Chapter 1. The Role of the Nurse Practitioner

Multiple Choice

Identify the choice that best completes the statement or answers the question.

1. Nurse practitioner prescriptive authority is regulated by:

1. The National Council of State Boards of Nursing

2. The U.S. Drug Enforcement Administration

3. The State Board of Nursing for each state

4. The State Board of Pharmacy

2. The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber

include:

1. Nurses know more about Pharmacology than other prescribers because they take it

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

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

decision making regarding their care.

3. APRNs are less likely to prescribe narcotics and other controlled substances.

4. APRNs are able to prescribe independently in all states, whereas a physician’s

assistant needs to have a physician supervising their practice.

3. Clinical judgment in prescribing includes:

1. Factoring in the cost to the patient of the medication prescribed

2. Always prescribing the newest medication available for the disease process

3. Handing out drug samples to poor patients

4. Prescribing all generic medications to cut costs

4. Criteria for choosing an effective drug for a disorder include:

1. Asking the patient what drug they think would work best for them

2. Consulting nationally recognized guidelines for disease management

3. Prescribing medications that are available as samples before writing a prescription

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

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

1. The demonstrated ability of nurse practitioners to control costs and improve patient

outcomes

2. The fact that nurse practitioners will be able to practice independently

3. The fact that nurse practitioners will have full reimbursement under health-care

reform

4. The ability to shift accountability for Medicaid to the state level

Chapter 1. The Role of the Nurse Practitioner

Answer Section

MULTIPLE CHOICE

1. ANS: 3 PTS: 1

2. ANS: 2 PTS: 1

3. ANS: 1 PTS: 1

4. ANS: 2 PTS: 1

5. ANS: 1 PTS: 1

Chapter 2. Review of Basic Principles of Pharmacology

Multiple Choice

Identify the choice that best completes the statement or answers the question.

1. A patient’s nutritional intake and laboratory results reflect hypoalbuminemia. This is critical to

prescribing because:

1. Distribution of drugs to target tissue may be affected.

2. The solubility of the drug will not match the site of absorption.

3. There will be less free drug available to generate an effect.

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

2. Drugs that have a significant first-pass effect:

1. Must be given by the enteral (oral) route only

2. Bypass the hepatic circulation

3. Are rapidly metabolized by the liver and may have little if any desired action

4. Are converted by the liver to more active and fat-soluble forms

3. The route of excretion of a volatile drug will likely be the:

1. Kidneys

2. Lungs

3. Bile and feces

4. Skin

4. Medroxyprogesterone (Depo Provera) is prescribed intramuscularly (IM) to create a storage

reservoir of the drug. Storage reservoirs:

1. Assure that the drug will reach its intended target tissue

2. Are the reason for giving loading doses

3. Increase the length of time a drug is available and active

4. Are most common in collagen tissues

5. The NP chooses to give cephalexin every 8 hours based on knowledge of the drug’s:

1. Propensity to go to the target receptor

2. Biological half-life

3. Pharmacodynamics

4. Safety and side effects

6. 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:

1. Rapidly achieves drug levels in the therapeutic range

2. Requires four- to five-half-lives to attain

3. Is influenced by renal function

4. Is directly related to the drug circulating to the target tissues

7. The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect

is the:

1. Minimum adverse effect level

2. Peak of action

3. Onset of action

4. Therapeutic range

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

1. When the drug has a wide therapeutic range

2. When the drug will be administered for a short time only

3. When there is a high correlation between the dose and saturation of receptor sites

4. To determine if a drug is in the therapeutic range

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

This means that the:

1. Concentration will produce therapeutic effects

2. Concentration will produce an adverse response

3. Time between doses must be shortened

4. Duration of action of the drug is too long

10. Drugs that are receptor agonists may demonstrate what property?

1. Irreversible binding to the drug receptor site

2. Upregulation with chronic use

3. Desensitization or downregulation with continuous use

4. Inverse relationship between drug concentration and drug action

11. Drugs that are receptor antagonists, such as beta blockers, may cause:

1. Downregulation of the drug receptor

2. An exaggerated response if abruptly discontinued

3. Partial blockade of the effects of agonist drugs

4. An exaggerated response to competitive drug agonists