Advanced Practice Nurse
Prescribers with Davis Edge
6th Edition
• Author(s)Teri Moser Woo; Wendy
L. Wright
TEST BANK
▪ The Foundation
▪ Pharmacotherapeutics with Single Drugs
▪ Pharmacotherapeutics with Multiple Drugs
▪ Special Drug Treatment Considerations
,Question 1
A family nurse practitioner is preparing to prescribe a Schedule II
stimulant medication for an adolescent with attention-
deficit/hyperactivity disorder. Which action best reflects the APRN's
role as a safe and legally compliant prescriber?
• A.
Delegate the prescription to a registered nurse after the diagnosis is
confirmed
• B.
Verify state prescriptive authority requirements and review the state
prescription drug monitoring program before issuing the prescription
• C.
Provide a verbal prescription to the school nurse for immediate
administration
• D.
Prescribe a 12-month supply to reduce follow-up visits
Correct Answer: B
Rationale: Advanced practice nurses must practice within state-
specific prescriptive authority laws and use the prescription drug
monitoring program when prescribing controlled substances.
Reviewing the database helps identify duplicate therapy, misuse, or
diversion risk. Delegation of prescribing authority is generally not
permitted (A). Verbal orders for Schedule II stimulants are highly
restricted and inappropriate in this scenario (C). A 12-month supply
would not meet federal and state controlled-substance prescribing
standards and would reduce appropriate monitoring (D).
,Question 2
A 72-year-old man with chronic kidney disease stage 3 presents with
community-acquired pneumonia. The APRN plans to prescribe an
antibiotic that is primarily renally eliminated. What is the most
appropriate initial prescribing action?
• A.
Prescribe the standard adult dose because age alone does not affect
drug clearance
• B.
Delay treatment until a nephrology consultation is completed
• C.
Review the patient's estimated glomerular filtration rate and adjust
the dose if indicated
• D.
Reduce the dose by 50% for all renally eliminated antibiotics
Correct Answer: C
Rationale: Safe prescribing requires assessment of renal function
when using medications that undergo significant renal elimination.
Dose adjustment should be based on the estimated glomerular
filtration rate or creatinine clearance and the specific medication's
prescribing information. Standard dosing may increase toxicity risk
(A). Delaying treatment unnecessarily may worsen infection (B). A
universal 50% reduction is inappropriate because adjustments vary by
drug and renal function level (D).
Question 3
, A psychiatric-mental health nurse practitioner is considering initiating
a medication with a boxed warning for increased suicidal thoughts in
adolescents. Which prescriber action is most appropriate before
starting therapy?
• A.
Avoid discussing the warning to prevent treatment refusal
• B.
Document informed consent, discuss risks and benefits with the
patient and guardian, and establish a monitoring plan
• C.
Start the medication and reassess in 6 months
• D.
Obtain approval from the patient's school counselor before
prescribing
Correct Answer: B
Rationale: Medications with boxed warnings require careful informed
consent, discussion of risks and benefits, and a plan for close follow-
up monitoring, especially during treatment initiation and dose
changes. Avoiding the discussion violates ethical and legal standards
(A). Waiting 6 months for reassessment is inconsistent with
recommended monitoring (C). School counselor approval is not a
prescribing requirement (D).
Question 4
An adult-gerontology primary care nurse practitioner is prescribing
warfarin for new-onset atrial fibrillation. Which patient counseling
point is most important to include?