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Pharmacotherapeutics for Advanced Practice Nurse Prescribers Questions And Answers, Exams of Pharmacology

Canadian University CollegePharmacology

Pharmacotherapeutics for Advanced Practice Nurse Prescribers Questions And Answers

Typology: Exams

2023/2024

Available from 02/17/2024

Estrelia
Estrelia 🇨🇦

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Pharmacotherapeutics for Advanced
Practice Nurse Prescribers Questions
And Answers
Drugs that use CYP 3A4 isoenzymes for metabolism may:
1. Induce the metabolism of another drug
2. Inhibit the metabolism of another drug
3. Both 1 and 2
4. Neither 1 nor 2 - correct answer 3
Drugs that are prone to cause adverse drug effects include:
1. Diuretics
2. Inhaled anticholinergics
3. Insulins
4. Stimulants - correct answer 3
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Practice Nurse Prescribers Questions

And Answers

Drugs that use CYP 3A4 isoenzymes for metabolism may:

  1. Induce the metabolism of another drug
  2. Inhibit the metabolism of another drug
  3. Both 1 and 2
  4. Neither 1 nor 2 - correct answer 3 Drugs that are prone to cause adverse drug effects include:
  5. Diuretics
  6. Inhaled anticholinergics
  7. Insulins
  8. Stimulants - correct answer 3

Practice Nurse Prescribers Questions

And Answers

The U.S. Food and Drug Administration MedWatch system is activated when:

  1. There is an adverse event to a vaccine.
  2. The patient has a severe reaction that is noted in the "Severe Reaction" section in the medication label.
  3. A lactating woman takes a medication that is potentially toxic to the breastfeeding infant.
  4. An adverse event or serious problem occurs with a medication that is not already identified on the label. - correct answer 4 Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug?
  5. Stand facing him and speak slowly and clearly.
  6. Speak in low tones or find a provider who has a lower voice.

Practice Nurse Prescribers Questions

And Answers

  1. Unrestricted formularies for drugs, including brand names
  2. Increasing the number of people who have access to care
  3. Treating a wider range of disorders - correct answer 1 Ralph's blood pressure remains elevated despite increased doses of his drug. The NP is concerned that he might not be adhering to his treatment regimen. Which of the following events would suggest that he might not be adherent?
  4. Ralph states that he always takes the drug "when I feel my pressure is going up."
  5. Ralph contacts his NP to discuss the need to increase the dosage.
  6. Ralph consistently keeps his follow-up appointments to check his blood pressure.

Practice Nurse Prescribers Questions

And Answers

  1. All of the above show that he is adherent to the drug regimen. - correct answer 1 Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:
  2. Has a short half-life so that missing one dose has limited effect
  3. Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down
  4. Has a tolerability profile with fewer of the adverse effects that are considered "irritating," such as nausea and dizziness
  5. Must be taken no more than twice a day - correct answer 3 Factors in chronic conditions that contribute to nonadherence include:
  6. The complexity of the treatment regimen

Practice Nurse Prescribers Questions

And Answers

Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs:

  1. With a longer half-life so that missed doses produce a longer taper on the drug curve
  2. In oral formulations that are more easily taken
  3. That do not require frequent monitoring
  4. Combined with patient education about the need to adhere even when symptoms are absent - correct answer 1 Many disorders require multiple drugs to treat them. The more complex the drug regimen, the less likely the patient will adhere to it. Which of the following interventions will NOT improve adherence?
  5. Have the patient purchase a pill container with compartments for daily or multiple times-per-day dosing.

Practice Nurse Prescribers Questions

And Answers

  1. Match the clinic appointment to the next time the drug is to be refilled.
  2. Write prescriptions for new drugs with shorter times between refills.
  3. Give the patient a clear drug schedule that the provider devises to fit the characteristic of the drug. - correct answer 4 Providers have a responsibility for determining the best plan of care, but patients also have responsibilities. Patients the provider can be assured will carry through on these responsibilities include those who:
  4. Are well-educated and affluent
  5. Have chronic conditions
  6. Self-monitor drug effects on their symptoms
  7. None of the above guarantee adherence - correct answer 4 Ethnic differences have been found in drug:

Practice Nurse Prescribers Questions

And Answers

According to the National Standards of Culturally and Linguistically Appropriate Services, an interpreter for health care:

