NR565 / NR 565 Midterm Exam Question Bank (Latest 2025 /
2026): Advanced Pharmacology Fundamentals - Chamberlain
Which schedule drugs can APRNs prescribe? - ANSWER Varies state by state May include schedule II-V, but never schedule I Who determines and regulates prescriptive authority? - ANSWER The state's health professional board How does limited prescriptive authority impact patients within the healthcare system? - ANSWER Creates numerous barriers to quality, affordable, and accessible patient care May prevent outreach to areas of greatest need Physician approval of prescriptions can increase patient waits What are the key responsibilities of prescribing? - ANSWER A sound understanding of drugs and the conditions that they are used to manage Be deliberate in decision-making process 1 / 4
Do not prescribe for family or friends Document thorough history and physical for the records, including education provided on drug Have a documented plan for monitoring and titration What should be used in making prescribing decisions? - ANSWER Cost, follow current guidelines, availability, interactions, side effects, allergies, hepatic/renal function, need for monitoring, special populations PK and PD changes in older adults and how that affects how you prescribe? - ANSWER Very high risk of adverse drug reactions and drug-drug interactions D/t altered PK, multiple and severe illnesses, polypharmacy, poor adherence Beer's Criteria - ANSWER List of potentially inappropriate medications to use in the older populations Updated annually Prescribers ultimately decide whether to prescribe or not 2 / 4
Impacts/outcomes of polypharmacy? - ANSWER Increased ADRs and drug-drug interactions What are CYP450? - ANSWER Enzymes responsible for drug metabolism (biotransformation)-oxidization, reduction, hydrolyzed to promote renal dug excretion Hepatic enzyme system, composed of 12 enzyme families What do CYP450 enzymes do? - ANSWER Promote drug excretion by making them more "excretable"--hydrophilic/water soluble and charged (ion) Inactivate drugs, increase therapeutic action through metabolism, activate a prodrug, decrease drug toxicity CYP450 inhibitor examples? - ANSWER VISA credit card debt inhibits spending on designers like CK to look GQ Valproate Isoniazid Sulfonamides 3 / 4
Amiodarone Chloramphenicol Ketoconzaole Grapefruit juice Quinidine What do CYP450 inhibitors do? - ANSWER Decrease the rate of metabolism Act on liver through process of inhibition Slows rate of metabolism, increases active drug accumulation which can lead to adverse reactions and drug toxicity What do CYP450 inhibitors do if not used correctly? - ANSWER Can lead to adverse effects and drug toxicity What happens when someone has a poor metabolism phenotype? - ANSWER Associated with accumulation of drugs in the body and they may experience drug toxicity
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