TEST BANK
Pharmacotherapeutics for Advanced Practice Nurse Prescribers
Teri Moser Woo, and Wendy L. Wright
6th Edition Table of Contents
Chapter 01 The Role of the Advanced Practice Nurse as Prescriber 1
Chapter 02 Review of Basic Principles of Pharmacology 2
Chapter 03 Rational Drug Selection 8
Chapter 04 Legal and Professional Issues in Prescribing 11
Chapter 05 Adverse Drug Reactions 13
Chapter 06 An Introduction to Pharmacogenomics 16
Chapter 07 Nutrition and Nutraceuticals 19
Chapter 08 Herbal Therapies 25
Chapter 09 Cannabis 28
Chapter 10 Pharmacoeconomics 32
Chapter 11 Drugs Affecting the Autonomic Nervous System 35
Chapter 12 Drugs Affecting the Central Nervous System 42
Chapter 13 Drugs Affecting the Cardiovascular and Renal Systems 50
Chapter 14 Drugs Affecting the Respiratory System 58
Chapter 15 Drugs Affecting the Hematological System 62
Chapter 16 Drugs Affecting the Immune System: Vaccines and Immunoglobulins 66
Chapter 17 Drugs Affecting the Immune System: Immunomodulators 72
Chapter 18 Drugs Affecting the Gastrointestinal System 74
Chapter 19 Drugs Affecting the Endocrine System: Pancreatic Hormones and Antidiabetic Drugs 77
Chapter 20 Drugs Affecting the Endocrine System: Pituitary, Thyroid, and Adrenal Drugs 80
Chapter 21 Drugs Affecting the Reproductive System 83
Chapter 22 Drugs Affecting the Bones and Joints 89
Chapter 23 Drugs Affecting the Integumentary System 93
Chapter 24 Drugs Used to Treat Bacterial Infections 98
Chapter 25 Drugs Used to Treat Viral, Fungal, and Protozoal Infections 102
Chapter 26 Drugs Used to Treat Inflammatory Processes 105
Chapter 27 Drugs Used to Treat Eye and Ear Disorders 108
Chapter 28 Anemia 110
Chapter 29 Anxiety and Depression 113
Chapter 30 Attention Deficit-Hyperactivity Disorder 117
Chapter 31 Asthma and Allergy 119
Chapter 32 Chronic Obstructive Pulmonary Disease 122
Chapter 33 Contraception 124
Chapter 34 COVID-19: Acute and Chronic 127
Chapter 35 Dermatological Conditions 131
Chapter 36 Diabetes Management 135
Chapter 37 Gastroesophageal Reflux and Peptic Ulcer Disease 143
Chapter 38 Headaches 146
Chapter 39 Heart Failure 150
Chapter 40 HIV Disease and Acquired Immunodeficiency Syndrome 155 Chapter 41 Menopausal Hormone Therapy 158
Chapter 42 Hyperlipidemia 161
Chapter 43 Hypertension 166
Chapter 44 Hyperthyroidism and Hypothyroidism 171
Chapter 45 Obesity 174
Chapter 46 Pain Management: Acute and Chronic Pain 178
Chapter 47 Pneumonia 182
Chapter 48 Sexually Transmitted Diseases and Vaginitis 184
Chapter 49 Substance Use Disorders 187
Chapter 50 Tuberculosis 192
Chapter 51 Upper Respiratory Tract Infection, Pharyngitis, Sinusitis, Otitis Media, and Otitis Externa 194
Chapter 52 Urinary Tract Infections 197
Chapter 53 Women as Patients 200
Chapter 54 Men as Patients 204
Chapter 55 Pediatric Patients 206
Chapter 56 Transgendered Clients as Patients 208
Chapter 57 Geriatric Patients 210 Woo 1 Pharmacotherapeutics for APN Prescribers, 6e Ch01 Chapter 1. The Role of the Advanced Practice Nurse as Prescriber MULTIPLE CHOICE 1. Nurse practitioner prescriptive authority is regula ted by: A. The National Council of State Boards of Nursing B. The U.S. Drug Enforcement Administration C. The State Board of Nursing for each state D. The State Board of Pharmacy ANS: C PTS: 1 2. The benefits to the patient of having an advanced p ractice registered nurse (APRN) prescriber include: A. Nurses know more about pharmacology than other pres cribers because they take it both in their basic nursing program and in their AP RN program. B. Nurses care for the patient from a holistic approac h and include the patient in decision-making regarding their care. C. APRNs are less likely to prescribe narcotics and ot her controlled substances. D. APRNs are able to prescribe independently in all st ates, whereas a physician’s assistant needs to have a physician supervising the ir practice. ANS: B PTS: 1 3. Clinical judgment in prescribing includes: A. Factoring in the cost to the patient of the medicat ion prescribed B. Always prescribing the newest medication available for the disease process C. Handing out drug samples to poor patients D. Prescribing all generic medications to cut costs ANS: A PTS: 1 4. The process for choosing an effective drug for a disord er includes: A. Asking the patient what drug they think would work best for them B. Consulting nationally recognized guidelines for dis ease management C. Prescribing medications that are available as sampl es before writing a prescription D. Following U.S. Drug Enforcement Administration guid elines for prescribing ANS: B PTS: 1 5. Nonintentional nonadherence of drug therapy may occ ur due to: A. Belief that medication does not work B. Adverse drug reactions C. Chronic conditions that require daily therapy D. Forgetfulness or distraction ANS: D PTS: 1 ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 6th Edition (Woo, 2024)
