BEST ANSWERS Test Bank Lehnes
Pharmacotherapeutics for
Advanced Practice Nurses and
Physician
1. An APRN works in a urology clinic under the supervision of a physician who
does not restrict the types of medications the APRN is allowed to prescribe.
State law does not require the APRN to practice under physician supervision.
How would the APRN’s prescriptive authority be described?
a. Full authority
b. Independent
c. Without limitation
d. Limited authority
ANS: B
The APRN has independent prescriptive authority because the regulating body does
not require that the APRN work under physician supervision. Full prescriptive
authority gives the provider the right to prescribe independently and without
limitation. Limited authority places restrictions on the types of drugs that can be
prescribed.
2. Which factors increase the need for APRNs to have full prescriptive
authority?
a. More patients will have access to health care.
b. Enrollment in medical schools is predicted to decrease.
c. Physician’s assistants are being utilized less often.
d. APRN education is more complex than education for physicians.
ANS: A
Implementation of the Affordable Care Act has increased the number of individuals
with health care coverage, and thus the number who have access to health care
services. The increase in the number of patients creates the need for more providers
with prescriptive authority.
3. Which factors could be attributed to limited prescriptive authority for
APRNs? Select all that apply.
a. Inaccessibility of patient care
b. Higher health care costs
c. Higher quality medical treatment
,d. Improved collaborative care
e. Enhanced health literacy
ANS: A, B
Limiting prescriptive authority for APRNs can create barriers to quality, affordable,
and accessible patient care. It may also lead to poor collaboration among providers
and higher health care costs. It would not directly impact a patient's health literacy.
4. Which aspects support the APRN’s provision for full prescriptive authority?
Select all that apply.
a. Clinical education includes prescription of medications and disease processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN’s ability to provide safe care.
d. Licensure ensures compliance with health care and safety standards.
ANS: A, C, D
APRNs are educated to practice and prescribe independently without supervision.
National examinations validate the ability to provide safe and competent care.
Licensure ensures compliance with standards to promote public health and safety.
5. A family nurse practitioner practicing in Maine is hired at a practice across
state lines in Virginia. Which aspect of practice may change for the APRN?
a. The APRN will have less prescriptive authority in the new position.
b. The APRN will have more prescriptive authority in the new position.
c. The APRN will have equal prescriptive authority in the new position.
d. The APRN’s authority will depend on federal regulations.
ANS: A
Virginia allows limited prescriptive authority, while Maine gives full authority to
certified nurse practitioners. The federal government does not regulate prescriptive
authority.
6. How can collaboration with a pharmacist improve positive outcomes for
patients? Select all that apply.
a. Pharmacists can suggest foods that will help with the patient’s condition.
b. Pharmacists have additional information on drug interactions.
c. The pharmacist can suggest adequate medication dosing.
d. Pharmacists have firsthand knowledge of the facility formulary.
e. Pharmacy can alter prescriptions when necessary to prevent patient harm.
ANS: B, C, D
Providers should collaborate with pharmacists because they will likely have additional
information on formulary, drug interactions, and suggestions for adequate
medication dosing. A pharmacist can contact the prescriber about questionable
prescriptions but cannot alter the prescription without approval by the provider.
,7. A patient presents with delirium tremens requiring Ativan administration.
The provider of care is not in the facility. Which action by the nurse is most
appropriate?
a. Obtain a telephone order.
b. Contact the on-call hospitalist.
c. Obtain an order from the charge nurse.
d. Wait for a written Ativan order.
ANS: A
In an emergency situation, such as delirium tremens with seizure activity, it is
acceptable to obtain a telephone order. Contacting the on-call hospitalist or waiting
for a written order would take more time than available for a patient with high
seizure risk.
8. A patient with chronic pain calls the provider’s office to request a refill on
their oxycontin. Which action is most appropriate?
a. Fax an order to the pharmacy.
b. Schedule an appointment with the patient.
c. Verify the patient’s adherence to drug regimen.
d. Determine the patient’s current medication dosage.
ANS: B
Schedule II medications are not eligible for refills, and prescriptions must be
handwritten. It is important to verify the patient’s adherence and current dosage, but
this can be accomplished by scheduling an appointment and evaluating the patient
in person.
9. A patient prescribed amoxicillin for streptococcal pharyngitis reports new
onset of a flat, itchy red rash on the chest and neck. Which action is most
important?
a. Provide a different prescription.
b. Discontinue the medication.
c. Prescribe an antihistamine cream.
d. Assess for respiratory compromise.
