Assignment Prompt & Instructions
complete this assignment following the instructions and rubric attached.
**files (1)**
– ## wk9assignment.docx
**## wk9assignment.docx**
**Directions:** For each of the scenarios below, answer the questions below using your required learning resources, clinical practice guidelines, and medscape. Explain the problem and explain how you would address the problem. When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply), refills, etc. Also state if you would continue, discontinue or taper the patient’s current medications. *Use at least 3 sources for each scenario and cite sources using APA format.*
Sources you can read:
· Rosenthal, L. D., & Burchum, J. R. (2025)
_. Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants_ (3rd ed.). Elsevier.
· Chapters 50, “Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp. 425–436)
· Chapter 51, “Birth Control” (pp. 437–446)
· Chapter 52, “Androgens” (pp. 447–452)
· Chapter 53, “Male Sexual Dysfunction and Benign Prostatic Hyperplasia” (pp. 453–456)
· Chapter 84, “Drug Therapy for Sexually Transmitted Diseases” (pp. 764–772)
· Chapter 89, “Drugs for the Eye” (pp. 819–829)
· Chapter 90, “Drugs for the Skin” (pp. 830–854)
· Chapter 91, “Drugs for the Ear” (pp. 855–861)
Rubric:
| | | |
| — | — | — |
| Scenario 1: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection. | **15 to >11.0 ptsExcellent** Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.<br> <br>**11 to >7.0 ptsGood** Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.<br> <br>**7 to >3.0 ptsFair** Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.<br> <br>**3 to >0 ptsPoor** Medication selected is inappropriate or would not be provided based on patient unique characteristics. | 15 pts |
| This criterion is linked to a Learning OutcomeScenario 1: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. | **3 ptsComplete** Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.<br> <br>**0 ptsPoor** The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 1: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. | **4 ptsExcellent** References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.<br> <br>**3 ptsGood** References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.<br> <br>**2 ptsFair** References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.<br> <br>**0 ptsPoor** No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors. | 4 pts |
| This criterion is linked to a Learning OutcomeScenario 1: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation | **3 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**2 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**1 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 2: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection. | **15 to >11.0 ptsExcellent** Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.<br> <br>**11 to >7.0 ptsGood** Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.<br> <br>**7 to >3.0 ptsFair** Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.<br> <br>**3 to >0 ptsPoor** Medication selected is inappropriate or would not be provided based on patient unique characteristics. | 15 pts |
| This criterion is linked to a Learning OutcomeScenario 2: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. | **3 ptsComplete** Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.<br> <br>**0 ptsPoor** The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 2: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. | **4 ptsExcellent** References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.<br> <br>**3 ptsGood** References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.<br> <br>**2 ptsFair** References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.<br> <br>**0 ptsPoor** No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors. | 4 pts |
| This criterion is linked to a Learning OutcomeScenario 2: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation | **3 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**2 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**1 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 3: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection. | **15 to >11.0 ptsExcellent** Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.<br> <br>**11 to >7.0 ptsGood** Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.<br> <br>**7 to >3.0 ptsFair** Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.<br> <br>**3 to >0 ptsPoor** Medication selected is inappropriate or would not be provided based on patient unique characteristics. | 15 pts |
| This criterion is linked to a Learning OutcomeScenario 3: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. | **3 ptsComplete** Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.<br> <br>**0 ptsPoor** The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 3: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. | **4 ptsExcellent** References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.<br> <br>**3 ptsGood** References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.<br> <br>**2 ptsFair** References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.<br> <br>**0 ptsPoor** No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors. | 4 pts |
| This criterion is linked to a Learning OutcomeScenario 3: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation | **3 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**2 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**1 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 4: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection. | **15 to >11.0 ptsExcellent** Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.<br> <br>**11 to >7.0 ptsGood** Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.<br> <br>**7 to >3.0 ptsFair** Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.<br> <br>**3 to >0 ptsPoor** Medication selected is inappropriate or would not be provided based on patient unique characteristics. | 15 pts |
| This criterion is linked to a Learning OutcomeScenario 4: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. | **3 ptsComplete** Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.<br> <br>**0 ptsPoor** The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 4: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. | **4 ptsExcellent** References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.<br> <br>**3 ptsGood** References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.<br> <br>**2 ptsFair** References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.<br> <br>**0 ptsPoor** No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors. | 4 pts |
| This criterion is linked to a Learning OutcomeScenario 4: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation | **3 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**2 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**1 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 3 pts |
Total Points: 100
SCENARIO 1
What are the
**errors** in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication’s classification and mechanism of action (MOA)?
