PHARMACOTHERAPEUTICS FOR ADVANCED v v
Pharmacotherapeutics
PRACTICE NURSE for Advanced Practice Nurse
PRESCRIBERS,
v
v
5THv
Prescribers,
EDITION
v 5th Wv v
v
v
v
v
v
edition Woo Robinson Test Bank v v v v
OO ROBINSON TESTBANK v v
PharmacotherapeuticsvforvAdvancedvPracticevNursevPrescribers,v5thveditionvWoovRobinsonvTestvBank
Chapterv1.vThevRolevofvthevNursevPractitionervasvPrescriberv
MultiplevChoice
Identifyvthevchoicevthatvbestvcompletesvthevstatementvorvanswersvthevquestion.
v 1.vNursevpractitionervprescriptivevauthorityvisvregulatedv by:
1. ThevNationalvCouncilvofvStatevBoardsvofvNursing
2. ThevU.S.vDrugvEnforcementvAdministration
3. ThevStatevBoardvofvNursingvforveachvstate
4. ThevStatevBoardvofvPharmacy
v 2.vThevbenefitsvtovthevpatientvofvhavingvanvAdvancedvPracticevRegisteredvNursev(APRN)vprescribervi
nclude:
1. NursesvknowvmorevaboutvPharmacologyvthanvothervprescribersvbecausevtheyvtakevitv
bothvinvtheirvbasicvnursingvprogramvandvinvtheirvAPRNvprogram.
2. Nursesvcarevforvthevpatientvfromvavholisticvapproachvandvincludevthevpatientvinvd
ecisionvmakingvregardingvtheirvcare.
3. APRNsvarevlessvlikelyvtovprescribevnarcoticsvandvothervcontrolledvsubstances.
4. APRNsvarevablevtovprescribevindependentlyvinvallvstates,vwhereasvavphysician’sv
assistantvneedsvtovhavevavphysicianvsupervisingvtheirvpractice.
v 3.vClinicalvjudgmentvinvprescribingv includes:
1. Factoringvinvthevcostvtovthevpatientvofvthevmedicationvprescribed
2. Alwaysvprescribingvthevnewestvmedicationvavailablevforvthevdiseasevprocess
3. Handingvoutvdrugvsamplesvtovpoorvpatients
4. Prescribingvallvgenericvmedicationsvtovcutvcosts
v 4.vCriteriavforvchoosingvanveffectivevdrugvforvavdisorderv include:
1. Askingvthevpatientvwhatvdrugvtheyvthinkvwouldvworkvbestvforvthem
2. Consultingvnationallyvrecognizedvguidelinesvforvdiseasevmanagement
3. Prescribingvmedicationsvthatvarevavailablevasvsamplesvbeforevwritingvavprescription
4. FollowingvU.S.vDrugvEnforcementvAdministrationvguidelinesvforvprescribing
v 5.vNursevpractitionervpracticevmayvthrivevundervhealth-carevreformvbecausev of:
1. Thevdemonstratedvabilityvofvnursevpractitionersvtovcontrolvcostsvandvimprovevpatientv
outcomes
2. Thevfactvthatvnursevpractitionersvwillvbevablevtovpracticevindependently
3. Thevfactvthatvnursevpractitionersvwillvhavevfullvreimbursementvundervhealth-
vcarevreform
4. ThevabilityvtovshiftvaccountabilityvforvMedicaidvtovthevstatevlevel
, Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 5th e
v v v v v v vv
dition Woo Robinson Test Bank
v v v v
Chapterv1.vThevRolevofvthevNursevPractitionervasvPrescribervA
nswervSection
MULTIPLEvCHOICE
1.vANS: 3 PTS: 1
2.vANS: 2 PTS: 1
3.vANS: 1 PTS: 1
4.vANS: 2 PTS: 1
5.vANS: 1 PTS: 1
, Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 5th e
v v v v v v vv
dition Woo Robinson Test Bank v v v v
Chapterv2.vReviewvofvthevBasicvPrinciplesvofvPharmacologyvM
ultiplevChoice
Identifyvthevchoicevthatvbestvcompletesvthevstatementvorvanswersvthevquestion.
