Pharmacotherapeutics for Advanced Practice Nurse Prescribers Questions and answers, Exams of Pharmacology

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Questions and answers

Nurse practitioner prescriptive authority is regulated by who? CORRECT ANSWERS✅ The State Board of Nursing for Each State What is the benefits of having an APRN prescriber? CORRECT ANSWERS✅ APRN's care for patients more holistically and include patients in making decisions regarding their care What does clinical judgement in prescribing include? CORRECT ANSWERS✅ Factoring in the cost of the particular What is included in the criteria for choosing and effective drug for a disorder? CORRECT ANSWERS✅ Consulting nationally recognized guidelines for disease management NP's thrive under the new health-care reform because of what? CORRECT ANSWERS✅ NP's have the ability to control care cost and improve patient outcome Nutritional intake and lab results reflect hypoalbuminemia; why is this important for prescribers? CORRECT ANSWERS✅ The Distribution of drugs to target tissues may be affected Drugs that have an significant first-pass effect what? CORRECT ANSWERS✅ they are rapidly metabolized by the liver and may have little if any desired action The route of excretion of a volatile drug will likely be? CORRECT ANSWERS✅ Lungs

Questions and answers

Medroxyprogesterone (Depo Provera) is prescribed IM to create storage reservoir of the drug. What are storage reserviors> CORRECT ANSWERS✅ Increased the length of time a drug is available and active Why is Cephalexin given every 8 hours? What knowledge of the drug does the NP know? CORRECT ANSWERS✅ Half Life Azithromycin doing requires that the first day's doing be twice those of the other four day; This is considered a loading does. What is a loading dose? CORRECT ANSWERS✅ Rapidly actives drug levels in the therapeutic range The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the: CORRECT ANSWERS✅ Onset of action Phenytoin required that a trough level be drawn. When and why are peak and trough levels are done CORRECT ANSWERS✅ To determine if a d rug is in the therapeutic range Drugs that are receptor agonists may demonstrate what property? CORRECT ANSWERS✅ Concentrations will produce an adverse effect Factors that affect gastric drug absorption include CORRECT ANSWERS✅ Lipid solubility of the drug Drugs that are receptors antagonists, such as beta-blockers, may cause what? CORRECT ANSWERS✅ An exaggerated response if abrupt discontinues

Questions and answers

3. The fetal-placental barrier protects the fetus from drugs taken by the mother.
4. Lipid-soluble drugs do not pass these barriers and are safe for pregnant women CORRECT ANSWERS✅ The blood-brain barrier slows the entry of many drugs into and from brain cells. What is the purpose of phase I and phase II of metabolism in the liver? CORRECT ANSWERS✅ Change drug molecules to a form that an excretory organ can excrete What happens to the metabolites after they are metabolized in the liver? CORRECT ANSWERS✅ the metabolite may or may not be more active than the parent drug and they are totally deactivated so they are excreted without and effect; it depends on the medication being given What causes the body to increased the excretion of a drug through the renal system CORRECT ANSWERS✅ Unbinding a nonvolatile drug from plasma proteins. What is "steady state"? CORRECT ANSWERS✅ When the amount of the drug in the body remains constant When two pain medications are given together to treat pain, what kind of drug-to- drug interaction occurs? CORRECT ANSWERS✅ Additive Actions taken to reduce drug—drug interaction problems include all of the following EXCEPT:
5. Reducing the dosage of one of the drugs
6. Scheduling their administration at different times
7. Prescribing a third drug to counteract the adverse reaction of the combination

Questions and answers

4. Reducing the dosage of both drugs CORRECT ANSWERS✅ Prescribing a third drug to counteract the adverse reaction of the combination What reduces the inhibition properties of Phase 1 Oxidative reductive process of drug metabolism? CORRECT ANSWERS✅ What is the period of time called that it takes for a drug too decreased by 50% in the body? CORRECT ANSWERS✅ Half Life Drug antagonism is best defined as an effect of a drug that:

1. Leads to major physiological and psychological dependence
2. Is modified by the concurrent administration of another drug
3. Cannot be metabolized before another dose is administered
4. Leads to a decreased physiological response when combined with another drug CORRECT ANSWERS✅ Is modified by the concurrent administration of another drug What happens when a drug antagonist is given regularly? CORRECT ANSWERS✅ Down regulated the number of specific receptors What should be included in the education fo those who are prescribed oral enteric coated tables CORRECT ANSWERS✅ To achieve best effect, take the tablet with at least 8 oz of fluids What is the main reason for not crushing a sustained-released. capsule? CORRECT ANSWERS✅ It can cause toxicity

Questions and answers

Ppregulation or hyper sensitization may lead to CORRECT ANSWERS✅ An exaggerated response if the drug is withdrawn Why do prescribers often use liquid medications such as liquid ibuprofen for children? CORRECT ANSWERS✅ Children often able to swallow pills In deciding which of multiple drugs used to treat a condition, the NPO chooses Drug A because it:

1. Has serious side effects and it is being used for a life-threatening condition
2. Will be taken twice daily and will be taken at home
3. Is expensive, but covered by health insurance
4. Non of these are important in choosing a drug CORRECT ANSWERS✅ Will be taken twice daily and will be taken at home What is known about the differences between the pharmacokinetics of men and women. CORRECT ANSWERS✅ Percentage of fat differs between genders What is the first step of the prescribing process according to WHO? CORRECT ANSWERS✅ Diagnosis the problem Treatment goals in prescribing should: CORRECT ANSWERS✅ be patient-centered The therapeutic goals when prescribing include CORRECT ANSWERS✅ curative, palliative, and preventative

