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Pharmacotherapeutics for Advanced Practice Nurse Prescribers Questions With Answers….., Exams of Health sciences

Chamberlain College of NursingHealth sciences

Pharmacotherapeutics for Advanced Practice Nurse Prescribers Questions With Answers…..

Typology: Exams

2023/2024

Available from 07/23/2024

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Pharmacotherapeutics for Advanced Practice
Nurse Prescribers Questions With
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 - correctly Answered 3
Medication agreements or "Pain Medication Contracts" are recommended to be used:
1. Universally for all prescribing for chronic pain
2. For patients who have repeated requests for pain medication
3. When you suspect a patient is exhibiting drug-seeking behavior
4. For patients with pain associated with malignancy - correctly Answered 1
Drugs that are prone to cause adverse drug effects include:
1. Diuretics
2. Inhaled anticholinergics
3. Insulins
4. Stimulants - correctly Answered 3
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.
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Download Pharmacotherapeutics for Advanced Practice Nurse Prescribers Questions With Answers….. and more Exams Health sciences in PDF only on Docsity!

Pharmacotherapeutics for Advanced Practice

Nurse Prescribers Questions With

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 - correctly Answered 3 Medication agreements or "Pain Medication Contracts" are recommended to be used:
  5. Universally for all prescribing for chronic pain
  6. For patients who have repeated requests for pain medication
  7. When you suspect a patient is exhibiting drug-seeking behavior
  8. For patients with pain associated with malignancy - correctly Answered 1 Drugs that are prone to cause adverse drug effects include:
  9. Diuretics
  10. Inhaled anticholinergics
  11. Insulins
  12. Stimulants - correctly Answered 3 The U.S. Food and Drug Administration MedWatch system is activated when:
  13. There is an adverse event to a vaccine.
  14. The patient has a severe reaction that is noted in the "Severe Reaction" section in the medication label.
  15. A lactating woman takes a medication that is potentially toxic to the breastfeeding infant.
  1. An adverse event or serious problem occurs with a medication that is not already identified on the label. - correctly Answered 4 The Vaccine Adverse Events Reporting System is:
  2. A mandatory reporting system for all health-care providers when they encounter an adverse vaccine event
  3. A voluntary reporting system that health-care providers or consumers may use to report vaccine adverse events
  4. Utilized to send out safety alerts regarding emerging vaccine safety issues
  5. Activated when a vaccine has been proven to cause significant adverse effects - correctly Answered 2 A comprehensive assessment of a patient should be holistic when trying to determine competence in drug administration. Which of the following factors would the NP omit from this type of assessment?
  6. Financial status
  7. Mobility
  8. Social support
  9. Sexual practices - correctly Answered 4 Elena Vasquez's primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed?
  10. Use correct medical terminology because Spanish has a Latin base.
  11. Use a family member who speaks more English to act as an interpreter.
  12. Use a professional interpreter or a reliable staff member who can act as an interpreter.
  13. Use careful, detailed explanations. - correctly Answered 3 Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug?
  14. Stand facing him and speak slowly and clearly.
  15. Speak in low tones or find a provider who has a lower voice.
  1. Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down
  2. Has a tolerability profile with fewer of the adverse effects that are considered "irritating," such as nausea and dizziness
  3. Must be taken no more than twice a day - correctly Answered 3 Factors in chronic conditions that contribute to nonadherence include:
  4. The complexity of the treatment regimen
  5. The length of time over which it must be taken
  6. Breaks in the usual daily routine, such as vacations and weekends
  7. All of the above - correctly Answered 4 While patient education about their drugs is important, information alone does not necessarily lead to adherence to a drug regimen. Patients report greater adherence when:
  8. The provider spent a lot of time discussing the drugs with them
  9. Their concerns and specific area of knowledge deficit were addressed
  10. They were given written material, such as pamphlets, about the drugs
  11. The provider used appropriate medical and pharmacological terms - correctly Answered 2 Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs:
  12. With a longer half-life so that missed doses produce a longer taper on the drug curve
  13. In oral formulations that are more easily taken
  14. That do not require frequent monitoring
  15. Combined with patient education about the need to adhere even when symptoms are absent - correctly Answered 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?
  1. Have the patient purchase a pill container with compartments for daily or multiple times-per- day dosing.
  2. Match the clinic appointment to the next time the drug is to be refilled.
  3. Write prescriptions for new drugs with shorter times between refills.
  4. Give the patient a clear drug schedule that the provider devises to fit the characteristic of the drug. - correctly Answered 4 Pharmacologic interventions are costly. Patients for whom the cost/benefit variable is especially important include:
  5. Older adults and those on fixed incomes
  6. Patients with chronic illnesses
  7. Patients with copayments for drugs on their insurance
