Pharmacology for Advanced Practice Pre-Test
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Course Introduction
This course provides an in-depth exploration of pharmacological principles and their application in advanced clinical practice. Emphasizing the safe and effective use of medications across diverse patient populations, the curriculum covers drug classifications, mechanisms of action, pharmacokinetics, pharmacodynamics, and the impact of genetic, cultural, and environmental factors on drug therapy. Students will analyze case studies and clinical scenarios to develop advanced skills in selecting, prescribing, and monitoring pharmacotherapies, with particular focus on complex and co-morbid conditions. Regulatory and legal considerations, as well as patient education and interprofessional collaboration, are also examined to prepare students for autonomous and evidence-based medication management in advanced practice roles.
Recommended Textbook
Primary Care Art and Science of Advanced Practice Nursing 4th Edition by Dunphy
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Chapter 3: Health Promotion
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Q1) The number of cases of a particular disease for the past 5 years is an example of the incidence rate.
A)True
B)False
Answer: False
Q2) Which of the following is an example of secondary prevention in a 50-year-old woman?
A)Yearly mammogram
B)Low animal fat diet
C)Use of seat belt
D)Daily application of sunscreen
Answer: A
Q3) Which of the following is a primary prevention measure for a 76-year-old man newly diagnosed with a testosterone deficiency?
A)Calcium supplementation
B)Testicular self-examination
C)Bone density test
D)Digital rectal examination
Answer: A
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Page 3
Chapter 5: Evidence-Based Care
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Q1) Which of the following would be considered the research design for Level VII evidence?
A)Well-designed controlled trials without randomization
B)Opinion of authorities and expert committees
C)Well-designed case control or cohort studies
D)Single descriptive or qualitative study .
Q2) Practice guidelines are designed to:
A)Be inflexible
B)Be utilized in every circumstance
C)Provide a reference point for decision making
D)Be created by a professional organization to guide the practice of a profession
Q3) Which is the most important question to ask in nursing research?
A)What findings constitute evidence?
B)How will the findings be used?
C)Is this a randomized controlled trial?
D)What theory is being utilized?
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Chapter 6: Neurological Problems
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Q1) A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as?
A)Spinothalamic dysfunction
B)Ratcheting
C)Cogwheeling
D)Hand tremors
Q2) Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?
A)Dementia
B)Alzheimer's disease
C)Parkinson's disease
D)Delirium
Q3) Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)?
A)A teenage male
B)A 65-year-old male
C)A 25-year-old female
D)A 60-year-old female
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Chapter 7: Skin Problems
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Q1) Tori is on systemic antifungals for a bad tinea infection.You are aware that the antifungals may cause:
A)Renal failure
B)Skin discoloration
C)Breathing difficulties
D)Hepatotoxicity
Q2) Your patient is in her second trimester of pregnancy and has a yeast infection.Which of the following is a treatment that you usually recommend/order in nonpregnant patients, but is listed as a Pregnancy category D?
A)Vagistat vaginal cream
B)Monistat combination pack
C)Terazol vaginal cream
D)Diflucan, 150 mg
Q3) Which scalp problem can be caused by a fever and certain drugs?
A)Telogen effluvium (TE)
B)Trichotillomania
C)Psoriasis
D)Alopecia areata
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Chapter 8: Eyes, Ears, Nose, and Throat
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Q1) The clinician is assessing a patient complaining of hearing loss.The clinician places a tuning fork over the patient's mastoid process, and when the sound fades away, the fork is placed without restriking it over the external auditory meatus.The patient is asked to let the clinician know when the sound fades away.This is an example of which type of test?
A)Weber test
B)Schwabach test
C)Rinne test
D)Auditory brainstem response (ABR) test
Q2) Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than:
A)4 weeks
B)8 weeks
C)12 weeks
D)16 weeks
Q3) Severe pain associated with acute otitis media signifies perforation of the tympanic membrane.
A)True
B)False
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Chapter 9: Respiratory Problems
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Q1) Your patient states he has a strep throat infection.Which of the following symptoms makes you consider a viral etiology instead?
