Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change
Test Bank
MULTIPLE CHOICE
1. Which of the following has influenced an emphasis on primary care education in medical
schools?
a. Changes in Medicare reimbursement
methods recommended in 1992
b. Competition from nonphysicians desiring
to meet primary care shortages
c. The need for monopolistic control in the
a
a
marketplace of primary outpatient care
d. The recognition that nonphysicians have
hM
hM
i
i
variable success providing primary care
ANS: A
The Physician Payment Review Commission in 1992 directly increased financial
W
W
t
t
reimbursement to clinicians who provide primary care. Coupled with a shortage of
primary care providers, this incentive led medical schools to place greater emphasis on
u
u
preparing primary care physicians. Competition from nonphysicians increased
coincidentally as professionals from other disciplines stepped up to meet the needs.
b
b
Nonphysicians have had increasing success at providing primary care and have been
M
M
shown to be safe and effective.
m
m
DIF: Cognitive Level: Remembering (Knowledge) REF: 2
2. Which of the following statements is true about the prescribing practices of physicians?
a. Older physicians tend to prescribe more
appropriate medications than younger
physicians.
b. Antibiotic medications remain in the top
five classifications of medications
prescribed.
c. Most physicians rely on a “therapeutic
armamentarium” that consists of less than
100 drug preparations per physician.
d. The dominant form of drug information
used by primary care physicians continues
to be that provided by pharmaceutical
companies.
ANS: D
Even though most physicians claim to place little weight on drug advertisements,
, pharmaceutical representatives, and patient preference and state that they rely on a. without physician supervision in private
academic sources for drug information, a study showed that commercial rather than practice.
scientific sources of drug information dominated their drug information materials.
Younger physicians tend to prescribe fewer and more appropriate drugs. Antibiotics have b. as CRNAs without physician supervision
dropped out of the top five classifications of drugs prescribed. Most physicians have a in a hospital setting.
therapeutic armamentarium of about 144 drugs. c. in any situation but will not be reimbursed
for this by government insurers.
DIF: Cognitive Level: Remembering (Knowledge) REF: 3
d. only with physician supervision in both
3. As primary care nurse practitioners (NPs) continue to develop their role as prescribers of private practice and a hospital setting.
medications, it will be important to:
ANS: B
a. attain the same level of expertise as In 2001, the Centers for Medicare and Medicaid Services changed the federal physician
physicians who currently prescribe supervision rule for CRNAs to allow state governors to opt out, allowing CRNAs to write
medications. prescriptions and dispense drugs without physician supervision.
a
a
b. learn from the experiences of physicians
DIF: Cognitive Level: Understanding (Comprehension) REF: 9
and develop expertise based on evidence-
hM
hM
i
i
based practice.
2. CRNAs in most states:
c. maintain collaborative and supervisorial a. must have a Drug Enforcement
relationships with physicians who will
Administration (DEA) number to practice.
W
W
t
t
oversee prescribing practices.
b. must have prescriptive authority to
u
u
d. develop relationships with pharmaceutical
practice.
representatives to learn about new
medications as they are developed. c. order and administer controlled substances
b
b
M
M
but do not have full prescriptive authority.
ANS: B
As nonphysicians develop the roles associated with prescriptive authority, it will be d. administer medications, including
m
m
important to learn from the past experiences of physicians and to develop prescribing controlled substances, under direct
practices based on evidence-based medicine. It is hoped that all prescribers, including physician supervision.
physicians and nurse practitioners, will strive to do better than in the past. NPs should ANS: C
work toward prescriptive authority and for practice that is not supervised by another Only five states grant independent prescriptive authority to CRNAs. CRNAs do not
professional. Pharmaceutical representatives provide information that carries some bias. require prescriptive authority because they dispense a drug immediately to a patient and
Academic sources are better. do not prescribe. Without prescriptive authority, they do not need a DEA number.
DIF: Cognitive Level: Applying (Application) REF: 4 DIF: Cognitive Level: Understanding (Comprehension) REF: 9
Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs, 3. A CNM:
CNMs, CRNAs, and CNSs) and Physician Assistants a. may treat only women.
Test Bank
b. has prescriptive authority in all 50 states.
MULTIPLE CHOICE c. may administer only drugs used during
labor and delivery.
