Rosenthal: Lehne's Pharmacotherapeutics for Advanced
Practice Providers, 1st Ed. Chapter 1: Prescriptive Authority
1.ANS: B
The APRN has independent prescriptive authority because the regulating body does
not require that the APRN work under physician supervision. Full prescriptive
authority gives the provider the right to prescribe independently and without
limitation. Limited authority places restrictions on the types of drugs that can be
prescribed.
DIF: Cognitive Level: ComprehensionREF: p. 1TOP: Nursing Process: I MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Par-
enteral Therapies: An APRN works in a urology clinic under the supervision of
a physician who does not restrict the types of medications the APRN is allowed to
prescribe. State law does not require the APRN to practice under physician supervision.
How would the APRN's prescriptive authority be described?
A. Full authority
B. Independent
C. Without limitation
D.Limited authority
2.ANS: A
Implementation of the Affordable Care Act has increased the number of indi- viduals
with health care coverage, and thus the number who have access to health care
services. The increase in the number of patients creates the need for more providers
with prescriptive authority. APRNs can fill this practice gap.
DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing Process: Imple-
mentation MSC: NCLEX Client Needs Category: Physiologic Integrity: Phar-
macologic and Parenteral Therapies: Which factors increase the need for APRNs to
have full prescriptive authority?
A. More patients will have access to health care.
B. Enrollment in medical schools is predicted to decrease.
C. Physician's assistants are being utilized less often.
D.APRN education is more complex than education for physicians.
3.ANS: A,B
Limiting prescriptive authority for APRNs can create barriers to quality, afford- able,
and accessible patient care. It may also lead to poor collaboration among providers
and higher health care costs. It would not directly impact patient's health literacy.
, Rosenthal: Lehne's Pharmacotherapeutics for Advanced
Practice Providers, 1st Ed. Chapter 1: Prescriptive Authority
DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing Process: Imple-
mentation MSC: NCLEX Client Needs Category: Physiologic Integrity: Phar-
macologic and Parenteral Therapies: Which factors could be attributed to limited
prescriptive authority for APRNs? Select all that apply.
A. Inaccessibility of patient care
B. Higher health care costs
C. Higher quality medical treatment
D.Improved collaborative care
E. Enhanced health literacy
4.ANS: A,C,D
APRNs are educated to practice and prescribe independently without supervi- sion.
National examinations validate the ability to provide safe and competent care.
Licensure ensures compliance with standards to promote public health and safety.
Limited prescriptive authority creates numerous barriers to quality, affordable, and
accessible patient care.
DIF: Cognitive Level: ComprehensionREF: pp. 1-2TOP: Nursing Process: Im-
plementation MSC:: Which aspects support the APRN's provision for full prescrip- tive
authority? Select all that apply.
A. Clinical education includes prescription of medications and disease processes.
B. Federal regulations support the provision of full authority for APRNs.
C. National examinations provide validation of the APRN's ability to provide safe care.
D.Licensure ensures compliance with health care and safety standards.
E. Limiting provision can decrease health care affordability.
5.ANS: A
Virginia allows limited prescriptive authority, while Maine gives full authority to
certified nurse practitioners. The federal government does not regulate prescriptive
authority.
DIF: Cognitive Level: ComprehensionREF: p. 3TOP: Nursing Process: Imple-
mentation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharma-
cologic and Parenteral Therapies: A family nurse practitioner practicing in Maine is
hired at a practice across state lines in Virginia. Which aspect of practice may change for
the APRN?
A. The APRN will have less prescriptive authority in the new position.
, Rosenthal: Lehne's Pharmacotherapeutics for Advanced
Practice Providers, 1st Ed. Chapter 1: Prescriptive Authority
B.The APRN will have more prescriptive authority in the new position.
C. The APRN will have equal prescriptive authority in the new position.
D.The APRN's authority will depend on federal regulations.
6.ANS: B,C,D
Providers should collaborate with pharmacists because they will likely have
additional information on formulary, drug interactions, and suggestions for adequate
medication dosing. Dietitians can make food recommendations to treat the patient's
condition. The pharmacist can contact the prescriber about questionable
prescriptions, but cannot alter the prescription without notifica- tion of and approval
by the provider.
DIF: Cognitive Level: ComprehensionREF: p. 9TOP: Nursing Process: Diagno- sis
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential: How can collaboration with a pharmacist improve positive outcomes for
patients? Select all that apply.
A. Pharmacists can suggest foods that will help with the patient's condition.
B. Pharmacists have additional information on drug interactions.
C. The pharmacist can suggest adequate medication dosing.
D.Pharmacists have firsthand knowledge of the facility formulary.
