NURS 5334 ADV PHARM FOR ANP -
v7 v7 v7 v7 v7 v7
MODULE 1 LECTURES
v7 v7 v7
Whenv7writingv7anyv7prescription,v7therev7arev7keyv7elementsv7thatv7mustv7bev7
onv7thev7prescriptionv7includingv7prescriberv7name,v7licensev7number,v7andv7c
ontactv7information;v7DEAv7numberv7ofv7bothv7thev7supervisingv7physicianv7a
ndv7thev7prescriberv7ifv7applicable;v7patientv7namev7andv7datev7ofv7birth;v7patie
ntv7allergies;v7thev7namev7ofv7thev7medication;v7thev7indicationv7ofv7thev7medic
ation;v7thev7strengthv7ofv7thev7medication;v7thev7dosingv7frequency;v7numberv7
ofv7tablets/capsulesv7tov7dispense;v7andv7thev7numberv7ofv7refills.v7Abbreviati
onsv7arev7nov7longerv7acceptable.v7Everythingv7shouldv7bev7writtenv7out.v7Exa
mple:v725v7milligramsv7oncev7dailyv7byv7mouthv7forv7hypertension.v7Andv7Ifv7
youv7arev7usingv7anv7electronicv7medicalv7recordv7forv7prescriptions,v7thesev7a
rev7goingv7tov7automaticallyv7bev7onv7therev7inv7somev7instances,v7butv7otherv7i
nstancesv7youv7mayv7needv7tov7addv7them.v7Youv7willv7havev7assignmentsv7inv7
thisv7coursev7involvingv7writingv7prescriptions.v7Studentsv7getv7confusedv7wh
env7itv7comesv7tov7thev7SIGv7onv7thev7prescription.v7Sigv7stv7-v7correctv7answer
✔ ✔
Whatv7isv7prescriptivev7authority?v7-v7correctv7answer✔ ✔
Thev7abilityv7andv7extentv7ofv7NP'sv7abilityv7tov7prescribev7medicationv7tov7p
atientv7isv7dependentv7onv7statev7nursev7practicev7act
Wallv7EEv7EAv7hasv7ruledv7thatv7nursesv7inv7advancedv7practicev7rolesv7mayv7o
btainv7registeredv7members,v7statev7practicev7actsv7dictatev7thev7levelv7ofv7pres
criptivev7authorityv7allowed
,Componentsv7ofv7prescriptivev7authorityv7-v7correctv7answer✔ ✔
arev7thev7rightv7tov7prescribev7independently,v7andv7thev7rightv7tov7prescribev
7withoutv7limitation.v7Thev7prescriberv7whov7prescribesv7independentlyv7isv7n
otv7subjectv7tov7rulesv7requiringv7physicianv7supervisionv7orv7collaboration.v7
Thev7providerv7whov7prescribesv7withoutv7limitationv7mayv7prescribev7anyv7d
rugs,v7includingv7controlledv7drugs,v7withv7thev7exceptionv7ofv7Schedulev71v7d
rugs,v7whichv7havev7nov7currentv7medicalv7use.
Prescriptivev7authorityv7isv7determinedv7byv7statev7law.v7Asv7av7resultv7-v7-
v7correctv7answer✔ ✔
ofv7differencev7fromv7statev7tov7statev7advancedv7practicev7providersv7mayv7
havev7fullv7prescriptivev7authorityv7inv7somev7states,v7yetv7facev7av7lotv7ofv7restr
ictionsv7inv7otherv7states.v7Texas,v7unfortunately,v7isv7av7statev7wherev7wev7arev
7restricted.v7Thev7differencesv7particularlyv7affectv7providersv7whov7servev7inv
7locumv7tenemsv7staffingv7positions,v7orv7whov7havev7practicesv7inv7twov7conti
guousv7states.v7Thev7regulationv7ofv7prescriptivev7authorityv7isv7underv7thev7ju
risdictionv7ofv7av7healthv7professionalv7board.v7Thisv7mayv7bev7thev7statev7boar
dv7ofv7nursing,v7statev7boardv7ofv7medicine,v7orv7thev7statev7boardv7ofv7pharmac
yv7asv7determinedv7byv7eachv7state.v7Althoughv7thev7federalv7governmentv7con
trolsv7drugv7regulation,v7itv7hasv7nov7controlv7overv7prescriptivev7authority.
