Test Bank for Pharmacotherapeutics for Advanced Practice Nurse Prescribers 4th Moser Woo

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Pharmacotherapeutics for Advanced Practice Nurse Prescribers 4th Moser Woo

Chapter 6. Factors That Foster Positive Outcomes

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   A comprehensive assessment of a patient should be holistic when trying to determine competence in drug administration. Which of the following factors would the NP omit from this type of assessment?

1. Financial status
2. Mobility
3. Social support
4. Sexual practices

 

 

____    2.   Elena Vasquez’s primary language is Spanish, and she speaks very limited English. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed?

1. Use correct medical terminology because Spanish has a Latin base.
2. Use a family member who speaks more English to act as an interpreter.
3. Use a professional interpreter or a reliable staff member who can act as an interpreter.
4. Use careful, detailed explanations.

 

 

____    3.   Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug?

1. Stand facing him and speak slowly and clearly.
2. Speak in low tones or find a provider who has a lower voice.
3. Write down the instructions as well as speaking them.
4. If he reads lips, exaggerate lips movements when pronouncing the vowel sounds.

 

 

____    4.   Which of the following factors may adversely affect a patient’s adherence to a therapeutic drug regimen?

1. Complexity of the drug regimen
2. Patient perception of the potential adverse effects of the drugs
3. Both 1 and 2
4. Neither 1 nor 2

 

 

____    5.   The health-care delivery system itself can create barriers to adherence to a treatment regimen. Which of the following system variables creates such a barrier?

1. Increasing copayments for care
2. Unrestricted formularies for drugs, including brand names
3. Increasing the number of people who have access to care
4. Treating a wider range of disorders

 

 

____    6.   Ralph’s blood pressure remains elevated despite increased doses of his drug. The NP is concerned that he might not be adhering to his treatment regimen. Which of the following events would suggest that he might not be adherent?

1. Ralph states that he always takes the drug “when I feel my pressure is going up.”
2. Ralph contacts his NP to discuss the need to increase the dosage.
3. Ralph consistently keeps his follow-up appointments to check his blood pressure.
4. All of the above show that he is adherent to the drug regimen.

 

 

____    7.   Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that:

1. Has a short half-life so that missing one dose has limited effect
2. Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down
3. Has a tolerability profile with fewer of the adverse effects that are considered “irritating,” such as nausea and dizziness
4. Must be taken no more than twice a day

 

 

____    8.   Factors in chronic conditions that contribute to nonadherence include:

1. The complexity of the treatment regimen
2. The length of time over which it must be taken
3. Breaks in the usual daily routine, such as vacations and weekends
4. All of the above

 

 

____    9.   While patient education about their drugs is important, information alone does not necessarily lead to adherence to a drug regimen. Patients report greater adherence when:

1. The provider spent a lot of time discussing the drugs with them
2. Their concerns and specific area of knowledge deficit were addressed
3. They were given written material, such as pamphlets, about the drugs
4. The provider used appropriate medical and pharmacological terms

 

 

____  10.   Patients with psychiatric illnesses have adherence rates to their drug regimen between 35% and 60%. To improve adherence in this population, prescribe drugs:

1. With a longer half-life so that missed doses produce a longer taper on the drug curve
2. In oral formulations that are more easily taken
3. That do not require frequent monitoring
4. Combined with patient education about the need to adhere even when symptoms are absent

 

 

____  11.   Many disorders require multiple drugs to treat them. The more complex the drug regimen, the less likely the patient will adhere to it. Which of the following interventions will NOT improve adherence?

1. Have the patient purchase a pill container with compartments for daily or multiple times-per-day dosing.
2. Match the clinic appointment to the next time the drug is to be refilled.
3. Write prescriptions for new drugs with shorter times between refills.
4. Give the patient a clear drug schedule that the provider devises to fit the characteristic of the drug.

