Pharmacotherapeutics for Advanced
Practice Nurse Prescribers
________ should be monitored when vitamin B12 therapy is started.
1. Serum calcium
2. Serum potassium
3. Ferritin
4. C-reactive protein - ANS-2
A 19-year-old male was started on risperidone. Monitoring for risperidone includes observing
for common side effects, including:
1. Bradykinesia, akathisia, and agitation
2. Excessive weight gain
3. Hypertension
4. Potentially fatal agranulocytosis - ANS-1
A 66-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for
recalcitrant depression. The NP managing his primary health care needs to understand the
following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs):
1. He should not be prescribed any serotonergic drug such as sumatriptan (Imitrex)
2. MAOIs interact with many common foods, including yogurt, sour cream, and soy sauce
4. All of the above - ANS-4
A challenge faced with antiretroviral therapy (ART) is:
1. Patients abusing ART
2. Drug-resistant mutations of HIV
3. Reduction of transmissibility of HIV
,4. Lack of efficacy data - ANS-2
A comprehensive assessment of a patient should be holistic when trying to determine
competence in drug administration. Which of the following factors would the NP omit from
this type of assessment?
1. Financial status
2. Mobility
3. Social support
4. Sexual practices - ANS-4
A first-line drug for abortive therapy in simple migraine is:
1. Sumatriptan (Imitrex)
2. Naproxen (Aleve)
3. Butorphanol nasal spray (Stadol NS)
4. Butalbital and acetaminophen (Fioricet) - ANS-2
A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated
by the body may lead to:
1. Decreased effectiveness of irinotecan in the treatment of cancer
2. Increased adverse drug reactions, such as neutropenia
3. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
4. Increased concerns for irinotecan being carcinogenic - ANS-2
A good history of herb and supplement use is critical before prescribing because
approximately ____ % of patients in the United States are using herbal products.
1. 10
2. 5
3. 38
4. 70 - ANS-3
A low-carbohydrate, high-protein diet may:
1. Increase drug-metabolizing enzymes
2. Decrease drug absorption from the GI tract
,3. Alter drug binding to plasma proteins
4. Enhance drug elimination - ANS-1
A number of barriers and concerns exist before the goals of a safe and efficient information
technology (IT) system can be realized. Which of the following is NOT a barrier to adoption
and use of IT in prescribing drugs?
1. Cost of initial setup
2. Access to highly skilled experts
3. Compatibility between systems
4. Patient confidentiality risks - ANS-2
A patient presents with a complaint of dark stools and epigastric pain described as gnawing
and burning. Which of the medications is the most likely cause?
1. Acetaminophen
2. Estradiol
3. Donepezil
4. Bethanechol - ANS-4
A patient with a new onset of systolic ejection murmur should be assessed for which
nutritional deficiency?
1. Vitamin B12
2. Vitamin C
3. Folate
4. Niacine - ANS-3
A patient with anxiety and depression may respond to:
1. Duloxetine (Cymbalta)
2. Fluoxetine (Prozac)
3. Oxazepam (Serax)
4. Buspirone (Buspar) and an SSRI combined - ANS-4
A potential harmful effect on patients who take some herbal medication is:
1. Constipation
2. Lead poisoning
, 3. Diarrhea
4. Life-threatening rash - ANS-2
A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors
is angioedema. Which of the following statements is true about this adverse response?
1. Swelling of the tongue or hoarseness are the most common symptoms.
2. It appears to be related to the decrease in aldosterone production.
3. Presence of a dry, hacky cough indicates a high risk for this adverse response.
4. Because it takes time to build up a blood level, it occurs after being on the drug for about
1 week. - ANS-1
A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast
cancer to:
1. Ensure the patient will not have increased adverse drug reactions to the tamoxifen
2. Identify potential drug-drug interactions that may occur with tamoxifen
3. Reduce the likelihood of therapeutic failure with tamoxifen treatment
4. Identify poor metabolizers of tamoxifen - ANS-3
A stepwise approach to the pharmacologic management of asthma:
1. Begins with determining the severity of asthma and assessing asthma control
2. Is used when asthma is severe and requires daily steroids
3. Allows for each provider to determine their personal approach to the care of asthmatic
patients
4. Provides a framework for the management of severe asthmatics, but is not as helpful
when patients have intermittent asthma - ANS-1
A thorough understanding of herbs is critical to patient safety. An example is the use of
cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the
commercially available cassia cinnamon contains:
1. Coumadin, which may lead to bleeding problems
2. Coumarin, which can cause liver and kidney damage
3. Cinnamic aldehyde, which is toxic to the kidney
4. Cinnamate eugenol, which is toxic to the liver - ANS-2
A treatment plan for management of chronic pain should include:
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