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Quizzes > Quizzes for Business > Healthcare

Take the Nursing Pharmacology and Prescriptive Authority Knowledge Test

Master Core Pharmacology and Prescriptive Authority Concepts

Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art promoting a quiz on Nursing Pharmacology and Prescriptive Authority Knowledge.

Ready to boost your prescribing confidence? Dive into this prescriptive authority knowledge test with 15 multiple-choice questions covering drug actions, regulations, and patient safety. Ideal for nursing students and practitioners seeking to refine pharmacology skills. Each question is fully editable in our quiz editor to personalise your review. Explore similar challenges like the Nursing Pharmacology Knowledge Quiz or the Pharmacology Knowledge Quiz, and browse more quizzes.

What is the primary mechanism of action of beta-blockers like propranolol?
They stimulate renin release from the kidney.
They inhibit beta-adrenergic receptors, reducing heart rate and contractility.
They block voltage-gated calcium channels in vascular smooth muscle.
They inhibit ACE, preventing conversion of angiotensin I to II.
Beta-blockers competitively antagonize beta-adrenergic receptors, decreasing sympathetic stimulation of the heart. This leads to reduced heart rate and myocardial oxygen demand.
Which route of administration provides the fastest onset of action for a medication?
Intravenous bolus
Intramuscular injection
Oral tablet
Subcutaneous injection
IV bolus administration delivers drug directly into the bloodstream, providing almost immediate onset. Other routes require absorption that delays effect.
An order is written for 500 mg of a drug. The available tablets are 250 mg each. How many tablets should the nurse administer?
1 tablet
3 tablets
2 tablets
0.5 tablet
To achieve a 500 mg dose with 250 mg tablets, the nurse administers 2 tablets. This simple calculation prevents dosing errors.
Metformin, used in type 2 diabetes, belongs to which drug class?
DPP-4 inhibitor
Sulfonylurea
Thiazolidinedione
Biguanide
Metformin is the prototype biguanide, reducing hepatic gluconeogenesis and improving insulin sensitivity. Other classes have different mechanisms.
Which schedule of controlled substances has the highest potential for abuse but is still available for medical use?
Schedule V
Schedule II
Schedule III
Schedule I
Schedule II substances have high abuse potential with accepted medical use, requiring strict regulation. Schedule I has no accepted medical use.
A patient on warfarin therapy has an elevated INR. Which food should the nurse advise the patient to avoid increasing intake of?
Leafy green vegetables
Bananas
Grapefruit juice
Dairy products
Leafy greens are high in vitamin K, which can antagonize warfarin's anticoagulant effect and destabilize INR. Managing dietary vitamin K intake is key.
Which state-level regulation typically grants nurse practitioners prescriptive authority?
Controlled Substances Act
Nurse Practice Act
Harrison Narcotic Tax Act
Federal Food, Drug, and Cosmetic Act
Each state's Nurse Practice Act defines the scope of practice and prescriptive authority for nurse practitioners. Federal acts regulate drug approval and controlled substances.
A drug has a half-life of 4 hours. Approximately how long will it take to eliminate 90% of the drug from the body?
20 hours
4 hours
8 hours
13.2 hours
Ninety percent elimination requires about 3.3 half-lives (3.3 × 4 hours ≈ 13.2 hours). This calculation guides dosing intervals and duration.
Impaired renal function primarily affects which pharmacokinetic parameter?
Clearance
Volume of distribution
Bioavailability
Protein binding
The kidneys excrete many drugs and their metabolites, so renal impairment reduces clearance and prolongs half-life. Dose adjustments are often required.
Which of the following is a classic sign of lithium toxicity?
Hyperglycemia
Bradycardia
Coarse tremor
Hypertension
A coarse tremor is an early and common indicator of lithium toxicity. Monitoring levels and patient symptoms can prevent severe toxicity.
Prescribing a medication off-label means the drug is being used:
Without any FDA approval at all.
In a manner not approved by the FDA for that indication.
At a higher dose than listed on the label.
Without patient consent.
Off-label use refers to prescribing within FDA-approved drugs but for unapproved indications or populations. It is legal with clinical justification.
Which antibiotic is known to induce hepatic enzymes and decrease warfarin's anticoagulant effect?
Metronidazole
Trimethoprim
Erythromycin
Rifampin
Rifampin is a potent inducer of CYP450 enzymes, increasing warfarin metabolism and reducing its anticoagulant effect. Monitoring INR is essential.
Calculate the loading dose for a drug with a volume of distribution of 0.7 L/kg in a 70 kg patient if the desired plasma concentration is 10 mg/L.
70 mg
4900 mg
490 mg
700 mg
Loading dose = Vd × weight × desired concentration: 0.7 L/kg × 70 kg × 10 mg/L = 490 mg. Accurate calculation achieves therapeutic levels quickly.
Blockade of which receptor type is primarily responsible for orthostatic hypotension seen with prazosin?
Dopamine D2 receptors
Beta-1 adrenergic receptors
Muscarinic receptors
Alpha-1 adrenergic receptors
Prazosin blocks alpha-1 receptors in vascular smooth muscle, impairing vasoconstriction upon standing and causing orthostatic hypotension.
Which cytochrome P450 enzyme is primarily responsible for the metabolism of theophylline?
CYP1A2
CYP2D6
CYP2C9
CYP3A4
CYP1A2 is the main enzyme metabolizing theophylline. Variations in CYP1A2 activity significantly affect theophylline clearance and risk of toxicity.
Which DEA form must a prescriber use to order schedule II controlled substances from a supplier?
DEA Form 222
DEA Form 225
DEA Form 41
DEA Form 224
DEA Form 222 is the official order form for schedule II controlled substances. Other forms pertain to registration, renewal, or disposal.
Which pharmacokinetic interaction occurs when broad-spectrum antibiotics reduce the enterohepatic recirculation of oral contraceptives?
Altered protein binding increasing free hormone levels
Increased first-pass metabolism of estrogen
Enhanced renal clearance of progesterone
Reduced bioavailability of estrogen leading to decreased efficacy
Broad-spectrum antibiotics can disrupt gut flora responsible for deconjugating estrogen metabolites, reducing enterohepatic recycling and lowering contraceptive efficacy.
A patient develops angioedema while on an ACE inhibitor. What is the best initial action?
Increase the ACE inhibitor dose
Administer a beta-blocker
Switch to another ACE inhibitor
Discontinue the ACE inhibitor immediately
ACE inhibitor - induced angioedema can be life-threatening. Immediate discontinuation of the drug is required, and alternative antihypertensives are considered.
Which action by a nurse practitioner would violate prescriptive authority regulations?
Documenting the rationale for a nonformulary medication
Using a collaborative agreement for controlled substances
Prescribing a schedule II opioid to a family member
Adhering to state protocols when prescribing antibiotics
Prescribing controlled substances to family members or personal acquaintances is prohibited due to ethical and regulatory guidelines. Proper documentation and agreements are required for prescriptive practice.
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Learning Outcomes

