The University of West Florida NGR 6172
Rosenthal: Lehne's Pharmacotherapeutics for Advanced
Practice Nurses and Physician Assistants exam with
question and answer 100% correct
Students also studie
C
Terms in this set (133)
An APRN works in a urology clinic under the ANS: B
supervision of a physician who does not The APRN has independent prescriptive authority because the
restrict the types of medications the APRN is regulating body does not require that the APRN work under
allowed to prescribe. State law does not physician supervision. Full prescriptive authority gives the
require the APRN to practice under provider the right to prescribe independently and without
physician supervision. How would the limitation. Limited authority places restrictions on the types of
APRN's prescriptive authority be described? drugs that can be prescribed.
A. Full authority DIF: Cognitive Level: ComprehensionREF: p. 1TOP: Nursing
B. Independent Process: I MSC: NCLEX Client Needs Category: Physiologic
C. Without limitation Integrity: Pharmacologic and Parenteral Therapies
D. Limited authority
Which factors increase the need for APRNs ANS: A
to have full prescriptive authority? Implementation of the Affordable Care Act has increased the
number of individuals with health care coverage, and thus
A. More patients will have access to health the number who have access to health care services. The
care. increase in the number of patients creates the need for more
B. Enrollment in medical schools is providers with prescriptive authority. APRNs can fill this
predicted to decrease. practice gap.
C. Physician's assistants are being utilized
less often. DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing
D. APRN education is more complex than Process: Implementation MSC: NCLEX Client Needs Category:
education for physicians. Physiologic Integrity: Pharmacologic and Parenteral Therapies
,Which factors could be attributed to limited ANS: A,B
prescriptive authority for APRNs? Select all Limiting prescriptive authority for APRNs can create barriers
that apply. to quality, affordable, and accessible patient care. It may also
lead to poor collaboration among providers and higher health
A. Inaccessibility of patient care care costs. It would not directly impact patient's health
B.Higher health care costs literacy.
C. Higher quality medical treatment
D.Improved collaborative care DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing
E. Enhanced health literacy Process: Implementation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Pharmacologic and Parenteral Therapies
Which aspects support the APRN's provision ANS: A,C,D
for full prescriptive authority? Select all that APRNs are educated to practice and prescribe independently
apply. without supervision. National examinations validate the ability
to provide safe and competent care. Licensure ensures
A. Clinical education includes prescription compliance with standards to promote public health and
of medications and disease processes. safety. Limited prescriptive authority creates numerous
B.Federal regulations support the provision barriers to quality, affordable, and accessible patient care.
of full authority for APRNs.
C. National examinations provide DIF: Cognitive Level: ComprehensionREF: pp. 1-2TOP: Nursing
validation of the APRN's ability to Process: Implementation MSC:
provide safe care.
D.Licensure ensures compliance with
health care and safety standards.
E. Limiting provision can decrease
health care affordability.
A family nurse practitioner practicing in ANS: A
Maine is hired at a practice across state Virginia allows limited prescriptive authority, while Maine
lines in Virginia. Which aspect of practice gives full authority to certified nurse practitioners. The
may change for the APRN? federal
government does not regulate prescriptive authority.
A. The APRN will have less prescriptive
authority in the new position. DIF: Cognitive Level: ComprehensionREF: p. 3TOP: Nursing
B. The APRN will have more Process: Implementation MSC: NCLEX Client Needs Category:
prescriptive authority in the new Physiologic Integrity: Pharmacologic and Parenteral Therapies
position.
C. The APRN will have equal prescriptive
authority in the new position.
D.The APRN's authority will depend on
federal regulations.
How can collaboration with a pharmacist ANS: B,C,D
improve positive outcomes for patients? Ch 2
Select all that apply. Providers should collaborate with pharmacists because they
will likely have additional information on formulary, drug
A. Pharmacists can suggest foods that interactions, and suggestions for adequate medication dosing.
will help with the patient's condition. Dietitians can make food recommendations to treat the
B.Pharmacists have additional information patient's condition. The pharmacist can contact the prescriber
on drug interactions. about questionable prescriptions, but cannot alter the
C. The pharmacist can suggest prescription without notification of and approval by the
adequate medication dosing. provider.