Whatv7isv7thev7argumentv7forv7fullv7prescriptivev7authority?v7-
v7correctv7answer✔ ✔
Advancedv7practicev7providersv7completev7rigorousv7programsv7ofv7studyv7
largelyv7inv7accreditedv7programsv7thatv7meetv7stringentv7nationalv7standards.
v7Althoughv7therev7arev7differencesv7inv7eachv7program,v7theyv7allv7includev7co
mmonv7components.v7Forv7example,v7theyv7requirev7extensivev7educationv7fo
cusedv7onv7assessment,v7diagnosis,v7andv7managementv7ofv7healthv7problems
,.v7Diagnosticv7reasoning,v7criticalv7thinkingv7andv7proceduralv7skillsv7arev7eva
luatedv7inv7bothv7didacticv7andv7clinicalv7courses.v7Nationalv7examinationsv7v
alidatev7thev7abilityv7tov7providev7safev7andv7competentv7care,v7andv7licensurev
7ensuresv7thatv7providersv7complyv7withv7standards v7ofv7practicev7thatv7promo
tev7publicv7healthv7andv7safety.v7Advancedv7practicev7providersv7arev7prepare
dv7tov7fullyv7implementv7thev7advancedv7practicev7rolev7inv7theirv7profession.
Limitedv7prescriptivev7authorityv7createsv7av7numberv7ofv7barriers.v7Whatv7are
v7somev7ofv7thosev7barriers? v7-v7correctv7answer✔ ✔
Itv7createsv7barriersv7tov7quality,v7affordablev7andv7accessiblev7patientv7care.
v7Anv7examplev7isv7restrictionsv7onv7thev7distancev7ofv7thev7APRN v7fromv7thev7
physicianv7providingv7supervisionv7orv7collaborationv7mayv7preventv7outreac
hv7tov7areasv7thatv7havev7thev7greatestv7need.v7Av7requirementv7tov7obtainv7thev7
physician'sv7co-
signaturev7onv7prescriptionsv7canv7increasev7patientv7waits.v7Despitev7thev7use
v7ofv7termsv7suchv7asv7collaborativev7arrangements. v7Thesev7relationshipsv7cre
atev7av7situationv7inv7whichv7onev7partnerv7holdsv7allv7thev7power.v7Itv7isv7estim
atedv7thatv7byv7thev7yearv72025,v7thev7physicianv7shortagev7willv7bev7betweenv7
46,100v7tov790,400.v7Inv7primaryv7carev7alonev7av712,500v7tov731,100v7physicia
nv7shortagev7isv7anticipated.v7APRN'sv7withv7fullv7prescriptivev7authorityv7wo
uldv7helpv7offsetv7thev7shortagev7andv7meetv7thev7futurev7needsv7ofv7healthcarev
7demands.
Manyv7factorsv7arev7involvedv7whenv7consideringv7drugv7selection.v7Somev7in
cludev7-v7-v7correctv7answer✔ ✔
cost,v7guidelines,v7liabilityv7interactions,v7sidev7effects,v7allergies,v7liverv7a
ndv7renalv7function,v7needv7forv7monitoring,v7andv7specialv7populations.
