Pharmacotherapeutics for Advanced Practice
Nurse Prescribers with Davis Edge
6th Edition
TEST BANK
Reference: Ch. 1, The Role of the Advanced Practice Nurse as
Prescriber — Prescriptive Authority & Scope
Question Stem: An experienced family nurse practitioner
evaluates a 68-year-old patient with multiple chronic conditions
who requests a benzodiazepine refill for insomnia. Which initial
action best reflects appropriate prescriptive practice?
A. Refill the benzodiazepine for 90 days to avoid patient
inconvenience.
B. Conduct focused assessment of sleep, comorbidities, and
medication list before deciding.
C. Substitute with a different sedative-hypnotic without
assessment because the patient reports benefit.
D. Refer immediately to a psychiatrist without any attempt to
manage in primary care.
Correct Answer: B
Rationales:
• Correct (B): The APRN must perform a focused clinical
assessment (sleep history, risk of dependence,
, interactions, comorbidities) prior to continuing controlled
or sedating medications; this aligns with safe prescribing
responsibilities.
• A: Inappropriate because long refills for benzodiazepines
without reassessment increase risk of dependence and
adverse effects.
• C: Substituting medications without assessment risks
interactions or inadequate treatment and bypasses clinical
judgment.
• D: Referral may be appropriate if needed, but immediate
referral without an initial assessment fails to use the
APRN’s scope and clinical judgment.
Teaching Point: Always assess clinical status and risks
before refilling sedative or controlled medications.
Citation: Woo & Wright, Ch. 1, Prescriptive Authority &
Scope.
2
Reference: Ch. 1, Prescribing Safety & Medication Reconciliation
Question Stem: A patient presents with a new prescription for
warfarin from the clinic. Which step best demonstrates safe
prescribing practices by the APRN at the point of care?
A. Prescribe warfarin and schedule INR in 3 months.
B. Check current medications including OTC/herbal, document
interactions, and plan initial INR monitoring.
,C. Tell the patient to stop all other medications to prevent
interactions.
D. Start warfarin at a fixed high dose to reach therapeutic INR
quickly.
Correct Answer: B
Rationales:
• Correct (B): Safe prescribing includes medication
reconciliation, identifying interactions (e.g., antibiotics,
herbal supplements), and planning timely INR monitoring
and dosing adjustments.
• A: Waiting 3 months for INR is unsafe; warfarin requires
frequent early INR checks.
• C: Advising blanket cessation of other meds is
inappropriate and unsafe without evaluation.
• D: High fixed dosing ignores individual factors (age,
comorbidities, drug interactions) and risks bleeding.
Teaching Point: Perform medication reconciliation and
arrange appropriate monitoring when initiating
anticoagulation.
Citation: Woo & Wright, Ch. 1, Prescribing Safety &
Medication Reconciliation.
3
Reference: Ch. 1, Legal, Ethical, and Professional
Responsibilities
, Question Stem: An APRN practicing in a state with collaborative
agreement requirements prescribes an opioid outside the
established collaborative protocol. Which is the best immediate
consequence for the APRN’s prescribing decision?
A. This is acceptable; collaborative agreements are optional.
B. The APRN may face professional/disciplinary action for
practicing outside the agreed scope.
C. The APRN should immediately cancel the collaborative
agreement.
D. There are no legal implications if the patient requests the
medication.
Correct Answer: B
Rationales:
• Correct (B): Prescribing outside state or collaborative
agreement requirements risks disciplinary action and
violates professional/legal obligations.
• A: False — collaborative agreements may be mandatory in
some jurisdictions and must be followed.
• C: Cancelling the agreement doesn’t justify the prior
inappropriate prescribing and could worsen regulatory risk.
• D: Patient request does not negate legal requirements or
professional responsibilities.
Teaching Point: Follow jurisdictional prescriptive authority
and collaborative agreements.
Citation: Woo & Wright, Ch. 1, Legal, Ethical, and
Professional Responsibilities.
