&Answers, Rationales & Advanced Nursing
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Nurse practitioner practice may thrive under health-care reform due
to:
A. The demonstrated ability of nurse practitioners to control costs
and improve patient outcomes
B. The fact that nurse practitioners will be able to practice
independently
C. The fact that nurse practitioners will have full reimbursement
under health-care reform
D. The ability to shift accountability for Medicaid to the state level
ANSWER: A. The demonstrated ability of nurse practitioners to
control costs and improve patient outcomes
Criteria for choosing an effective drug for a disorder include:
A. Asking the patient what drug they think would work best for them
B. Consulting nationally recognized guidelines for disease
management
C. Prescribing medications that are available as samples before
writing a prescription
D. Following U.S. Drug Enforcement Administration (DEA) guidelines
for prescribing
,ANSWER: B. Consulting nationally recognized guidelines for disease
management
Nurse practitioner prescriptive authority is regulated by:
A. The National Council of State Boards of Nursing
B. The U.S. Drug Enforcement Administration
C. The State Board of Nursing for each state
D. The State Board of Pharmacy
ANSWER: C. The State Board of Nursing for each state
Physician Assistant (PA) prescriptive authority is regulated by:
A. The National Council of State Boards of Nursing
B. The U.S. Drug Enforcement Administration
C. The State Board of Nursing
D. The State Board of Medical Examiners
ANSWER: D. The State Board of Medical Examiners
Clinical judgment in prescribing includes:
A. Factoring in the cost to the patient of the medication prescribed
B. Always prescribing the newest medication available for the
disease process C. Handing out drug samples to poor patients
D. Prescribing all generic medications to cut costs
ANSWER: A. Factoring in the cost to the patient of the medication
prescribed
A patient's nutritional intake and lab work reflects hypoalbuminemia.
This is critical to prescribing because:
A. Distribution of drugs to target tissue may be affected
B. The solubility of the drug will not match the site of absorption
C. There will be less free drug available to generate an effect
D. Drugs bound to albumin are readily excreted by the kidney
ANSWER: A. Distribution of drugs to target tissue may be affected
Drugs that have a significant first-pass effect: A. Must be given by
the enteral (oral) route only
,B. Bypass the hepatic circulation
C. Are rapidly metabolized by the liver and may have little if any
desired action
D. Are converted by the liver to more active and fat-soluble forms
ANSWER: C. Are rapidly metabolized by the liver and may have little
if any desired action
The route of excretion of a volatile drug will likely be:
A. The kidneys
B. The lungs
C. The bile and feces
D. The skin
ANSWER: B. The lungs
Medroxyprogesterone (Depo Provera) is prescribed IM to create a
storage reservoir of the drug. Storage reservoirs:
A. Assure that the drug will reach its intended target tissue
B. Are the reason for giving loading doses
C. Increase the length of time a drug is available and active
D. Are most common in collagen tissues
ANSWER: C. Increase the length of time a drug is available and
active
The NP chooses to give cephalexin every 8 hours based on
knowledge of the drug's:
A. Propensity to go to the target receptor
B. Biological half-life
C. Pharmacodynamics
D. Safety and side effects
ANSWER: B. Biological half-life
Azithromycin dosing requires the first day's dose be twice those of
the other 4 days of the prescription. This is considered a loading
dose. A loading dose: A. Rapidly achieves drug levels in the
therapeutic range
, B. Requires four to five half-lives to attain
C. Is influenced by renal function
D. Is directly related to the drug circulating to the target tissues
ANSWER: A. Rapidly achieves drug levels in the therapeutic range
The point in time on the drug concentration curve that indicates the
first sign of a therapeutic effect is the:
A. Minimum adverse effect level
B. Peak of action
C. Onset of action
D. Therapeutic range
ANSWER: C. Onset of action
Phenytoin requires a trough level be drawn. Peak and trough levels
are done: A. When the drug has a wide therapeutic range
B. When the drug will be administered for a short time only
C. When there is a high correlation between the dose and saturation
of receptor sites
D. To determine if a drug is in the therapeutic range
ANSWER: D. To determine if a drug is in the therapeutic range
A laboratory result indicates the peak level for a drug is above the
minimum toxic concentration. This means that the:
A. Concentration will produce therapeutic effects
B. Concentration will produce an adverse response
C. Time between doses must be shortened
D. Duration of action of the drug is too long
ANSWER: B. Concentration will produce an adverse response
Drugs that are receptor agonists may demonstrate what property?
A. Irreversible binding to the drug receptor site
B. Up-regulation with chronic use
C. Desensitization or down-regulation with continuous use
D. Inverse relationship between drug concentration and drug action