D.Pharmacists have firsthand knowledge
of the facility formulary. DIF: Cognitive Level: ComprehensionREF: p. 9TOP: Nursing
E. Pharmacy can alter prescriptions Process: Diagnosis MSC: NCLEX Client Needs Category:
when necessary to prevent patient Physiologic Integrity: Reduction of Risk Potential
harm.
,A patient presents with delirium tremens ANS: A
requiring Ativan administration. The provider In an emergency situation, such as delirium tremens with
of care is not the facility. Which action by seizure activity, it is acceptable to provide a telephone order.
the nurse is the most appropriate? Contacting the on-call hospitalist or waiting for a written
order would take more time than available for a patient with
A. Obtain a telephone order. high seizure risk. Writing an order is outside the scope of
B.Contact the on-call hospitalist. practice for the charge nurse.
C. Obtain an order from the charge nurse.
D.Wait for a written Ativan order. DIF: Cognitive Level: ApplicationREF: p. 7TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
A patient with chronic pain calls the ANS: B
provider's office to request a refill on their Schedule II medications are not eligible for refills, and
oxycontin. Which action is most prescriptions must be handwritten. It is important to verify the
appropriate? patient's adherence to the drug regimen and determine the
current dosage of medication; however, this can be
A. Fax an order to the pharmacy. accomplished by scheduling an appointment and evaluating
B.Schedule an appointment with the patient. the patient in person.
C. Verify the patient's adherence to
drug regimen. DIF: Cognitive Level: ApplicationREF: p. 8TOP: Nursing
D.Determine the patient's current Process: Implementation MSC: NCLEX Client Needs Category:
medication dosage. Physiologic Integrity: Reduction of Risk Potential
A patient prescribed amoxicillin for ANS: B
streptococcal pharyngitis reports new onset The priority action is to discontinue the medication to prevent
of a flat, itchy red rash on the chest and worsening of the patient's symptoms. A different prescription
neck. Which action is most important? would be provided, topical antihistamine may be
administered, and the patient would be assessed for
A. Provide a different prescription. respiratory involvement, but these actions would not be
B.Discontinue the medication. performed first.
C. Prescribe an antihistamine cream.
D.Assess for respiratory compromise. DIF: Cognitive Level: ApplicationREF: p. 6TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
A patient taking three medications for ANS: B
hypertension is diagnosed with COPD. Prior to adding medications to the treatment regimen, it is
Which action should be taken prior to essential to assess for any potential drug- drug interactions
prescribing medications to treat COPD? through a complete medical history. Baseline laboratory
values are not necessary for COPD treatment. Liver enzyme
A. Obtain baseline laboratory values. levels may give insight into the possibility of altered
B.Obtain a complete medication history. metabolism but would not be the first action. The presence of
C. Assess liver enzyme levels. insurance coverage would affect the patient's access to
D.Determine if the patient has treatment but may not affect the type of medication
insurance coverage. prescribed.
DIF: Cognitive Level: ApplicationREF: p. 6TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
, A patient with diabetes reports losing their ANS: C
job and an inability to purchase required Providing a 7-day sample will address the patient's
medications. Which action is most immediate need, but will not help with the patient's long-
appropriate? term need for medication. Decreasing the daily dose will
diminish the effectiveness of the medication. Selecting a
A. Provide a 7-day sample pack. different
B.Decrease the daily dose by half. pharmacy could decrease the cost of the medication, as costs
C. Contact a different pharmacy. vary based on the location and the pharmacy dispensing the
D.Prescribe a different medication. medication. Prescribing a different medication would be the
last option.
