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PHARMACOTHERAPEUTICS FOR ADVANCED
PRACTICE NURSE PRESCRIBERS WITH STRUCTURED
QUESTIONS AND WELL RESEARCHED ANSWERS
Nurse practitioner prescriptive authority is regulated by who? - CORRECT ANSWER>>> The State
Board of Nursing for Each State
What is the benefits of having an APRN prescriber? - CORRECT ANSWER>>> APRN's care for patients
more holistically and include patients in making decisions regarding their care
What does clinical judgement in prescribing include? - CORRECT ANSWER>>> Factoring in the cost
of the particular
What is included in the criteria for choosing and effective drug for a disorder? - CORRECT
ANSWER>>> Consulting nationally recognized guidelines for disease management
NP's thrive under the new health-care reform because of what? - CORRECT ANSWER>>> 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 ANSWER>>> The Distribution of drugs to target tissues may be affected
Drugs that have an significant first-pass effect what? - CORRECT ANSWER>>> 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 ANSWER>>> Lungs
Medroxyprogesterone (Depo Provera) is prescribed IM to create storage reservoir of the drug. What are
storage reserviors> - CORRECT ANSWER>>> 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
ANSWER>>> 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 ANSWER>>> 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 ANSWER>>> Onset of action
Phenytoin required that a trough level be drawn. When and why are peak and trough levels are done -
CORRECT ANSWER>>> To determine if a d rug is in the therapeutic range
Drugs that are receptor agonists may demonstrate what property? - CORRECT ANSWER>>>
Concentrations will produce an adverse effect
Factors that affect gastric drug absorption include - CORRECT ANSWER>>> Lipid solubility of the
drug
Drugs that are receptors antagonists, such as beta-blockers, may cause what? - CORRECT
ANSWER>>> An exaggerated response if abrupt discontinues
Drug administration via IV:
- need to be lipid soluble in order to absorb easily
- Begin distribution in the body immediately
- Are easily absorbed if they are nonionized
4) May use pinocytosis to be absorbed - CORRECT ANSWER>>> Are easily absorbed if they are
nonionized
What is "steady state"? - CORRECT ANSWER>>> 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 ANSWER>>> Additive
Actions taken to reduce drug—drug interaction problems include all of the following EXCEPT:
- Reducing the dosage of one of the drugs
- Scheduling their administration at different times
- Prescribing a third drug to counteract the adverse reaction of the combination
4) Reducing the dosage of both drugs - CORRECT ANSWER>>> 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 ANSWER>>>
What is the period of time called that it takes for a drug too decreased by 50% in the body? -
CORRECT ANSWER>>> Half Life
Drug antagonism is best defined as an effect of a drug that:
- Leads to major physiological and psychological dependence
- Is modified by the concurrent administration of another drug
- Cannot be metabolized before another dose is administered
4. Leads to a decreased physiological response when combined with another drug - CORRECT
ANSWER>>> Is modified by the concurrent administration of another drug
What happens when a drug antagonist is given regularly? - CORRECT ANSWER>>> Down regulated
the number of specific receptors
What should be included in the education fo those who are prescribed oral enteric coated tables -
CORRECT ANSWER>>> 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 ANSWER>>> It
can cause toxicity What medication in the follow is mostly absorbed in the intestines rather than the stomach?
- Sodium bicarb
- ascorbic acid
- salicylic acid
4) glucose - CORRECT ANSWER>>> Sodium Bicarb
Which of the following variables is a factor in drug absorption?
- The smaller the surface area for absorption, the more rapidly the drug is absorbed.
- A rich blood supply to the area of absorption leads to better absorption.
- The less soluble the drug, the more easily it is absorbed.
