,Pharmacotherapeutics 2025 Test Bank:
Arcangelo & Peterson Exam Success Guide
📘 Verified | Detailed Rationales | 1,120 Questions | Designed for Guaranteed Clinical
Competency
Table of Contents
1. Issues for the Practitioner in Drug Therapy
2. Pharmacokinetic Basis of Therapeutics and Pharmacodynamic Principles
3. Impact of Drug Interactions and Adverse Events on Therapeutics
4. Principles of Pharmacotherapy in Pediatrics, Pregnancy and Lactation
5. Pharmacotherapy Principles in Older Adults
6. Principles of Antimicrobial Therapy
7. Pharmacogenomics
8. The Economics of Pharmacotherapeutics
9. Principles of Pharmacology in Pain Management
10. Pain Management in Opioid Use Disorder (OUD) Patients
11. Cannabis and Pain Management
12. Dermatitis
13. Bacterial, Fungal, and Viral Infections of the Skin
14. Psoriasis
15. Acne Vulgaris and Rosacea
16. Ophthalmic Disorders
17. Otitis Media and Otitis Externa
18. Hypertension
19. Hyperlipidemia
,20. Chronic Stable Angina and Myocardial Infarction
21. Heart Failure
22. Arrhythmias
23. Respiratory Infections
24. Asthma and Chronic Obstructive Pulmonary Disease
25. Gastric, Functional and Inflammatory Bowel Disorders
26. Gastroesophageal Reflux Disease and Peptic Ulcer Disease
27. Liver Diseases
28. Urinary Tract Infection
29. Prostatic Disorders and Erectile Dysfunction
30. Overactive Bladder
31. Sexually Transmitted Infections
32. Osteoarthritis and Gout
33. Osteoporosis
34. Rheumatoid Arthritis
35. Headaches
36. Seizure Disorders
37. Alzheimer’s Disease
38. Parkinson Disease
39. Major Depressive Disorder and Bipolar Disorders
40. Anxiety Disorders
41. Sleep Disorders
42. Attention Deficit Hyperactivity Disorder
43. Substance Use Disorders
44. Diabetes Mellitus
45. Thyroid and Parathyroid Disorders
46. Allergies and Allergic Reactions
,47. Human Immunodeficiency Virus
48. Organ Transplantation
49. Pharmacotherapy for Select Thromboembolic Disorders
50. Anemias
51. Immunizations
52. Smoking Cessation
53. Weight Loss
54. Contraception
55. Menopause
56. Vaginitis
, 1. A nurse practitioner (NP) is practicing in a state where
independent prescribing authority is granted. Which
action is within the NP’s legal scope?
A. Prescribing Schedule II controlled substances without
physician oversight
B. Prescribing antibiotics for a patient with
community-acquired pneumonia
C. Delegating prescription signing to a licensed practical
nurse
D. Adjusting a patient’s chemotherapy protocol per
oncologist’s orders
Correct Answer: B
Rationale: State law allows independent NPs to prescribe
noncontrolled substances like antibiotics. Schedule II controlled
substances often require special registration or collaborative
agreements (A incorrect). LPNs cannot sign prescriptions (C).
Adjusting chemo outside protocol requires oncologist (D).
2. An APP must ensure compliance with state-specific
prescribing regulations. Which resource provides the
most accurate guidance?
A. A colleague’s recollection of past practice
B. The state board of nursing’s official website
C. A national social media group discussion
D. A manufacturer’s drug recall bulletin
,Correct Answer: B
Rationale: The state board website gives current legal scope.
Colleagues or social media may be outdated or anecdotal (A, C).
Manufacturer bulletins address safety, not scope (D).
3. An NP considers prescribing opioids for chronic pain.
Ethically, the APP must first:
A. Prescribe the maximum allowed dose to ensure relief
B. Assess risk for misuse and discuss benefits/risks with the
patient
C. Delegate monitoring to a pharmacist
D. Refer the patient immediately to pain management
specialists
Correct Answer: B
Rationale: Ethical prescribing requires risk assessment and
informed consent. Maximum dose without assessment risks
harm (A). Pharmacists cannot replace initial risk/benefit
discussion (C). Referral may be needed later, but initial
assessment by APP is required (D).