DIF: Cognitive Level: ApplicationREF: p. 5TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
A patient recently prescribed ANS: A,B,D
hydrocodone calls to report they are In order to fill a hydrocodone prescription, the prescriber
unable to fill the name, license number, DEA number, and contact information
prescription. Which factors could contribute must be included. Schedule II medications, such as narcotics,
to the inability to fill the prescription? must be prescribed using written prescriptions. Though the
Select all that apply. pharmacist may question the high dosing, that would not
prevent filling the prescription. The patient's name and date
a. DEA number missing from prescription of birth must be included on the prescription, but there
B.Prescription sent via electronic are no regulations that the name cannot be handwritten.
messenger
C. Dose higher than typically prescribed DIF: Cognitive Level: ComprehensionREF: pp. 6-8TOP: Nursing
D. Prescriber license number not included Process: Diagnosis MSC: NCLEX Client Needs Category:
E. Patient name and date of birth Physiologic Integrity: Reduction of Risk Potential.
were handwritten
A patient reports that a ANS: A
medication prescribed for When evaluating the effectiveness of a drug, it is important to
recurrent migraine determine whether the patient is using the drug as
headaches is not working. Which action ordered. Asking the patient to tell the nurse how many
should be taken first? tablets are taken and how often helps the nurse determine
compliance.
a.Ask the patient about the number Assessing current pain does not yield information about how
and frequency of tablets taken. well the medication is working unless the patient is currently
b.Assess the patient's headache pain on taking it. The nurse should gather as much information
a scale from 1 to 10. about compliance, symptoms, and drug effectiveness as
c. Report the patient's complaint to possible before contacting the prescriber. Biofeedback
the prescriber. may be an effective adjunct to treatment, but it should
d. Suggest biofeedback as an adjunct to not be
drug therapy. recommended without complete information about drug
effectiveness.
DIF: Cognitive Level: ApplicationREF: pp. 15-16TOP: Nursing
Process: Evaluation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Pharmacologic and Parenteral Therapies
Rosenthal: Lehne's Pharmacotherapeutics for Advanced
Practice Nurses and Physician Assistants exam with
question and answer 100% correct
Students also studie
C
Terms in this set (133)
An APRN works in a urology clinic under the ANS: B
supervision of a physician who does not The APRN has independent prescriptive authority because the
restrict the types of medications the APRN is regulating body does not require that the APRN work under
allowed to prescribe. State law does not physician supervision. Full prescriptive authority gives the
require the APRN to practice under provider the right to prescribe independently and without
physician supervision. How would the limitation. Limited authority places restrictions on the types of
APRN's prescriptive authority be described? drugs that can be prescribed.
A. Full authority DIF: Cognitive Level: ComprehensionREF: p. 1TOP: Nursing
B. Independent Process: I MSC: NCLEX Client Needs Category: Physiologic
C. Without limitation Integrity: Pharmacologic and Parenteral Therapies
D. Limited authority
Which factors increase the need for APRNs ANS: A
to have full prescriptive authority? Implementation of the Affordable Care Act has increased the
number of individuals with health care coverage, and thus
A. More patients will have access to health the number who have access to health care services. The
care. increase in the number of patients creates the need for more
B. Enrollment in medical schools is providers with prescriptive authority. APRNs can fill this
predicted to decrease. practice gap.
C. Physician's assistants are being utilized
less often. DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing
D. APRN education is more complex than Process: Implementation MSC: NCLEX Client Needs Category:
education for physicians. Physiologic Integrity: Pharmacologic and Parenteral Therapies
,Which factors could be attributed to limited ANS: A,B
prescriptive authority for APRNs? Select all Limiting prescriptive authority for APRNs can create barriers
that apply. to quality, affordable, and accessible patient care. It may also
lead to poor collaboration among providers and higher health
A. Inaccessibility of patient care care costs. It would not directly impact patient's health
B.Higher health care costs literacy.