v 1.vAvpatient’svnutritionalvintakevandvlaboratoryvresultsvreflectvhypoalbuminemia.vThisvisvcriticalvtovp
rescribingvbecause:
1. Distributionvofvdrugsvtovtargetvtissuevmayvbevaffected.
2. Thevsolubilityvofvthevdrugvwillvnotvmatchvthevsitevofvabsorption.
3. Therevwillvbevlessvfreevdrugvavailablevtovgeneratevanveffect.
4. Drugsvboundvtovalbuminvarevreadilyvexcretedvbyvthevkidneys.
v 2.vDrugsvthatvhavevavsignificantvfirst-passv effect:
1. Mustvbevgivenvbyvtheventeralv(oral)vroutevonly
2. Bypassvthevhepaticvcirculation
3. Arevrapidlyvmetabolizedvbyvthevlivervandvmayvhavevlittlevifvanyvdesiredvaction
4. Arevconvertedvbyvthevlivervtovmorevactivevandvfat-solublevforms
v 3.vThevroutevofvexcretionvofvavvolatilevdrugvwillvlikelyvbev the:
1. Kidneys
2. Lungs
3. Bilevandvfeces
4. Skin
v 4.vMedroxyprogesteronev(DepovProvera)visvprescribedvintramuscularlyv(IM)vtovcreatevavstoragevr
eservoirvofvthevdrug.vStoragevreservoirs:
1. Assurevthatvthevdrugvwillvreachvitsvintendedvtargetvtissue
2. Arevthevreasonvforvgivingvloadingvdoses
3. Increasevthevlengthvofvtimevavdrugvisvavailablevandvactive
4. Arevmostvcommonvinvcollagenvtissues
v 5.vThevNPvchoosesvtovgivevcephalexinveveryv8vhoursv basedvonvknowledgevofvthev drug’s:
1. Propensityvtovgovtovthevtargetvreceptor
2. Biologicalvhalf-life
3. Pharmacodynamics
4. Safetyvandvsideveffects
v 6.vAzithromycinvdosingvrequiresvthatvthevfirstvday’svdosagevbevtwicevthosevofvthevotherv4vdaysvofvthevpr
escription.vThisvisvconsideredvavloadingvdose.vAvloadingvdose:
1. Rapidlyvachievesvdrugvlevelsvinvthevtherapeuticvrange
2. Requiresvfour-vtovfive-half-livesvtovattain
3. Isvinfluencedvbyvrenalvfunction
4. Isvdirectlyvrelatedvtovthevdrugvcirculatingvtovthevtargetvtissues
v 7.vThevpointvinvtimevonvthevdrugvconcentrationvcurvevthatvindicatesvthevfirstvsignvofvavtherapeuticveffectvis
vthe:
1. Minimumvadverseveffectvlevel
2. Peakvofvaction
, Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 5th e
v v v v v v vv
dition Woo Robinson Test Bank
v v v v
3. Onsetvofvaction
4. Therapeuticvrange
v 8.vPhenytoinvrequiresvthatvavtroughvlevelvbevdrawn.vPeakvandvtroughvlevelsvarev done:
1. Whenvthevdrugvhasvavwidevtherapeuticvrange
2. Whenvthevdrugvwillvbevadministeredvforvavshortvtimevonly
3. Whenvtherevisvavhighvcorrelationvbetweenvthevdosevandvsaturationvofvreceptorvsites
4. Tovdeterminevifvavdrugvisvinvthevtherapeuticvrange
v 9.vAvlaboratoryvresultvindicatesvthatvthevpeakvlevelvforvavdrugvisvabovevthevminimumv toxicvconcentration.
