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 newly certified APRN joins a family practice and is preparing to
prescribe medications independently. Before initiating
pharmacotherapy, the APRN reviews state regulations and institutional
policies. Which action is most appropriate to ensure legal and safe
prescribing?
A. Prescribe according to national guidelines regardless of state
regulations.
B. Verify state scope-of-practice laws, prescriptive authority
requirements, and applicable collaborative or supervisory requirements
before prescribing.
C. Prescribe independently after obtaining national certification
because certification supersedes state regulations.
D. Rely on the collaborating physician to determine which medications
may be prescribed.
Correct Answer: B
Rationale:
State laws govern APRN scope of practice, prescriptive authority,
controlled substance privileges, and any collaborative or supervisory
requirements. An APRN must understand and comply with these legal
requirements before prescribing. National certification alone does not
determine legal prescribing authority, and institutional policies cannot
override state law. National guidelines support clinical decision-making
but do not replace statutory requirements.
Question 2
,A 72-year-old woman with hypertension, chronic kidney disease, and
osteoarthritis presents for medication review. She receives
prescriptions from multiple specialists and reports taking several over-
the-counter supplements. Which prescribing strategy best
demonstrates high-quality APRN practice?
A. Continue all medications because each specialist prescribed them.
B. Focus only on medications prescribed by the primary care practice.
C. Perform comprehensive medication reconciliation, assess for
interactions, evaluate ongoing indications, and deprescribe when
appropriate.
D. Recommend discontinuing all dietary supplements without assessing
their potential risks or benefits.
Correct Answer: C
Rationale:
Medication reconciliation is a core prescribing responsibility. APRNs
should review prescription medications, over-the-counter products,
herbal supplements, adherence, duplicate therapies, drug interactions,
renal and hepatic function, and ongoing indications for each
medication. Deprescribing unnecessary or potentially harmful
medications reduces adverse drug events, especially in older adults
with polypharmacy. Automatically continuing medications or
discontinuing supplements without assessment does not reflect
evidence-based prescribing.
Question 3
A 30-year-old woman presents with symptoms consistent with
uncomplicated acute cystitis. She requests "the strongest antibiotic
, available" because she wants to recover quickly. Which response best
reflects evidence-based prescribing principles?
A. Prescribe the broadest-spectrum antibiotic available to maximize
effectiveness.
B. Explain that antibiotic selection should be guided by the most likely
pathogen, patient-specific factors, local resistance patterns, and the
narrowest effective therapy.
C. Delay treatment until urine culture results are available for every
patient.
D. Prescribe two antibiotics simultaneously to reduce the risk of
resistance.
Correct Answer: B
Rationale:
Appropriate antimicrobial stewardship emphasizes selecting the
narrowest effective antimicrobial based on the likely organism, local
resistance patterns, allergy history, renal function, pregnancy status,
and severity of illness. Broad-spectrum antibiotics should not be used
routinely because they increase the risk of antimicrobial resistance and
adverse effects. Routine dual therapy and delaying treatment for all
uncomplicated infections are not appropriate.
Question 4
An APRN is evaluating a patient before initiating long-term
pharmacotherapy for newly diagnosed hypertension. Which action best
demonstrates patient-centered prescribing?
A. Select the medication with the lowest acquisition cost without
discussing alternatives.