· rivoraxaban 20 mg PO daily with evening meal #30 0RF
· tamsulosin (Proscar) 0.4 mg po daily, 30 minutes after the same meal each day #30 2 RF
·
**Bactrim DS** (sulfamethoxazole/trimethoprim 875/125 mg) po twice daily for 7 days for UTI #14 0RF
· cephalexin (Cefzil) 500 mg po QID x 7 days #28 0 RF
· ciprofloxacin 0.3% otic solution for bacterial conjunctivitis; instill 1-2 drops into eye every 2 hours while awake for 2 days then 1-2 drops every 4 hours while awake for the next 5 days #1 bottle 0 RF
SCENARIO 2
FL is 48-year-old woman presenting with hot flashes related to menopause. Current medical conditions include hypertension and ADHD. She reports that stimulant medications caused significant insomnia and appetite suppression in the past. She is seeking a single medication that may help manage more than one of her conditions.
Which of the following medications would be the most appropriate choice for this patient? WHY? What is the medication’s MOA and what would you monitor?
· estradiol 1 mg PO daily
· progesterone 200 mg PO at bedtime
· venlafaxine XR 75 mg PO daily
· clonidine 0.1 mg PO twice daily
· bupropion XL 150 mg PO daily
SCENARIO 3
TN is a 26-year-old female presenting with thick white, odorless vaginal discharge and itching for 2 days. She is sexually active and has had unprotected sex with a new male partner for the last month. Current medications include fluoxetine 20 mg po daily, valacyclovir 500 mg po daily, zolpidem 10 mg po qHS, Depo-Provera 150 mg IM q3 months. TN reports drinking kava several times a day. She is allergic to sulfa drugs. What medication would you prescribe for TN (include complete medication order)? What is a possible differential diagnosis? How long should she abstain from sexual activity? What patient education would you provide?
SCENARIO 4
GA (70 kg patient) is prescribed
**vancomycin 15 mg/kg IV** every
**12 hours**. The pharmacy stocks
**vancomycin 1 g per 20 mL** vials.
·
**How much vancomycin (mg) should be administered per dose?**
·
**How many milliliters of vancomycin solution should be drawn up for each dose?**
·
**If the infusion rate is 10 mg/min, how long will it take to administer one dose?**
· A
**trough level** is drawn
**30 minutes before the 4th dose**, and the result is
**9 mcg/mL.** Is the current dosing regimen appropriate based on the trough level? Would you increase, decrease, or leave the dose the same? Please include a complete medication order. What are risks associated with vancomycin therapy?
·
**Why is vancomycin usually given IV and not PO? How does this relate to bioavailability?**
**## wk9assignment.docx**
**Directions:** For each of the scenarios below, answer the questions below using your required learning resources, clinical practice guidelines, and medscape. Explain the problem and explain how you would address the problem. When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply), refills, etc. Also state if you would continue, discontinue or taper the patient’s current medications. *Use at least 3 sources for each scenario and cite sources using APA format.*
Sources you can read:
· Rosenthal, L. D., & Burchum, J. R. (2025)
_. Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants_ (3rd ed.). Elsevier.
· Chapters 50, “Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp. 425–436)
· Chapter 51, “Birth Control” (pp. 437–446)
· Chapter 52, “Androgens” (pp. 447–452)
· Chapter 53, “Male Sexual Dysfunction and Benign Prostatic Hyperplasia” (pp. 453–456)
· Chapter 84, “Drug Therapy for Sexually Transmitted Diseases” (pp. 764–772)
· Chapter 89, “Drugs for the Eye” (pp. 819–829)
· Chapter 90, “Drugs for the Skin” (pp. 830–854)
· Chapter 91, “Drugs for the Ear” (pp. 855–861)
Rubric:
| | | |
| — | — | — |
| Scenario 1: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection. | **15 to >11.0 ptsExcellent** Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.<br> <br>**11 to >7.0 ptsGood** Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.<br> <br>**7 to >3.0 ptsFair** Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.<br> <br>**3 to >0 ptsPoor** Medication selected is inappropriate or would not be provided based on patient unique characteristics. | 15 pts |
| This criterion is linked to a Learning OutcomeScenario 1: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. | **3 ptsComplete** Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.<br> <br>**0 ptsPoor** The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 1: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. | **4 ptsExcellent** References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.<br> <br>**3 ptsGood** References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.<br> <br>**2 ptsFair** References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.<br> <br>**0 ptsPoor** No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors. | 4 pts |
| This criterion is linked to a Learning OutcomeScenario 1: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation | **3 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**2 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**1 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 2: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection. | **15 to >11.0 ptsExcellent** Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.<br> <br>**11 to >7.0 ptsGood** Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.<br> <br>**7 to >3.0 ptsFair** Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.<br> <br>**3 to >0 ptsPoor** Medication selected is inappropriate or would not be provided based on patient unique characteristics. | 15 pts |
| This criterion is linked to a Learning OutcomeScenario 2: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. | **3 ptsComplete** Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.<br> <br>**0 ptsPoor** The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 2: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. | **4 ptsExcellent** References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.<br> <br>**3 ptsGood** References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.<br> <br>**2 ptsFair** References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.<br> <br>**0 ptsPoor** No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors. | 4 pts |