E. Pharmacy can alter prescriptions when necessary to prevent patient harm.
7.ANS: A
In an emergency situation, such as delirium tremens with seizure activity, it is
acceptable to provide a telephone order. Contacting the on-call hospitalist or waiting
for a written order would take more time than available for a patient with high
seizure risk. Writing an order is outside the scope of practice for the charge nurse.
DIF: Cognitive Level: ApplicationREF: p. 7TOP: Nursing Process: Implementa- tion
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential: A patient presents with delirium tremens requiring Ativan adminis- tration. The
provider of care is not the facility. Which action by the nurse is the most appropriate?
A. Obtain a telephone order.
B. Contact the on-call hospitalist.
C. Obtain an order from the charge nurse.
D.Wait for a written Ativan order.
, Rosenthal: Lehne's Pharmacotherapeutics for Advanced
Practice Providers, 1st Ed. Chapter 1: Prescriptive Authority
8.ANS: B
Schedule II medications are not eligible for refills, and prescriptions must be
handwritten. It is important to verify the patient's adherence to the drug regimen
and determine the current dosage of medication; however, this can
be accomplished by scheduling an appointment and evaluating the patient in person.
DIF: Cognitive Level: ApplicationREF: p. 8TOP: Nursing Process: Implementa- tion
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential: A patient with chronic pain calls the provider's office to request a refill on their
oxycontin. Which action is most appropriate?
A. Fax an order to the pharmacy.
B. Schedule an appointment with the patient.
C. Verify the patient's adherence to drug regimen.
D.Determine the patient's current medication dosage.
9.ANS: B
The priority action is to discontinue the medication to prevent worsening of the
patient's symptoms. A different prescription would be provided, topical
antihistamine may be administered, and the patient would be assessed for respiratory
involvement, but these actions would not be performed first.
DIF: Cognitive Level: ApplicationREF: p. 6TOP: Nursing Process: Implementa- tion
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential: A patient prescribed amoxicillin for streptococcal pharyngitis reports new onset
of a flat, itchy red rash on the chest and neck. Which action is most important?
A. Provide a different prescription.
B. Discontinue the medication.
C. Prescribe an antihistamine cream.
D.Assess for respiratory compromise.
10.ANS: B
Prior to adding medications to the treatment regimen, it is essential to assess for any
potential drug- drug interactions through a complete medical histo- ry. Baseline
laboratory values are not necessary for COPD treatment. Liver enzyme levels may
give insight into the possibility of altered metabolism but would not be the first
action. The presence of insurance coverage would affect the patient's access to
treatment but may not affect the type of medication
Practice Providers, 1st Ed. Chapter 1: Prescriptive Authority
1.ANS: B
The APRN has independent prescriptive authority because the regulating body does
not require that the APRN work under physician supervision. Full prescriptive
authority gives the provider the right to prescribe independently and without
limitation. Limited authority places restrictions on the types of drugs that can be
prescribed.
DIF: Cognitive Level: ComprehensionREF: p. 1TOP: Nursing Process: I MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Par-
enteral Therapies: An APRN works in a urology clinic under the supervision of
a physician who does not restrict the types of medications the APRN is allowed to
prescribe. State law does not require the APRN to practice under physician supervision.
How would the APRN's prescriptive authority be described?
A. Full authority
B. Independent
C. Without limitation
D.Limited authority
2.ANS: A
Implementation of the Affordable Care Act has increased the number of indi- viduals
with health care coverage, and thus the number who have access to health care
services. The increase in the number of patients creates the need for more providers
with prescriptive authority. APRNs can fill this practice gap.
DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing Process: Imple-
mentation MSC: NCLEX Client Needs Category: Physiologic Integrity: Phar-
macologic and Parenteral Therapies: Which factors increase the need for APRNs to
have full prescriptive authority?
A. More patients will have access to health care.
B. Enrollment in medical schools is predicted to decrease.
C. Physician's assistants are being utilized less often.
D.APRN education is more complex than education for physicians.
3.ANS: A,B
Limiting prescriptive authority for APRNs can create barriers to quality, afford- able,
and accessible patient care. It may also lead to poor collaboration among providers
and higher health care costs. It would not directly impact patient's health literacy.
, Rosenthal: Lehne's Pharmacotherapeutics for Advanced
Practice Providers, 1st Ed. Chapter 1: Prescriptive Authority
DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing Process: Imple-
mentation MSC: NCLEX Client Needs Category: Physiologic Integrity: Phar-
macologic and Parenteral Therapies: Which factors could be attributed to limited
prescriptive authority for APRNs? Select all that apply.
