Midterm Exam: NR565/ NR 565 Advanced Pharmacology Care
of the Fundamentals Exam | Questions and Verified Answers
(2023/ 2024 Update)- Chamberlain
Section I: Prescriptive Authority & Legal/Regulatory Principles
1. What is the primary determinant of an APRN's prescriptive authority?
A. Federal DEA regulations
B. State practice and licensure laws
C. Hospital formulary committees
D. The Joint Commission standards
Rationale: Prescriptive authority is determined by state law and regulated by health
professional boards (e.g., State Board of Nursing). While the federal government controls drug
regulations through the DEA, it does not have authority over prescriptive practices. Each state
determines the level of practice authority (full, reduced, or restricted).
2. An APRN with full practice authority is authorized to do which of the following? (Select All
That Apply)
A. Evaluate patients and diagnose conditions
B. Order and interpret diagnostic tests
C. Initiate and manage treatments including controlled substances
D. Practice without physician oversight or collaborative agreements
Rationale: Full practice authority allows NPs to operate at the highest level of their training,
including evaluating patients, diagnosing, ordering/interpreting tests, initiating/managing
treatments, and prescribing controlled substances—all without physician supervision or
collaborative agreements. This is determined by state law.
3. Beyond standard medications, an APRN's prescriptive authority may include which of the
following?
A. Only over-the-counter medications
B. Durable Medical Equipment (DME) and medical services such as PT/OT
C. Only hospital-administered medications
D. Only Schedule II controlled substances
Rationale: Prescriptive authority extends beyond drugs to include therapeutic devices, DME
(wheelchairs, hospital beds, oxygen equipment, handicap placards), and medical services such
,as physical therapy, occupational therapy, and home health services, as outlined in state
practice laws.
4. Which documentation elements are required for prudent prescribing practices? (Select All
That Apply)
A. Documentation of a provider-patient relationship
B. Documentation of a thorough history and physical examination
C. Documentation of discussions regarding risk factors, side effects, and therapy options
D. Documentation of a drug monitoring or titration plan
Rationale: Prudent prescribing requires documentation of: (1) a formal provider-patient
relationship, (2) comprehensive history and physical, (3) discussions of risks/side effects/therapy
options, (4) drug monitoring or titration plans, (5) consultations, and (6) strict avoidance of
prescribing for self, family, or friends.
5. What is the purpose of a Prescription Drug Monitoring Program (PDMP)?
A. Help identify patients who may be at risk for overdose
B. Make prescribing faster for providers
C. Educate patients about overdose prevention
D. Provide correct dosing and pricing information
Rationale: PDMP tracks controlled substance prescriptions across providers and
pharmacies. It identifies "doctor shopping," early refills, and high-risk combinations. It reduces
opioid overdose risk by informing prescribing decisions. Most states mandate PDMP use before
prescribing controlled substances.
6. Which of the following best describes "administration" versus "prescribing"?
A. They are the same process
B. Administration is a complex decision-making process; prescribing is giving a dose
C. Prescribing is a complex decision-making process involving selecting the correct agent,
determining dosage, and setting duration of therapy
D. There is no difference
Rationale: Administration is the act of giving a dose to a patient. Prescribing is a complex
decision-making process involving selecting the correct agent, determining precise dosage, and
setting duration based on safety standards and patient-specific needs.
7. What are the primary advantages of full practice authority for a Nurse Practitioner?
,A. NPs must practice under physician supervision at all times
B. NPs have autonomy to evaluate, diagnose, order tests, and prescribe medications including
controlled substances without physician oversight
C. NPs can only prescribe non-controlled substances
D. NPs must have a collaborative agreement with a physician
Rationale: Full practice authority allows NPs to operate at the highest level of their training,
including autonomy in evaluation, diagnosis, test interpretation, treatment management, and
prescribing—including controlled substances—without physician supervision or collaborative
agreements.
8. Which of the following are key components of rational drug selection? (Select All That
Apply)
A. Cost, guidelines, and availability
B. Interactions, side effects, and allergies
C. Hepatic and renal function
D. Need for monitoring and special populations
Rationale: Rational drug selection requires a logical approach that considers: cost,
guidelines, availability, interactions, side effects, allergies, hepatic/renal functions, need for
monitoring, and special populations. This ensures safe and effective pharmacological treatment.
9. How does limited prescriptive authority impact patient care?
A. It improves access to care in rural areas
B. It creates barriers to quality, affordable, and accessible patient care
C. It has no impact on patient care
D. It reduces wait times for patients
Rationale: Limited prescriptive authority creates numerous barriers to quality, affordable,
and accessible patient care. Restrictions on distance from supervising physicians may prevent
outreach to areas of greatest need, resulting in increased patient wait times.