1 | P a g e Woo Pharmacotherapeutics for APN Prescribers, 6e 1 Ch02 Chapter 2. Review of Basic Principles of Pharmacolo gy MULTIPLE CHOICE 1. A patient’s nutritional intake and laboratory resul ts reflect hypoalbuminemia. This is critical to prescribing because: A. Distribution of drugs to target tissue may be affec ted. B. The solubility of the drug will not match the site of absorption. C. There will be less free drug available to generate an effect. D. Drugs bound to albumin are readily excreted by the kidneys. ANS: A PTS: 1 2. Drugs that have a significant first-pass effect: A. Must be given by the enteral (oral) route only B. Bypass the hepatic circulation C. Are rapidly metabolized by the liver and may have l ittle, if any, desired action D. Are converted by the liver to more active and fat-s oluble forms ANS: C PTS: 1 3. The route of excretion of a volatile drug will like ly be the: A. Kidneys B. Lungs C. Bile and feces D. Skin ANS: B PTS: 1 4. A major disadvantage to IV administration is that: A. First-pass metabolism is eliminated. B. Needles and sterility are required. C. Absorption of the drug cannot be slowed after admin istration. D. It is significantly more expensive than other route s. ANS: C PTS: 1 5. The nurse practitioner (NP) chooses to give cephale xin every 8 hours based on knowledge of the drug’s: A. Propensity to go to the target receptor B. Biological half-life C. Pharmacodynamics D. Safety and side effects ANS: B PTS: 1 6. Deferasirox is a chelating agent used to treat iron overload by binding iron to render it biologically inactive. This is best characterized a s a(n): ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 6th Edition (Woo, 2024)
2 | P a g e Woo Pharmacotherapeutics for APN Prescribers, 6e 2 Ch02 A. Nonreceptor mechanism B. Partial agonist C. Full agonist D. Noncompetitive antagonist ANS: A PTS: 1 7. The point in time on the drug concentration curve t hat indicates the first sign of a therapeutic effect is the: A. Minimum adverse effect level B. Peak of action C. Onset of action D. Therapeutic range ANS: C PTS: 1 8. Phenytoin requires that a trough level be drawn. Pe ak and trough levels are done: A. When the drug has a wide therapeutic range B. When the drug will be administered for a short time only C. When there is a high correlation between the dose a nd saturation of receptor sites D. To determine if a drug is in the therapeutic range ANS: D PTS: 1 9. A laboratory result indicates that the peak level f or a drug is above the minimum toxic concentration. This means that the: A. Concentration will produce therapeutic effects. B. Concentration will produce an adverse response. C. Time between doses must be shortened. D. Duration of action of the drug is too long. ANS: B PTS: 1 10. Drugs that are receptor agonists may demonstrate wh at property? A. Irreversible binding to the drug receptor site B. Up-regulation with chronic use C. Desensitization or down-regulation with continuous use D. Inverse relationship between drug concentration and drug action ANS: C PTS: 1 11. Drugs that are receptor antagonists, such as beta b lockers, may cause: A. Down-regulation of the drug receptor B. An exaggerated response if abruptly discontinued C. Partial blockade of the effects of agonist drugs D. An exaggerated response to competitive drug agonist s ANS: B PTS: 1 ______________________________________________________________________________________________
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3 | P a g e Woo Pharmacotherapeutics for APN Prescribers, 6e 3 Ch02 12. Factors that affect gastric drug absorption include : A. Liver enzyme activity B. Protein-binding properties of the drug molecule C. Lipid solubility of the drug D. Ability to chew and swallow ANS: C PTS: 1 13. Drugs administered via IV: A. Need to be lipid soluble in order to be easily abso rbed B. Begin distribution into the body immediately C. Are easily absorbed if they are nonionized D. May use pinocytosis to be absorbed ANS: B PTS: 1 14. When a medication is added to a regimen for a syner gistic effect, the combined effect of the drugs is: A. The sum of the effects of each drug individually B. Greater than the sum of the effects of each drug in dividually C. Less than the effect of each drug individually D. Not predictable, as it varies with each individual ANS: B PTS: 1 15. Which of the following statements about bioavailabi lity is true? A. Bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained-release mechanisms. B. All brands of a drug have the same bioavailability. C. Drugs that are administered more than once a day ha ve greater bioavailability than drugs given once daily. D. Combining an active drug with an inert substance do es not affect bioavailability. ANS: A PTS: 1 16. Which of the following statements about the major d istribution barriers (blood–brain or fetal– placental) is true? A. Water soluble and ionized drugs cross these barrier s rapidly. B. The blood–brain barrier slows the passage of many d rugs into and out of brain cells. C. The fetal–placental barrier protects the fetus from drugs taken by the mother. D. Lipid-soluble drugs do not pass these barriers and are safe for pregnant women. ANS: B PTS: 1 17. Drugs are metabolized mainly by the liver via phase I or phase II reactions. The purpose of both of these types of reactions is to: A. Inactivate prodrugs before they can be activated by target tissues ______________________________________________________________________________________________
