j j j
4. FollowingU.S.DrugEnforcementAdministration guidelinesforprescribing - Correct Answer - 2. j j j v v v vv
Consulting nationally recognized guidelines for disease management
v v v v v v
Nursepractitionerpracticemay thriveunderhealth-carereformbecauseof: j
1. Thedemonstratedabilityofnursepractitionerstocontrolcostsandimprovepatientoutcomes
2. Thefactthatnursepractitionerswillbeabletopracticeindependently
3. Thefact thatnursepractitionerswillhave fullreimbursementunderhealth-carereform
j j j
4.TheabilitytoshiftaccountabilityforMedicaidtothestatelevel -Correct Answer - 1. The
j j j v v v v
Apatient'snutritionalintakeandlaboratoryresultsreflecthypoalbuminemia.Thisis critical
j j j
toprescribingbecause:
j
1. Distributionofdrugstotarget tissuemaybeaffected. j
2. Thesolubilityofthedrugwill notmatchthe siteof absorption. j j j
3. Therewillbeless freedrugavailableto generateaneffect.
v j
4. Drugs boundtoalbuminarereadilyexcretedbythekidneys.-Correct Answer - 1. Distribution of drugs to
j v v v v v v v
target tissue may be affected.
v v v v v
Drugsthathaveasignificantfirst-pass effect: j
1. Mustbegivenbytheenteral(oral)routeonly
2. Bypassthehepaticcirculation
3. Arerapidlymetabolizedby theliverandmayhavelittleifanydesiredaction
j
2
,4. Areconvertedbythelivertomoreactiveandfat-solubleforms - Correct Answer - 3. Are rapidly j j j 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.Storage reservoirs:
j j j
1. Assurethatthedrugwillreach itsintendedtarget tissue j j
2. Arethereasonforgivingloadingdoses
3. Increasethelengthoftime adrugis availableandactive j j
4. Aremostcommonincollagentissues- Correct Answer - 3. Increase the length of time a drug is B j v v v v v v v v v v v vv
available and active v v
TheNPchoosestogivecephalexinevery8hours basedonknowledgeofthedrug's: j
1. Propensitytogotothetargetreceptor
2. Biological half-life j
3. Pharmacodynamics
4. Safetyandsideeffects-Correct Answer - 2. Biological half-life v v v v v
Azithromycindosingrequiresthatthefirstday'sdosagebetwicethoseoftheother4daysoftheprescription. This j j j j
isconsidered a loading dose. A loadingdose:
j j j j j j j
1. Rapidlyachievesdruglevelsinthetherapeuticrange j
2. Requiresfour-to five-half-livestoattain j
3. Isinfluencedbyrenalfunction
4. Isdirectlyrelatedtothedrugcirculatingtothetargettissues -Correct Answer - 1. Rapidly achieves
j j j 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:
j j j
1. Whenthedrughasawidetherapeuticrange
B
2. Whenthedrugwillbeadministeredforashorttimeonly
j
3. Whenthereisahighcorrelationbetweenthedoseandsaturationofreceptorsites
4. Todetermineifadrug isinthetherapeuticrange - Correct Answer - 4. To determine if a drug is in the
j j j v v v v v v v v v v v vv
therapeutic range
v
Alaboratoryresultindicatesthatthepeaklevelfora drug is abovetheminimum toxicconcentration. Thismeans
B j B j j
thatthe:
j
1. Concentrationwillproducetherapeuticeffects
j
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
j
2. Upregulationwithchronicuse
3. Desensitizationordownregulationwithcontinuoususe
4. Inverserelationshipbetweendrugconcentrationanddrugaction- Correct Answer - 3. Desensitization or j 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 j 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.
j j j j j j j
2. Nursescareforthepatientfromaholisticapproachandincludethepatientindecisionmaking j
regardingtheircare.
