Test Bank for Pharmacotherapeutics for Advanced Practice A

pg. 1 Test Bank for Pharmacotherapeutics for Advanced Practice A Practical Approach 5th Edition By Virginia Poole Arcangelo, Andrew M Peterson, Veronica Wilbur, Tep M. Kang/ All Chapters Covered – Latest Update 2024.

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 - Correct Answer - 3. 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. - Correct Answer - 2. 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
• Handing out drug samples to poor patients
• Prescribing all generic medications to cut costs - Correct Answer - 1. Factoring in the cost to the

patient of the medication prescribed 1 / 4

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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 - Correct Answer - 2.

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 - Correct Answer - 1. 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.
• Drugs bound to albumin are readily excreted by the kidneys. - Correct Answer - 1. 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 2 / 4

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• Are converted by the liver to more active and fat-soluble forms - Correct Answer - 3. 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 - Correct Answer - 2. Lungs

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 - Correct Answer - 3. Increase the length of time a drug is

available and active

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 - Correct Answer - 2. 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 - Correct Answer - 1. Rapidly achieves

drug levels in the therapeutic range 3 / 4

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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 - Correct Answer - 3. 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
• When there is a high correlation between the dose and saturation of receptor sites
• To determine if a drug is in the therapeutic range - Correct Answer - 4. To determine if a drug is in the

therapeutic range

A laboratory result indicates that the peak level for a drug is above the minimum toxic concentration.

This means that the:

• Concentration will produce therapeutic effects
• Concentration will produce an adverse response
• Time between doses must be shortened
• Duration of action of the drug is too long - Correct Answer - 2. Concentration will produce an adverse

response

Drugs that are receptor agonists may demonstrate what property?

• Irreversible binding to the drug receptor site
• Upregulation with chronic use
• Desensitization or downregulation with continuous use
• Inverse relationship between drug concentration and drug action - Correct Answer - 3. Desensitization

or downregulation with continuous use

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