C. Higher quality medical treatment
D.Improved collaborative care DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing
E. Enhanced health literacy Process: Implementation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Pharmacologic and Parenteral Therapies
Which aspects support the APRN's provision ANS: A,C,D
for full prescriptive authority? Select all that APRNs are educated to practice and prescribe independently
apply. without supervision. National examinations validate the ability
to provide safe and competent care. Licensure ensures
A. Clinical education includes prescription compliance with standards to promote public health and
of medications and disease processes. safety. Limited prescriptive authority creates numerous
B.Federal regulations support the provision barriers to quality, affordable, and accessible patient care.
of full authority for APRNs.
C. National examinations provide DIF: Cognitive Level: ComprehensionREF: pp. 1-2TOP: Nursing
validation of the APRN's ability to Process: Implementation MSC:
provide safe care.
D.Licensure ensures compliance with
health care and safety standards.
E. Limiting provision can decrease
health care affordability.
A family nurse practitioner practicing in ANS: A
Maine is hired at a practice across state Virginia allows limited prescriptive authority, while Maine
lines in Virginia. Which aspect of practice gives full authority to certified nurse practitioners. The
may change for the APRN? federal
government does not regulate prescriptive authority.
A. The APRN will have less prescriptive
authority in the new position. DIF: Cognitive Level: ComprehensionREF: p. 3TOP: Nursing
B. The APRN will have more Process: Implementation MSC: NCLEX Client Needs Category:
prescriptive authority in the new Physiologic Integrity: Pharmacologic and Parenteral Therapies
position.
C. The APRN will have equal prescriptive
authority in the new position.
D.The APRN's authority will depend on
federal regulations.
How can collaboration with a pharmacist ANS: B,C,D
improve positive outcomes for patients? Ch 2
Select all that apply. Providers should collaborate with pharmacists because they
will likely have additional information on formulary, drug
A. Pharmacists can suggest foods that interactions, and suggestions for adequate medication dosing.
will help with the patient's condition. Dietitians can make food recommendations to treat the
B.Pharmacists have additional information patient's condition. The pharmacist can contact the prescriber
on drug interactions. about questionable prescriptions, but cannot alter the
C. The pharmacist can suggest prescription without notification of and approval by the
adequate medication dosing. provider.
D.Pharmacists have firsthand knowledge
of the facility formulary. DIF: Cognitive Level: ComprehensionREF: p. 9TOP: Nursing
E. Pharmacy can alter prescriptions Process: Diagnosis MSC: NCLEX Client Needs Category:
when necessary to prevent patient Physiologic Integrity: Reduction of Risk Potential
harm.
,A patient presents with delirium tremens ANS: A
requiring Ativan administration. The provider In an emergency situation, such as delirium tremens with
of care is not the facility. Which action by seizure activity, it is acceptable to provide a telephone order.
the nurse is the most appropriate? Contacting the on-call hospitalist or waiting for a written
order would take more time than available for a patient with
A. Obtain a telephone order. high seizure risk. Writing an order is outside the scope of
B.Contact the on-call hospitalist. practice for the charge nurse.
C. Obtain an order from the charge nurse.
D.Wait for a written Ativan order. DIF: Cognitive Level: ApplicationREF: p. 7TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
A patient with chronic pain calls the ANS: B
provider's office to request a refill on their Schedule II medications are not eligible for refills, and
oxycontin. Which action is most prescriptions must be handwritten. It is important to verify the
appropriate? patient's adherence to the drug regimen and determine the
current dosage of medication; however, this can be
A. Fax an order to the pharmacy. accomplished by scheduling an appointment and evaluating
B.Schedule an appointment with the patient. the patient in person.