 

 

____  12.   Pharmacologic interventions are costly. Patients for whom the cost/benefit variable is especially important include:

1. Older adults and those on fixed incomes
2. Patients with chronic illnesses
3. Patients with copayments for drugs on their insurance
4. Patients on public assistance

 

 

____  13.   Providers have a responsibility for determining the best plan of care, but patients also have responsibilities. Patients the provider can be assured will carry through on these responsibilities include those who:

1. Are well-educated and affluent
2. Have chronic conditions
3. Self-monitor drug effects on their symptoms
4. None of the above guarantee adherence

 

 

____  14.   Monitoring adherence can take several forms, including:

1. Patient reports from data in a drug diary
2. Pill counts
3. Laboratory reports and other diagnostic markers
4. All of the above

 

 

____  15.   Factors that explain and predict medication adherence include:

1. Social
2. Financial
3. Health system
4. All of the above

 

Chapter 6. Factors That Foster Positive Outcomes

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  4                    PTS:   1

 

  1. ANS:  3                    PTS:   1

 

  1. ANS:  4                    PTS:   1

 

  1. ANS:  3                    PTS:   1

 

  1. ANS:  1                    PTS:   1

 

  1. ANS:  1                    PTS:   1

 

  1. ANS:  3                    PTS:   1

 

  1. ANS:  4                    PTS:   1

 

  1. ANS:  2                    PTS:   1

 

  1. ANS:  1                    PTS:   1

 

  1. ANS:  4                    PTS:   1

 

  1. ANS:  1                    PTS:   1

 

  1. ANS:  4                    PTS:   1

 

  1. ANS:  4                    PTS:   1

 

  1. ANS:  4                    PTS:   1

 

Chapter 7. Cultural and Ethnic Influences in Pharmacotherapeutics

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   Cultural factors that must be taken into account when prescribing include(s):

1. Who the decision maker is in the family regarding health-care decisions
2. The patient’s view of health and illness
3. Attitudes regarding the use of drugs to treat illness
4. All of the above

 

 

____    2.   Ethnic differences have been found in drug:

1. Absorption
2. Hepatic metabolism
3. Filtration at the glomerulus
4. Passive tubular reabsorption

 

 

____    3.   The National Standards of Culturally and Linguistically Appropriate Services are required to be implemented in all:

1. Hospitals
2. Clinics that serve the poor
3. Organizations that receive federal funds
4. Clinics that serve ethnic minorities

 

 

____    4.   According to the National Standards of Culturally and Linguistically Appropriate Services, an interpreter for health care:

1. May be a bilingual family member
2. May be a bilingual nurse or other health-care provider
3. Must be a professionally trained medical interpreter
4. Must be an employee of the organization

 

 

____    5.   According to the U.S. Office of Minority Health, poor health outcomes among African Americans are attributed to:

1. The belief among African Americans that prayer is more powerful than drugs
2. Poor compliance on the part of the African American patient
3. The genetic predisposition for illness found among African Americans
4. Discrimination, cultural barriers, and lack of access to health care

 

 

____    6.   The racial difference in drug pharmacokinetics seen in American Indian or Alaskan Natives are:

1. Increased CYP 2D6 activity, leading to rapid metabolism of some drugs
2. Largely unknown due to lack of studies of this population
3. Rapid metabolism of alcohol, leading to increased tolerance
4. Decreased elimination of opioids, leading to increased risk for addiction

 

 

____    7.   Pharmacokinetics among Asians are universal to all the Asian ethnic groups.

1. True
2. False

 

 

____    8.   Alterations in drug metabolism among Asians may lead to:

1. Slower metabolism of antidepressants, requiring lower doses
2. Faster metabolism of neuroleptics, requiring higher doses
3. Altered metabolism of omeprazole, requiring higher doses
4. Slower metabolism of alcohol, requiring higher doses

 

 

____    9.   Asians from Eastern Asia are known to be fast acetylators. Fast acetylators:

1. Require acetylization in order to metabolize drugs
2. Are unable to tolerate higher doses of some drugs that require acetylization
3. May have a toxic reaction to drugs that require acetylization
4. Require higher doses of drugs metabolized by acetylization to achieve efficacy

 

 

____  10.   Hispanic native healers (curanderas):

1. Are not heavily utilized by Hispanics who immigrate to the United States
2. Use herbs and teas in their treatment of illness
3. Provide unsafe advice to Hispanics and should not be trusted
4. Need to be licensed in their home country in order to practice in the United States

 

Chapter 7. Cultural and Ethnic Influences in Pharmacotherapeutics

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  4                    PTS:   1

 

  1. ANS:  2                    PTS:   1

 

  1. ANS:  3                    PTS:   1

 

  1. ANS:  3                    PTS:   1

 

  1. ANS:  4                    PTS:   1

 

  1. ANS:  2                    PTS:   1

 

  1. ANS:  2                    PTS:   1

 

  1. ANS:  1                    PTS:   1

 

  1. ANS:  4                    PTS:   1

 

  1. ANS:  2                    PTS:   1