10. Which schedule of drugs can APRNs prescribe?
A. Schedule I only
B. Schedule II–V
C. Schedule I–V
D. Schedule III–V only
, Rationale: APRNs with prescriptive authority can prescribe Schedule II–V drugs, depending
on state law. Schedule I drugs have no currently accepted medical use and cannot be
prescribed. Examples of Schedule II drugs include hydromorphone, oxycodone, and fentanyl.
11. What does the scope of an APRN's prescriptive authority include beyond standard
medications?
A. Only prescription drugs and controlled substances
B. Durable Medical Equipment (DME) and medical services such as PT and OT
C. Only over-the-counter medications
D. Only hospital-administered medications
Rationale: Prescriptive authority extends to Durable Medical Equipment (DME)—such as
oxygen equipment, hospital beds, and mobility aids—as well as medical services like Physical
and Occupational Therapy. It is a comprehensive role governed by state laws.
12. Which of the following is a critical restriction for telephone prescriptions?
A. All prescriptions can be called in
B. Schedule II medications cannot be prescribed or refilled by telephone except in emergencies
C. Only Schedule V drugs can be called in
D. Telephone prescriptions are not allowed for any controlled substances
Rationale: Schedule II medications cannot be prescribed or refilled by telephone except in
genuine emergencies. Written or electronic prescriptions are required for Schedule II drugs
under normal circumstances.
13. What is the purpose of black box warnings?
A. Ways to reduce and prevent harm, such as pregnant women avoiding teratogenic drugs
B. Potential common side effects, such as nausea, vomiting, or upset stomach
C. Potential severe side effects, such as fetal harm, suicidality, or near-fatal dysrhythmias
D. Information about drug pricing and availability
Rationale: Black box warnings are the FDA's strongest safety warning. They highlight serious
or life-threatening risks such as fetal harm, suicidality, or near-fatal dysrhythmias. They also
provide guidance on risk mitigation strategies.
14. Which of the following are benefits of full practice authority? (Select All That Apply)
A. NPs can evaluate and diagnose patients independently
B. NPs can prescribe medications including controlled substances
of the Fundamentals Exam | Questions and Verified Answers
(2023/ 2024 Update)- Chamberlain
Section I: Prescriptive Authority & Legal/Regulatory Principles
1. What is the primary determinant of an APRN's prescriptive authority?
A. Federal DEA regulations
B. State practice and licensure laws
C. Hospital formulary committees
D. The Joint Commission standards
Rationale: Prescriptive authority is determined by state law and regulated by health
professional boards (e.g., State Board of Nursing). While the federal government controls drug
regulations through the DEA, it does not have authority over prescriptive practices. Each state
determines the level of practice authority (full, reduced, or restricted).
2. An APRN with full practice authority is authorized to do which of the following? (Select All
That Apply)
A. Evaluate patients and diagnose conditions
B. Order and interpret diagnostic tests
C. Initiate and manage treatments including controlled substances
D. Practice without physician oversight or collaborative agreements
Rationale: Full practice authority allows NPs to operate at the highest level of their training,
including evaluating patients, diagnosing, ordering/interpreting tests, initiating/managing
treatments, and prescribing controlled substances—all without physician supervision or
collaborative agreements. This is determined by state law.
3. Beyond standard medications, an APRN's prescriptive authority may include which of the
following?
A. Only over-the-counter medications
B. Durable Medical Equipment (DME) and medical services such as PT/OT
C. Only hospital-administered medications
D. Only Schedule II controlled substances
Rationale: Prescriptive authority extends beyond drugs to include therapeutic devices, DME
(wheelchairs, hospital beds, oxygen equipment, handicap placards), and medical services such
,as physical therapy, occupational therapy, and home health services, as outlined in state
practice laws.
4. Which documentation elements are required for prudent prescribing practices? (Select All
That Apply)
A. Documentation of a provider-patient relationship
B. Documentation of a thorough history and physical examination
C. Documentation of discussions regarding risk factors, side effects, and therapy options
D. Documentation of a drug monitoring or titration plan
Rationale: Prudent prescribing requires documentation of: (1) a formal provider-patient
relationship, (2) comprehensive history and physical, (3) discussions of risks/side effects/therapy
options, (4) drug monitoring or titration plans, (5) consultations, and (6) strict avoidance of
prescribing for self, family, or friends.