4. When reviewing a patient’s medication list, the APP
identifies potential polypharmacy. The next best step is:
A. Stop all nonessential medications immediately
B. Conduct a medication reconciliation and prioritize
deprescribing targets
C. Leave all medications unchanged to avoid withdrawal
D. Increase the primary medication dose to simplify
regimen
,Correct Answer: B
Rationale: Medication reconciliation identifies unnecessary
drugs; deprescribing can be planned. Abrupt cessation risks
withdrawal (A). Doing nothing misses harm reduction (C).
Increasing dose worsens polypharmacy (D).
5. An APP uses evidence-based guidelines to choose an
antihypertensive. This demonstrates:
A. Ethical prescribing only
B. Provider accountability only
C. Evidence-based decision-making
D. Cultural competence
Correct Answer: C
Rationale: Applying guidelines exemplifies evidence-based
practice. Ethical prescribing and accountability are broader
constructs; cultural competence relates to tailoring to culture
(D).
6. Which strategy most improves medication adherence in
patients with low health literacy?
A. Providing a 10-page drug brochure
B. Using teach-back and simplified dosing schedules
C. Assuming understanding after verbal instructions
D. Sending refill reminders via text only
Correct Answer: B
Rationale: Teach-back confirms understanding; simplified
regimens reduce confusion. Long brochures overwhelm (A).
,Assuming understanding may miss gaps (C). Text reminders
help but don’t build comprehension (D).
7. During a shared decision-making discussion, an APP
should:
A. Directly order the medication that the APP deems best
B. Encourage the patient to state preferences and goals
C. Limit discussion to benefits, not risks, to avoid confusion
D. Use technical jargon to appear knowledgeable
Correct Answer: B
Rationale: Shared decision-making involves eliciting patient
values. Direct orders bypass patient input (A). Discussing both
benefits and risks fosters informed consent (C). Jargon hinders
communication (D).
8. An APP suspects off-label use of a drug lacking strong
pediatric data. Ethically, the APP must:
A. Prescribe anyway if standard adult dose used
B. Explain limited evidence and obtain informed consent
C. Refuse care solely based on lack of FDA approval
D. Delegate prescribing decision to a pharmacist
Correct Answer: B
Rationale: Informed consent is required for off-label pediatric
use. Adult doses may be inappropriate (A). Refusal without
discussion is paternalistic (C). Pharmacists advise but APP holds
prescribing responsibility (D).
, 9. Which factor increases the risk of iatrogenic
polypharmacy?
A. Single-provider prescribing with full medication review
B. Multiple specialists prescribing without coordination
C. Use of electronic health records with alerts
D. Regular medication reconciliation in every visit
Correct Answer: B
Rationale: Uncoordinated multiple prescribers often lead to
duplicate or interacting meds. Single-provider review and EHR
alerts mitigate risk (A, C). Regular reconciliation also reduces
polypharmacy (D).
10. Under the principle of provider accountability, an
APP must:
A. Shift prescribing errors to supervising physician
B. Document rationale for medication choices clearly
C. Omit documentation to expedite workflow
D. Allow unlicensed staff to chart prescriptions
Correct Answer: B
Rationale: Accountability requires clear record-keeping. Errors
cannot be shifted (A). Omitting documentation violates
standards (C). Only licensed providers may authorize and
document prescriptions (D).
(Questions 11–50 continue below.)
, 11. A physician assistant (PA) is unsure if they can
prescribe a new anticoagulant under their state scope.
The best first step is to:
A. Prescribe and adjust based on patient labs
B. Consult the state’s medical board prescribing
regulations
C. Ask the patient to research online
D. Refer to the drug manufacturer for legal advice
Correct Answer: B
Rationale: State medical board regulations clarify PA
prescribing scope. Other sources are unreliable or
inappropriate.
12. An APP prescribes metformin to a newly diagnosed
diabetic. To ensure ethical prescribing, the APP should:
A. Order baseline renal function tests before initiation
B. Assume normal kidney function in all adults
C. Delay labs to avoid patient costs
D. Delegate lab ordering to nursing staff without oversight
Correct Answer: A
Rationale: Metformin requires renal monitoring to avoid lactic
acidosis. Assumptions risk safety; labs must be ordered and
reviewed by APP.