Nurse Prescribers with Davis Edge
6th Edition
TEST BANK
Reference: Ch. 1, The Role of the Advanced Practice Nurse as
Prescriber — Prescriptive Authority & Scope
Question Stem: An experienced family nurse practitioner
evaluates a 68-year-old patient with multiple chronic conditions
who requests a benzodiazepine refill for insomnia. Which initial
action best reflects appropriate prescriptive practice?
A. Refill the benzodiazepine for 90 days to avoid patient
inconvenience.
B. Conduct focused assessment of sleep, comorbidities, and
medication list before deciding.
C. Substitute with a different sedative-hypnotic without
assessment because the patient reports benefit.
D. Refer immediately to a psychiatrist without any attempt to
manage in primary care.
Correct Answer: B
Rationales:
• Correct (B): The APRN must perform a focused clinical
assessment (sleep history, risk of dependence,
, interactions, comorbidities) prior to continuing controlled
or sedating medications; this aligns with safe prescribing
responsibilities.
• A: Inappropriate because long refills for benzodiazepines
without reassessment increase risk of dependence and
adverse effects.
• C: Substituting medications without assessment risks
interactions or inadequate treatment and bypasses clinical
judgment.
• D: Referral may be appropriate if needed, but immediate
referral without an initial assessment fails to use the
APRN’s scope and clinical judgment.
Teaching Point: Always assess clinical status and risks
before refilling sedative or controlled medications.
Citation: Woo & Wright, Ch. 1, Prescriptive Authority &
Scope.
2
Reference: Ch. 1, Prescribing Safety & Medication Reconciliation
Question Stem: A patient presents with a new prescription for
warfarin from the clinic. Which step best demonstrates safe
prescribing practices by the APRN at the point of care?
A. Prescribe warfarin and schedule INR in 3 months.
B. Check current medications including OTC/herbal, document
interactions, and plan initial INR monitoring.
,C. Tell the patient to stop all other medications to prevent
interactions.
D. Start warfarin at a fixed high dose to reach therapeutic INR
quickly.
Correct Answer: B
Rationales:
• Correct (B): Safe prescribing includes medication
reconciliation, identifying interactions (e.g., antibiotics,
herbal supplements), and planning timely INR monitoring
and dosing adjustments.
• A: Waiting 3 months for INR is unsafe; warfarin requires
frequent early INR checks.
• C: Advising blanket cessation of other meds is
inappropriate and unsafe without evaluation.
• D: High fixed dosing ignores individual factors (age,
comorbidities, drug interactions) and risks bleeding.
Teaching Point: Perform medication reconciliation and
arrange appropriate monitoring when initiating
anticoagulation.
Citation: Woo & Wright, Ch. 1, Prescribing Safety &
Medication Reconciliation.
3
Reference: Ch. 1, Legal, Ethical, and Professional
Responsibilities
, Question Stem: An APRN practicing in a state with collaborative
agreement requirements prescribes an opioid outside the
established collaborative protocol. Which is the best immediate
consequence for the APRN’s prescribing decision?
A. This is acceptable; collaborative agreements are optional.
B. The APRN may face professional/disciplinary action for
practicing outside the agreed scope.
C. The APRN should immediately cancel the collaborative
agreement.
D. There are no legal implications if the patient requests the
medication.
Correct Answer: B
Rationales:
• Correct (B): Prescribing outside state or collaborative
agreement requirements risks disciplinary action and
violates professional/legal obligations.
• A: False — collaborative agreements may be mandatory in
some jurisdictions and must be followed.
• C: Cancelling the agreement doesn’t justify the prior
inappropriate prescribing and could worsen regulatory risk.
• D: Patient request does not negate legal requirements or
professional responsibilities.
Teaching Point: Follow jurisdictional prescriptive authority
and collaborative agreements.
Citation: Woo & Wright, Ch. 1, Legal, Ethical, and
Professional Responsibilities.