  1. Analyse drug mechanisms and interactions for safe prescribing
  2. Identify prescriptive authority regulations and legal considerations
  3. Evaluate pharmacokinetic principles in clinical scenarios
  4. Apply dosage calculations and prescribing guidelines accurately
  5. Demonstrate knowledge of drug classes and therapeutic uses
  6. Master adverse effect recognition and patient monitoring

Cheat Sheet

  1. Master Pharmacokinetics Basics (ADME) - Ever wondered how your body handles medications? Absorption, Distribution, Metabolism, and Excretion are the four musketeers of drug movement - understanding them helps you nail the perfect dose. Pharmacokinetics - StatPearls
  2. Navigate Drug Interactions Safely - Some medications can play nice together, while others gang up and cause trouble. Knowing how enzyme induction or inhibition affects drug levels keeps your patients safe and therapies effective. Drug Interactions Labeling - FDA
  3. Grasp Prescriptive Authority Laws - Laws and collaborative practice agreements vary by state, so it's critical to know your legal playground. Staying compliant not only protects you but also builds trust with patients and colleagues. Nurse Practitioner Prescriptive Authority - AANP
  4. Ace Dosage Calculations - Ditch the calculator jitters by mastering unit conversions, dose formulas, and patient-specific adjustments. Accurate math skills are the backbone of patient safety and therapeutic success. Dosage Calculations - UNC School of Nursing
  5. Decode Drug Schedules and Classifications - Controlled substances are sorted into Schedules I - V based on abuse potential and medical use. Recognizing each category ensures you prescribe responsibly and legally. Drug Scheduling - DEA
  6. Spot and Manage Adverse Drug Reactions - Even well-prescribed drugs can surprise you with side effects, so be on the lookout for ADRs. Early detection and prompt management prevent complications and keep patients happy. Adverse Drug Reactions - FDA
  7. Embrace Evidence-Based Prescribing - Combine solid research, clinical guidelines, and patient preferences to tailor the best therapy. This data-driven approach boosts outcomes and builds your credibility. Clinical Guidelines and Recommendations - AHRQ
  8. Unpack Drug Mechanisms of Action - Ever wonder why some meds hit the spot while others miss? Learning receptor sites, agonists, and antagonists lets you predict both therapeutic effects and side effects. Drug Receptors - Merck Manual
  9. Maintain Your Prescriptive Authority - From initial certifications to ongoing CE and state laws, keeping your credentials current is non-negotiable. Staying informed safeguards your license and your practice. Prescriptive Authority Requirements - Mass.gov
  10. Perfect Patient Medication Education - Clear, engaging counseling boosts adherence and reduces errors. Use teach-back methods, visual aids, and plain language to empower patients. Improving Medication Adherence - IHI
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