Questions and answers

When determining drug treatment, what should an NP always do? CORRECT ANSWERS✅ Individualize the drug choice for the specific patient What should patient education include when prescribing a medication? CORRECT ANSWERS✅ Discussion on adverse effects of the medication Passive monitoring of drug effectiveness includes:

1. Therapeutic drug levels
2. Adding or subtracting medications from the treatment regimen
3. Ongoing provider visits
4. Instructing the patient to report if the drug is not effective CORRECT ANSWERS✅ Instructing the patient to report if the drug is not effective Pharmacokinetic factors that affect prescribing include CORRECT ANSWERS✅ Bioavailability What recommendations bu the Institute of Medicine were made to address the impact of pharmaceutical promotion CORRECT ANSWERS✅ Conflicts of interest and financial relationships should be disclosed by those providing education Under new U.S. FDA labeling, Pregnancy Categories will be: CORRECT ANSWERS✅ Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label What does the US FDA Regulate? CORRECT ANSWERS✅ The official labeling of all prescriptions and over the counter drugs

Questions and answers

What are some behaviors that predict addition to controlled substances CORRECT ANSWERS✅ Stealing and borrowing another patients drugs When are medications agreements/pain medication contracts recommended? CORRECT ANSWERS✅ Universally for all medications prescribed for chronic pain When and what do prescriptions needs to be written CORRECT ANSWERS✅ Medical devices, controlled drugs, and legend drugs Based on the patients below, who is at high risk for experiencing an adverse drug reaction?

1. 32-year old male
2. 22- year told female
3. 3 month old female 4)48 year old male CORRECT ANSWERS✅ 3 month old Why are infants and babies are a higher risk of adverse drug reactions? CORRECT ANSWERS✅ lack of safety and efficacy studies in pediatric populations Why are elderly at high risk of adverse drug reactions? CORRECT ANSWERS✅ Age- related decrease in renal function The type of adverse drug reaction that is idiosyncratic when a drug is given in the usual therapeutic dose is type CORRECT ANSWERS✅ Type B

Questions and answers

Digoxin may cause a type A adverse drug reaction due to:

1. Idiosyncratic effects
2. Its narrow therapeutic index
3. Being a teratogen
4. Being a carcinogen CORRECT ANSWERS✅ Its narrow therapeutic index What type of reaction occurs after a medication is used? CORRECT ANSWERS✅ Type IV If neutropenia occurs after the use of a topical medication, what type of reaction is neutropenia characterized as CORRECT ANSWERS✅ Cytotoxic hypersensitivyt reaction What type of reaction is anaphylactic shock? CORRECT ANSWERS✅ Type 1 Reaction; Also known as an immediate hypersensitivity reaction What time of reaction is someone using a corticosteroid at risk for? CORRECT ANSWERS✅ Type C Why do immunomodulators such as azathioprine cause a delayed reaction (type D reaction) CORRECT ANSWERS✅ because they are carcinogens An example of a first-dose reaction that may occur includes:
5. Orthostatic hypotension that does not occur with repeated doses
6. Purple glove syndrome with phenytoin use

Questions and answers

What is it called when a pharmacoeconomic analysis takes place regarding two similar treatments for a disease? CORRECT ANSWERS✅ Cost-minimization analysis Cost-effectiveness analysis compares two or more treatments or programs that are: CORRECT ANSWERS✅ not necessarily therapeutically equivalent When the cost of a specific treatment or intervention are calculated and then compared with the dollar value of the benefit received it is referred to as CORRECT ANSWERS✅ Cost-benefit analysis What is a two-tiered prescription benefit plan? CORRECT ANSWERS✅ Higher co- pay for brand name drugs than for generic drugs When a provider proscribes a less expensive drug what does it increase and how? CORRECT ANSWERS✅ Compliance & by decreasing the financial burden set on the patient When someone asks to explain what a coverage plan means, such as a Medicare plan, what should the NP do? CORRECT ANSWERS✅ Refer the patient to a Medicare Specialist at his insurance carrier to explain the benefits of his insurance Digoxin levels need to be monitored closely when the following medication is started:

1. Loratadine
2. Diphenhydramine
3. Ipratropium
4. Albuterol CORRECT ANSWERS✅ Albuterol

Questions and answers

Patients with pheochromocytoma should avoid what class of drug and why? CORRECT ANSWERS✅ Beta-2-Agonists as it causes hypertensive crisis What medications should be use cautiously with African American men with moderate persistent asthma? CORRECT ANSWERS✅ Salmeterol - It is an inhaled long-acting beta agonist; studies showed increase of respiratory and asthma related deaths in African Americans LTBA's received a black box warning due to? CORRECT ANSWERS✅ increased risk of asthma related deaths What is the bronchodilator of choice for those taking propranolol? CORRECT ANSWERS✅ Ipratropium Life-style management for those taking theophylline. CORRECT ANSWERS✅ self- monitoring of respiratory status w. peak flowmeter; stop smoking; voice environmental triggers for asthma What does Tiotropium bromide treat (Spiriva)? CORRECT ANSWERS✅ COPD the medication is an inhaled anticholinergic How often should Beclomethasone be used for someone with asthma? CORRECT ANSWERS✅ Daily What are some side effects if montelukast (singular)? CORRECT ANSWERS✅ Aggression, anxiety, depression, and or suicidal thoughts

Questions and answers

What is the first line decongestant for someone who is hypertensive? CORRECT ANSWERS✅ Nasal Oxymetazoline What is the first line treatment for a 5 year old with a URI? CORRECT ANSWERS✅ Fluids and symptomatic care What is an effective, cost effective treatment for impetigo form an insect bite? CORRECT ANSWERS✅ Bacitracin and Ploymixin B What are the instructions for applying a topical antibiotic or antiviral ointment? CORRECT ANSWERS✅ Was hands before and after the application of topical antimicrobials