Thisvmeansvthatvthe:
1. Concentrationvwillvproducevtherapeuticveffects
2. Concentrationvwillvproducevanvadversevresponse
3. Timevbetweenvdosesvmustvbevshortened
4. Durationvofvactionvofvthevdrugvisvtoovlong
10.vDrugsvthatvarevreceptorvagonistsvmayvdemonstratevwhatv property?
v
1. Irreversiblevbindingvtovthevdrugvreceptorvsite
2. Upregulationvwithvchronicvuse
3. Desensitizationvorvdownregulationvwithvcontinuousvuse
4. Inversevrelationshipvbetweenvdrugvconcentrationvandvdrugvaction
11.vDrugsvthatvarevreceptorvantagonists,vsuchvasvbetavblockers,vmayvcause:
v
1. Downregulationvofvthevdrugvreceptor
2. Anvexaggeratedvresponsevifvabruptlyvdiscontinued
3. Partialvblockadevofvtheveffectsvofvagonistvdrugs
4. Anvexaggeratedvresponsevtovcompetitivevdrugvagonists
12.vFactorsvthatvaffectvgastricvdrugvabsorptionvinclude:
v
1. Livervenzymevactivity
2. Protein-bindingvpropertiesvofvthevdrugvmolecule
3. Lipidvsolubilityvofvthevdrug
4. Abilityvtovchewvandvswallow
13.vDrugsvadministeredvviav IV:
v
1. Needvtovbevlipidvsolublevinvordervtovbeveasilyvabsorbed
2. Beginvdistributionvintovthevbodyvimmediately
3. Areveasilyvabsorbedvifvtheyvarevnonionized
4. Mayvusevpinocytosisvtovbevabsorbed
14.vWhenvavmedicationvisvaddedvtovavregimenvforvavsynergisticveffect,vthevcombinedveffectvofvthevdrugsvis:
v
1. Thevsumvofvtheveffectsvofveachvdrugvindividually
2. Greatervthanvthevsumvofvtheveffectsvofveachvdrugvindividually
3. Lessvthanvtheveffectvofveachvdrugvindividually
4. Notvpredictable,vasvitvvariesvwithveachvindividual
15.vWhichvofvthevfollowingvstatementsvaboutvbioavailabilityvisvtrue?
v
1. Bioavailabilityvissuesvarevespeciallyvimportantvforvdrugsvwithvnarrowvtherapeuticvr
angesvorvsustained-releasevmechanisms.
2. Allvbrandsvofvavdrugvhavevthevsamevbioavailability.
Pharmacotherapeutics
PRACTICE NURSE for Advanced Practice Nurse
PRESCRIBERS,
v
v
5THv
Prescribers,
EDITION
v 5th Wv v
v
v
v
v
v
edition Woo Robinson Test Bank v v v v
OO ROBINSON TESTBANK v v
PharmacotherapeuticsvforvAdvancedvPracticevNursevPrescribers,v5thveditionvWoovRobinsonvTestvBank
Chapterv1.vThevRolevofvthevNursevPractitionervasvPrescriberv
MultiplevChoice
Identifyvthevchoicevthatvbestvcompletesvthevstatementvorvanswersvthevquestion.
v 1.vNursevpractitionervprescriptivevauthorityvisvregulatedv by:
1. ThevNationalvCouncilvofvStatevBoardsvofvNursing
2. ThevU.S.vDrugvEnforcementvAdministration
3. ThevStatevBoardvofvNursingvforveachvstate
4. ThevStatevBoardvofvPharmacy
v 2.vThevbenefitsvtovthevpatientvofvhavingvanvAdvancedvPracticevRegisteredvNursev(APRN)vprescribervi
nclude:
1. NursesvknowvmorevaboutvPharmacologyvthanvothervprescribersvbecausevtheyvtakevitv
bothvinvtheirvbasicvnursingvprogramvandvinvtheirvAPRNvprogram.
2. Nursesvcarevforvthevpatientvfromvavholisticvapproachvandvincludevthevpatientvinvd
ecisionvmakingvregardingvtheirvcare.