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4 | P a g e Woo Pharmacotherapeutics for APN Prescribers, 6e 4 Ch02 B. Change the drugs so they can cross plasma membranes C. Change drug molecules to a form that an excretory o rgan can excrete D. Make these drugs more ionized and polar to facilita te excretion ANS: C PTS: 1 18. Once they have been metabolized by the liver, the m etabolites may be: A. More active than the parent drug B. Less active than the parent drug C. Totally “deactivated” so they are excreted without any effect D. All of the above ANS: D PTS: 1 19. All drugs continue to act in the body until they ar e changed or excreted. The ability of the body to excrete drugs via the renal system would be increased by: A. Reduced circulation and perfusion of the kidney B. Chronic renal disease C. Competition for a transport site from another drug D. Increased renal blood flow ANS: D PTS: 1 20. Steady state is: A. The point on the drug concentration curve when abso rption exceeds excretion B. When the peak and trough remain constant C. When the amount of drug in the body stays below the minimum toxic concentration D. All of the above ANS: B PTS: 1 21. A patient is being treated for pain with hydrocodon e. If the patient is then prescribed a CYP2D6 inhibitor, the likely clinical result is: A. Hydrocodone toxicity B. Prolonged action of hydrocodone C. Parasympathetic adverse effects D. Inadequate pain control ANS: D PTS: 1 22. Actions taken to reduce drug–drug interaction probl ems include all of the following EXCEPT: A. Reducing the dosage of one of the drugs B. Scheduling their administration at different times C. Prescribing a third drug to counteract the adverse reaction of the combination D. Reducing the dosage of both drugs ANS: C PTS: 1 ______________________________________________________________________________________________
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5 | P a g e Woo Pharmacotherapeutics for APN Prescribers, 6e 5 Ch02 23. The time required for the amount of drug in the bod y to decrease by 50% is called: A. Steady state B. Half-life C. Phase II metabolism D. Reduced bioavailability time ANS: B PTS: 1 24. An agonist activates a receptor and stimulates a re sponse. When given frequently over time, the body may: A. Up-regulate the total number of receptors B. Block the receptor with a partial agonist C. Alter the drug’s metabolism D. Down-regulate the numbers of that specific receptor ANS: D PTS: 1 25. Antagonists are best characterized as: A. Medications that lead to major physiological and ps ychological dependence B. Medications that do not produce a response C. Medications that are incapable of metabolism before another dose is administered D. Medications that produce a decreased physiological response when combined with another drug ANS: B PTS: 1 26. Instructions to a patient regarding self-administra tion of oral enteric-coated tablets should include which of the following statements? A. “Avoid any other oral medicines while taking this d rug.” B. “If swallowing this tablet is difficult, dissolve i t in 3 ounces of orange juice.” C. “The tablet may be crushed if you have any difficul ty taking it.” D. “To achieve best effect, take the tablet with at le ast 8 ounces of fluid.” ANS: D PTS: 1 27. A patient takes 650 mg of acetaminophen and achieve s reduction of pain from 7 to 3 on a scale of 1 to 10. The next day, the patient takes 4 00 mg of ibuprofen and achieves reduction of the pain from 7 to 2. The ibuprofen is more: A. Potent B. Efficacious C. Absorbed D. Responsive ANS: B PTS: 1 28. Which of the following substances is the most likel y to be absorbed in the intestines rather than in the stomach? A. Enteric-coated medications ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 6th Edition (Woo, 2024)
6 | P a g e Woo Pharmacotherapeutics for APN Prescribers, 6e 6 Ch02 B. Long-acting agents C. ETOH D. Acidic products ANS: A PTS: 1 29. Which of the following variables is a factor in dru g absorption? A. The smaller the surface area for absorption, the mo re rapidly the drug is absorbed. B. A rich blood supply to the area of absorption leads to better absorption. C. The less soluble the drug, the more easily it is ab sorbed. D. Ionized drugs are easily absorbed across the cell m embrane. ANS: B PTS: 1 30. An advantage of prescribing a sublingual medication is that the medication is: A. Absorbed rapidly B. Excreted rapidly C. Metabolized minimally D. Distributed equally ANS: A PTS: 1 31. Drugs that are CYP3A4 substrates may: A. Induce the metabolism of another drug B. Inhibit the metabolism of another drug C. Both A and B D. Neither A nor B ANS: D PTS: 1 32. Therapeutic drug levels are drawn when a drug reach es steady state. Drugs reach steady state: A. After the second dose B. After four to five half-lives C. When the patient feels the full effect of the drug D. One hour after IV administration ANS: B PTS: 1 ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Pharmacotherapeutics for Advanced Practice Nurse Prescribers, 6th Edition (Woo, 2024)
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