A)Fever
B)Headache
C)Exudative pharyngitis
D)Rhinorrhea
Q2) Marci has been started on a tuberculosis (TB) regimen.Because isoniazid (INH) may cause peripheral neuropathy, you consider ordering which of the following drugs prophylactically?
A)Pyridoxine
B)Thiamine
C)Probiotic
D)Phytonadione
Q3) Marta is taking TB drugs prophylactically.How do you instruct her to take them?
A)Take them on an empty stomach to facilitate absorption.
B)Take them with aspirin (ASA) to prevent flushing.
C)Take them with ibuprofen to prevent a headache.
D)Take them with food to prevent nausea.
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Chapter 10: Cardiovascular Problems
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Q1) Mary has hypertension and previously had a stroke.Which hypertensive drug would you order for her?
A)Angiotensin converting enzyme inhibitor
B)Calcium channel blocker
C)Angiotensin II receptor blocker
D)Beta blocker
Q2) If chest pain can be alleviated with time, analgesics, and heat applications, what might the differential diagnosis be?
A)Peptic ulcer
B)Hiatal hernia
C)Costochondritis
D)Pericarditis
Q3) Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:
A)Severe asthma
B)A common valvular lesion
C)Severe hypertension
D)A prosthetic heart valve
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Chapter 11: Abdominal Problems
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Q1) Mr.J.K., 38 years old, is 5 feet 8 inches tall and weighs 189 pounds.He reports that he has had intermittent heartburn for several months and takes Tums¨ with temporary relief.He has been waking during the night with a burning sensation in his chest.Which additional information would lead you to believe that gastroesophageal reflux disease (GERD) is the cause of his pain?
A)The pain seems better when he smokes to relieve his nerves.
B)Coffee and fried foods donÕt bother him,
C)He wakes at night coughing with a bad taste in his mouth.
D)All of the above
Q2) A patient comes to the office complaining of constipation.The patient lists all of the following medications.Which drug could be responsible for the constipation?
A)Multivitamin
B)Magnesium hydroxide
C)Pepto-Bismol¨
D)Ibuprofen
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Chapter 12: Renal Problems
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Q1) Which of the following patients is at risk for developing urinary tract cancer?
A)The 45-year-old woman who is 100 lbs overweight
B)The 78-year-old man who smokes three packs of cigarettes a day
C)The 84-year-old man who worked in the asbestos mines
D)All of the above
Q2) A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis.In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses?
A)Pancreatitis
B)Peptic ulcer disease
C)Diverticulitis
D)All of the above
Q3) The patient is diagnosed with ARF.Which of the following conditions is the most common cause?
A)Renal calculi
B)Acute tubular necrosis
C)Cardiac failure
D)Acute glomerulonephritis
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Chapter 13: Mens Health Problems
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Q1) A patient with testicular cancer is being followed after completing treatment 1 year ago.He has been symptom-free with no evidence of disease.How often should he have a CT scan?
A)Every month
B)Every 3 to 4 months
C)Every 6 to 12 months
D)Every year
Q2) A 14-year-old male is seen with complaints of severe testicular pain.The clinician suspects testicular torsion.Which of the following is the appropriate action?
A)Refer to a urologist immediately.
B)Obtain a computed tomography (CT) scan.
C)Instruct the patient to elevate the scrotum.
D)Prescribe ibuprofen.
Q3) A 30-year-old man is seen with a chief complaint of loss of libido.Which of the following laboratory tests would help establish a diagnosis?
A)Testosterone level
B)Prostate-specific antigen
C)Nocturnal penile tumescence and rigidity
D)Prolactin level
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Chapter 14: Womens Health Problems
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Q1) A 32-year-old woman is seen in the clinic because she has been unable to get pregnant after 12 months of unprotected sex.In order to determine the cause of the infertility, the clinician should question her about which of these possible causes?
