MSN 571 FINAL PAPER 2025/2026 QUESTIONS WITH
SOLUTIONS RATED A+
✔✔A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a CYP3A4
inducing drug is prescribed, what drug adjustment may be necessary to maintain a
therapeutic level of CYP3A4 substrate? - ✔✔Increase dosage of the CYP3A4 substrate
✔✔The provider prescribes hydrocodone with acetaminophen for a patient's
postsurgical pain. What instruction will the prescriber include regarding alcohol intake? -
✔✔"You should avoid drinking alcohol while you are taking the pain medication I've
ordered."
✔✔Which order for furosemide is written appropriately by the prescriber? -
✔✔Furosemide [Lasix] 20 mg PO daily
✔✔A drug can cause symptoms that resemble those of Parkinson disease. What action
should the prescriber take to minimize the potential patient risk? - ✔✔Thoroughly
educate the patient about recognizing such symptoms and the need to notify the office
immediately.
✔✔A patient who has been taking sertraline for depression was prescribed azithromycin
to treat an infection by a provider at an after-hours clinic. What action will the primary
care provider take to address the risk this combination of medication has posed for the
patient? - ✔✔Discontinue the azithromycin and write an order for an alternative
antibiotic.
✔✔A patient reports mild nausea within an hour after taking the first two doses of a
newly approved medication. Nausea is not listed among the known side effects of this
drug. What instructions will the provider give the patient? - ✔✔"Take the next dose with
food and call the office if the nausea reoccurs or if other symptoms develop."
✔✔A patient develops shortness of breath shortly after taking the initial dose of a newly
prescribed medication. The patient's heart rate is 86 beats/minute, the respiratory rate is
24 breaths/minute, and the blood pressure is 120/70 mm Hg. The prescriber will
discontinue the drug based on the assumption the patient experienced what medication
induced effect? - ✔✔A side effect
✔✔A provider recommends genetic testing of a patient before prescribing a medication.
What response should the provider give when asked by the patient about the purpose of
genetic testing? - ✔✔"Such testing will tell us how quickly your body is likely to
metabolize, or process, the drug."
✔✔A patient is prescribed digoxin. Which screening will the provider order to monitor for
potential adverse effects from this drug? - ✔✔Serum electrolytes
,✔✔A provider considers prescribing tamoxifen for a woman with breast cancer. Upon
reviewing results of genetic testing, the prescriber notes that the patient has variations
in the CYP2Dy allele resulting in a deficiency of the CYP2D6 isoenzymes. What action
will this deficiency warrant in the prescribing of tamoxifen, a CYP2D6 substrate? -
✔✔The tamoxifen will not be prescribed.
✔✔A patient has taken a narcotic analgesic for chronic pain for several months. At a
follow-up appointment, the provider notes that the patient has been taking more than
the prescribed dosage. The patient has normal vital signs, is awake and alert, and
reports mild pain. What does the provider suspect is responsible for the patient's
response? - ✔✔This patient has developed pharmacodynamic tolerance, which has
increased the minimal effective concentration (MEC) needed for analgesic effect
✔✔Which patient ethnic ancestry creates a risk factor that may result in minimal
beneficial response to tamoxifen therapy? - ✔✔French
✔✔Before initiating cetuximab therapy, the provider will order epidermal growth factor
receptor (EGFR) testing for the patient having which condition? - ✔✔Colorectal cancer
✔✔When considering the benefit of pharmacogenomics, what information should the
prescriber include when prescribing a new medication? - ✔✔Provide definitions and
possible examples of related idiosyncratic responses to this medication
✔✔1. A provider has prescribed a female patient a medication that induces P-
glycoprotein (PGP). The provider will be particularly concerned about which aspects of
the patient's medical history? - ✔✔Intestinal problems, Kidney function, Liver function
✔✔When prescribing medications to infants, it is important for the provider to consider
which fact? - ✔✔Breast-feeding infants are more likely to develop toxicity when the
mother is taking lipid-soluble drugs, Immaturity of renal function in infancy causes
infants to excrete drugs less efficiently. Infants have immature livers, which slows drug
metabolism, Infants are more sensitive to medications that act on the central nervous
system (CNS).