, Ifv7youv7findv7thatv7yourv7patientv7isv7havingv7difficultyv7purchasingv7thev7pres
cribedv7medications,v7whatv7shouldv7youv7do?v7-v7correctv7answer✔ ✔
considerv7changingv7pharmaciesv7orv7drugv7regimens.v7Thev7costv7ofv7av7dru
gv7canv7varyv7widelyv7betweenv7pharmacies,v7evenv7withinv7thev7samev7city.v7
Manyv7corporationsv7havev7createdv7genericv7$4v7listsv7orv7specialv7prescripti
onv7programsv7thatv7allowv7patientsv7tov7fillv7theirv7medicationsv7forv7av7reason
ablev7cost.v7Whenv7inv7doubt,v7followv7currentv7guidelinesv7forv7thev7treatmen
tv7ofv7av7particularv7diseasev7orv7symptom.v7Almostv7allv7medicalv7andv7nursin
gv7societiesv7havev7publishedv7guidelines,v7includingv7thev7Americanv7Heartv7
Association,v7thev7Americanv7Collegev7ofv7Cardiology,v7thev7Infectiousv7Dis
easesv7Societyv7ofv7America,v7andv7thev7Americanv7Diabetesv7Association.v7I
tv7isv7thev7provider'sv7responsibilityv7tov7keepv7abreastv7ofv7newv7recommenda
tionsv7orv7changesv7inv7guidelinesv7andv7tov7incorporatev7thesev7intov7theirv7pre
scribingv7practices.v7Althoughv7closelyv7followingv7thev7guidelinesv7isv7desir
able,v7wev7mustv7alwaysv7takev7intov7accountv7thatv7ourv7patientsv7mayv7notv7fit
v7wellv7intov7thesev7guidelinesv7andv7thatv7individualizedv7carev7isv7alwaysv7be
st.v7Inv7thesev7cases,v7itv7isv7importantv7tov7documentv7thev7rationalev7forv7devi
atingv7fromv7standardv7ofv7care.v7Everyv7facilityv7andv7pharmacyv7providev7dr
ugsv7accordingv7tov7av7formulary.v7Thisv7formularyv7isv7selectedv7byv7av7panelv
7ofv7pharmacists v7andv7providersv7andv7mayv7bev7subjectv7tov7followingv7guid
elinesv7createdv7byv7regulatoryv7agencies,v7suchv7asv7thev7Centersv7forv7Medic
arev7andv7Medicaidv7Servicesv7(CMS).v7Thev7formularyv7mayv7alsov7dependv7
onv7regionalv7andv7nationalv7drugv7supplies,v7drugv7costsv7andv7availablev7reb
ates,v7andv7thev7presencev7ofv7genericv7medicationsv7onv7thev7market.v7Inv7shor
t,v7thev7drugv7youv7wantv7mayv7notv7bev7availablev7inv7yourv7facilityv7orv7atv7av7s
pecificv7pharmacy.v7Thisv7canv7affectv7yourv7choicev7inv7medications.v7Beco
mev7familiarv7withv7thev7formularyv7wherev7youv7arev7employedv7andv7knowv7t
hatv7itv7canv7changev7overv7time.v7Oftenv7therev7arev7substitutesv7orv7similarv7m
edicationsv7youv7canv7orderv7inv7placev7ofv7whatv7youv7originallyv7intended.
v7 v7 v7 v7 v7 v7
MODULE 1 LECTURES
v7 v7 v7
Whenv7writingv7anyv7prescription,v7therev7arev7keyv7elementsv7thatv7mustv7bev7
onv7thev7prescriptionv7includingv7prescriberv7name,v7licensev7number,v7andv7c
ontactv7information;v7DEAv7numberv7ofv7bothv7thev7supervisingv7physicianv7a
ndv7thev7prescriberv7ifv7applicable;v7patientv7namev7andv7datev7ofv7birth;v7patie
ntv7allergies;v7thev7namev7ofv7thev7medication;v7thev7indicationv7ofv7thev7medic
ation;v7thev7strengthv7ofv7thev7medication;v7thev7dosingv7frequency;v7numberv7
ofv7tablets/capsulesv7tov7dispense;v7andv7thev7numberv7ofv7refills.v7Abbreviati
onsv7arev7nov7longerv7acceptable.v7Everythingv7shouldv7bev7writtenv7out.v7Exa
mple:v725v7milligramsv7oncev7dailyv7byv7mouthv7forv7hypertension.v7Andv7Ifv7
youv7arev7usingv7anv7electronicv7medicalv7recordv7forv7prescriptions,v7thesev7a
rev7goingv7tov7automaticallyv7bev7onv7therev7inv7somev7instances,v7butv7otherv7i
nstancesv7youv7mayv7needv7tov7addv7them.v7Youv7willv7havev7assignmentsv7inv7
thisv7coursev7involvingv7writingv7prescriptions.v7Studentsv7getv7confusedv7wh
env7itv7comesv7tov7thev7SIGv7onv7thev7prescription.v7Sigv7stv7-v7correctv7answer
✔ ✔
Whatv7isv7prescriptivev7authority?v7-v7correctv7answer✔ ✔
Thev7abilityv7andv7extentv7ofv7NP'sv7abilityv7tov7prescribev7medicationv7tov7p
atientv7isv7dependentv7onv7statev7nursev7practicev7act
Wallv7EEv7EAv7hasv7ruledv7thatv7nursesv7inv7advancedv7practicev7rolesv7mayv7o
btainv7registeredv7members,v7statev7practicev7actsv7dictatev7thev7levelv7ofv7pres
criptivev7authorityv7allowed
,Componentsv7ofv7prescriptivev7authorityv7-v7correctv7answer✔ ✔
arev7thev7rightv7tov7prescribev7independently,v7andv7thev7rightv7tov7prescribev
7withoutv7limitation.v7Thev7prescriberv7whov7prescribesv7independentlyv7isv7n
otv7subjectv7tov7rulesv7requiringv7physicianv7supervisionv7orv7collaboration.v7
Thev7providerv7whov7prescribesv7withoutv7limitationv7mayv7prescribev7anyv7d
rugs,v7includingv7controlledv7drugs,v7withv7thev7exceptionv7ofv7Schedulev71v7d
rugs,v7whichv7havev7nov7currentv7medicalv7use.