13. When deprescribing in older adults, the APP should
prioritize stopping medications that:
A. Have the shortest half-life
B. Are prescribed for symptom relief only
Arcangelo & Peterson Exam Success Guide
📘 Verified | Detailed Rationales | 1,120 Questions | Designed for Guaranteed Clinical
Competency
Table of Contents
1. Issues for the Practitioner in Drug Therapy
2. Pharmacokinetic Basis of Therapeutics and Pharmacodynamic Principles
3. Impact of Drug Interactions and Adverse Events on Therapeutics
4. Principles of Pharmacotherapy in Pediatrics, Pregnancy and Lactation
5. Pharmacotherapy Principles in Older Adults
6. Principles of Antimicrobial Therapy
7. Pharmacogenomics
8. The Economics of Pharmacotherapeutics
9. Principles of Pharmacology in Pain Management
10. Pain Management in Opioid Use Disorder (OUD) Patients
11. Cannabis and Pain Management
12. Dermatitis
13. Bacterial, Fungal, and Viral Infections of the Skin
14. Psoriasis
15. Acne Vulgaris and Rosacea
16. Ophthalmic Disorders
17. Otitis Media and Otitis Externa
18. Hypertension
19. Hyperlipidemia
,20. Chronic Stable Angina and Myocardial Infarction
21. Heart Failure
22. Arrhythmias
23. Respiratory Infections
24. Asthma and Chronic Obstructive Pulmonary Disease
25. Gastric, Functional and Inflammatory Bowel Disorders
26. Gastroesophageal Reflux Disease and Peptic Ulcer Disease
27. Liver Diseases
28. Urinary Tract Infection
29. Prostatic Disorders and Erectile Dysfunction
30. Overactive Bladder
31. Sexually Transmitted Infections
32. Osteoarthritis and Gout
33. Osteoporosis
34. Rheumatoid Arthritis
35. Headaches
36. Seizure Disorders
37. Alzheimer’s Disease
38. Parkinson Disease
39. Major Depressive Disorder and Bipolar Disorders
40. Anxiety Disorders
41. Sleep Disorders
42. Attention Deficit Hyperactivity Disorder
43. Substance Use Disorders
44. Diabetes Mellitus
45. Thyroid and Parathyroid Disorders
46. Allergies and Allergic Reactions
,47. Human Immunodeficiency Virus
48. Organ Transplantation
49. Pharmacotherapy for Select Thromboembolic Disorders
50. Anemias
51. Immunizations
52. Smoking Cessation
53. Weight Loss
54. Contraception
55. Menopause
56. Vaginitis
, 1. A nurse practitioner (NP) is practicing in a state where
independent prescribing authority is granted. Which
action is within the NP’s legal scope?
A. Prescribing Schedule II controlled substances without
physician oversight
B. Prescribing antibiotics for a patient with
community-acquired pneumonia
C. Delegating prescription signing to a licensed practical
nurse
D. Adjusting a patient’s chemotherapy protocol per
oncologist’s orders
Correct Answer: B
Rationale: State law allows independent NPs to prescribe
noncontrolled substances like antibiotics. Schedule II controlled
substances often require special registration or collaborative
agreements (A incorrect). LPNs cannot sign prescriptions (C).
Adjusting chemo outside protocol requires oncologist (D).
2. An APP must ensure compliance with state-specific
prescribing regulations. Which resource provides the
most accurate guidance?
A. A colleague’s recollection of past practice
B. The state board of nursing’s official website
C. A national social media group discussion
D. A manufacturer’s drug recall bulletin
,Correct Answer: B
Rationale: The state board website gives current legal scope.
Colleagues or social media may be outdated or anecdotal (A, C).
Manufacturer bulletins address safety, not scope (D).
3. An NP considers prescribing opioids for chronic pain.
Ethically, the APP must first:
A. Prescribe the maximum allowed dose to ensure relief
B. Assess risk for misuse and discuss benefits/risks with the
patient
C. Delegate monitoring to a pharmacist
D. Refer the patient immediately to pain management
specialists
Correct Answer: B
Rationale: Ethical prescribing requires risk assessment and
informed consent. Maximum dose without assessment risks
harm (A). Pharmacists cannot replace initial risk/benefit
discussion (C). Referral may be needed later, but initial
assessment by APP is required (D).