A)Pelvic inflammatory disease
B)Oral contraceptive use for 15 years
C)Early menarche
D)Diet high in soy protein
Q2) Which of the following tests is essential for a 46-year-old woman who the clinician suspects is perimenopausal?
A)Pregnancy
B)Estrogen level
C)Progesterone level
D)LH level
Q3) When assessing a woman for infertility, which of the following tests should be done first?
A)Analysis of partner's sperm
B)Magnetic resonance imaging (MRI)
C)Hysterosalpingogram
D)Estrogen level
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Page 13
Chapter 15: Musculoskeletal Problems
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Q1) Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?
A)Decreased C-reactive protein
B)Hyperalbuminemia
C)Morning stiffness
D)Weight gain
Q2) Which of the following statements concerning the musculoskeletal examination is true?
A)The uninvolved side should be examined initially and then compared to the involved side.
B)The part of the body that is causing the patient pain should be examined first.
C)When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain.
D)Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.
Q3) Osteoarthritis is primarily a noninflammatory condition.
A)True
B)False
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Chapter 16: Endocrinemetabolic Problems
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Q1) The clinician should question the patient with suspected gout about use of which of these medications?
A)Low-dose aspirin
B)Thiazide diuretics
C)Ethambutol
D)All of the above
Q2) The clinician prescribes glipizide (Glucotrol) for a diabetic patient.Which statement made by the patient would indicate that your teaching has been effective?
A)"I'll take my pill at least 30 minutes before breakfast."
B)"I'll take my Glucotrol before bedtime."
C)"It is important to take my medication right after I eat."
D)"Since I only like to eat two meals a day, I can take the pill between my meals."
Q3) Which of the following laboratory findings should the clinician expect in a patient with untreated Graves' disease?
A)Elevated TSH
B)Elevated T4
C)Elevated thyrotropin-releasing hormone (TRH)
D)All of the above
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Chapter 17: Hematologic and Immune Problems
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Q1) CFS tends to occur in which individuals?
A)Active, highly functional adults
B)Depressed middle-aged persons
C)Individuals with a depressed immune system
D)Individuals who are hypochondriacs
Q2) Infectious mononucleosis results from an acute infection with which of the following?
A)Epstein-Barr virus
B)Acute HIV infection
C)Guillain-Barre
D)Hepatitis
Q3) Dryness of the eyes and mouth is typical of which condition?
A)Sjögrens syndrome
B)CFS
C)FMS
D)Hypothyroidism
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Chapter 18: Psychosocial Problems
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Q1) A no-suicide contract can prevent a suicide attempt.
A)True
B)False
Q2) Depressive episodes associated with bipolar disorder are treated the same as major depressive disorder.
A)True
B)False
Q3) Which of the following may be used to evaluate a person's suicide risk?
A)CAGE
B)SANE
C)SAD PERSONAS
D)DIGFAST
Q4) Assessing for adherence with prescribed medications and developing a plan for what to do if they are stopped is a major treatment issue for which of the following diagnostic groups?
A)ADHD
B)Bipolar
C)Depression
D)Anxiety
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Chapter 19: Emergency Problems
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Q1) Which carboxyhemoglobin (COHb) level correlates with the clinical symptoms of confusion, lethargy, and ST-segment depression on the electrocardiogram?
A)Less than 10%
B)20% COHb
C)30% COHb
D)40% to 60% COHb
Q2) If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?
A)Permanent tissue damage may occur, resulting in necrosis to that body part.
B)The area will be super sensitive.
C)The area is prone to a repeat frostbite.
D)The area is as susceptible as any other area.
Q3) Pink, cherry red tissues and skin may result from which type of poisoning?
A)Arsenic
B)Lead
C)Carbon monoxide
D)Strychnine
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18
Chapter 20: Palliative Care
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Q1) A patient is preparing to be discharged to home with hospice.She is on a morphine patient-controlled analgesia (PCA) in the hospital.She is concerned as to whether she can stay on her morphine PCA at home even when she is not able to give herself boluses.What would be an appropriate response from the clinician?
