Provider 5th Edition
By Constance G Visovsky & Cheryl H Zambroski & Rebecca M Lutz
All Chapters (1-73) Q&As Verified With Rationales| Grade A+ Assured
ISBN 9780323661171
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,Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs.
Change
MULTIPLE CHOICE
1. Which of the following has influenced an emphasis on primary care education in
medicalschools?
a. Changes in Medicare
reimbursementmethods
recommended in 1992
b. Competition from nonphysicians
desiringto meet primary care
shortages
c. The need for monopolistic control in
themarketplace of primary
outpatient care
d. The recognition that nonphysicians
havevariable success providing
primary care
CORRECT ANSWER A
The Physician Payment Review Commission in 1992 directly increased financial
reimbursement to clinicians who provide primary care. Coupled with a shortage of
primary care providers, this incentive led medical schools to place greater
emphasis onpreparing primary care physicians. Competition from nonphysicians
increased coincidentally as professionals from other disciplines stepped up to
meet the needs.
Nonphysicians have had increasing success at providing primary care and have
beenshown to be safe and effective.
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
moreappropriate medications than
younger physicians.
b. Antibiotic medications remain in the
topfive classifications of medications
prescribed.
c. Most physicians rely on a
“therapeutic armamentarium” that
consists of less than
100 drug preparations per physician.
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, d. The dominant form of drug
information used by primary care
physicians continuesto be that
provided by pharmaceutical
companies.
CORRECT ANSWER D
Even though most physicians claim to place little weight on drug advertisements,
pharmaceutical representatives, and patient preference and state that they rely on
academic sources for drug information, a study showed that commercial rather
than scientific sources of drug information dominated their drug information
materials. Younger physicians tend to prescribe fewer and more appropriate
drugs. Antibiotics havedropped out of the top five classifications of drugs
prescribed. Most physicians have a therapeutic armamentarium of about 144
drugs.
DIF: Cognitive Level: Remembering (Knowledge) REF: 3
3. As primary care nurse practitioners (NPs) continue to develop their role as
prescribers ofmedications, it will be important to:
a. attain the same level of
expertise asphysicians who
currently prescribe
medications.
b. learn from the experiences of
physicians and develop expertise
based on evidence-based practice.
c. maintain collaborative and
supervisorialrelationships with
physicians who will oversee
prescribing practices.
d. develop relationships with
pharmaceuticalrepresentatives to
learn about new medications as they
are developed.
CORRECT ANSWER B
As nonphysicians develop the roles associated with prescriptive authority, it will
be important to learn from the past experiences of physicians and to develop
prescribing practices based on evidence-based medicine. It is hoped that all
prescribers, including physicians and nurse practitioners, will strive to do better
than in the past. NPs should work toward prescriptive authority and for practice
that is not supervised by another professional. Pharmaceutical representatives
provide information that carries some bias.Academic sources are better.
DIF: Cognitive Level: Applying (Application) REF: 4
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, Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses
(NPs, CNMs, CRNAs, and CNSs) and Physician Assistants
Test Bank
MULTIPLE CHOICE
1. A primary care NP will begin practicing in a state in which the governor has opted
out of the federal facility reimbursement requirement. The NP should be aware that
this defineshow NPs may write prescriptions:
a. without physician supervision in
privatepractice.
b. as CRNAs without physician
supervisionin a hospital setting.
c. in any situation but will not be
reimbursedfor this by government
insurers.
d. only with physician supervision in
bothprivate practice and a hospital
setting.
CORRECT ANSWER B
In 2001, the Centers for Medicare and Medicaid Services changed the federal
physician supervision rule for CRNAs to allow state governors to opt out, allowing
CRNAs to writeprescriptions and dispense drugs without physician supervision.
DIF: Cognitive Level: Understanding (Comprehension) REF: 9
2. CRNAs in most states:
a. must have a Drug Enforcement
Administration (DEA) number to
practice.
b. must have prescriptive
authority topractice.
c. order and administer controlled
substancesbut do not have full
prescriptive authority.
d. administer medications,
including controlled
substances, under direct
physician supervision.
CORRECT ANSWER C
Only five states grant independent prescriptive authority to CRNAs. CRNAs do not
require prescriptive authority because they dispense a drug immediately to a
patient anddo not prescribe. Without prescriptive authority, they do not need a
DEA number.
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