ANS: B
The priority action is to discontinue the medication to prevent worsening of the
patient’s symptoms.
10. A patient taking three medications for hypertension is diagnosed with
COPD. Which action should be taken prior to prescribing medications to treat
COPD?
a. Obtain baseline laboratory values.
b. Obtain a complete medication history.
, c. Assess liver enzyme levels.
d. Determine if patient has insurance coverage.
ANS: B
Prior to adding medications to the treatment regimen, it is essential to assess for any
potential drug-drug interactions through a complete medical history. Liver enzyme
levels may give insight into the possibility of altered metabolism but would not be
the first action.
11. A patient with diabetes reports losing their job and an inability to purchase
required medications. Which action is most appropriate?
a. Provide a 7-day sample pack.
b. Decrease the daily dose by half.
c. Contact a different pharmacy.
d. Prescribe a different medication.
ANS: C
Selecting a different pharmacy could decrease the cost of the medication, as costs
vary based on the location and the pharmacy dispensing the medication.
12. A patient recently prescribed hydrocodone calls to report they are unable to
fill the prescription. Which factors could contribute to the inability to fill the
prescription? Select all that apply.
a. DEA number missing from prescription
b. Prescription sent via electronic messenger
c. Dose higher than typically prescribed
d. Prescriber license number not included
e. Patient name and date of birth were handwritten
ANS: A, B, D
In order to fill a hydrocodone prescription, the prescriber name, license number, DEA
number, and contact information must be included. Schedule II medications, such as
narcotics, must be prescribed using written prescriptions.
13. A patient reports that a medication prescribed for recurrent migraine
headaches is not working. Which action should be taken first?
a. Ask the patient about the number and frequency of tablets taken.
b. Assess the patient’s headache pain on a scale from 1 to 10.
c. Report the patient’s complaint to the prescriber.
d. Suggest biofeedback as an adjunct to drug therapy.
ANS: A
When evaluating the effectiveness of a drug, it is important to determine whether the
patient is using the drug as ordered. Asking the patient to tell the nurse how many
tablets are taken and how often helps the nurse determine compliance
Pharmacotherapeutics for
Advanced Practice Nurses and
Physician
1. An APRN works in a urology clinic under the supervision of a physician who
does not restrict the types of medications the APRN is allowed to prescribe.
State law does not require the APRN to practice under physician supervision.
How would the APRN’s prescriptive authority be described?
a. Full authority
b. Independent
c. Without limitation
d. Limited authority
ANS: B
The APRN has independent prescriptive authority because the regulating body does
not require that the APRN work under physician supervision. Full prescriptive
authority gives the provider the right to prescribe independently and without
limitation. Limited authority places restrictions on the types of drugs that can be
prescribed.
2. Which factors increase the need for APRNs to have full prescriptive
authority?
a. More patients will have access to health care.
b. Enrollment in medical schools is predicted to decrease.
c. Physician’s assistants are being utilized less often.
d. APRN education is more complex than education for physicians.
ANS: A
Implementation of the Affordable Care Act has increased the number of individuals
with health care coverage, and thus the number who have access to health care
services. The increase in the number of patients creates the need for more providers
with prescriptive authority.
3. Which factors could be attributed to limited prescriptive authority for
APRNs? Select all that apply.
a. Inaccessibility of patient care
b. Higher health care costs
c. Higher quality medical treatment
,d. Improved collaborative care
e. Enhanced health literacy
ANS: A, B
Limiting prescriptive authority for APRNs can create barriers to quality, affordable,
and accessible patient care. It may also lead to poor collaboration among providers
and higher health care costs. It would not directly impact a patient's health literacy.
4. Which aspects support the APRN’s provision for full prescriptive authority?
Select all that apply.
a. Clinical education includes prescription of medications and disease processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN’s ability to provide safe care.
d. Licensure ensures compliance with health care and safety standards.
ANS: A, C, D
APRNs are educated to practice and prescribe independently without supervision.
National examinations validate the ability to provide safe and competent care.
Licensure ensures compliance with standards to promote public health and safety.
5. A family nurse practitioner practicing in Maine is hired at a practice across
state lines in Virginia. Which aspect of practice may change for the APRN?
a. The APRN will have less prescriptive authority in the new position.
b. The APRN will have more prescriptive authority in the new position.
c. The APRN will have equal prescriptive authority in the new position.
d. The APRN’s authority will depend on federal regulations.