j
3. APRNsarelesslikelyto prescribenarcoticsandothercontrolledsubstances.
j
4. APRNsareabletoprescribeindependentlyinallstates,whereasaphysician'sassistantneeds tohavea j
physiciansupervising their practice. - Correct Answer - 2. Nurses care for the patient from a holistic
j j j j j 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 j B
2. Alwaysprescribingthenewestmedicationavailable for thediseaseprocess j j
3. Handingoutdrugsamplestopoorpatients j
4. Prescribingallgenericmedicationstocutcosts - Correct Answer - 1. Factoring in the cost to the j j v v v v v v v v v vv
patient of the medication prescribed
v v v v
1
,Criteriaforchoosing aneffectivedrugforadisorderinclude:
j
1. Askingthepatientwhatdrugtheythinkwouldwork bestforthem j B
2. Consultingnationallyrecognizedguidelinesfordiseasemanagement
3. Prescribingmedicationsthat areavailableas samples beforewritingaprescription
j j j
4. FollowingU.S.DrugEnforcementAdministration guidelinesforprescribing - Correct Answer - 2. j j j v v v vv
Consulting nationally recognized guidelines for disease management
v v v v v v
Nursepractitionerpracticemay thriveunderhealth-carereformbecauseof: j
1. Thedemonstratedabilityofnursepractitionerstocontrolcostsandimprovepatientoutcomes
2. Thefactthatnursepractitionerswillbeabletopracticeindependently
3. Thefact thatnursepractitionerswillhave fullreimbursementunderhealth-carereform
j j j
4.TheabilitytoshiftaccountabilityforMedicaidtothestatelevel -Correct Answer - 1. The
j j j v v v v
Apatient'snutritionalintakeandlaboratoryresultsreflecthypoalbuminemia.Thisis critical
j j j
toprescribingbecause:
j
1. Distributionofdrugstotarget tissuemaybeaffected. j
2. Thesolubilityofthedrugwill notmatchthe siteof absorption. j j j
3. Therewillbeless freedrugavailableto generateaneffect.
v j
4. Drugs boundtoalbuminarereadilyexcretedbythekidneys.-Correct Answer - 1. Distribution of drugs to
j v v v v v v v
target tissue may be affected.
v v v v v
Drugsthathaveasignificantfirst-pass effect: j
1. Mustbegivenbytheenteral(oral)routeonly
2. Bypassthehepaticcirculation
3. Arerapidlymetabolizedby theliverandmayhavelittleifanydesiredaction
j
2
,4. Areconvertedbythelivertomoreactiveandfat-solubleforms - Correct Answer - 3. Are rapidly j j j 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.Storage reservoirs:
j j j
1. Assurethatthedrugwillreach itsintendedtarget tissue j j
2. Arethereasonforgivingloadingdoses
3. Increasethelengthoftime adrugis availableandactive j j
4. Aremostcommonincollagentissues- Correct Answer - 3. Increase the length of time a drug is B j v v v v v v v v v v v vv
available and active v v
TheNPchoosestogivecephalexinevery8hours basedonknowledgeofthedrug's: j
1. Propensitytogotothetargetreceptor
2. Biological half-life j
3. Pharmacodynamics
4. Safetyandsideeffects-Correct Answer - 2. Biological half-life v v v v v
Azithromycindosingrequiresthatthefirstday'sdosagebetwicethoseoftheother4daysoftheprescription. This j j j j
isconsidered a loading dose. A loadingdose:
j j j j j j j
1. Rapidlyachievesdruglevelsinthetherapeuticrange j
2. Requiresfour-to five-half-livestoattain j
3. Isinfluencedbyrenalfunction
4. Isdirectlyrelatedtothedrugcirculatingtothetargettissues -Correct Answer - 1. Rapidly achieves
j j j 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:
j j j
1. Whenthedrughasawidetherapeuticrange
B
2. Whenthedrugwillbeadministeredforashorttimeonly
j
3. Whenthereisahighcorrelationbetweenthedoseandsaturationofreceptorsites
4. Todetermineifadrug isinthetherapeuticrange - Correct Answer - 4. To determine if a drug is in the
j j j v v v v v v v v v v v vv
therapeutic range
v
Alaboratoryresultindicatesthatthepeaklevelfora drug is abovetheminimum toxicconcentration. Thismeans
B j B j j
thatthe:
j
1. Concentrationwillproducetherapeuticeffects
j
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
j
2. Upregulationwithchronicuse
3. Desensitizationordownregulationwithcontinuoususe
4. Inverserelationshipbetweendrugconcentrationanddrugaction- Correct Answer - 3. Desensitization or j v v v v v
downregulation with continuous use
v v v v
pg.4
