ADVANCE PHARMACY NR565
MIDTERM EXAM 2025/2026 QUESTIONS
AND ANSWERS 100% PASS
Which schedule drugs can APRNs prescribe? - ANS Schedule II-V
· Who determines and regulates prescriptive authority? - ANS Nurse practitioner scope of
practice is determined by state practice and licensure laws.
· How does limited prescriptive authority impact patients within the healthcare system? -
ANS limited authority creates problems for the patient. The patient is not able to get the care
they need
· What are the key responsibilities of prescribing? - ANS 1. Be prudent and deliberate in your
decision-making process
2. Have a documented provider-patient relationship with the person for whom you are
prescribing
3. Do not prescribe medications for family or friends or for yourself
4. Document a thorough history and physical examination in your records
5.Include any discussions you have with the patient regarding risk factors, side effects, or
therapy options
6. Have a documented plan regarding drug monitoring or titration, if applicable
· What should be used to make prescribing decisions? - ANS
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Pharmakinetiscs and Pharmodynamics of older adults - ANS drug accumulation secondary to
reduced renal function
polypharmacy (the use of five or more medications daily)
greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy
poor patient adherence
· Beer's Criteria - ANS •potentially Inappropriate Medication (PIM) use in older adults
•PIM use in older adults due to medication-disease or medication-syndrome interactions that
may exacerbate the disease or syndrome
•medications to be used cautiously in older adults
•clinically significant drug interactions that should be avoided in older adults
•medications to be avoided or dosage decreased in the presence of impaired kidney function in
older adults (American Geriatric Society Beers Criteria Update Expert Panel, 2019)
CYP450 - ANS Many medications are metabolized through the liver enzyme system called
cytochrome P450 (CYP450). Metabolization can be inhibited or induced by drugs and once this
happens drug-drug interactions can occur.
VISA credit card dept Inhibits Spending on CK and GQ - ANS Valproate
I-soniazid
S-ulfamids
A-miodarone
C-hloramphenical
Ketoconazole
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, G-rapefruit Juice
Q-uinidine
CYP450 Inhibitors - ANS - Decreases the CYP450 which keeps the medication in your body
longer which can cause toxicity
CYP450 INDUCERS - ANS Increase CYP450 to work faster causes
Drugs to leave your body faster.
Inducers for PY450 Chronic Alcholics Steal Phen Phen and Never Refuse Greasy Carbs -
ANS Chronic Alcoholics
St. Johns Wort
Phenytoin
Phenobarbital
Nevirapine
Refiampin
Griseofalvin
Carbamazepine
· What happens when someone has a poor metabolism phenotype? - ANS Metabolizes to
slow or to fast.
How is absorption of intramuscular medication different in neonates? - ANS •Slow and erratic
due to low blood flow in muscles first few days of life
•Why is absorption of medication in the stomach increased in infancy? - ANS Delayed gastric
emptying (adult values reached by 6-8 months)
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
MIDTERM EXAM 2025/2026 QUESTIONS
AND ANSWERS 100% PASS
Which schedule drugs can APRNs prescribe? - ANS Schedule II-V
· Who determines and regulates prescriptive authority? - ANS Nurse practitioner scope of
practice is determined by state practice and licensure laws.
· How does limited prescriptive authority impact patients within the healthcare system? -
ANS limited authority creates problems for the patient. The patient is not able to get the care
they need
· What are the key responsibilities of prescribing? - ANS 1. Be prudent and deliberate in your
decision-making process
2. Have a documented provider-patient relationship with the person for whom you are
prescribing
3. Do not prescribe medications for family or friends or for yourself
4. Document a thorough history and physical examination in your records
5.Include any discussions you have with the patient regarding risk factors, side effects, or
therapy options
6. Have a documented plan regarding drug monitoring or titration, if applicable
· What should be used to make prescribing decisions? - ANS
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Pharmakinetiscs and Pharmodynamics of older adults - ANS drug accumulation secondary to
reduced renal function
polypharmacy (the use of five or more medications daily)
greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy
poor patient adherence
· Beer's Criteria - ANS •potentially Inappropriate Medication (PIM) use in older adults
•PIM use in older adults due to medication-disease or medication-syndrome interactions that
may exacerbate the disease or syndrome
•medications to be used cautiously in older adults
•clinically significant drug interactions that should be avoided in older adults
•medications to be avoided or dosage decreased in the presence of impaired kidney function in
older adults (American Geriatric Society Beers Criteria Update Expert Panel, 2019)
CYP450 - ANS Many medications are metabolized through the liver enzyme system called
cytochrome P450 (CYP450). Metabolization can be inhibited or induced by drugs and once this
happens drug-drug interactions can occur.
VISA credit card dept Inhibits Spending on CK and GQ - ANS Valproate
I-soniazid
S-ulfamids
A-miodarone
C-hloramphenical
Ketoconazole
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, G-rapefruit Juice
Q-uinidine
CYP450 Inhibitors - ANS - Decreases the CYP450 which keeps the medication in your body
longer which can cause toxicity
CYP450 INDUCERS - ANS Increase CYP450 to work faster causes
Drugs to leave your body faster.
Inducers for PY450 Chronic Alcholics Steal Phen Phen and Never Refuse Greasy Carbs -
ANS Chronic Alcoholics
St. Johns Wort
Phenytoin
Phenobarbital
Nevirapine
Refiampin
Griseofalvin
Carbamazepine
· What happens when someone has a poor metabolism phenotype? - ANS Metabolizes to
slow or to fast.
How is absorption of intramuscular medication different in neonates? - ANS •Slow and erratic
due to low blood flow in muscles first few days of life
•Why is absorption of medication in the stomach increased in infancy? - ANS Delayed gastric
emptying (adult values reached by 6-8 months)
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