4) Ionized drugs are easily absorbed across the cell membrane. - CORRECT ANSWER>>> A rich blood
supply of the are of absorption leads to better absorption
What is an advantage of prescribing a sublingual medication? - CORRECT ANSWER>>> Absorbed
rapidly
Drugs that use CYP 3A4 isoenzymes for metabolism may? - CORRECT ANSWER>>> Induced and
inhibit the metabolism of another drug
When do drugs reach steady state? - CORRECT ANSWER>>> After four or give half lives
Ppregulation or hyper sensitization may lead to - CORRECT ANSWER>>> An exaggerated response if
the drug is withdrawn
4. Instructing the patient to report if the drug is not effective - CORRECT ANSWER>>> Instructing the
patient to report if the drug is not effective
Pharmacokinetic factors that affect prescribing include - CORRECT ANSWER>>> Bioavailability
What recommendations bu the Institute of Medicine were made to address the impact of
pharmaceutical promotion - CORRECT ANSWER>>> Conflicts of interest and financial relationships
should be disclosed by those providing education
Under new U.S. FDA labeling, Pregnancy Categories will be: - CORRECT ANSWER>>> Changed to
incorporate a pregnancy risk summary and clinical considerations on the drug label
What does the US FDA Regulate? - CORRECT ANSWER>>> The official labeling of all prescriptions
and over the counter drugs
What is approval of the FDA required for? - CORRECT ANSWER>>> Medical devices, including
artificial joints
When is an investigational new drug filed with the FDA? - CORRECT ANSWER>>> Prior to human
testing of any new drug entity
Phase IV clinical trials in the US are also known as - CORRECT ANSWER>>> Postmarketing research
trials
Is off-label prescribing legal? - CORRECT ANSWER>>> yes if there is scientific evidence for the use
What does the US Drug Enforcement Administration Regulate? - CORRECT ANSWER>>> Registers
manufacturers and prescribers of controlled substances
Are drugs that are disgnedated Schedule II by the DEA refillable - CORRECT ANSWER>>> No. A new
prescription needs to be written
What are some precautions when prescribing a controlled substance? - CORRECT ANSWER>>>
Using tamper-proof paper for all prescriptions written for controlled drugs.
What are some strategies for prescribers to use to prevent the misuse of controlled prescriptions? -
CORRECT ANSWER>>> Use a chemical dependency screening tool; fir limit-setting regarding
controlled substances; and practicing saying no to deal with patients who are push overs
What are some behaviors that predict addition to controlled substances - CORRECT ANSWER>>>
Stealing and borrowing another patients drugs
When are medications agreements/pain medication contracts recommended? - CORRECT
ANSWER>>> Universally for all medications prescribed for chronic pain
When and what do prescriptions needs to be written - CORRECT ANSWER>>> Medical devices,
controlled drugs, and legend drugs Based on the patients below, who is at high risk for experiencing an adverse drug reaction?
- 32-year old male
- 22- year told female
- 3 month old female
4)48 year old male - CORRECT ANSWER>>> 3 month old
Why are infants and babies are a higher risk of adverse drug reactions? - CORRECT ANSWER>>> lack
of safety and efficacy studies in pediatric populations
Why are elderly at high risk of adverse drug reactions? - CORRECT ANSWER>>> 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 ANSWER>>> Type B
The Vaccine Adverse Events Reporting System is - CORRECT ANSWER>>> A voluntary reporting
system that healthcare providers or consumers may use to report vaccine adverse events
What is pharmacoeconomics? - CORRECT ANSWER>>> The analysis of the cost and consequences of
any health-care related treatment or services
The direct cost of drug therapy includes - CORRECT ANSWER>>> Pain and suffering due to
inadequate drug therapy
Indirect costs associated with drug therapy include? - CORRECT ANSWER>>> Loss of wages while
undergoing drug therapy
The intangible cost of drug therapy include? - CORRECT ANSWER>>> Inconvenience, pain, and
suffering incurred with therapy What is it called when a pharmacoeconomic analysis takes place regarding two similar treatments for a
disease? - CORRECT ANSWER>>> Cost-minimization analysis
Cost-effectiveness analysis compares two or more treatments or programs that are: - CORRECT
ANSWER>>> 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 ANSWER>>> Cost-benefit analysis
What is a two-tiered prescription benefit plan? - CORRECT ANSWER>>> 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
ANSWER>>> 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 ANSWER>>> 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:
- Loratadine
- Diphenhydramine
- Ipratropium
4. Albuterol - CORRECT ANSWER>>> Albuterol
Patients with pheochromocytoma should avoid what class of drug and why? - CORRECT
ANSWER>>> Beta- 2 - Agonists as it causes hypertensive crisis
What medications should be use cautiously with African American men with moderate persistent
asthma? - CORRECT ANSWER>>> 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 ANSWER>>> increased risk of asthma
related deaths
What is the bronchodilator of choice for those taking propranolol? - CORRECT ANSWER>>>
Ipratropium
Life-style management for those taking theophylline. - CORRECT ANSWER>>> self-monitoring of
respiratory status w. peak flowmeter; stop smoking; voice environmental triggers for asthma
What does Tiotropium bromide treat (Spiriva)? - CORRECT ANSWER>>> COPD
the medication is an inhaled anticholinergic
How often should Beclomethasone be used for someone with asthma? - CORRECT ANSWER>>>
Daily
What is an effective, cost effective treatment for impetigo form an insect bite? - CORRECT
ANSWER>>> Bacitracin and Ploymixin B
What are the instructions for applying a topical antibiotic or antiviral ointment? - CORRECT
ANSWER>>> Was hands before and after the application of topical antimicrobials