A)"We are unable to prescribe a PCA for use at home.If you are comfortable on the PCA, you should remain in the hospital."
B)"It would be possible for your nurse or another trained family member to activate the dosing button when you are unable to do so."
C)"A PCA is not an appropriate method of pain medication delivery once you are unable to use the dosing button.I will switch you to another form of pain control."
D)"You should not be concerned about your pain management at home.It will be taken care of for you."
Q2) Which of the following would be a cause of visceral pain?
A)Bone metastases
B)Intra-abdominal metastases
C)Musculoskeletal inflammation
D)Postsurgical incisional pain
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Page 19
Chapter 21: Ethical and Legal Issues of a Caring-Based Practice
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Q1) Three components must be present to establish malpractice.Which one does NOT apply?
A)The APRN must be paid for the services in question.
B)The provider must have a duty to the patient.
C)The standard of care must have been deviated from or breached.
D)Harm or damages must have occurred as a result of the duty and a breach of the standards of care.
Q2) In an outpatient setting, what is the most common reason for a malpractice suit?
A)Failure to treat a condition
B)Failure to diagnose correctly
C)Ordering the wrong medication
D)Failure to manage care
Q3) Which statement about the American Nurses Association Code of Ethics is accurate?
A)The state's legal requirements exceed those of the Code of Ethics.
B)The primary purpose of the Code is to show physicians that nurses are professional.
C)The Code was formulated by physicians for all nurses.
D)The Code sets forth the values and ethical principles that guide clinical decisions.
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Chapter 22: Business of Advanced Practice
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Q1) Accounting keeps track of the financial state of a business.The accounting report that demonstrates the growth in assets is:
A)Net income statement
B)Balance sheet
C)Cash flow statement
D)Operating statement
Q2) All health-care practices should develop a compliance plan.Compliance plans offer practice safeguards that prevent which of the following?
A)Malpractice claims
B)Conflict of interest claims
C)Health Insurance Portability and Accountability Act violations
D)Occupational Safety and Health Administration violations
Q3) Medicare benefits were offered to U.S.beneficiaries beginning in 1965.What was the service added with the Medicare D plan in 2006?
A)Health-care screening
B)Health-care education
C)Pharmaceutical coverage
D)Durable medical equipment coverage
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Chapter 23: The 15-Minute Hour
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Q1) The BATHE technique was developed more than 20 years ago and has been used extensively in primary care and family practice.The new 'Positive BATHE' stresses:
A)A belief that all things are possible through positive affirmations
B)A belief that one should only refer to practitioners who embrace the viewpoint of positive psychology
C)Personal accomplishment, thankfulness, autonomy, and general positive effect
D)The patient's problems and concerns
Q2) One benefit of motivational interviewing (MI) is:
A)It assumes that ambivalence is a normal part of the change process.
B)It can be utilized during routine office visits.
C)It is a therapeutic technique which is not necessarily time intensive.
D)All are benefits of MI.
Q3) Commonalities among psychotherapeutic techniques include the following:
A)Dream therapy, listening, and reflection
B)Psychodrama, group psychotherapy, and 12-step programs
C)Self-help groups
D)Obtaining external perspective and participation in a helping relationship
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Chapter 24: Putting Caring Into Practice: Caring for Self
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Q1) APRNs need to develop their own self-management plans.Two key elements of self-management plans are:
A)Taking vacations and keeping up with new knowledge and developments in medicine
B)Resilience and positive intentionality
C)Family support and a healthy diet
D)Being physically and emotionally "fit"
Q2) According to nurse theorist Jean Watson, a focus on positive intentionality_holding caring thoughts, loving kindness, and open receptivity_enhances caring energy, which leads to healing.How can the APRN bring this to their practice?
A)Spiritual readings, centering oneself before patient encounters, engaging in behaviors that help build positive energy
B)Review of materials on primary care before going into the work environment to increase one's confidence, leading to caring energy
C)Travel to sacred places
D)Helping the poor and homeless_volunteering at a domestic violence shelter, for example_in addition to one's regular practice .
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