Pharmacotherapeutics for Advanced
Practice Nurse Prescribers
Drugs that use CYP 3A4 isoenzymes for metabolism may:
1. Induce the metabolism of another drug
2. Inhibit the metabolism of another drug
3. Both 1 and 2
4. Neither 1 nor 2 - ANS3
Medication agreements or "Pain Medication Contracts" are recommended to be used:
1. Universally for all prescribing for chronic pain
2. For patients who have repeated requests for pain medication
3. When you suspect a patient is exhibiting drug-seeking behavior
4. For patients with pain associated with malignancy - ANS1
Drugs that are prone to cause adverse drug effects include:
1. Diuretics
2. Inhaled anticholinergics
3. Insulins
4. Stimulants - ANS3
The U.S. Food and Drug Administration MedWatch system is activated when:
1. There is an adverse event to a vaccine.
2. The patient has a severe reaction that is noted in the "Severe Reaction" section in the
medication label.
3. A lactating woman takes a medication that is potentially toxic to the breastfeeding infant.
,4. An adverse event or serious problem occurs with a medication that is not already identified on
the label. - ANS4
The Vaccine Adverse Events Reporting System is:
1. A mandatory reporting system for all health-care providers when they encounter an adverse
vaccine event
2. A voluntary reporting system that health-care providers or consumers may use to report
vaccine adverse events
3. Utilized to send out safety alerts regarding emerging vaccine safety issues
4. Activated when a vaccine has been proven to cause significant adverse effects - ANS2
A comprehensive assessment of a patient should be holistic when trying to determine
competence in drug administration. Which of the following factors would the NP omit from this
type of assessment?
1. Financial status
2. Mobility
3. Social support
4. Sexual practices - ANS4
Elena Vasquez's primary language is Spanish, and she speaks very limited English. Which
technique would be appropriate to use in teaching her about a new drug you have just
prescribed?
1. Use correct medical terminology because Spanish has a Latin base.
2. Use a family member who speaks more English to act as an interpreter.
3. Use a professional interpreter or a reliable staff member who can act as an interpreter.
4. Use careful, detailed explanations. - ANS3
Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that
he understands teaching about his drug?
1. Stand facing him and speak slowly and clearly.
,2. Speak in low tones or find a provider who has a lower voice.
3. Write down the instructions as well as speaking them.
4. If he reads lips, exaggerate lips movements when pronouncing the vowel sounds. - ANS4
Which of the following factors may adversely affect a patient's adherence to a therapeutic drug
regimen?
1. Complexity of the drug regimen
2. Patient perception of the potential adverse effects of the drugs
3. Both 1 and 2
4. Neither 1 nor 2 - ANS3
The health-care delivery system itself can create barriers to adherence to a treatment regimen.
Which of the following system variables creates such a barrier?
1. Increasing copayments for care
2. Unrestricted formularies for drugs, including brand names
3. Increasing the number of people who have access to care
4. Treating a wider range of disorders - ANS1
Ralph's blood pressure remains elevated despite increased doses of his drug. The NP is
concerned that he might not be adhering to his treatment regimen. Which of the following events
would suggest that he might not be adherent?
1. Ralph states that he always takes the drug "when I feel my pressure is going up."
2. Ralph contacts his NP to discuss the need to increase the dosage.
3. Ralph consistently keeps his follow-up appointments to check his blood pressure.
4. All of the above show t - ANS1
Nonadherence is especially common in drugs that treat asymptomatic conditions, such as
hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a
drug that:
, 1. Has a short half-life so that missing one dose has limited effect
2. Requires several dosage titrations so that missed doses can be replaced with lower doses to
keep costs down
3. Has a tolerability profile with fewer of the adverse effects that are considered "irritating," such
as nausea and diz - ANS3
Factors in chronic conditions that contribute to nonadherence include:
1. The complexity of the treatment regimen
2. The length of time over which it must be taken
3. Breaks in the usual daily routine, such as vacations and weekends
4. All of the above - ANS4
While patient education about their drugs is important, information alone does not necessarily
lead to adherence to a drug regimen. Patients report greater adherence when:
1. The provider spent a lot of time discussing the drugs with them
2. Their concerns and specific area of knowledge deficit were addressed
3. They were given written material, such as pamphlets, about the drugs
4. The provider used appropriate medical and pharmacological terms - ANS2
Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and
60%. To improve adherence in this population, prescribe drugs:
1. With a longer half-life so that missed doses produce a longer taper on the drug curve
2. In oral formulations that are more easily taken
3. That do not require frequent monitoring
4. Combined with patient education about the need to adhere even when symptoms are absent
- ANS1
Practice Nurse Prescribers
Drugs that use CYP 3A4 isoenzymes for metabolism may:
1. Induce the metabolism of another drug
2. Inhibit the metabolism of another drug
3. Both 1 and 2
4. Neither 1 nor 2 - ANS3
Medication agreements or "Pain Medication Contracts" are recommended to be used:
1. Universally for all prescribing for chronic pain
2. For patients who have repeated requests for pain medication
3. When you suspect a patient is exhibiting drug-seeking behavior
4. For patients with pain associated with malignancy - ANS1
Drugs that are prone to cause adverse drug effects include:
1. Diuretics
2. Inhaled anticholinergics
3. Insulins
4. Stimulants - ANS3
The U.S. Food and Drug Administration MedWatch system is activated when:
