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Chapter 1. The Role of the Nurse Practitioner as Prescriber
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Identify the choice that best completes the statement or answers the question.
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1. The National Council of State Boards of Nursing T L T L L
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2. The U.S. Drug Enforcement Administration L
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3. The State Board of Nursing for each state L
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4. The State Board of Pharmacy T L T L T L T L
T L 2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber
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include: T L
1. Nurses know more about Pharmacology than other prescribers because they take it L
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both in their basic nursing program and in their APRN program.
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2. Nurses care for the patient from a holistic approach and include the patient in T L L
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decision making regarding their care.
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3. APRNs are less likely to prescribe narcotics and other controlled substances. L
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4. APRNs are able to prescribe independently in all states, whereas a physician’s L
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assistant needs to have a physician supervising their practice.
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T L 3. Clinical judgment in prescribing includes:
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1. Factoring in the cost to the patient of the medication prescribed L
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2. Always prescribing the newest medication available for the disease process L
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3. Handing out drug samples to poor patients L
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4. Prescribing all generic medications to cut costs T L T L L
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T L 4. Criteria for choosing an effective drug for a disorder include:
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1. Asking the patient what drug they think would work best for them T L L
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2. Consulting nationally recognized guidelines for disease management L
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3. Prescribing medications that are available as samples before writing a prescription L
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4. Following U.S. Drug Enforcement Administration guidelines for prescribing L
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T L 5. Nurse practitioner practice may thrive under health-care reform because of:
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1. The demonstrated ability of nurse practitioners to control costs and improve patient
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outcomes T L
2. The fact that nurse practitioners will be able to practice independently
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3. The fact that nurse practitioners will have full reimbursement under health-
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care reform T L
4. The ability to shift accountability for Medicaid to the state level
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,Chapter 1. The Role of the Nurse Practitioner as Prescriber
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Answer Section
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MULTIPLE CHOICE L
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1. ANS:
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2. ANS:
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3. ANS:
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4. ANS:
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5. ANS:
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,Chapter 2. Review of the Basic Principles of Pharmacology
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Multiple Choice L
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Identify the choice that best completes the statement or answers the question.
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T L 1. A patient’s nutritional intake and laboratory results reflect hypoalbuminemia. This is critical to
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prescribing because:
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1. Distribution of drugs to target tissue may be affected. L
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2. The solubility of the drug will not match the site of absorption. L
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3. There will be less free drug available to generate an effect. L
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4. Drugs bound to albumin are readily excreted by the kidneys. L
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T L 2. Drugs that have a significant first-pass effect:
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1. Must be given by the enteral (oral) route only L
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2. Bypass the hepatic circulation T L T L L
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3. Are rapidly metabolized by the liver and may have little if any desired action
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4. Are converted by the liver to more active and fat-soluble formsL
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T L T L 3. The route of excretion of a volatile drug will likely be the:
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1. Kidneys
2. Lungs
3. Bile and feces L
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4. Skin
T L 4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage
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reservoir of the drug. Storage reservoirs:
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1. Assure that the drug will reach its intended target tissue T L L
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2. Are the reason for giving loading doses L
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3. Increase the length of time a drug is available and active L
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4. Are most common in collagen tissues L
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T L T L 5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:
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1. Propensity to go to the target receptor T L T L T L T L L
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2. Biological half-life L
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3. Pharmacodynamics
4. Safety and side effects T L T L L
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T L 6. Azithromycin dosing requires that the first day’s dosage be twice those of the other 4 days of the
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prescription. This is considered a loading dose. A loading dose:
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1. Rapidly achieves drug levels in the therapeutic range T L L
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2. Requires four- to five-half-lives to attain L
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3. Is influenced by renal function L
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4. Is directly related to the drug circulating to the target tissues
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is the: T L T L
1. Minimum adverse effect level T L T L T L
2. Peak of action L
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, 3. Onset of action T L T L
4. Therapeutic range L
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T L 8. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:
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1. When the drug has a wide therapeutic range T L T L T L T L L
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2. When the drug will be administered for a short time only T L T L T L L
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3. When there is a high correlation between the dose and saturation of receptor sites T L L
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4. To determine if a drug is in the therapeutic range L
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T L T L 9. A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration.
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This means that the: L
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1. Concentration will produce therapeutic effects T L L
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2. Concentration will produce an adverse response T L T L L
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3. Time between doses must be shortened L
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4. Duration of action of the drug is too long T L T L T L L
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T L 10. Drugs that are receptor agonists may demonstrate what property?
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1. Irreversible binding to the drug receptor site T L T L T L T L L
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2. Upregulation with chronic use T L L
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3. Desensitization or downregulation with continuous use T L T L L
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4. Inverse relationship between drug concentration and drug action L
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T L 11. Drugs that are receptor antagonists, such as beta blockers, may cause:
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1. Downregulation of the drug receptor T L T L T L T L
2. An exaggerated response if abruptly discontinued L
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3. Partial blockade of the effects of agonist drugs L
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4. An exaggerated response to competitive drug agonists L
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1. Liver enzyme activity L
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2. Protein-binding properties of the drug molecule T L T L L
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3. Lipid solubility of the drug T L T L T L T L
4. Ability to chew and swallow T L T L T L L
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T L 13. Drugs administered via IV:
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1. Need to be lipid soluble in order to be easily absorbed T L T L L
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2. Begin distribution into the body immediately L
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3. Are easily absorbed if they are nonionized L
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4. May use pinocytosis to be absorbed L
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1. The sum of the effects of each drug individually L
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2. Greater than the sum of the effects of each drug individually T L T L L
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3. Less than the effect of each drug individually L
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4. Not predictable, as it varies with each individual L
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1. Bioavailability issues are especially important for drugs with narrow therapeutic L
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ranges or sustained-release mechanisms.
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2. All brands of a drug have the same bioavailability. L
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3. Drugs that are administered more than once a day have greater bioavailability than L
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