3. APRNsvarevlessvlikelyvtovprescribevnarcoticsvandvothervcontrolledvsubstances.
4. APRNsvarevablevtovprescribevindependentlyvinvallvstates,vwhereasvavphysician’sv
assistantvneedsvtovhavevavphysicianvsupervisingvtheirvpractice.
v 3.vClinicalvjudgmentvinvprescribingv includes:
1. Factoringvinvthevcostvtovthevpatientvofvthevmedicationvprescribed
2. Alwaysvprescribingvthevnewestvmedicationvavailablevforvthevdiseasevprocess
3. Handingvoutvdrugvsamplesvtovpoorvpatients
4. Prescribingvallvgenericvmedicationsvtovcutvcosts
v 4.vCriteriavforvchoosingvanveffectivevdrugvforvavdisorderv include:
1. Askingvthevpatientvwhatvdrugvtheyvthinkvwouldvworkvbestvforvthem
2. Consultingvnationallyvrecognizedvguidelinesvforvdiseasevmanagement
3. Prescribingvmedicationsvthatvarevavailablevasvsamplesvbeforevwritingvavprescription
4. FollowingvU.S.vDrugvEnforcementvAdministrationvguidelinesvforvprescribing
v 5.vNursevpractitionervpracticevmayvthrivevundervhealth-carevreformvbecausev of:
1. Thevdemonstratedvabilityvofvnursevpractitionersvtovcontrolvcostsvandvimprovevpatientv
outcomes
2. Thevfactvthatvnursevpractitionersvwillvbevablevtovpracticevindependently
3. Thevfactvthatvnursevpractitionersvwillvhavevfullvreimbursementvundervhealth-
vcarevreform
4. ThevabilityvtovshiftvaccountabilityvforvMedicaidvtovthevstatevlevel
, Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 5th e
v v v v v v vv
dition Woo Robinson Test Bank
v v v v
Chapterv1.vThevRolevofvthevNursevPractitionervasvPrescribervA
nswervSection
MULTIPLEvCHOICE
1.vANS: 3 PTS: 1
2.vANS: 2 PTS: 1
3.vANS: 1 PTS: 1
4.vANS: 2 PTS: 1
5.vANS: 1 PTS: 1
, Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 5th e
v v v v v v vv
dition Woo Robinson Test Bank v v v v
Chapterv2.vReviewvofvthevBasicvPrinciplesvofvPharmacologyvM
ultiplevChoice
Identifyvthevchoicevthatvbestvcompletesvthevstatementvorvanswersvthevquestion.
v 1.vAvpatient’svnutritionalvintakevandvlaboratoryvresultsvreflectvhypoalbuminemia.vThisvisvcriticalvtovp
rescribingvbecause:
1. Distributionvofvdrugsvtovtargetvtissuevmayvbevaffected.
2. Thevsolubilityvofvthevdrugvwillvnotvmatchvthevsitevofvabsorption.
3. Therevwillvbevlessvfreevdrugvavailablevtovgeneratevanveffect.
4. Drugsvboundvtovalbuminvarevreadilyvexcretedvbyvthevkidneys.
v 2.vDrugsvthatvhavevavsignificantvfirst-passv effect:
1. Mustvbevgivenvbyvtheventeralv(oral)vroutevonly
2. Bypassvthevhepaticvcirculation
3. Arevrapidlyvmetabolizedvbyvthevlivervandvmayvhavevlittlevifvanyvdesiredvaction
4. Arevconvertedvbyvthevlivervtovmorevactivevandvfat-solublevforms
v 3.vThevroutevofvexcretionvofvavvolatilevdrugvwillvlikelyvbev the:
1. Kidneys
2. Lungs
3. Bilevandvfeces
4. Skin
v 4.vMedroxyprogesteronev(DepovProvera)visvprescribedvintramuscularlyv(IM)vtovcreatevavstoragevr
eservoirvofvthevdrug.vStoragevreservoirs:
1. Assurevthatvthevdrugvwillvreachvitsvintendedvtargetvtissue
2. Arevthevreasonvforvgivingvloadingvdoses
3. Increasevthevlengthvofvtimevavdrugvisvavailablevandvactive
4. Arevmostvcommonvinvcollagenvtissues
v 5.vThevNPvchoosesvtovgivevcephalexinveveryv8vhoursv basedvonvknowledgevofvthev drug’s:
