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NR 508 NR508 ADVANCED PHARM POSSIBLE MIDTERM QUESTIONS AND ANSWERS EXAM 3 2023
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A parent calls a clinic for advice about giving an over-the-counter cough medicine to a 6-year-old child. The parent
tells the NP that the medication label does not give instructions about how much to give a child. The NP should:
order a prescription antitussive medication for the child.
ask the parent to identify all of the ingredients listed on the medication label.
calculate the dose for the active ingredient in the over-the-counter preparation.
tell the parent to approximate the dose at about one third to one half the adult dose.
A parent calls a clinic for advice about giving an over-the-counter cough medicine to a 6-year-old c...
ask the parent to identify all of the ingredients listed on the medication label.
Over-the-counter cough medications often contain dextromethorphan, which can be toxic to young children. It is
important to identify ingredients of an over-the-counter medication before deciding if it is safe for children. A
prescription antitussive is probably not warranted until the cough is evaluated to determine the cause. Until the
ingredients are known, it is not safe to approximate the child’s dose based on only the active ingredient.
The primary care NP prescribes an extended-cycle monophasic pill regimen for a young woman who reports having
multiple partners. Which statement by the patient indicates she understands the regimen?
“I have to take a pill only every 3 months.”
“I should expect to have only four periods each year.”
“I will need to use condoms for only 7 more days.”
“This type of pill has fewer side effects than other types.”
The primary care NP prescribes an extended-cycle monophasic pill regimen for a young woman who repor...
“I should expect to have only four periods each year.”
The extended-cycle pills have fewer pill-free intervals, so women have only four periods a year. Patients take pills
every day. Because this patient has multiple partners, she should continue to use condoms. This type of pill has the
same side effects as other types.
The primary care NP prescribes an inhaled corticosteroid for a patient who has asthma. The third-party payer for this
patient denies coverage for the brand that comes in the specific strength the NP prescribes. The NP should:
provide pharmaceutical company samples of the medication for the patient.
inform the patient that the drug must be paid for out of pocket because it is not covered.
order the closest formulary-approved approximation of the drug and monitor effectiveness.
write a letter of medical necessity to the insurer to explain the need for this particular medication.
The primary care NP prescribes an inhaled corticosteroid for a patient who has asthma. The third-par...
order the closest formulary-approved approximation of the drug and monitor effectiveness.
The second step of medical decision making takes into account benefits versus costs along with an understanding
that it is impossible to do everything because of limited resources. The NP should prescribe what is covered and
evaluate its effectiveness; if it does not work, the third-party payer may be approached about the need for the other
medication. Providing samples is not always possible, and this practice is being discouraged, so it is not a viable
solution. Asking patients to pay out of pocket ultimately may be necessary but carries risks that the patient will not
obtain the medication. Writing a letter of medical necessity may be indicated if the available drugs are not effective
but is not the initial step.
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