  8. Patients on public assistance - correctly Answered 1 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:
  9. Are well-educated and affluent
  10. Have chronic conditions
  11. Self-monitor drug effects on their symptoms
  12. None of the above guarantee adherence - correctly Answered 4 Monitoring adherence can take several forms, including:
  13. Patient reports from data in a drug diary
  14. Pill counts
  15. Laboratory reports and other diagnostic markers
  16. All of the above - correctly Answered 4 Factors that explain and predict medication adherence include:
  17. Social
  1. Must be an employee of the organization - correctly Answered 3 According to the U.S. Office of Minority Health, poor health outcomes among African Americans are attributed to:
  2. The belief among African Americans that prayer is more powerful than drugs
  3. Poor compliance on the part of the African American patient
  4. The genetic predisposition for illness found among African Americans
  5. Discrimination, cultural barriers, and lack of access to health care - correctly Answered 4 The racial difference in drug pharmacokinetics seen in American Indian or Alaskan Natives are:
  6. Increased CYP 2D6 activity, leading to rapid metabolism of some drugs
  7. Largely unknown due to lack of studies of this population
  8. Rapid metabolism of alcohol, leading to increased tolerance
  9. Decreased elimination of opioids, leading to increased risk for addiction - correctly Answered 2 Pharmacokinetics among Asians are universal to all the Asian ethnic groups.
  10. True
  11. False - correctly Answered 2 Alterations in drug metabolism among Asians may lead to:
  12. Slower metabolism of antidepressants, requiring lower doses
  13. Faster metabolism of neuroleptics, requiring higher doses
  14. Altered metabolism of omeprazole, requiring higher doses
  15. Slower metabolism of alcohol, requiring higher doses - correctly Answered 1 Asians from Eastern Asia are known to be fast acetylators. Fast acetylators:
  16. Require acetylization in order to metabolize drugs
  17. Are unable to tolerate higher doses of some drugs that require acetylization
  1. May have a toxic reaction to drugs that require acetylization
  2. Require higher doses of drugs metabolized by acetylization to achieve efficacy - correctly Answered 4 Hispanic native healers (curanderas):
  3. Are not heavily utilized by Hispanics who immigrate to the United States
  4. Use herbs and teas in their treatment of illness
  5. Provide unsafe advice to Hispanics and should not be trusted
  6. Need to be licensed in their home country in order to practice in the United States - correctly Answered 2 Genetic polymorphisms account for differences in metabolism, including:
  7. Poor metabolizers, who lack a working enzyme
  8. Intermediate metabolizers, who have one working, wild-type allele and one mutant allele
  9. Extensive metabolizers, with two normally functioning alleles
  10. All of the above - correctly Answered 4 Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
  11. A need to monitor drugs metabolized by 2D6 for toxicity
  12. Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors
  13. Decreased conversion of codeine to morphine by CYP 2D
  14. The need for lowered dosages of drugs, such as beta blockers - correctly Answered 2 Rifampin is a nonspecific CYP450 inducer that may:
  15. Lead to toxic levels of rifampin and must be monitored closely
  16. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
  17. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure
  1. Decreased effectiveness of carbamazepine in treating seizures in Asian patients with the HLA- B*1502 allele
  2. Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
  3. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 allele
  4. Patients who have the HLA-B*1502 allele being more likely to have a resistance to carbamazepine - correctly Answered 3 A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the body may lead to:
  5. Decreased effectiveness of irinotecan in the treatment of cancer
  6. Increased adverse drug reactions, such as neutropenia
  7. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-
  8. Increased concerns for irinotecan being carcinogenic - correctly Answered 2 Patients who have a poor metabolism phenotype will have:
  9. Slowed metabolism of a prodrug into an active drug, leading to accumulation of prodrug
  10. Accumulation of inactive metabolites of drugs
  11. A need for increased dosages of medications
  12. Increased elimination of an active drug - correctly Answered 1 Ultra-rapid metabolizers of drugs may have:
  13. To have dosages of drugs adjusted downward to prevent drug accumulation
  14. Active drug rapidly metabolized into inactive metabolites, leading to potential therapeutic failure
  15. Increased elimination of active, nonmetabolized drug
  16. Slowed metabolism of a prodrug into an active drug, leading to an accumulation of prodrug - correctly Answered 2 A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to:
  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 - correctly Answered 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 - correctly Answered 3 A potential harmful effect on patients who take some herbal medication is:
  9. Constipation
  10. Lead poisoning
  11. Diarrhea
  12. Life-threatening rash - correctly Answered 2 A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:
  13. Coumadin, which may lead to bleeding problems
  14. Coumarin, which can cause liver and kidney damage
  15. Cinnamic aldehyde, which is toxic to the kidney
  16. Cinnamate eugenol, which is toxic to the liver - correctly Answered 2 Traditional Chinese medicine utilizes yin (cooling) versus yang (warming) in assessing and treating disease. Menopause is considered a time of imbalance, therefore the Chinese herbalist would prescribe:
  17. Herbs which are yang in nature

