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NURSING 6005- Adv Pharm-final exam

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Chapter 1. The Role of the Nurse Practitioner 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 & in their APRN program. 2 . Nurses care for the patient from a holistic approach & include the patient in decision making regarding their care. 3 . APRNs are less likely to prescribe narcotics & 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 . H&ing 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 & 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 2. Review of Basic Principles of Pharmacology 1. A patient’s nutritional intake & 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 & may have little if any desired action CONTINUED.............

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