Question 1

The first step in the prescribing process according to the World Health Organization is:

Accepted Answer

The first step in the prescribing process according to the World Health Organization is diagnosing the patient's problem. This is crucial for ensuring that the medication prescribed is appropriate and effective for the patient's condition. Choosing the treatment, starting the treatment, and educating the patient about the medication may come later in the process.

Question 2

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?

Accepted Answer

The percentage of fat differs between genders, with women generally having a higher percentage of body fat than men. This can have an impact on drug distribution and metabolism, as many drugs are stored and metabolized in fatty tissues. Other factors such as body weight, hormonal differences, and liver function may also play a role in pharmacokinetic differences between men and women. However, proven subjective factors have not been shown to have a significant impact on drug effects.

Question 3

An NP would prescribe the liquid form of ibuprofen for a 6-year-old child because:

Accepted Answer

A 6-year-old child may have difficulties swallowing a pill, making the liquid form of ibuprofen the best option for administration.

Question 4

The therapeutic goals when prescribing include(s):

Accepted Answer

All three therapeutic goals are important when prescribing medications. Curative medications aim to treat or cure the underlying disease or condition. Palliative medications aim to relieve symptoms and improve quality of life, even if the underlying disease cannot be cured. Preventive medications aim to prevent the onset or progression of a particular disease or condition. Therefore, all of these goals should be considered when prescribing medications to ensure the best possible outcome for the patient.

Question 5

Passive monitoring of drug effectiveness includes:

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 6

In deciding which of multiple drugs used to use to treat a condition, the NP chooses Drug A because it:

Accepted Answer

The NP chose Drug A because it can be taken twice daily and can be taken at home. This suggests that patient convenience and ease of use were significant factors in the decision. The other options (serious side effects, cost, and lack of life-threatening condition) did not appear to be important considerations in this case.

Question 7

Patient education regarding prescribed medication includes:

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 8

Treatment goals in prescribing should:

Accepted Answer

Treatment goals in prescribing should be patient-centered, meaning that the focus should be on the individual patient's needs, preferences, and values. The goal is not always curative, as some conditions may not have a cure but require management of symptoms. The convenience of the provider and the cost of therapy should also be considered, but they should not be the primary focus.

Question 9

Under new U.S. Food and Drug Administration labeling, Pregnancy Categories will be:

Accepted Answer

The new FDA labeling will incorporate a pregnancy risk summary and clinical considerations on the drug label, providing more comprehensive information about any potential risks to the fetus during pregnancy.

Question 10

When determining drug treatment the NP prescriber should:

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 11

Pharmacokinetic factors that affect prescribing include:

Accepted Answer

Bioavailability, or the proportion of a drug dose that reaches the systemic circulation, is an important pharmacokinetic factor to consider when prescribing. It affects the efficacy, onset of action, and duration of drug effects. High bioavailability allows for lower doses and less frequent dosing, while low bioavailability requires higher doses and more frequent dosing.

Question 12

Pharmaceutical promotion may affect prescribing. To address the impact of pharmaceutical promotion, the following recommendations have been made by the Institute of Medicine:

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.

Quiz 3: Rational Drug Selection