Lehne’s Pharmacotherapeutics 3rd Edition
-Advanced Practice Nurses and Physician
Assistants Complete Study Guide PDF
A patient is prescribed metronidazole for bacterial vaginosis. Which patient
history finding
would be most concerning to the provider?
The patient drinks two glasses of wine every night.
A patient reports that a medication prescribed for recurrent migraine
headaches is not
working. Which action is the prescriber's priority when addressing the
patient's concern?
Ask the patient about the number and frequency of tablets taken.
Which factor best supports an increase for full prescriptive authority for both
advanced
practice registered nurses (APRNs) and physician assistants (PAs)?
More patients will have access to health care.
A pediatric patient prescribed ampicillin for streptococcal pharyngitis reports
new onset of a
pruritic, dull red, maculopapular rash on the chest and neck. Which action is
most important
for the provider to take to minimize this patient's risk for injury?
Discontinue the ampicillin.
Which prescriber action will have the greatest impact on the patient's
commitment to adherence to any type of medication therapy?
Providing medication education that the patient can easily understand
When prescribing lovastatin, what will a provider advise to decrease the risk
of developing
muscle toxicity?
Substitute grapefruit juice with orange juice.
A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a
CYP3A4 inducing
drug is prescribed, what drug adjustment may be necessary to maintain a
therapeutic level of CYP3A4 substrate?
Increase dosage of the CYP3A4 substrate.
,A patient who has been taking sertraline for depression was prescribed
azithromycin to treat an infection by a provider at an after-hours clinic. What
action will the primary care provider take to address the risk this
combination of medication has posed for the patient?
Discontinue the azithromycin and write an order for an alternative antibiotic.
A provider considers prescribing tamoxifen for a woman with breast cancer.
Upon
reviewing results of genetic testing, the prescriber notes that the patient has
variations in the CYP2Dy allele resulting in a deficiency of the CYP2D6
isoenzymes. What action will this deficiency warrant in the prescribing of
tamoxifen, a CYP2D6 substrate?
The tamoxifen will not be prescribed
When considering the benefit of pharmacogenomics, what information should
the prescriber include when prescribing a new medication?
Provide definitions and possible examples of related idiosyncratic responses to this
medication.
A provider speaking to a class or a group of pregnant patients correctly
teaches that the
highest risk of teratogen-induced gross malformations exists during which
time period?
During the first trimester
A woman who breastfeeds her infant must take a prescription medication for
2 weeks. The medication is safe, but the patient wants to make sure her baby
receives as little of the drug as possible. What instructions will the prescriber
give the patient to best address her concerns?
"Take the medication immediately after breastfeeding your baby."
Which type of medication prescribed to a pregnant patient is more likely to
have effects on her fetus?
Lipid-soluble drugs
An infant developed a pruritic rash following exposure to an allergen. The
infant's parents
ask the provider about using a topical antihistamine. What information
should the provider use to address the parents' question?
Applying an antihistamine to the skin can cause toxicity in this age group.
The parents of a child with asthma ask the provider why their child cannot
use oral
corticosteroids more often, because they are so effective. The provider will
base the
discussion with the parents on what fact concerning oral corticosteroids?
Chronic glucocorticoid use can inhibit physical growth.
, A medication prescribed for a neonate is eliminated primarily by hepatic
metabolism. What action will the prescriber take to minimize risk to the
infant?
Prescribe a dose that is relatively lower than an adult dose when adjusted for body
surface area.
A 5-year-old has gray teeth. When taking a medication history, the provider
will ask about previous use of which group of medications?
Tetracyclines
An older adult patient with a history of forgetfulness will need to take
multiple drugs after discharge from the hospital. What provider action will
most successfully promote medication adherence in a forgetful patient?
Schedule medications to be taken at the same times as much as possible.
A provider is reviewing an older adult patient's chart during a routine visit.
Which patient information is of most concern regarding the renewing of
medication prescriptions for highly protein-bound drugs?
Low serum albumin
Four older adult patients are taking multiple medications. For which patient
is the provider most concerned about the risk for adverse drug effects?
An underweight patient with a chronically low appetite
An older adult patient who lives alone and admits to being "somewhat
forgetful" has an
overactive bladder (OAB) and occasional constipation. The patient has tried
behavioral
therapy to treat the OAB without success. Which treatment will the provider
likely prescribe
for this patient?
Oxybutynin [Oxytrol] transdermal patch
The prescriber has ordered neostigmine for a patient with myasthenia gravis.
What
physiological process would be assessed to best assure patient safety and the
long-term
effectiveness of the medication therapy?
The patient's current swallowing ability
The provider is assessing an older adult male patient prior to beginning a
prescribed anticholinergic drug. Which question concerning preexisting
conditions demonstrates the provider's understanding of possible
contraindications to this therapy?
"Do you have any vision problems that require a prescribed medication?"
A client is about to begin anticholinergic medication therapy. What
instructions will the provider give to best minimize common side effects?