| This criterion is linked to a Learning OutcomeScenario 2: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation | **3 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**2 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**1 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 3: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection. | **15 to >11.0 ptsExcellent** Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.<br> <br>**11 to >7.0 ptsGood** Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.<br> <br>**7 to >3.0 ptsFair** Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.<br> <br>**3 to >0 ptsPoor** Medication selected is inappropriate or would not be provided based on patient unique characteristics. | 15 pts |
| This criterion is linked to a Learning OutcomeScenario 3: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. | **3 ptsComplete** Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.<br> <br>**0 ptsPoor** The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 3: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. | **4 ptsExcellent** References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.<br> <br>**3 ptsGood** References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.<br> <br>**2 ptsFair** References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.<br> <br>**0 ptsPoor** No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors. | 4 pts |
| This criterion is linked to a Learning OutcomeScenario 3: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation | **3 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**2 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**1 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 4: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection. | **15 to >11.0 ptsExcellent** Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.<br> <br>**11 to >7.0 ptsGood** Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.<br> <br>**7 to >3.0 ptsFair** Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.<br> <br>**3 to >0 ptsPoor** Medication selected is inappropriate or would not be provided based on patient unique characteristics. | 15 pts |
| This criterion is linked to a Learning OutcomeScenario 4: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. | **3 ptsComplete** Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.<br> <br>**0 ptsPoor** The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate. | 3 pts |
| This criterion is linked to a Learning OutcomeScenario 4: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. | **4 ptsExcellent** References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.<br> <br>**3 ptsGood** References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.<br> <br>**2 ptsFair** References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.<br> <br>**0 ptsPoor** No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors. | 4 pts |
| This criterion is linked to a Learning OutcomeScenario 4: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation | **3 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors.<br> <br>**2 ptsGood** Contains a few (1 or 2) grammar, spelling, and punctuation errors.<br> <br>**1 ptsFair** Contains several (3 or 4) grammar, spelling, and punctuation errors.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. | 3 pts |
Total Points: 100
SCENARIO 1
What are the
**errors** in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication’s classification and mechanism of action (MOA)?
· rivoraxaban 20 mg PO daily with evening meal #30 0RF
· tamsulosin (Proscar) 0.4 mg po daily, 30 minutes after the same meal each day #30 2 RF
·
**Bactrim DS** (sulfamethoxazole/trimethoprim 875/125 mg) po twice daily for 7 days for UTI #14 0RF
· cephalexin (Cefzil) 500 mg po QID x 7 days #28 0 RF
· ciprofloxacin 0.3% otic solution for bacterial conjunctivitis; instill 1-2 drops into eye every 2 hours while awake for 2 days then 1-2 drops every 4 hours while awake for the next 5 days #1 bottle 0 RF
SCENARIO 2
FL is 48-year-old woman presenting with hot flashes related to menopause. Current medical conditions include hypertension and ADHD. She reports that stimulant medications caused significant insomnia and appetite suppression in the past. She is seeking a single medication that may help manage more than one of her conditions.
Which of the following medications would be the most appropriate choice for this patient? WHY? What is the medication’s MOA and what would you monitor?
· estradiol 1 mg PO daily
· progesterone 200 mg PO at bedtime
· venlafaxine XR 75 mg PO daily
· clonidine 0.1 mg PO twice daily
· bupropion XL 150 mg PO daily
SCENARIO 3
TN is a 26-year-old female presenting with thick white, odorless vaginal discharge and itching for 2 days. She is sexually active and has had unprotected sex with a new male partner for the last month. Current medications include fluoxetine 20 mg po daily, valacyclovir 500 mg po daily, zolpidem 10 mg po qHS, Depo-Provera 150 mg IM q3 months. TN reports drinking kava several times a day. She is allergic to sulfa drugs. What medication would you prescribe for TN (include complete medication order)? What is a possible differential diagnosis? How long should she abstain from sexual activity? What patient education would you provide?
SCENARIO 4
GA (70 kg patient) is prescribed
**vancomycin 15 mg/kg IV** every
**12 hours**. The pharmacy stocks
**vancomycin 1 g per 20 mL** vials.
·
**How much vancomycin (mg) should be administered per dose?**
·
**How many milliliters of vancomycin solution should be drawn up for each dose?**
·
**If the infusion rate is 10 mg/min, how long will it take to administer one dose?**
· A
**trough level** is drawn
**30 minutes before the 4th dose**, and the result is
**9 mcg/mL.** Is the current dosing regimen appropriate based on the trough level? Would you increase, decrease, or leave the dose the same? Please include a complete medication order. What are risks associated with vancomycin therapy?
·
**Why is vancomycin usually given IV and not PO? How does this relate to bioavailability?**