Prescriptivev7authorityv7isv7determinedv7byv7statev7law.v7Asv7av7resultv7-v7-
v7correctv7answer✔ ✔
ofv7differencev7fromv7statev7tov7statev7advancedv7practicev7providersv7mayv7
havev7fullv7prescriptivev7authorityv7inv7somev7states,v7yetv7facev7av7lotv7ofv7restr
ictionsv7inv7otherv7states.v7Texas,v7unfortunately,v7isv7av7statev7wherev7wev7arev
7restricted.v7Thev7differencesv7particularlyv7affectv7providersv7whov7servev7inv
7locumv7tenemsv7staffingv7positions,v7orv7whov7havev7practicesv7inv7twov7conti
guousv7states.v7Thev7regulationv7ofv7prescriptivev7authorityv7isv7underv7thev7ju
risdictionv7ofv7av7healthv7professionalv7board.v7Thisv7mayv7bev7thev7statev7boar
dv7ofv7nursing,v7statev7boardv7ofv7medicine,v7orv7thev7statev7boardv7ofv7pharmac
yv7asv7determinedv7byv7eachv7state.v7Althoughv7thev7federalv7governmentv7con
trolsv7drugv7regulation,v7itv7hasv7nov7controlv7overv7prescriptivev7authority.
Whatv7isv7thev7argumentv7forv7fullv7prescriptivev7authority?v7-
v7correctv7answer✔ ✔
Advancedv7practicev7providersv7completev7rigorousv7programsv7ofv7studyv7
largelyv7inv7accreditedv7programsv7thatv7meetv7stringentv7nationalv7standards.
v7Althoughv7therev7arev7differencesv7inv7eachv7program,v7theyv7allv7includev7co
mmonv7components.v7Forv7example,v7theyv7requirev7extensivev7educationv7fo
cusedv7onv7assessment,v7diagnosis,v7andv7managementv7ofv7healthv7problems
,.v7Diagnosticv7reasoning,v7criticalv7thinkingv7andv7proceduralv7skillsv7arev7eva
luatedv7inv7bothv7didacticv7andv7clinicalv7courses.v7Nationalv7examinationsv7v
alidatev7thev7abilityv7tov7providev7safev7andv7competentv7care,v7andv7licensurev
7ensuresv7thatv7providersv7complyv7withv7standards v7ofv7practicev7thatv7promo
tev7publicv7healthv7andv7safety.v7Advancedv7practicev7providersv7arev7prepare
dv7tov7fullyv7implementv7thev7advancedv7practicev7rolev7inv7theirv7profession.
Limitedv7prescriptivev7authorityv7createsv7av7numberv7ofv7barriers.v7Whatv7are
v7somev7ofv7thosev7barriers? v7-v7correctv7answer✔ ✔
Itv7createsv7barriersv7tov7quality,v7affordablev7andv7accessiblev7patientv7care.
v7Anv7examplev7isv7restrictionsv7onv7thev7distancev7ofv7thev7APRN v7fromv7thev7
physicianv7providingv7supervisionv7orv7collaborationv7mayv7preventv7outreac
hv7tov7areasv7thatv7havev7thev7greatestv7need.v7Av7requirementv7tov7obtainv7thev7
physician'sv7co-
signaturev7onv7prescriptionsv7canv7increasev7patientv7waits.v7Despitev7thev7use
v7ofv7termsv7suchv7asv7collaborativev7arrangements. v7Thesev7relationshipsv7cre
atev7av7situationv7inv7whichv7onev7partnerv7holdsv7allv7thev7power.v7Itv7isv7estim
atedv7thatv7byv7thev7yearv72025,v7thev7physicianv7shortagev7willv7bev7betweenv7
46,100v7tov790,400.v7Inv7primaryv7carev7alonev7av712,500v7tov731,100v7physicia
nv7shortagev7isv7anticipated.v7APRN'sv7withv7fullv7prescriptivev7authorityv7wo
uldv7helpv7offsetv7thev7shortagev7andv7meetv7thev7futurev7needsv7ofv7healthcarev
7demands.
