ADVANCED PHARMACOLOGY TEST BANK ALL
CHAPTERS QUESTIONS AND ANSWERS WITH
RATIONALES
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 marketplace of primary outpatient
care
d. The recognition that nonphysicians
have variable success providing
primary care
ANS: 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 on preparing 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
been shown 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
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 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 have dropped 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 of medications, it will be important to:
a. attain the same level of
expertise as physicians who
currently prescribe medications.
b. learn from the experiences of
physicians and develop expertise
based on evidence- based practice.
c. maintain collaborative and
supervisorial relationships with
physicians who will oversee
prescribing practices.
d. develop relationships with
pharmaceutical representatives to
learn about new medications as they
are developed.
ANS: 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
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 defines how NPs may write prescriptions:
, a. without physician supervision in
private practice.
b. as CRNAs without physician
supervision in a hospital setting.
c. in any situation but will not be
reimbursed for this by government
insurers.
d. only with physician supervision in both
private practice and a hospital
setting.
ANS: 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 write prescriptions 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 to
practice.
c. order and administer controlled
substances but do not have full
prescriptive authority.
d. administer medications,
including controlled
substances, under direct
physician supervision.
ANS: 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 and do not prescribe. Without prescriptive authority, they do not need a
DEA number.
DIF: Cognitive Level: Understanding (Comprehension) REF: 9
3. A CNM:
a. may treat only women.
b. has prescriptive authority in all 50
states.
c. may administer only drugs used during
labor and delivery.
d. may practice only in birthing centers
and home birth settings.
ANS: B
CHAPTERS QUESTIONS AND ANSWERS WITH
RATIONALES
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 marketplace of primary outpatient
care
d. The recognition that nonphysicians
have variable success providing
primary care
ANS: 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 on preparing 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
been shown 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
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 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 have dropped 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 of medications, it will be important to:
a. attain the same level of
expertise as physicians who
currently prescribe medications.
b. learn from the experiences of
physicians and develop expertise
based on evidence- based practice.
c. maintain collaborative and
supervisorial relationships with
physicians who will oversee
prescribing practices.
d. develop relationships with
pharmaceutical representatives to
learn about new medications as they
are developed.
ANS: 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
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 defines how NPs may write prescriptions:
, a. without physician supervision in
private practice.
b. as CRNAs without physician
supervision in a hospital setting.
c. in any situation but will not be
reimbursed for this by government
insurers.
d. only with physician supervision in both
private practice and a hospital
setting.
ANS: 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 write prescriptions 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 to
practice.
c. order and administer controlled
substances but do not have full
prescriptive authority.
d. administer medications,
including controlled
substances, under direct
physician supervision.
ANS: 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 and do not prescribe. Without prescriptive authority, they do not need a
DEA number.
DIF: Cognitive Level: Understanding (Comprehension) REF: 9
3. A CNM:
a. may treat only women.
b. has prescriptive authority in all 50
states.
c. may administer only drugs used during
labor and delivery.
d. may practice only in birthing centers
and home birth settings.
ANS: B