Valerian tea causes relaxation and can be used to help a patient fall asleep. Overdosage of valerian (more than 2.5 gm/dose) may lead to:

  1. Cardiac disturbances
  2. Central nervous system depression
  3. Respiratory depression
  4. Skin rashes - correctly Answered 1 The standard dosage of St John's wort for the treatment of mild depression is:
  5. 300 mg daily
  6. 100 mg three times a day
  7. 300 mg three times a day
  8. 600 mg three times a day - correctly Answered 3 Patients need to be instructed regarding the drug interactions with St John's wort, including:
  9. MAO inhibitors
  10. Serotonin reuptake inhibitors
  11. Over-the-counter cough and cold medications
  12. All of the above - correctly Answered 4 Ginseng, which is taken to assist with memory, may potentiate:
  13. Aricept
  14. Insulin
  15. Digoxin
  16. Propranolol - correctly Answered 2 Licorice root is a common treatment for dyspepsia. Drug interactions with licorice include:
  17. Antihypertensives, diuretics, and digoxin
  18. Antidiarrheals, antihistamines, and omeprazole
  1. Penicillin antibiotic class and benzodiazepines
  2. None of the above - correctly Answered 1 Patients should be warned about the overuse of topical wintergreen oil to treat muscle strains, as overapplication can lead to:
  3. Respiratory depression
  4. Cardiac disturbance
  5. Salicylates poisoning
  6. Life-threatening rashes - correctly Answered 3 The role of the NP in the use of herbal medication is to:
  7. Maintain competence in the prescribing of common herbal remedies
  8. Recommend common over-the-counter herbs to patients
  9. Educate patients and guide them to appropriate sources of care
  10. Encourage patients to not use herbal therapy due to the documented dangers - correctly Answered 3 Being competent in the use of information technology in clinical practice is expected in professional nurses. Advanced practice competence includes the ability to:
  11. Search for information using the most common search engines
  12. Serve as content experts in developing, implementing, and evaluating information systems
  13. Write programs to assure the integrity of health information
  14. Use information technology to prescribe drugs - correctly Answered 2 You are going to prescribe a drug and the electronic health record (EHR) alerts you that there is a potential drug-drug interaction. The alert is generated by:
  15. The Food and Drug Administration MedWatch system
  16. TOXNET, the National Institutes of Health alert system
  17. The EHR clinical decision support system