-Advanced Practice Nurses and Physician
Assistants Complete Study Guide PDF
A patient is prescribed metronidazole for bacterial vaginosis. Which patient
history finding
would be most concerning to the provider?
The patient drinks two glasses of wine every night.
A patient reports that a medication prescribed for recurrent migraine
headaches is not
working. Which action is the prescriber's priority when addressing the
patient's concern?
Ask the patient about the number and frequency of tablets taken.
Which factor best supports an increase for full prescriptive authority for both
advanced
practice registered nurses (APRNs) and physician assistants (PAs)?
More patients will have access to health care.
A pediatric patient prescribed ampicillin for streptococcal pharyngitis reports
new onset of a
pruritic, dull red, maculopapular rash on the chest and neck. Which action is
most important
for the provider to take to minimize this patient's risk for injury?
Discontinue the ampicillin.
Which prescriber action will have the greatest impact on the patient's
commitment to adherence to any type of medication therapy?
Providing medication education that the patient can easily understand
When prescribing lovastatin, what will a provider advise to decrease the risk
of developing
muscle toxicity?
Substitute grapefruit juice with orange juice.
A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a
CYP3A4 inducing
drug is prescribed, what drug adjustment may be necessary to maintain a
therapeutic level of CYP3A4 substrate?
Increase dosage of the CYP3A4 substrate.
,A patient who has been taking sertraline for depression was prescribed
azithromycin to treat an infection by a provider at an after-hours clinic. What
action will the primary care provider take to address the risk this
combination of medication has posed for the patient?
Discontinue the azithromycin and write an order for an alternative antibiotic.
A provider considers prescribing tamoxifen for a woman with breast cancer.
Upon
reviewing results of genetic testing, the prescriber notes that the patient has
variations in the CYP2Dy allele resulting in a deficiency of the CYP2D6
isoenzymes. What action will this deficiency warrant in the prescribing of
tamoxifen, a CYP2D6 substrate?
The tamoxifen will not be prescribed
When considering the benefit of pharmacogenomics, what information should
the prescriber include when prescribing a new medication?
Provide definitions and possible examples of related idiosyncratic responses to this
medication.
A provider speaking to a class or a group of pregnant patients correctly
teaches that the
highest risk of teratogen-induced gross malformations exists during which
time period?
During the first trimester
A woman who breastfeeds her infant must take a prescription medication for
2 weeks. The medication is safe, but the patient wants to make sure her baby
receives as little of the drug as possible. What instructions will the prescriber
give the patient to best address her concerns?
"Take the medication immediately after breastfeeding your baby."
Which type of medication prescribed to a pregnant patient is more likely to
have effects on her fetus?
Lipid-soluble drugs
An infant developed a pruritic rash following exposure to an allergen. The
infant's parents
ask the provider about using a topical antihistamine. What information
should the provider use to address the parents' question?
Applying an antihistamine to the skin can cause toxicity in this age group.
The parents of a child with asthma ask the provider why their child cannot
use oral
corticosteroids more often, because they are so effective. The provider will
base the
discussion with the parents on what fact concerning oral corticosteroids?
Chronic glucocorticoid use can inhibit physical growth.
, A medication prescribed for a neonate is eliminated primarily by hepatic
metabolism. What action will the prescriber take to minimize risk to the
infant?
Prescribe a dose that is relatively lower than an adult dose when adjusted for body
surface area.
A 5-year-old has gray teeth. When taking a medication history, the provider
will ask about previous use of which group of medications?
Tetracyclines
An older adult patient with a history of forgetfulness will need to take
multiple drugs after discharge from the hospital. What provider action will
most successfully promote medication adherence in a forgetful patient?
Schedule medications to be taken at the same times as much as possible.
A provider is reviewing an older adult patient's chart during a routine visit.
Which patient information is of most concern regarding the renewing of
medication prescriptions for highly protein-bound drugs?
Low serum albumin
Four older adult patients are taking multiple medications. For which patient
is the provider most concerned about the risk for adverse drug effects?
An underweight patient with a chronically low appetite
An older adult patient who lives alone and admits to being "somewhat
forgetful" has an
overactive bladder (OAB) and occasional constipation. The patient has tried
behavioral
therapy to treat the OAB without success. Which treatment will the provider
likely prescribe
for this patient?
Oxybutynin [Oxytrol] transdermal patch
The prescriber has ordered neostigmine for a patient with myasthenia gravis.
What
physiological process would be assessed to best assure patient safety and the
long-term
effectiveness of the medication therapy?
The patient's current swallowing ability
The provider is assessing an older adult male patient prior to beginning a
prescribed anticholinergic drug. Which question concerning preexisting
conditions demonstrates the provider's understanding of possible
contraindications to this therapy?
"Do you have any vision problems that require a prescribed medication?"
A client is about to begin anticholinergic medication therapy. What
instructions will the provider give to best minimize common side effects?