C. Verify the patient's adherence to
drug regimen. DIF: Cognitive Level: ApplicationREF: p. 8TOP: Nursing
D.Determine the patient's current Process: Implementation MSC: NCLEX Client Needs Category:
medication dosage. Physiologic Integrity: Reduction of Risk Potential
A patient prescribed amoxicillin for ANS: B
streptococcal pharyngitis reports new onset The priority action is to discontinue the medication to prevent
of a flat, itchy red rash on the chest and worsening of the patient's symptoms. A different prescription
neck. Which action is most important? would be provided, topical antihistamine may be
administered, and the patient would be assessed for
A. Provide a different prescription. respiratory involvement, but these actions would not be
B.Discontinue the medication. performed first.
C. Prescribe an antihistamine cream.
D.Assess for respiratory compromise. DIF: Cognitive Level: ApplicationREF: p. 6TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
A patient taking three medications for ANS: B
hypertension is diagnosed with COPD. Prior to adding medications to the treatment regimen, it is
Which action should be taken prior to essential to assess for any potential drug- drug interactions
prescribing medications to treat COPD? through a complete medical history. Baseline laboratory
values are not necessary for COPD treatment. Liver enzyme
A. Obtain baseline laboratory values. levels may give insight into the possibility of altered
B.Obtain a complete medication history. metabolism but would not be the first action. The presence of
C. Assess liver enzyme levels. insurance coverage would affect the patient's access to
D.Determine if the patient has treatment but may not affect the type of medication
insurance coverage. prescribed.
DIF: Cognitive Level: ApplicationREF: p. 6TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
, A patient with diabetes reports losing their ANS: C
job and an inability to purchase required Providing a 7-day sample will address the patient's
medications. Which action is most immediate need, but will not help with the patient's long-
appropriate? term need for medication. Decreasing the daily dose will
diminish the effectiveness of the medication. Selecting a
A. Provide a 7-day sample pack. different
B.Decrease the daily dose by half. pharmacy could decrease the cost of the medication, as costs
C. Contact a different pharmacy. vary based on the location and the pharmacy dispensing the
D.Prescribe a different medication. medication. Prescribing a different medication would be the
last option.
DIF: Cognitive Level: ApplicationREF: p. 5TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
A patient recently prescribed ANS: A,B,D
hydrocodone calls to report they are In order to fill a hydrocodone prescription, the prescriber
unable to fill the name, license number, DEA number, and contact information
prescription. Which factors could contribute must be included. Schedule II medications, such as narcotics,
to the inability to fill the prescription? must be prescribed using written prescriptions. Though the
Select all that apply. pharmacist may question the high dosing, that would not
prevent filling the prescription. The patient's name and date
a. DEA number missing from prescription of birth must be included on the prescription, but there
B.Prescription sent via electronic are no regulations that the name cannot be handwritten.
messenger
C. Dose higher than typically prescribed DIF: Cognitive Level: ComprehensionREF: pp. 6-8TOP: Nursing
D. Prescriber license number not included Process: Diagnosis MSC: NCLEX Client Needs Category:
E. Patient name and date of birth Physiologic Integrity: Reduction of Risk Potential.
were handwritten
A patient reports that a ANS: A
medication prescribed for When evaluating the effectiveness of a drug, it is important to
recurrent migraine determine whether the patient is using the drug as
headaches is not working. Which action ordered. Asking the patient to tell the nurse how many
should be taken first? tablets are taken and how often helps the nurse determine
compliance.
a.Ask the patient about the number Assessing current pain does not yield information about how
and frequency of tablets taken. well the medication is working unless the patient is currently
b.Assess the patient's headache pain on taking it. The nurse should gather as much information
a scale from 1 to 10. about compliance, symptoms, and drug effectiveness as
c. Report the patient's complaint to possible before contacting the prescriber. Biofeedback
the prescriber. may be an effective adjunct to treatment, but it should
d. Suggest biofeedback as an adjunct to not be
drug therapy. recommended without complete information about drug
effectiveness.
DIF: Cognitive Level: ApplicationREF: pp. 15-16TOP: Nursing
Process: Evaluation MSC: NCLEX Client Needs Category:
Physiologic Integrity: Pharmacologic and Parenteral Therapies
