CH 1-3

An APRN works in a urology clinic under the supervision of a physician who does not restrict
the types of medications the APRN is allowed to prescribe. State law does not require the
APRN to practice under physician supervision. How would the APRN’s prescriptive authority
be described?
A. Full authority
B. Without limitation
C. Independent
D. Limited authority

Which factor could be attributed to limited prescriptive authority for APRNs?
A. Enhanced health literacy
B. Higher quality medical treatment
C. Improved collaborative care
D. Inaccessibility of patient care

Which aspects support the APRN’s provision for full prescriptive authority? Select all that apply.
a. Clinical education includes prescription of medications and disease processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN’s ability to provide safe care.
d. Licensure ensures compliance with health care and safety standards.

A family nurse practitioner practicing in Maine is hired at a practice across state lines in Virginia. Which aspect of practice may change for the APRN?
A. The APRN will have more prescriptive authority in the new position.
B. The APRN’s authority will depend on federal regulations.
C. The APRN will have equal prescriptive authority in the new position.
D. The APRN will have less prescriptive authority in the new position.

Collaboration with a pharmacist can improve positive outcomes for patients except for which aspect?
A. Pharmacists can suggest foods that will help with the patient’s condition.
B. The pharmacist can suggest adequate medication dosing.
C. Pharmacists have firsthand knowledge of the facility formulary.
D. Pharmacists have additional information on drug interactions.

A patient presents with delirium tremens requiring Ativan administration. The provider of care
is not in the facility. Which action by the nurse is most appropriate?
A. Contact the on-call hospitalist.
B. Obtain an order from the charge nurse.
C. Obtain a telephone order.
D. Wait for a written Ativan order.

A patient with chronic pain calls the provider’s office to request a refill on their oxycontin.
Which action is most appropriate?
A. Fax an order to the pharmacy.
B. Verify the patient’s adherence to drug regimen.
C. Determine the patient’s current medication dosage.
D. Schedule an appointment with the patient.

A patient prescribed amoxicillin for streptococcal pharyngitis reports new onset of a flat, itchy
red rash on the chest and neck. Which action is most important?
A. Assess for respiratory compromise.
B. Prescribe an antihistamine cream.
C. Provide a different prescription.
D. Discontinue the medication.

A patient taking three medications for hypertension is diagnosed with COPD. Which action
should be taken prior to prescribing medications to treat COPD?
A. Assess liver enzyme levels.
B. Obtain baseline laboratory values.
C. Obtain a complete medication history.
D. Determine if patient has insurance coverage.

A patient with diabetes reports losing their job and an inability to purchase required
medications. Which action is most appropriate?
A. Prescribe a different medication.
B. Contact a different pharmacy.
C. Provide a 7-day sample pack.
D. Decrease the daily dose by half.

A patient recently prescribed hydrocodone calls to report they are unable to fill the prescription.
Which factors would contribute to the inability to fill the prescription?
a. DEA number missing from prescription
b. Prescription sent via electronic messenger
c. Patient name and date of birth were handwritten
d. Prescriber license number not included

A patient reports that a medication prescribed for recurrent migraine headaches is not working. Which action should be taken first?
A. Suggest biofeedback as an adjunct to drug therapy.
B. Ask the patient about the number and frequency of tablets taken.
C. Report the patient’s complaint to the prescriber.
D. Assess the patient’s headache pain on a scale from 1 to 10.

A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding
would be most concerning?
A. Recent yeast infection
B. Family history of cervical cancer
C. Patient is currently unemployed
D. Drinks two glasses of wine every night

A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label
instructs the patient to administer “two puffs every 4 hours as needed for coughing or wheezing.” The patient reports feeling jittery sometimes when taking the medication, and she
doesn’t feel that the medication is always effective. Which action is most appropriate?
A. Assessing the patient’s exposure to tobacco smoke
B. Auscultating lung sounds and obtaining vital signs
C. Suggesting that the patient use one puff to reduce side effects
D. Asking the patient to demonstrate use of the inhaler

A patient newly diagnosed with diabetes is to be discharged from the hospital. Which action should be taken first during medication education?
A. Discussing methods of storing insulin and discarding syringes
B. Teaching the patient about the long-term consequences of poor diabetes control
C. Giving information about how diet and exercise affect insulin requirements
D. Asking the patient to demonstrate how to measure and administer insulin

The drug manual states that older adult patients are at increased risk for hepatic side effects. Which action is most important when prescribing this medication to an 80-year-old patient?
A. Obtain pretreatment laboratory work.
B. Discontinue the order; the drug is contraindicated for this patient.
C. Ensure that the drug is given in the correct dose at the correct time to minimize the risk of adverse effects.
D. Give the medication intravenously so that the drug does not pass through the liver.

A patient recently diagnosed with HIV is prescribed several medications to treat the condition.
Which factors would impact the patient’s adherence to the treatment regimen? Select all that apply.
a. The patient is uninsured
b. The patient works three part-time jobs
c. The medication regimen includes six different pills
d. Patient has an eighth-grade reading comprehension level

A patient diagnosed with bipolar disorder is prescribed daily lithium. Which action is most important to determine if the therapeutic level is maintained?
A. Administer medication at regular intervals.
B. Assess the patient for adverse effects.
C. Ensure periodic laboratory testing is completed.
D. Obtain preadministration blood work.