place

  1. Having patients sign informed consent documents to have their data on an EHR - correctly Answered 1 Decision support systems often provide medication alerts that tell the prescriber:
  2. Patient history data with a summary of their diagnoses
  3. The usual dosage for the drug being prescribed
  4. The patient's latest laboratory values, such as potassium levels
  5. Potential drug-to-drug interactions with other medications the patient is taking - correctly Answered 4 Prescribers have been shown to override a medication alert about a patient's allergies when:
  6. The history showed that the patient had tolerated the medication in the past
  7. The benefit outweighed the risk
  8. The medication was therapeutically appropriate and needed
  9. All of the above - correctly Answered 4 The use of information technology for quality improvement in pharmacotherapeutics includes:
  10. Incorporating the use of "apps" into all patient encounters
  11. Tracking data trends within the practice via the electronic health record database
  12. Informing patients that they have access to their medication list via the Internet
  13. Using macros for individualizing patient care management - correctly Answered 2 The advantage of using information technology for patient education includes:
  14. The ability to track the number of times you have given the patient the same instructions regarding their medication
  15. Standardized and individualized patient education that is simultaneously recorded into the patient record
  16. Easy access to private patient information specific to populations with a similar diagnosis
  1. The ability to download and interpret patient information in multiple languages, easily and accurately - correctly Answered 2 One barrier to use of the Internet for both prescribing and for patient teaching is:
  2. Lack of free public access to the Internet
  3. Age, with older adults rarely understanding how to use a computer
  4. Web pages and hyperlinks may change, be deleted, or be replaced
  5. Few Web sites with information about drugs are free - correctly Answered 3 Information technology can be a time-saving device in a busy practice if it is used wisely. One way to make it a help rather than a hindrance is to:
  6. Prioritize what is needed information and avoid spending time reading "interesting" information not central to the problem at hand
  7. Integrate professional and personal searching so that the same browser does not need to be accessed repeatedly
  8. Check e-mail frequently so that patient questions can be addressed promptly
  9. Check for viruses, spyware, and malware - correctly Answered 1 Data in the electronic health record that the provider reviews prior to a patient encounter varies with the clinic setting. In an urgent care clinic, the provider should review:
  10. The patient's current diagnosis and history
  11. Drugs the patient is currently taking
  12. Any recent previous encounter for the same problem as this visit and what was done
  13. All of the above - correctly Answered 4 nformation technology (IT) can also be used to interact with a patient between encounters. Which of the following statements about such interactions is true?
  14. Patients feel the provider does not care about them if they are not seen in a face-to-face encounter.
  15. Data collected from patients between encounters via IT is less accurate and complete.
  16. Collecting data between encounters via IT may mean a more efficient face-to-face encounter.
  1. The analysis of the clinical efficacy of the drug - correctly Answered 3 The direct costs of drug therapy include:
  2. The actual cost of acquiring the medication
  3. The loss of income due to illness
  4. Pain and suffering due to inadequate drug therapy
  5. The cost of a funeral associated with premature death - correctly Answered 3 Indirect costs associated with drug therapy include:
  6. The cost of diagnostic tests to monitor therapeutic levels
  7. Health-care provider time to prescribe and educate the patient
  8. Child-care expenses incurred while receiving therapy
  9. Loss of wages while undergoing drug therapy - correctly Answered 4 The intangible costs of drug therapy include:
  10. Loss of wages while undergoing therapy
  11. Inconvenience, pain, and suffering incurred with therapy
  12. Cost of medical equipment in the laboratory used to monitor therapeutic drug levels
  13. Cost of prescription drug coverage, such as Medicare Part D - correctly Answered 2 When a pharmacoeconomic analysis looks at two or more treatment alternatives that are considered equal in efficacy and compares the costs of each it is referred to as:
  14. Cost-minimization analysis
  15. Cost-of-illness analysis
  16. Cost-effectiveness analysis
  17. Cost-benefit analysis - correctly Answered 1 Cost-effectiveness analysis compares two or more treatments or programs that are:
  18. Not necessarily therapeutically equivalent
  1. Considered equal in efficacy
  2. Compared with the dollar value of the benefit received
  3. Expressed in terms of patient preference or quality-adjusted life years - correctly Answered 1 When the costs of a specific treatment or intervention are calculated and then compared with the dollar value of the benefit received it is referred to as:
  4. Cost-minimization analysis
  5. Cost-of-illness analysis
  6. Cost-effectiveness analysis
  7. Cost-benefit analysis - correctly Answered 4 Mary has a two-tiered prescription benefit plan, which means:
  8. She can receive differing levels of care based on whether she chooses an "in-plan" provider or not.
  9. She is eligible for the new Medicare Part D "donut hole" reduction of costs program.
  10. She pays a higher copay for brand-name drugs than for generic drugs.
  11. She must always choose to be treated with generic drugs first. - correctly Answered 3 Prescribing less-expensive generic drugs or drugs off the $4 retail pharmacy lists:
  12. Increases the complexity of the pharmacoeconomics of prescribing for the individual patient
  13. Increases compliance by reducing the financial burden of drug costs to the patient
  14. Is not sound prescribing practice due to the inferiority of the generic products
  15. Will increase the overall cost of drugs to the system due to the ease of overprescribing less- expensive drugs - correctly Answered 2 James tells you that he is confused by his Medicare Part D coverage plan. An appropriate intervention would be:
  16. Order cognitive testing to determine the source of his confusion.