4. When reviewing a patient’s medication list, the APP
identifies potential polypharmacy. The next best step is:
A. Stop all nonessential medications immediately
B. Conduct a medication reconciliation and prioritize
deprescribing targets
C. Leave all medications unchanged to avoid withdrawal
D. Increase the primary medication dose to simplify
regimen
,Correct Answer: B
Rationale: Medication reconciliation identifies unnecessary
drugs; deprescribing can be planned. Abrupt cessation risks
withdrawal (A). Doing nothing misses harm reduction (C).
Increasing dose worsens polypharmacy (D).
5. An APP uses evidence-based guidelines to choose an
antihypertensive. This demonstrates:
A. Ethical prescribing only
B. Provider accountability only
C. Evidence-based decision-making
D. Cultural competence
Correct Answer: C
Rationale: Applying guidelines exemplifies evidence-based
practice. Ethical prescribing and accountability are broader
constructs; cultural competence relates to tailoring to culture
(D).
6. Which strategy most improves medication adherence in
patients with low health literacy?
A. Providing a 10-page drug brochure
B. Using teach-back and simplified dosing schedules
C. Assuming understanding after verbal instructions
D. Sending refill reminders via text only
Correct Answer: B
Rationale: Teach-back confirms understanding; simplified
regimens reduce confusion. Long brochures overwhelm (A).
,Assuming understanding may miss gaps (C). Text reminders
help but don’t build comprehension (D).
7. During a shared decision-making discussion, an APP
should:
A. Directly order the medication that the APP deems best
B. Encourage the patient to state preferences and goals
C. Limit discussion to benefits, not risks, to avoid confusion
D. Use technical jargon to appear knowledgeable
Correct Answer: B
Rationale: Shared decision-making involves eliciting patient
values. Direct orders bypass patient input (A). Discussing both
benefits and risks fosters informed consent (C). Jargon hinders
communication (D).
8. An APP suspects off-label use of a drug lacking strong
pediatric data. Ethically, the APP must:
A. Prescribe anyway if standard adult dose used
B. Explain limited evidence and obtain informed consent
C. Refuse care solely based on lack of FDA approval
D. Delegate prescribing decision to a pharmacist
Correct Answer: B
Rationale: Informed consent is required for off-label pediatric
use. Adult doses may be inappropriate (A). Refusal without
discussion is paternalistic (C). Pharmacists advise but APP holds
prescribing responsibility (D).
, 9. Which factor increases the risk of iatrogenic
polypharmacy?
A. Single-provider prescribing with full medication review
B. Multiple specialists prescribing without coordination
C. Use of electronic health records with alerts
D. Regular medication reconciliation in every visit
Correct Answer: B
Rationale: Uncoordinated multiple prescribers often lead to
duplicate or interacting meds. Single-provider review and EHR
alerts mitigate risk (A, C). Regular reconciliation also reduces
polypharmacy (D).
10. Under the principle of provider accountability, an
APP must:
A. Shift prescribing errors to supervising physician
B. Document rationale for medication choices clearly
C. Omit documentation to expedite workflow
D. Allow unlicensed staff to chart prescriptions
Correct Answer: B
Rationale: Accountability requires clear record-keeping. Errors
cannot be shifted (A). Omitting documentation violates
standards (C). Only licensed providers may authorize and
document prescriptions (D).
(Questions 11–50 continue below.)
, 11. A physician assistant (PA) is unsure if they can
prescribe a new anticoagulant under their state scope.
The best first step is to:
A. Prescribe and adjust based on patient labs
B. Consult the state’s medical board prescribing
regulations
C. Ask the patient to research online
D. Refer to the drug manufacturer for legal advice
Correct Answer: B
Rationale: State medical board regulations clarify PA
prescribing scope. Other sources are unreliable or
inappropriate.
12. An APP prescribes metformin to a newly diagnosed
diabetic. To ensure ethical prescribing, the APP should:
A. Order baseline renal function tests before initiation
B. Assume normal kidney function in all adults
C. Delay labs to avoid patient costs
D. Delegate lab ordering to nursing staff without oversight
Correct Answer: A
Rationale: Metformin requires renal monitoring to avoid lactic
acidosis. Assumptions risk safety; labs must be ordered and
reviewed by APP.
13. When deprescribing in older adults, the APP should
prioritize stopping medications that:
A. Have the shortest half-life
B. Are prescribed for symptom relief only
