Lehnes Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants 2nd Edition – Test Bank

Test Bank-Lehner’s Pharmacotherapeutics for Advanced Practice&Physicianosenthal, 2001)

Unit 01: Introduction

Rosenthal Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Asistants, Ind Edition

MULTIPLE CHOICE

1. A patient diagnosed with chronic pain calls to request an oxycodone (Oxycoutin) refill Which action should the prescibernake initially?

a. Fax the reseval order to the phanmaку.

Amange to schedule an appointment with the gatest

e. Verify the patient’s adherence to the prescribed drug regimes

4. Determine the patient’s current medication dosage and pain level

ANS: B

Schedule Il medications are not eligible for refills, and prescriptionsbehande is importint to verify the potient’s adherence to the drug regimen and determine the current dosage of medication and poun level however, this can be accomplished by schedulingan appointment and evting the patient in person

2. A metered-dove albuterol istaler is prescribed for asthma managesmest. The patiest reports feeling jittery sometimes when taking the medication, and does not feel that the medication is always effective. Which action will the providertake to best minimize potient risks and mire medication effectress?

a. Ask the patient to demonstrates of the inhaler and aves effectiveness

Assess the patient’s exposure to first and second-hand tobacco smoke

Ascultate the patient’s hang sounds and obtain other relevant sigas

4. Decrease the dosage to reduce side effects

ANS: C

Assessing and endring hang sounds as well as other til signs helps determine the patient’s physical response to the medication and allows comparison to the patient’s baseline sipas Asking the patient to demonstrates helps to evaluate the patient’s ability to administer the medication property and is part of an effective evaluation, but is not a priority intervention based on the patient’s canent report Aviving tobacco smoke exposure helps determine whether ondrug therapies, such as sencke avoidanor, can be used as an adjunct no drug therapy, but does not relate to the patient’s current problem. Rewriting the presomption to decrease the dosage may address the degree of jimeniness experienced but does not address the patient’s concern that the drug is not always effective

3. A patient is prescribed metronidazole for bacterial vaginous Which patient history finding

would be most concerning to the provider?

a. The portient had a recent yeast infection

There is a fical cancer

The potent drinks to glasses of wine every might

4. The potient is unemployed

ANS: C

Priestsking metronidazole should be educated not to drink alcohol to prevesta drake reaction. It would be concerning that the potent drinks wine daly Mastory оf а укыт іnfесtiоn nay indicate increased risk for recuence with administration of an antimicrobial Abeilystory of cervical cancer is not related to metronidazolle. Unemployment can indicate lack of inrince coverage, which may the patient’s ability to purchase medications; however, generic metronidazole is one of the less expensive medicabo

4. The provider prepares a patient with newly diagnosed ryge diabetes for hospital discharge Which action by the providerlapport the patient’s blity to effectively manage medication therapy?

a Asking the potent to demonstrate how to measure and ad

Discussing orthods of storing insulin and discarding syringes

c. Giving information about how diet and exercise affect is requirements

4. Teaching the patient about the long-term consequences of poor diabetes control

ANS A

Because insist be given comectly to control symptoms and prevent an overdose, it is most important for the patient to know how to measure and administer it. Asking fo demonstration of technique is the best way to determine whether the patient has understood the teaching. The other teaching points are important as well, but they are not as contical

5. A patiest reports that a medication prescribed for recumeur migraine headaches is not working Which action is the prescriber’s priority when addressing the patient’s concmm?

a. Ad the patient about the number and frequency of tablets nen

Assess the potient’s headache poin on a scale from 1 to 10.

Prescribe a new medication for migraine magn 4. Suggest biofeedback as an adjunct to drug therapy

ANS A

When evabuting the effectiveness of a drug, it is important to determine how often the patientsing the drug. Asking the paties to identify how many billets are niken and how often belps the pedeffective dosages and adherence to the medication seimen. The patient has already stated that the medication is not working the actual level of pou may determine the depre to which it is not working, but it does not help the provider to determine why it is not working. The aveviment process should gather as much information about compliance, курпошs, and drug effectiveness as possible before enacting a change in treatment Biofeedback may be an effective adjunct to treatment, but it should not be recommended without complete information about drug effectiveness.

6. The drogates that older adult potents are at increased for beatotocity Which action is most important when presenting this medication to an 80-year-old potient?

Obrning boseline liver function studies

Ensuring that the drogistiken in the correct dose at the cometime

Dung the oder the drugscontrindicated the

4. Giving the condication intravenously to avoid first pass bl

ANS: A

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Test Bank-Lehner’s PhotherapeuticoPractices 2001)

The drug indicates that this drug increases risk of hepatotonacity for elderly patients Getting information about liver function before giving the drug establishes baseline data that can be compared with posttreatment data to determine whether the drug is affecting the Taking the correct dose at the comect interval may mimik, but without baseline information, the effects cannot be denennined. Drugs are not soutinely contraindicated for an increased risk of adverse effects

7. A patient with bipolar disorder is prescribed daily. Which action is most import for the provider to take in order to denemine if the therapeutic level is maintained

Este presministration blood work

Prescribe the lithium to be taken at regular intervals

c. Onder periodic laboratory testing

4. Assess the patient for sandypts of lithium toticity.

ANS C

Therapeutic sea levels are determined through periodic laboratory testing Preadministration blood work may be necessary to obtain baseline status prior to initiating treatment, but it will not determine therapeutic levels Scheduling medication at regular intervals will help to ensure medication is absorbed and metabolized predictably but it will not determine therapeutic blood levels. Assessing the patient for sigas and mptoms of ricity will help to determine if the therapeutic level has been exceeded not mintined

8. Which factor best supports an increase for fall prescriptive authority for bothached practice registered sur (APR) and gync(PA)

a. More patients will have access to health care.

Enrollment in medical schools is predicted to decrease

Exoment in both APRN and PA programs has increased

4. Physician practices have become so large, quality care is in jeopardy.

ANS A

Implementation of the Affordable Car Act has increased the number of indiahin health care coverage, and thus the number who have access to health care services. The increase in the number of patients creates the need for more providers with prescriptive authority APRNand physicalsts can fill this practice gap. Enrollment in medical school has increased in recent years and shows no indication of decline. While some medical practices have increased in potirat volume, there is no reason to believe care s suffered Women both APR and education has increased this not the primary factor associated with the need for increased prescriptive authority for these groviders

9. A pediatric patient presied ampicillin for streptococcal pharyngitis reports new onset of a gritic, dull red, maculopapular rash on the chest and neck. Which action is most po

for the provider to keto minimize this patient’s risk for injury?

a. Prescribe azithromycin to regiace the ampicillin

Discontine the pic

4. Flag all medical records with an “Allergic to Penicillin notice

ANS: B

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