Pharmacotherapeutics for Advanced Practice
Nurse Prescribers with Davis Edge
6th Edition
TEST BANK
Reference: Ch. 1, Section: The Role of the Advanced Practice
Nurse as Prescriber
Question Stem: An APRN in a state that requires collaborative
practice agreements is evaluating whether she may
independently change a controlled opioid prescription dose for
a chronic pain patient. Which is the MOST appropriate first step
before making any prescription change?
A. Increase the dose if the patient reports higher pain without
checking the agreement.
B. Review the state-specific scope-of-practice regulations and
the collaborative agreement terms.
C. Change the prescription and notify the collaborating
physician afterward.
D. Refer the patient to a pain clinic and avoid changing
prescriptions.
Correct Answer: B
Rationales:
, • Correct (B): APRNs must follow state scope-of-practice
laws and any collaborative agreement provisions before
altering controlled substance prescriptions; this prevents
legal/regulatory violations and ensures safe, authorized
prescribing. (Aligns with Ch. 1 emphasis on
legal/regulatory responsibilities.)
• A: Incorrect—acting without checking legal requirements
risks unlawful prescribing and professional discipline.
• C: Incorrect—retroactive notification does not substitute
for required prior authorization under many state
regulations.
• D: Incorrect—while referral is sometimes appropriate, it’s
not the first step when addressing a prescribing decision
for a current patient.
Teaching Point: Always confirm state law and collaborative
agreement before modifying controlled prescriptions.
Citation: Woo, T. M., & Wright, W. L. (2024). Ch. 1, The Role of
the Advanced Practice Nurse as Prescriber. In
Pharmacotherapeutics for Advanced Practice Nurse Prescribers
(6th ed.). F.A. Davis. fadavis.com+1
2
Reference: Ch. 1, Section: Prescribing Process & Clinical
Decision-Making
,Question Stem: An APRN intends to start an ACE inhibitor for a
patient with hypertension. Which element of the prescribing
process is MOST critical to document before initiating therapy?
A. Patient’s favorite pharmacy.
B. Baseline renal function and serum potassium.
C. Patient’s family history of hypertension only.
D. Time of day the patient prefers to take medications.
Correct Answer: B
Rationales:
• Correct (B): ACE inhibitors can affect renal function and
potassium; baseline creatinine and potassium guide safe
initiation and monitoring. (Ch. 1 stresses safety-oriented
pre-prescribing assessments.)
• A: Incorrect—useful for logistics but not critical safety data
before starting an ACE inhibitor.
• C: Incorrect—family history is relevant to risk but not
essential immediate safety data for ACE inhibitor initiation.
• D: Incorrect—administration preference aids adherence
but is not the most critical safety baseline.
Teaching Point: Obtain baseline renal function and potassium
before initiating ACE inhibitors.
Citation: Woo & Wright, Ch. 1. fadavis.com+1
, 3
Reference: Ch. 1, Section: Evidence-Based Prescribing
Question Stem: While choosing between two equally effective
medications for the same condition, which criterion best
reflects evidence-based prescribing per APN standards?
A. Choose the cheaper drug regardless of adverse-effect profile.
B. Select the drug supported by high-quality evidence
demonstrating better safety or tolerability.
C. Pick the newest drug because it is more advanced.
D. Follow patient requests without discussing benefits or risks.
Correct Answer: B
Rationales:
• Correct (B): Evidence-based prescribing prioritizes high-
quality evidence for efficacy and safety, including
tolerability, when selecting between equivalent options.
(Ch. 1 highlights evidence-based decision-making.)
• A: Incorrect—cost matters, but safety/tolerability should
guide choice when efficacy is similar.
• C: Incorrect—newer does not always equal better; robust
evidence must support superiority.
• D: Incorrect—patient preferences matter, but informed
discussion of benefits/risks is essential for shared decision-
making.
Nurse Prescribers with Davis Edge
6th Edition
TEST BANK
Reference: Ch. 1, Section: The Role of the Advanced Practice
Nurse as Prescriber
Question Stem: An APRN in a state that requires collaborative
practice agreements is evaluating whether she may
independently change a controlled opioid prescription dose for
a chronic pain patient. Which is the MOST appropriate first step
before making any prescription change?
A. Increase the dose if the patient reports higher pain without
checking the agreement.
B. Review the state-specific scope-of-practice regulations and
the collaborative agreement terms.
C. Change the prescription and notify the collaborating
physician afterward.
D. Refer the patient to a pain clinic and avoid changing
prescriptions.
Correct Answer: B
Rationales:
, • Correct (B): APRNs must follow state scope-of-practice
laws and any collaborative agreement provisions before
altering controlled substance prescriptions; this prevents
legal/regulatory violations and ensures safe, authorized
prescribing. (Aligns with Ch. 1 emphasis on
legal/regulatory responsibilities.)
• A: Incorrect—acting without checking legal requirements
risks unlawful prescribing and professional discipline.
• C: Incorrect—retroactive notification does not substitute
for required prior authorization under many state
regulations.
• D: Incorrect—while referral is sometimes appropriate, it’s
not the first step when addressing a prescribing decision
for a current patient.
Teaching Point: Always confirm state law and collaborative
agreement before modifying controlled prescriptions.
Citation: Woo, T. M., & Wright, W. L. (2024). Ch. 1, The Role of
the Advanced Practice Nurse as Prescriber. In
Pharmacotherapeutics for Advanced Practice Nurse Prescribers
(6th ed.). F.A. Davis. fadavis.com+1
2
Reference: Ch. 1, Section: Prescribing Process & Clinical
Decision-Making
,Question Stem: An APRN intends to start an ACE inhibitor for a
patient with hypertension. Which element of the prescribing
process is MOST critical to document before initiating therapy?
A. Patient’s favorite pharmacy.
B. Baseline renal function and serum potassium.
C. Patient’s family history of hypertension only.
D. Time of day the patient prefers to take medications.
Correct Answer: B
Rationales:
• Correct (B): ACE inhibitors can affect renal function and
potassium; baseline creatinine and potassium guide safe
initiation and monitoring. (Ch. 1 stresses safety-oriented
pre-prescribing assessments.)
• A: Incorrect—useful for logistics but not critical safety data
before starting an ACE inhibitor.
• C: Incorrect—family history is relevant to risk but not
essential immediate safety data for ACE inhibitor initiation.
• D: Incorrect—administration preference aids adherence
but is not the most critical safety baseline.
Teaching Point: Obtain baseline renal function and potassium
before initiating ACE inhibitors.
Citation: Woo & Wright, Ch. 1. fadavis.com+1
, 3
Reference: Ch. 1, Section: Evidence-Based Prescribing
Question Stem: While choosing between two equally effective
medications for the same condition, which criterion best
reflects evidence-based prescribing per APN standards?
A. Choose the cheaper drug regardless of adverse-effect profile.
B. Select the drug supported by high-quality evidence
demonstrating better safety or tolerability.
C. Pick the newest drug because it is more advanced.
D. Follow patient requests without discussing benefits or risks.
Correct Answer: B
Rationales:
• Correct (B): Evidence-based prescribing prioritizes high-
quality evidence for efficacy and safety, including
tolerability, when selecting between equivalent options.
(Ch. 1 highlights evidence-based decision-making.)
• A: Incorrect—cost matters, but safety/tolerability should
guide choice when efficacy is similar.
• C: Incorrect—newer does not always equal better; robust
evidence must support superiority.
• D: Incorrect—patient preferences matter, but informed
discussion of benefits/risks is essential for shared decision-
making.
