NR 508 Final Exam Review Questions

NR 508 Final Exam Review Questions

Nurse practitioner prescriptive authority is regulated by:

• The National Council of State Boards of Nursing
• The U.S. Drug Enforcement Administration

• The State Board of Nursing for each state
• The State Board of Pharmacy

(ANS- The State Board of Nursing for each state

The benefits to the patient of having an Advanced Practice Registered Nurse

(APRN) prescriber include:

• Nurses know more about Pharmacology than other prescribers because they take

it both in their basic nursing program and in their APRN program.

• Nurses care for the patient from a holistic approach and include the patient in

decision making regarding their care.

• APRNs are less likely to prescribe narcotics and other controlled substances.
• APRNs are able to prescribe independently in all states, whereas a physician's

assistant needs to have a physician supervising their practice.(ANS- Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care.

Clinical judgment in prescribing includes:

• Factoring in the cost to the patient of the medication prescribed
• Always prescribing the newest medication available for the disease process 1 / 4

• Handing out drug samples to poor patients
• Prescribing all generic medications to cut costs

(ANS- Factoring in the cost to the patient of the medication prescribed

Criteria for choosing an effective drug for a disorder include:

• Asking the patient what drug they think would work best for them
• Consulting nationally recognized guidelines for disease management
• Prescribing medications that are available as samples before writing a

prescription

• Following U.S. Drug Enforcement Administration guidelines for prescribing

(ANS- Consulting nationally recognized guidelines for disease management

Nurse practitioner practice may thrive under health-care reform because of:

• The demonstrated ability of nurse practitioners to control costs and improve

patient outcomes

• The fact that nurse practitioners will be able to practice independently
• The fact that nurse practitioners will have full reimbursement under health-care

reform

• The ability to shift accountability for Medicaid to the state level

(ANS- The demonstrated ability of nurse practitioners to control costs and improve patient outcomes

A patient's nutritional intake and laboratory results reflect hypoalbuminemia. This

is critical to prescribing because:

• Distribution of drugs to target tissue may be affected.
• The solubility of the drug will not match the site of absorption.
• There will be less free drug available to generate an effect. 2 / 4

• Drugs bound to albumin are readily excreted by the kidneys.

(ANS- Distribution of drugs to target tissue may be affected.

Drugs that have a significant first-pass effect:

• Must be given by the enteral (oral) route only
• Bypass the hepatic circulation
• Are rapidly metabolized by the liver and may have little if any desired action
• Are converted by the liver to more active and fat-soluble forms

(ANS- 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 the:

• Kidneys
• Lungs
• Bile and feces
• Skin

(ANS- Bile and feces

Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create

a storage reservoir of the drug. Storage reservoirs:

• Assure that the drug will reach its intended target tissue
• Are the reason for giving loading doses
• Increase the length of time a drug is available and active
• Are most common in collagen tissues

(ANS- Increase the length of time a drug is available and active

• / 4

The NP chooses to give cephalexin every 8 hours based on knowledge of the

drug's:

• Propensity to go to the target receptor
• Biological half-life
• Pharmacodynamics
• Safety and side effects

(ANS- Biological half-life

Azithromycin dosing requires that the first day's dosage be twice those of the other

4 days of the prescription. This is considered a loading dose. A loading dose:

• Rapidly achieves drug levels in the therapeutic range
• Requires four- to five-half-lives to attain
• Is influenced by renal function
• Is directly related to the drug circulating to the target tissues

(ANS- Rapidly achieves 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:

• Minimum adverse effect level
• Peak of action
• Onset of action
• Therapeutic range

(ANS- Onset of action

. Phenytoin requires that a trough level be drawn. Peak and trough levels are done:

• When the drug has a wide therapeutic range
• When the drug will be administered for a short time only
• / 4