Question 1

The therapeutic goals when prescribing include(s):&#10;A) Curative&#10;B) Palliative&#10;C) Preventive&#10;D) All of the above

Accepted Answer

The therapeutic goals when prescribing typically include all of the options listed: curative, palliative, and preventive. The specific goal will depend on the patient's condition and the intended use of the medication. For example, a medication may be prescribed with the goal of curing an infection (curative), relieving pain or symptoms (palliative), or preventing future disease (preventive).

Question 2

Pharmacokinetic factors that affect prescribing include:&#10;A) Therapeutic index&#10;B) Minimum effective concentration&#10;C) Bioavailability&#10;D) Ease of titration

Accepted Answer

Bioavailability, which refers to the amount of a drug that enters the bloodstream and reaches its target site, is a pharmacokinetic factor that affects prescribing. Physicians must consider the bioavailability of a drug when determining the appropriate dosage and route of administration. If a drug has poor bioavailability, a higher dose or a different route of administration may be necessary to achieve the desired therapeutic effect. The other options listed, therapeutic index and minimum effective concentration, are pharmacodynamic factors that relate to the safety and efficacy of a drug, while ease of titration is a practical consideration for dosing adjustments but not a strictly pharmacokinetic factor.

Question 3

Patient education regarding prescribed medication includes:&#10;A) Instructions written at the high school reading level&#10;B) Discussion of expected adverse drug reactions&#10;C) How to store leftover medication such as antibiotics&#10;D) Verbal instructions always in English

Accepted Answer

Discussion of expected adverse drug reactions is a crucial part of patient education regarding prescribed medication. It helps patients understand potential side effects and how to manage them, ensuring better compliance and safety. Instructions should be accessible to all literacy levels, not just high school level; storage instructions are important but specifically advising to store leftover antibiotics can promote misuse; and verbal instructions should be given in the patient's preferred language, not always in English, to ensure understanding.

Question 4

When determining drug treatment the NP prescriber should:&#10;A) Always use evidence-based guidelines&#10;B) Individualize the drug choice for the specific patient&#10;C) Rely on his or her experience when prescribing for complex patients&#10;D) Use the newest drug on the market for the condition being treated

Accepted Answer

The NP should make the drug choice based on the patient's specific needs, comorbidities, and other factors such as drug interactions and patient preferences. Individualizing treatment is a fundamental principle of patient-centered care.

Question 5

In deciding which of multiple drugs used to use to treat a condition,the NP chooses Drug A because it:&#10;A) Has serious side effects and it is not being used for a life-threatening condition&#10;B) Will be taken twice daily and will be taken at home&#10;C) Is expensive,and is not covered by health insurance&#10;D) None of these are important in choosing a drug

Accepted Answer

The fact that Drug A is taken at home and only needs to be taken twice daily is a more practical consideration that may increase adherence to the treatment, thus leading to better outcomes. The other options are not considered favorable factors in drug selection.

Question 6

Passive monitoring of drug effectiveness includes:&#10;A) Therapeutic drug levels&#10;B) Adding or subtracting medications from the treatment regimen&#10;C) Ongoing provider visits&#10;D) Instructing the patient to report if the drug is not effective

Accepted Answer

Passive monitoring involves less direct intervention and relies on the patient to provide feedback or report outcomes. Instructing the patient to report if the drug is not effective is a form of passive monitoring because it depends on the patient to initiate feedback about the drug's effectiveness.

Question 7

The first step in the prescribing process according to the World Health Organization is:&#10;A) Choosing the treatment&#10;B) Educating the patient about the medication&#10;C) Diagnosing the patient's problem&#10;D) Starting the treatment

Accepted Answer

According to the World Health Organization, the first step in the prescribing process is to diagnose the patient's problem. This allows the healthcare provider to determine the appropriate treatment and medication for the patient.

Question 8

Treatment goals in prescribing should:&#10;A) Always be curative&#10;B) Be patient-centered&#10;C) Be convenient for the provider&#10;D) Focus on the cost of therapy

Accepted Answer

Treatment goals should always be patient-centered, focusing on the individual's needs, preferences, and lifestyle. Treatment should aim to improve the patient's quality of life and manage their health condition effectively. While cost and convenience are valid considerations, they should not take precedence over the patient's well-being and preferences. Curative goals may not always be possible or appropriate, depending on the nature and severity of the condition.

Question 9

Pharmaceutical promotion may affect prescribing.To address the impact of pharmaceutical promotion,the following recommendations have been made by the Institute of Medicine:&#10;A) Conflicts of interest and financial relationships should be disclosed by those providing education.&#10;B) Providers should ban all pharmaceutical representatives from their office setting.&#10;C) Drug samples should be used for patients who have the insurance to pay for them,to ensure the patient can afford the medication.&#10;D) Providers should only accept low-value gifts,such as pens and pads of paper,from the pharmaceutical representative.

Accepted Answer

Disclosing conflicts of interest and financial relationships can help providers and patients make informed decisions and mitigate any potential influence from pharmaceutical promotion. This allows for transparency and accountability in the healthcare system. While banning all pharmaceutical representatives (Choice B) may decrease the influence of pharmaceutical promotion, it may also limit access to important information and resources for providers. Furthermore, drug samples should not be limited to patients with insurance (Choice C) as it may exclude those who need the medication but cannot afford it. Providers accepting low-value gifts (Choice D) can still be influenced by pharmaceutical promotion, and it is best to avoid any gifts that may create a conflict of interest.

Question 10

A client asks the NP about the differences in drug effects between men and women.What is known about the differences between the pharmacokinetics of men and women?&#10;A) Body temperature varies between men and women&#10;B) Muscle mass is greater in women&#10;C) Percentage of fat differs between genders&#10;D) Proven subjective factors exist between the genders

Accepted Answer

The percentage of fat in the body differs between genders, with women having a higher percentage of body fat on average than men. This can affect the distribution of drugs in the body and their half-life.

Question 11

An NP would prescribe the liquid form of ibuprofen for a 6 year old because:&#10;A) Drugs given in liquid form are less irritating to the stomach&#10;B) A 6 year old may have problems swallowing a pill&#10;C) Liquid forms of medication eliminate the concern for first-pass effect&#10;D) Liquid ibuprofen does not have to be dosed as often as tablet form

Accepted Answer

The answer of An NP would prescribe the liquid form...

Deck 3: Rational Drug Selection