✔✔What will the provider consider when prescribing two drugs that compete for plasma
albumin receptor sites? - ✔✔Binding of one or both agents will be reduced, Plasma
levels of free drug will rise, Plasma levels of free drug will fall
✔✔Which actions occur in most of the fatal medication errors? - ✔✔Giving a drug
intravenously instead of intramuscularly, Administering a drug that sounds like the
prescribed drug, Writing a prescription illegibly
, ✔✔A patient is found to have a genetic deficiency in the biomarker CYP2C19. The
provider recognizes that prescribing clopidogrel will increase the patient's risk for
developing what serious conditions? - ✔✔Myocardial infarction, Stroke
✔✔A provider speaking to a class or a group of pregnant patients correctly teaches that
the highest risk of teratogen-induced gross malformations exists during which time
period - ✔✔During the first trimester
✔✔A pregnant patient asks her provider about the safe use of medications during the
third trimester. What will the provider tell her about drugs taken at this stage? -
✔✔"They may need to be given in higher doses if they undergo renal clearance."
✔✔A woman who breastfeeds her infant must take a prescription medication for 2
weeks. The medication is safe, but the patient wants to make sure her baby receives as
little of the drug as possible. What instructions will the prescriber give the patient to best
address her concerns? - ✔✔"Take the medication immediately after breastfeeding your
baby."
✔✔Which type of medication prescribed to a pregnant patient is more likely to have
effects on her fetus? - ✔✔Lipid-soluble drugs
✔✔A pregnant woman asks why more is not known about the teratogenic effects of
maternal medication ingestion during pregnancy. Which response will the provider offer
to address the patient's concern? - ✔✔"Clinical trials to determine teratogenic effects
would put the fetus at risk."
✔✔An infant developed a pruritic rash following exposure to an allergen. The infant's
parents ask the provider about using a topical antihistamine. What information should
the provider use to address the parents' question? - ✔✔Applying an antihistamine to the
skin can cause toxicity in this age group.
✔✔The parents of a child with asthma ask the provider why their child cannot use oral
corticosteroids more often, because they are so effective. The provider will base the
discussion with the parents on what fact concerning oral corticosteroids? - ✔✔Chronic
glucocorticoid use can inhibit physical growth
✔✔An infant is prescribed a medication that has a narrow therapeutic range and is
excreted by the kidneys. The provider will monitor closely for which effect? -
✔✔Evidence of drug toxicity
✔✔A medication prescribed for a neonate is eliminated primarily by hepatic metabolism.
What action will the prescriber take to minimize risk to the infant? - ✔✔Prescribe a dose
that is relatively lower than an adult dose when adjusted for body surface area
SOLUTIONS RATED A+
✔✔A patient takes a drug that is metabolized by CYP3A4 isoenzymes. If a CYP3A4
inducing drug is prescribed, what drug adjustment may be necessary to maintain a
therapeutic level of CYP3A4 substrate? - ✔✔Increase dosage of the CYP3A4 substrate
✔✔The provider prescribes hydrocodone with acetaminophen for a patient's
postsurgical pain. What instruction will the prescriber include regarding alcohol intake? -
✔✔"You should avoid drinking alcohol while you are taking the pain medication I've
ordered."
✔✔Which order for furosemide is written appropriately by the prescriber? -
✔✔Furosemide [Lasix] 20 mg PO daily
✔✔A drug can cause symptoms that resemble those of Parkinson disease. What action
should the prescriber take to minimize the potential patient risk? - ✔✔Thoroughly
educate the patient about recognizing such symptoms and the need to notify the office
immediately.
✔✔A patient who has been taking sertraline for depression was prescribed azithromycin
to treat an infection by a provider at an after-hours clinic. What action will the primary
care provider take to address the risk this combination of medication has posed for the
patient? - ✔✔Discontinue the azithromycin and write an order for an alternative
antibiotic.
✔✔A patient reports mild nausea within an hour after taking the first two doses of a
newly approved medication. Nausea is not listed among the known side effects of this
drug. What instructions will the provider give the patient? - ✔✔"Take the next dose with
food and call the office if the nausea reoccurs or if other symptoms develop."
✔✔A patient develops shortness of breath shortly after taking the initial dose of a newly
prescribed medication. The patient's heart rate is 86 beats/minute, the respiratory rate is
24 breaths/minute, and the blood pressure is 120/70 mm Hg. The prescriber will
discontinue the drug based on the assumption the patient experienced what medication
induced effect? - ✔✔A side effect
✔✔A provider recommends genetic testing of a patient before prescribing a medication.
What response should the provider give when asked by the patient about the purpose of
genetic testing? - ✔✔"Such testing will tell us how quickly your body is likely to
metabolize, or process, the drug."