5. What is the purpose of a Prescription Drug Monitoring Program (PDMP)?
A. Help identify patients who may be at risk for overdose
B. Make prescribing faster for providers
C. Educate patients about overdose prevention
D. Provide correct dosing and pricing information
Rationale: PDMP tracks controlled substance prescriptions across providers and
pharmacies. It identifies "doctor shopping," early refills, and high-risk combinations. It reduces
opioid overdose risk by informing prescribing decisions. Most states mandate PDMP use before
prescribing controlled substances.
6. Which of the following best describes "administration" versus "prescribing"?
A. They are the same process
B. Administration is a complex decision-making process; prescribing is giving a dose
C. Prescribing is a complex decision-making process involving selecting the correct agent,
determining dosage, and setting duration of therapy
D. There is no difference
Rationale: Administration is the act of giving a dose to a patient. Prescribing is a complex
decision-making process involving selecting the correct agent, determining precise dosage, and
setting duration based on safety standards and patient-specific needs.
7. What are the primary advantages of full practice authority for a Nurse Practitioner?
,A. NPs must practice under physician supervision at all times
B. NPs have autonomy to evaluate, diagnose, order tests, and prescribe medications including
controlled substances without physician oversight
C. NPs can only prescribe non-controlled substances
D. NPs must have a collaborative agreement with a physician
Rationale: Full practice authority allows NPs to operate at the highest level of their training,
including autonomy in evaluation, diagnosis, test interpretation, treatment management, and
prescribing—including controlled substances—without physician supervision or collaborative
agreements.
8. Which of the following are key components of rational drug selection? (Select All That
Apply)
A. Cost, guidelines, and availability
B. Interactions, side effects, and allergies
C. Hepatic and renal function
D. Need for monitoring and special populations
Rationale: Rational drug selection requires a logical approach that considers: cost,
guidelines, availability, interactions, side effects, allergies, hepatic/renal functions, need for
monitoring, and special populations. This ensures safe and effective pharmacological treatment.
9. How does limited prescriptive authority impact patient care?
A. It improves access to care in rural areas
B. It creates barriers to quality, affordable, and accessible patient care
C. It has no impact on patient care
D. It reduces wait times for patients
Rationale: Limited prescriptive authority creates numerous barriers to quality, affordable,
and accessible patient care. Restrictions on distance from supervising physicians may prevent
outreach to areas of greatest need, resulting in increased patient wait times.
10. Which schedule of drugs can APRNs prescribe?
A. Schedule I only
B. Schedule II–V
C. Schedule I–V
D. Schedule III–V only
, Rationale: APRNs with prescriptive authority can prescribe Schedule II–V drugs, depending
on state law. Schedule I drugs have no currently accepted medical use and cannot be
prescribed. Examples of Schedule II drugs include hydromorphone, oxycodone, and fentanyl.
11. What does the scope of an APRN's prescriptive authority include beyond standard
medications?
A. Only prescription drugs and controlled substances
B. Durable Medical Equipment (DME) and medical services such as PT and OT
C. Only over-the-counter medications
D. Only hospital-administered medications
Rationale: Prescriptive authority extends to Durable Medical Equipment (DME)—such as
oxygen equipment, hospital beds, and mobility aids—as well as medical services like Physical
and Occupational Therapy. It is a comprehensive role governed by state laws.
12. Which of the following is a critical restriction for telephone prescriptions?
A. All prescriptions can be called in
B. Schedule II medications cannot be prescribed or refilled by telephone except in emergencies
C. Only Schedule V drugs can be called in
D. Telephone prescriptions are not allowed for any controlled substances
Rationale: Schedule II medications cannot be prescribed or refilled by telephone except in
genuine emergencies. Written or electronic prescriptions are required for Schedule II drugs
under normal circumstances.
13. What is the purpose of black box warnings?
A. Ways to reduce and prevent harm, such as pregnant women avoiding teratogenic drugs
B. Potential common side effects, such as nausea, vomiting, or upset stomach
C. Potential severe side effects, such as fetal harm, suicidality, or near-fatal dysrhythmias
D. Information about drug pricing and availability
Rationale: Black box warnings are the FDA's strongest safety warning. They highlight serious
or life-threatening risks such as fetal harm, suicidality, or near-fatal dysrhythmias. They also
provide guidance on risk mitigation strategies.
14. Which of the following are benefits of full practice authority? (Select All That Apply)
A. NPs can evaluate and diagnose patients independently
B. NPs can prescribe medications including controlled substances