  1. May be a bilingual family member
  2. May be a bilingual nurse or other health-care provider
  3. Must be a professionally trained medical interpreter
  4. Must be an employee of the organization - correct answer 3 According to the U.S. Office of Minority Health, poor health outcomes among African Americans are attributed to:
  5. The belief among African Americans that prayer is more powerful than drugs
  6. Poor compliance on the part of the African American patient
  7. The genetic predisposition for illness found among African Americans

Practice Nurse Prescribers Questions

And Answers

  1. Discrimination, cultural barriers, and lack of access to health care - correct answer 4 The racial difference in drug pharmacokinetics seen in American Indian or Alaskan Natives are:
  2. Increased CYP 2D6 activity, leading to rapid metabolism of some drugs
  3. Largely unknown due to lack of studies of this population
  4. Rapid metabolism of alcohol, leading to increased tolerance
  5. Decreased elimination of opioids, leading to increased risk for addiction - correct answer 2 Alterations in drug metabolism among Asians may lead to:
  6. Slower metabolism of antidepressants, requiring lower doses
  7. Faster metabolism of neuroleptics, requiring higher doses

Practice Nurse Prescribers Questions

And Answers

  1. Are not heavily utilized by Hispanics who immigrate to the United States
  2. Use herbs and teas in their treatment of illness
  3. Provide unsafe advice to Hispanics and should not be trusted
  4. Need to be licensed in their home country in order to practice in the United States - correct answer 2 Genetic polymorphisms account for differences in metabolism, including:
  5. Poor metabolizers, who lack a working enzyme
  6. Intermediate metabolizers, who have one working, wild-type allele and one mutant allele
  7. Extensive metabolizers, with two normally functioning alleles
  8. All of the above - correct answer 4

Practice Nurse Prescribers Questions

And Answers

Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:

  1. A need to monitor drugs metabolized by 2D6 for toxicity
  2. Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors
  3. Decreased conversion of codeine to morphine by CYP 2D
  4. The need for lowered dosages of drugs, such as beta blockers - correct answer 2 Rifampin is a nonspecific CYP450 inducer that may:
  5. Lead to toxic levels of rifampin and must be monitored closely
  6. Cause toxic levels of drugs, such as oral contraceptives, when coadministered

Practice Nurse Prescribers Questions

And Answers

  1. Toxic levels of warfarin building up
  2. Decreased response to warfarin
  3. Increased risk for significant drug interactions with warfarin
  4. Less risk of drug interactions with warfarin - correct answer 2 Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required prior to prescribing warfarin.
  5. True
  6. False - correct answer 2 Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to prescribing:
  7. Erythromycin

Practice Nurse Prescribers Questions

And Answers

  1. Digoxin
  2. Cetuximab
  3. Rifampin - correct answer 3 Carbamazepine has a Black Box Warning recommending testing for the HLA-B*1502 allele in patients with Asian ancestry prior to starting therapy due to:
  4. Decreased effectiveness of carbamazepine in treating seizures in Asian patients with the HLA-B*1502 allele
  5. Increased risk for drug interactions in Asian patients with the HLA- B*1502 allele
  6. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 allele
  7. Patients who have the HLA-B*1502 allele being more likely to have a resistance to carbamazepine - correct answer 3

Practice Nurse Prescribers Questions

And Answers

  1. A need for increased dosages of medications
  2. Increased elimination of an active drug - correct answer 1 Ultra-rapid metabolizers of drugs may have:
  3. To have dosages of drugs adjusted downward to prevent drug accumulation
  4. Active drug rapidly metabolized into inactive metabolites, leading to potential therapeutic failure
  5. Increased elimination of active, nonmetabolized drug
  6. Slowed metabolism of a prodrug into an active drug, leading to an accumulation of prodrug - correct answer 2 A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to:

Practice Nurse Prescribers Questions

And Answers

  1. Ensure the patient will not have increased adverse drug reactions to the tamoxifen
  2. Identify potential drug-drug interactions that may occur with tamoxifen
  3. Reduce the likelihood of therapeutic failure with tamoxifen treatment
  4. Identify poor metabolizers of tamoxifen - correct answer 3 A good history of herb and supplement use is critical before prescribing because approximately ____ % of patients in the United States are using herbal products.
  5. 10
  6. 5
  7. 38
  8. 70 - correct answer 3