✔✔A patient is prescribed digoxin. Which screening will the provider order to monitor for
potential adverse effects from this drug? - ✔✔Serum electrolytes
,✔✔A provider considers prescribing tamoxifen for a woman with breast cancer. Upon
reviewing results of genetic testing, the prescriber notes that the patient has variations
in the CYP2Dy allele resulting in a deficiency of the CYP2D6 isoenzymes. What action
will this deficiency warrant in the prescribing of tamoxifen, a CYP2D6 substrate? -
✔✔The tamoxifen will not be prescribed.
✔✔A patient has taken a narcotic analgesic for chronic pain for several months. At a
follow-up appointment, the provider notes that the patient has been taking more than
the prescribed dosage. The patient has normal vital signs, is awake and alert, and
reports mild pain. What does the provider suspect is responsible for the patient's
response? - ✔✔This patient has developed pharmacodynamic tolerance, which has
increased the minimal effective concentration (MEC) needed for analgesic effect
✔✔Which patient ethnic ancestry creates a risk factor that may result in minimal
beneficial response to tamoxifen therapy? - ✔✔French
✔✔Before initiating cetuximab therapy, the provider will order epidermal growth factor
receptor (EGFR) testing for the patient having which condition? - ✔✔Colorectal cancer
✔✔When considering the benefit of pharmacogenomics, what information should the
prescriber include when prescribing a new medication? - ✔✔Provide definitions and
possible examples of related idiosyncratic responses to this medication
✔✔1. A provider has prescribed a female patient a medication that induces P-
glycoprotein (PGP). The provider will be particularly concerned about which aspects of
the patient's medical history? - ✔✔Intestinal problems, Kidney function, Liver function
✔✔When prescribing medications to infants, it is important for the provider to consider
which fact? - ✔✔Breast-feeding infants are more likely to develop toxicity when the
mother is taking lipid-soluble drugs, Immaturity of renal function in infancy causes
infants to excrete drugs less efficiently. Infants have immature livers, which slows drug
metabolism, Infants are more sensitive to medications that act on the central nervous
system (CNS).
✔✔What will the provider consider when prescribing two drugs that compete for plasma
albumin receptor sites? - ✔✔Binding of one or both agents will be reduced, Plasma
levels of free drug will rise, Plasma levels of free drug will fall
✔✔Which actions occur in most of the fatal medication errors? - ✔✔Giving a drug
intravenously instead of intramuscularly, Administering a drug that sounds like the
prescribed drug, Writing a prescription illegibly
, ✔✔A patient is found to have a genetic deficiency in the biomarker CYP2C19. The
provider recognizes that prescribing clopidogrel will increase the patient's risk for
developing what serious conditions? - ✔✔Myocardial infarction, Stroke
✔✔A provider speaking to a class or a group of pregnant patients correctly teaches that
the highest risk of teratogen-induced gross malformations exists during which time
period - ✔✔During the first trimester
✔✔A pregnant patient asks her provider about the safe use of medications during the
third trimester. What will the provider tell her about drugs taken at this stage? -
✔✔"They may need to be given in higher doses if they undergo renal clearance."
✔✔A woman who breastfeeds her infant must take a prescription medication for 2
weeks. The medication is safe, but the patient wants to make sure her baby receives as
little of the drug as possible. What instructions will the prescriber give the patient to best
address her concerns? - ✔✔"Take the medication immediately after breastfeeding your
baby."
✔✔Which type of medication prescribed to a pregnant patient is more likely to have
effects on her fetus? - ✔✔Lipid-soluble drugs
✔✔A pregnant woman asks why more is not known about the teratogenic effects of
maternal medication ingestion during pregnancy. Which response will the provider offer
to address the patient's concern? - ✔✔"Clinical trials to determine teratogenic effects
would put the fetus at risk."
✔✔An infant developed a pruritic rash following exposure to an allergen. The infant's
parents ask the provider about using a topical antihistamine. What information should
the provider use to address the parents' question? - ✔✔Applying an antihistamine to the
skin can cause toxicity in this age group.
✔✔The parents of a child with asthma ask the provider why their child cannot use oral
corticosteroids more often, because they are so effective. The provider will base the
discussion with the parents on what fact concerning oral corticosteroids? - ✔✔Chronic
glucocorticoid use can inhibit physical growth
✔✔An infant is prescribed a medication that has a narrow therapeutic range and is
excreted by the kidneys. The provider will monitor closely for which effect? -
✔✔Evidence of drug toxicity
✔✔A medication prescribed for a neonate is eliminated primarily by hepatic metabolism.
What action will the prescriber take to minimize risk to the infant? - ✔✔Prescribe a dose
that is relatively lower than an adult dose when adjusted for body surface area