Manyv7factorsv7arev7involvedv7whenv7consideringv7drugv7selection.v7Somev7in
cludev7-v7-v7correctv7answer✔ ✔
cost,v7guidelines,v7liabilityv7interactions,v7sidev7effects,v7allergies,v7liverv7a
ndv7renalv7function,v7needv7forv7monitoring,v7andv7specialv7populations.
, Ifv7youv7findv7thatv7yourv7patientv7isv7havingv7difficultyv7purchasingv7thev7pres
cribedv7medications,v7whatv7shouldv7youv7do?v7-v7correctv7answer✔ ✔
considerv7changingv7pharmaciesv7orv7drugv7regimens.v7Thev7costv7ofv7av7dru
gv7canv7varyv7widelyv7betweenv7pharmacies,v7evenv7withinv7thev7samev7city.v7
Manyv7corporationsv7havev7createdv7genericv7$4v7listsv7orv7specialv7prescripti
onv7programsv7thatv7allowv7patientsv7tov7fillv7theirv7medicationsv7forv7av7reason
ablev7cost.v7Whenv7inv7doubt,v7followv7currentv7guidelinesv7forv7thev7treatmen
tv7ofv7av7particularv7diseasev7orv7symptom.v7Almostv7allv7medicalv7andv7nursin
gv7societiesv7havev7publishedv7guidelines,v7includingv7thev7Americanv7Heartv7
Association,v7thev7Americanv7Collegev7ofv7Cardiology,v7thev7Infectiousv7Dis
easesv7Societyv7ofv7America,v7andv7thev7Americanv7Diabetesv7Association.v7I
tv7isv7thev7provider'sv7responsibilityv7tov7keepv7abreastv7ofv7newv7recommenda
tionsv7orv7changesv7inv7guidelinesv7andv7tov7incorporatev7thesev7intov7theirv7pre
scribingv7practices.v7Althoughv7closelyv7followingv7thev7guidelinesv7isv7desir
able,v7wev7mustv7alwaysv7takev7intov7accountv7thatv7ourv7patientsv7mayv7notv7fit
v7wellv7intov7thesev7guidelinesv7andv7thatv7individualizedv7carev7isv7alwaysv7be
st.v7Inv7thesev7cases,v7itv7isv7importantv7tov7documentv7thev7rationalev7forv7devi
atingv7fromv7standardv7ofv7care.v7Everyv7facilityv7andv7pharmacyv7providev7dr
ugsv7accordingv7tov7av7formulary.v7Thisv7formularyv7isv7selectedv7byv7av7panelv
7ofv7pharmacists v7andv7providersv7andv7mayv7bev7subjectv7tov7followingv7guid
elinesv7createdv7byv7regulatoryv7agencies,v7suchv7asv7thev7Centersv7forv7Medic
arev7andv7Medicaidv7Servicesv7(CMS).v7Thev7formularyv7mayv7alsov7dependv7
onv7regionalv7andv7nationalv7drugv7supplies,v7drugv7costsv7andv7availablev7reb
ates,v7andv7thev7presencev7ofv7genericv7medicationsv7onv7thev7market.v7Inv7shor
t,v7thev7drugv7youv7wantv7mayv7notv7bev7availablev7inv7yourv7facilityv7orv7atv7av7s
pecificv7pharmacy.v7Thisv7canv7affectv7yourv7choicev7inv7medications.v7Beco
mev7familiarv7withv7thev7formularyv7wherev7youv7arev7employedv7andv7knowv7t
hatv7itv7canv7changev7overv7time.v7Oftenv7therev7arev7substitutesv7orv7similarv7m
edicationsv7youv7canv7orderv7inv7placev7ofv7whatv7youv7originallyv7intended.