1. A primary care NP will begin practicing in a state in which the governor has opted out of d. may practice only in birthing centers and
the federal facility reimbursement requirement. The NP should be aware that this defines home birth settings.
how NPs may write prescriptions:
ANS: B
Test Bank
MULTIPLE CHOICE
1. Which of the following has influenced an emphasis on primary care education in medical
schools?
a. Changes in Medicare reimbursement
methods recommended in 1992
b. Competition from nonphysicians desiring
to meet primary care shortages
c. The need for monopolistic control in the
a
a
marketplace of primary outpatient care
d. The recognition that nonphysicians have
hM
hM
i
i
variable success providing primary care
ANS: A
The Physician Payment Review Commission in 1992 directly increased financial
W
W
t
t
reimbursement to clinicians who provide primary care. Coupled with a shortage of
primary care providers, this incentive led medical schools to place greater emphasis on
u
u
preparing primary care physicians. Competition from nonphysicians increased
coincidentally as professionals from other disciplines stepped up to meet the needs.
b
b
Nonphysicians have had increasing success at providing primary care and have been
M
M
shown to be safe and effective.
m
m
DIF: Cognitive Level: Remembering (Knowledge) REF: 2
2. Which of the following statements is true about the prescribing practices of physicians?
a. Older physicians tend to prescribe more
appropriate medications than younger
physicians.
b. Antibiotic medications remain in the top
five classifications of medications
prescribed.
c. Most physicians rely on a “therapeutic
armamentarium” that consists of less than
100 drug preparations per physician.
d. The dominant form of drug information
used by primary care physicians continues
to be that provided by pharmaceutical
companies.
ANS: D
Even though most physicians claim to place little weight on drug advertisements,
, pharmaceutical representatives, and patient preference and state that they rely on a. without physician supervision in private
academic sources for drug information, a study showed that commercial rather than practice.
scientific sources of drug information dominated their drug information materials.
Younger physicians tend to prescribe fewer and more appropriate drugs. Antibiotics have b. as CRNAs without physician supervision
dropped out of the top five classifications of drugs prescribed. Most physicians have a in a hospital setting.
therapeutic armamentarium of about 144 drugs. c. in any situation but will not be reimbursed
for this by government insurers.
DIF: Cognitive Level: Remembering (Knowledge) REF: 3
d. only with physician supervision in both
3. As primary care nurse practitioners (NPs) continue to develop their role as prescribers of private practice and a hospital setting.
medications, it will be important to:
ANS: B
a. attain the same level of expertise as In 2001, the Centers for Medicare and Medicaid Services changed the federal physician
physicians who currently prescribe supervision rule for CRNAs to allow state governors to opt out, allowing CRNAs to write
medications. prescriptions and dispense drugs without physician supervision.
a
a
b. learn from the experiences of physicians
DIF: Cognitive Level: Understanding (Comprehension) REF: 9
and develop expertise based on evidence-
hM
hM
i
i
based practice.
2. CRNAs in most states:
c. maintain collaborative and supervisorial a. must have a Drug Enforcement
relationships with physicians who will
Administration (DEA) number to practice.
W
W
t
t
oversee prescribing practices.
b. must have prescriptive authority to
u
u
d. develop relationships with pharmaceutical
practice.
representatives to learn about new
medications as they are developed. c. order and administer controlled substances
b
b
M
M
but do not have full prescriptive authority.
ANS: B
As nonphysicians develop the roles associated with prescriptive authority, it will be d. administer medications, including
m
m
important to learn from the past experiences of physicians and to develop prescribing controlled substances, under direct
practices based on evidence-based medicine. It is hoped that all prescribers, including physician supervision.
physicians and nurse practitioners, will strive to do better than in the past. NPs should ANS: C
work toward prescriptive authority and for practice that is not supervised by another Only five states grant independent prescriptive authority to CRNAs. CRNAs do not
professional. Pharmaceutical representatives provide information that carries some bias. require prescriptive authority because they dispense a drug immediately to a patient and
Academic sources are better. do not prescribe. Without prescriptive authority, they do not need a DEA number.
DIF: Cognitive Level: Applying (Application) REF: 4 DIF: Cognitive Level: Understanding (Comprehension) REF: 9
Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs, 3. A CNM:
CNMs, CRNAs, and CNSs) and Physician Assistants a. may treat only women.
Test Bank
b. has prescriptive authority in all 50 states.
MULTIPLE CHOICE c. may administer only drugs used during
labor and delivery.
1. A primary care NP will begin practicing in a state in which the governor has opted out of d. may practice only in birthing centers and
the federal facility reimbursement requirement. The NP should be aware that this defines home birth settings.
how NPs may write prescriptions:
ANS: B