ANS: A
Virginia allows limited prescriptive authority, while Maine gives full authority to
certified nurse practitioners. The federal government does not regulate prescriptive
authority.
6. How can collaboration with a pharmacist improve positive outcomes for
patients? Select all that apply.
a. Pharmacists can suggest foods that will help with the patient’s condition.
b. Pharmacists have additional information on drug interactions.
c. The pharmacist can suggest adequate medication dosing.
d. Pharmacists have firsthand knowledge of the facility formulary.
e. Pharmacy can alter prescriptions when necessary to prevent patient harm.
ANS: B, C, D
Providers should collaborate with pharmacists because they will likely have additional
information on formulary, drug interactions, and suggestions for adequate
medication dosing. A pharmacist can contact the prescriber about questionable
prescriptions but cannot alter the prescription without approval by the provider.
,7. A patient presents with delirium tremens requiring Ativan administration.
The provider of care is not in the facility. Which action by the nurse is most
appropriate?
a. Obtain a telephone order.
b. Contact the on-call hospitalist.
c. Obtain an order from the charge nurse.
d. Wait for a written Ativan order.
ANS: A
In an emergency situation, such as delirium tremens with seizure activity, it is
acceptable to obtain a telephone order. Contacting the on-call hospitalist or waiting
for a written order would take more time than available for a patient with high
seizure risk.
8. A patient with chronic pain calls the provider’s office to request a refill on
their oxycontin. Which action is most appropriate?
a. Fax an order to the pharmacy.
b. Schedule an appointment with the patient.
c. Verify the patient’s adherence to drug regimen.
d. Determine the patient’s current medication dosage.
ANS: B
Schedule II medications are not eligible for refills, and prescriptions must be
handwritten. It is important to verify the patient’s adherence and current dosage, but
this can be accomplished by scheduling an appointment and evaluating the patient
in person.
9. A patient prescribed amoxicillin for streptococcal pharyngitis reports new
onset of a flat, itchy red rash on the chest and neck. Which action is most
important?
a. Provide a different prescription.
b. Discontinue the medication.
c. Prescribe an antihistamine cream.
d. Assess for respiratory compromise.
ANS: B
The priority action is to discontinue the medication to prevent worsening of the
patient’s symptoms.
10. A patient taking three medications for hypertension is diagnosed with
COPD. Which action should be taken prior to prescribing medications to treat
COPD?
a. Obtain baseline laboratory values.
b. Obtain a complete medication history.
, c. Assess liver enzyme levels.
d. Determine if patient has insurance coverage.
ANS: B
Prior to adding medications to the treatment regimen, it is essential to assess for any
potential drug-drug interactions through a complete medical history. Liver enzyme
levels may give insight into the possibility of altered metabolism but would not be
the first action.
11. A patient with diabetes reports losing their job and an inability to purchase
required medications. Which action is most appropriate?
a. Provide a 7-day sample pack.
b. Decrease the daily dose by half.
c. Contact a different pharmacy.
d. Prescribe a different medication.
ANS: C
Selecting a different pharmacy could decrease the cost of the medication, as costs
vary based on the location and the pharmacy dispensing the medication.
12. A patient recently prescribed hydrocodone calls to report they are unable to
fill the prescription. Which factors could contribute to the inability to fill the
prescription? Select all that apply.
a. DEA number missing from prescription
b. Prescription sent via electronic messenger
c. Dose higher than typically prescribed
d. Prescriber license number not included
e. Patient name and date of birth were handwritten
ANS: A, B, D
In order to fill a hydrocodone prescription, the prescriber name, license number, DEA
number, and contact information must be included. Schedule II medications, such as
narcotics, must be prescribed using written prescriptions.
13. A patient reports that a medication prescribed for recurrent migraine
headaches is not working. Which action should be taken first?
a. Ask the patient about the number and frequency of tablets taken.
b. Assess the patient’s headache pain on a scale from 1 to 10.
c. Report the patient’s complaint to the prescriber.
d. Suggest biofeedback as an adjunct to drug therapy.
ANS: A
When evaluating the effectiveness of a drug, it is important to determine whether the
patient is using the drug as ordered. Asking the patient to tell the nurse how many
tablets are taken and how often helps the nurse determine compliance