1. There is an adverse event to a vaccine.
2. The patient has a severe reaction that is noted in the "Severe Reaction" section in the
medication label.
3. A lactating woman takes a medication that is potentially toxic to the breastfeeding infant.
,4. An adverse event or serious problem occurs with a medication that is not already identified on
the label. - ANS4
The Vaccine Adverse Events Reporting System is:
1. A mandatory reporting system for all health-care providers when they encounter an adverse
vaccine event
2. A voluntary reporting system that health-care providers or consumers may use to report
vaccine adverse events
3. Utilized to send out safety alerts regarding emerging vaccine safety issues
4. Activated when a vaccine has been proven to cause significant adverse effects - ANS2
A comprehensive assessment of a patient should be holistic when trying to determine
competence in drug administration. Which of the following factors would the NP omit from this
type of assessment?
1. Financial status
2. Mobility
3. Social support
4. Sexual practices - ANS4
Elena Vasquez's primary language is Spanish, and she speaks very limited English. Which
technique would be appropriate to use in teaching her about a new drug you have just
prescribed?
1. Use correct medical terminology because Spanish has a Latin base.
2. Use a family member who speaks more English to act as an interpreter.
3. Use a professional interpreter or a reliable staff member who can act as an interpreter.
4. Use careful, detailed explanations. - ANS3
Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that
he understands teaching about his drug?
1. Stand facing him and speak slowly and clearly.
,2. Speak in low tones or find a provider who has a lower voice.
3. Write down the instructions as well as speaking them.
4. If he reads lips, exaggerate lips movements when pronouncing the vowel sounds. - ANS4
Which of the following factors may adversely affect a patient's adherence to a therapeutic drug
regimen?
1. Complexity of the drug regimen
2. Patient perception of the potential adverse effects of the drugs
3. Both 1 and 2
4. Neither 1 nor 2 - ANS3
The health-care delivery system itself can create barriers to adherence to a treatment regimen.
Which of the following system variables creates such a barrier?
1. Increasing copayments for care
2. Unrestricted formularies for drugs, including brand names
3. Increasing the number of people who have access to care
4. Treating a wider range of disorders - ANS1
Ralph's blood pressure remains elevated despite increased doses of his drug. The NP is
concerned that he might not be adhering to his treatment regimen. Which of the following events
would suggest that he might not be adherent?
1. Ralph states that he always takes the drug "when I feel my pressure is going up."
2. Ralph contacts his NP to discuss the need to increase the dosage.
3. Ralph consistently keeps his follow-up appointments to check his blood pressure.
4. All of the above show t - ANS1
Nonadherence is especially common in drugs that treat asymptomatic conditions, such as
hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a
drug that:
, 1. Has a short half-life so that missing one dose has limited effect
2. Requires several dosage titrations so that missed doses can be replaced with lower doses to
keep costs down
3. Has a tolerability profile with fewer of the adverse effects that are considered "irritating," such
as nausea and diz - ANS3
Factors in chronic conditions that contribute to nonadherence include:
1. The complexity of the treatment regimen
2. The length of time over which it must be taken
3. Breaks in the usual daily routine, such as vacations and weekends
4. All of the above - ANS4
While patient education about their drugs is important, information alone does not necessarily
lead to adherence to a drug regimen. Patients report greater adherence when:
1. The provider spent a lot of time discussing the drugs with them
2. Their concerns and specific area of knowledge deficit were addressed
3. They were given written material, such as pamphlets, about the drugs
4. The provider used appropriate medical and pharmacological terms - ANS2
Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and
60%. To improve adherence in this population, prescribe drugs:
1. With a longer half-life so that missed doses produce a longer taper on the drug curve
2. In oral formulations that are more easily taken
3. That do not require frequent monitoring
4. Combined with patient education about the need to adhere even when symptoms are absent
- ANS1