1. Propensityvtovgovtovthevtargetvreceptor
2. Biologicalvhalf-life
3. Pharmacodynamics
4. Safetyvandvsideveffects
v 6.vAzithromycinvdosingvrequiresvthatvthevfirstvday’svdosagevbevtwicevthosevofvthevotherv4vdaysvofvthevpr
escription.vThisvisvconsideredvavloadingvdose.vAvloadingvdose:
1. Rapidlyvachievesvdrugvlevelsvinvthevtherapeuticvrange
2. Requiresvfour-vtovfive-half-livesvtovattain
3. Isvinfluencedvbyvrenalvfunction
4. Isvdirectlyvrelatedvtovthevdrugvcirculatingvtovthevtargetvtissues
v 7.vThevpointvinvtimevonvthevdrugvconcentrationvcurvevthatvindicatesvthevfirstvsignvofvavtherapeuticveffectvis
vthe:
1. Minimumvadverseveffectvlevel
2. Peakvofvaction
, Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 5th e
v v v v v v vv
dition Woo Robinson Test Bank
v v v v
3. Onsetvofvaction
4. Therapeuticvrange
v 8.vPhenytoinvrequiresvthatvavtroughvlevelvbevdrawn.vPeakvandvtroughvlevelsvarev done:
1. Whenvthevdrugvhasvavwidevtherapeuticvrange
2. Whenvthevdrugvwillvbevadministeredvforvavshortvtimevonly
3. Whenvtherevisvavhighvcorrelationvbetweenvthevdosevandvsaturationvofvreceptorvsites
4. Tovdeterminevifvavdrugvisvinvthevtherapeuticvrange
v 9.vAvlaboratoryvresultvindicatesvthatvthevpeakvlevelvforvavdrugvisvabovevthevminimumv toxicvconcentration.
Thisvmeansvthatvthe:
1. Concentrationvwillvproducevtherapeuticveffects
2. Concentrationvwillvproducevanvadversevresponse
3. Timevbetweenvdosesvmustvbevshortened
4. Durationvofvactionvofvthevdrugvisvtoovlong
10.vDrugsvthatvarevreceptorvagonistsvmayvdemonstratevwhatv property?
v
1. Irreversiblevbindingvtovthevdrugvreceptorvsite
2. Upregulationvwithvchronicvuse
3. Desensitizationvorvdownregulationvwithvcontinuousvuse
4. Inversevrelationshipvbetweenvdrugvconcentrationvandvdrugvaction
11.vDrugsvthatvarevreceptorvantagonists,vsuchvasvbetavblockers,vmayvcause:
v
1. Downregulationvofvthevdrugvreceptor
2. Anvexaggeratedvresponsevifvabruptlyvdiscontinued
3. Partialvblockadevofvtheveffectsvofvagonistvdrugs
4. Anvexaggeratedvresponsevtovcompetitivevdrugvagonists
12.vFactorsvthatvaffectvgastricvdrugvabsorptionvinclude:
v
1. Livervenzymevactivity
2. Protein-bindingvpropertiesvofvthevdrugvmolecule
3. Lipidvsolubilityvofvthevdrug
4. Abilityvtovchewvandvswallow
13.vDrugsvadministeredvviav IV:
v
1. Needvtovbevlipidvsolublevinvordervtovbeveasilyvabsorbed
2. Beginvdistributionvintovthevbodyvimmediately
3. Areveasilyvabsorbedvifvtheyvarevnonionized
4. Mayvusevpinocytosisvtovbevabsorbed
14.vWhenvavmedicationvisvaddedvtovavregimenvforvavsynergisticveffect,vthevcombinedveffectvofvthevdrugsvis:
v
1. Thevsumvofvtheveffectsvofveachvdrugvindividually
2. Greatervthanvthevsumvofvtheveffectsvofveachvdrugvindividually
3. Lessvthanvtheveffectvofveachvdrugvindividually
4. Notvpredictable,vasvitvvariesvwithveachvindividual
15.vWhichvofvthevfollowingvstatementsvaboutvbioavailabilityvisvtrue?
v
1. Bioavailabilityvissuesvarevespeciallyvimportantvforvdrugsvwithvnarrowvtherapeuticvr
angesvorvsustained-releasevmechanisms.
2. Allvbrandsvofvavdrugvhavevthevsamevbioavailability.
