pg. 1 NR 565 – Chamberlain - Advanced Pharmacology Midterm Exam Latest 2024 Actual Exam Questions with Correct Verified Answers/ Graded A+
During what trimester is a pregnant woman most at risk for adverse drug reactions with potential long term consequences? - Correct Answer - 1st trimester (fetus most at risk d/t rapid growth)
Who regulates prescriptive authority? - Correct Answer - the jurisdiction of a health professional board. This may be the State Board of Nursing, the State Board of Medicine, or the State Board of Pharmacy, as determined by each state.
What is scope of practice determined by? - Correct Answer - is determined by state practice and licensure laws.
What is full practice authority? - Correct Answer - Nurse practitioners have the autonomy to evaluate patients, diagnose, order and interpret tests, initiate and manage treatments and prescribe medications, including controlled substances without physician oversight.
What is reduced practice authority? - Correct Answer - Nurse practitioners are limited in at least one element of practice. The state requires a formal collaborative agreement with an outside health discipline for the nurse practitioner to provide patient care. ex/ physician involvement for 5 yrs than independent
What is restricted practice authority? - Correct Answer - Nurse practitioners are limited in at least one element of practice by requiring supervision, delegation, or team management by an outside health discipline for the nurse practitioner to provide patient care.- typically doctor on site 1 / 4
pg. 2 What is the purpose of the Genetic Information Non-Discriminatory Act? - Correct Answer - Protects patients from discrimination by employers and insurance providers based on genetic information
Difference between practice authority and prescriptive authority? - Correct Answer - Practice authority refers to the nurse practitioner's ability to practice without physician oversight, whereas prescriptive authority refers to the nurse practitioner's authority to prescribe medications independently and without limitations.
What is the most important cause of adverse drug reactions? (older age)
- high drug dosages
- lack of monitoring medications
- decreased renal excretion
- overprescribing/polypharmacy - Correct Answer - decreased renal excretion
Distribution of medication can be affected in the elderly in what ways? SATA
- decreased hormones
- increased body fat
- decreased lean mass
- decreased albumin - Correct Answer - 2, 3, 4
changes in body composition associated with age due to an increase in body fat percentage and decrease in lean muscle mass. There is also a decrease in total body water. Distribution can also be impacted by decreased total body water and decreased cardiac output. Absorption can be impacted by increase gastric pH, decreased absorption surface area decreased G.I. motility and decrease gastric emptying.Metabolism can be impacted by de Cristo paddock blood flow, paddock mask, and activity of hepatic enzymes. Excretion can be impacted by decreased renal blood flow, decrease GFR, decrees to both secretion, and decrease number of nephrons
An 82 year old male visits the clinic complaining that his pain medications "take forever" to work after he takes his pill. What are possible reasons you can explain to him?
1.Perhaps we need to increase your dosage. 2 / 4
pg. 3 2.Sometimes as you get older, absorption may be slower resulting in a delayed response.
3.As we get older the gastric acid decreases and may slow absorption. - Correct Answer
- 2&3
What are some potential problems that arise with written prescriptions? - Correct Answer - Must contain all elements May have pre-populated information Write legibly Avoid error prone abbreviations Tamper resistant scripts are often required
Reasons for monitoring drug therapy - Correct Answer - determining therapeutic dosage evaluating medication adequacy identifying adverse effects serious or life-threatening risks.
Which schedules of drugs can APRNs prescribe? - Correct Answer - depends on state - most II-V
What are black box warnings? - Correct Answer - Is the strongest safety warning a drug can carry and still remain on the market. Usually presented on the label with a heavy black border.
Why are black box warnings issued? - Correct Answer - Issued by the FDA due to having serious or life-threatening risks
What is neonate and infant drug dosing based on? - Correct Answer - weight or body surface area (BSA)
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pg. 4 How does limited prescriptive authority impact patients within the healthcare system? - Correct Answer - longer wait times to sign a prescription limits practitioners that are needed in rural areas unequal relationships between providers. Ex. one has more power high need for providers due to lack of providers and high amounts of patients.Independent practitioners= more patients being seen= lessens the patient/provider load
Provider key responsibilities when prescribing? - Correct Answer - safe and competent practice understanding of the drugs, reactions, and pharmacology Be aware of the age group you are prescribing to Ex. Children vs older adults
What should be used to make prescribing decisions? - Correct Answer - documented provider-patient relationship, not prescribing for family or friends, documenting a thorough H&P, including discussions with the patient, drug monitoring/titrating.cost, guidelines, availability, interactions, side effects, allergies, hepatic and renal function, need for monitoring, and special populations
What happens when someone has a poor metabolism phenotype? - Correct Answer - medications metabolized slower, medication might not work or put them at risk for side- effects
What does the US food and drug administration regulate when it comes to medications?
- Correct Answer - Whether the drug is safe, effective, and benefits of a drug outweigh
the risks
reasons for medication non-adherence - Correct Answer - patients never filling/refilling prescriptions (resulting in therapeutic failure) multiple chronic disorders multiple prescription medications multiple doses per day for each medication
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