A. Inaccessibility of patient care
B. Higher health care costs
C. Higher quality medical treatment
D.Improved collaborative care
E. Enhanced health literacy
4.ANS: A,C,D
APRNs are educated to practice and prescribe independently without supervi- sion.
National examinations validate the ability to provide safe and competent care.
Licensure ensures compliance with standards to promote public health and safety.
Limited prescriptive authority creates numerous barriers to quality, affordable, and
accessible patient care.
DIF: Cognitive Level: ComprehensionREF: pp. 1-2TOP: Nursing Process: Im-
plementation MSC:: Which aspects support the APRN's provision for full prescrip- tive
authority? Select all that apply.
A. Clinical education includes prescription of medications and disease processes.
B. Federal regulations support the provision of full authority for APRNs.
C. National examinations provide validation of the APRN's ability to provide safe care.
D.Licensure ensures compliance with health care and safety standards.
E. Limiting provision can decrease health care affordability.
5.ANS: A
Virginia allows limited prescriptive authority, while Maine gives full authority to
certified nurse practitioners. The federal government does not regulate prescriptive
authority.
DIF: Cognitive Level: ComprehensionREF: p. 3TOP: Nursing Process: Imple-
mentation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharma-
cologic and Parenteral Therapies: A family nurse practitioner practicing in Maine is
hired at a practice across state lines in Virginia. Which aspect of practice may change for
the APRN?
A. The APRN will have less prescriptive authority in the new position.
, Rosenthal: Lehne's Pharmacotherapeutics for Advanced
Practice Providers, 1st Ed. Chapter 1: Prescriptive Authority
B.The APRN will have more prescriptive authority in the new position.
C. The APRN will have equal prescriptive authority in the new position.
D.The APRN's authority will depend on federal regulations.
6.ANS: B,C,D
Providers should collaborate with pharmacists because they will likely have
additional information on formulary, drug interactions, and suggestions for adequate
medication dosing. Dietitians can make food recommendations to treat the patient's
condition. The pharmacist can contact the prescriber about questionable
prescriptions, but cannot alter the prescription without notifica- tion of and approval
by the provider.
DIF: Cognitive Level: ComprehensionREF: p. 9TOP: Nursing Process: Diagno- sis
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential: How can collaboration with a pharmacist improve positive outcomes for
patients? Select all that apply.
A. Pharmacists can suggest foods that will help with the patient's condition.
B. Pharmacists have additional information on drug interactions.
C. The pharmacist can suggest adequate medication dosing.
D.Pharmacists have firsthand knowledge of the facility formulary.
E. Pharmacy can alter prescriptions when necessary to prevent patient harm.
7.ANS: A
In an emergency situation, such as delirium tremens with seizure activity, it is
acceptable to provide a telephone order. Contacting the on-call hospitalist or waiting
for a written order would take more time than available for a patient with high
seizure risk. Writing an order is outside the scope of practice for the charge nurse.
DIF: Cognitive Level: ApplicationREF: p. 7TOP: Nursing Process: Implementa- tion
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential: A patient presents with delirium tremens requiring Ativan adminis- tration. The
provider of care is not the facility. Which action by the nurse is the most appropriate?
A. Obtain a telephone order.
B. Contact the on-call hospitalist.
C. Obtain an order from the charge nurse.
D.Wait for a written Ativan order.
, Rosenthal: Lehne's Pharmacotherapeutics for Advanced
Practice Providers, 1st Ed. Chapter 1: Prescriptive Authority
8.ANS: B
Schedule II medications are not eligible for refills, and prescriptions must be
handwritten. It is important to verify the patient's adherence to the drug regimen
and determine the current dosage of medication; however, this can
be accomplished by scheduling an appointment and evaluating the patient in person.
DIF: Cognitive Level: ApplicationREF: p. 8TOP: Nursing Process: Implementa- tion
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential: A patient with chronic pain calls the provider's office to request a refill on their
oxycontin. Which action is most appropriate?
A. Fax an order to the pharmacy.
B. Schedule an appointment with the patient.
C. Verify the patient's adherence to drug regimen.
D.Determine the patient's current medication dosage.
9.ANS: B
The priority action is to discontinue the medication to prevent worsening of the
patient's symptoms. A different prescription would be provided, topical
antihistamine may be administered, and the patient would be assessed for respiratory
involvement, but these actions would not be performed first.
DIF: Cognitive Level: ApplicationREF: p. 6TOP: Nursing Process: Implementa- tion
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential: A patient prescribed amoxicillin for streptococcal pharyngitis reports new onset
of a flat, itchy red rash on the chest and neck. Which action is most important?
A. Provide a different prescription.
B. Discontinue the medication.
C. Prescribe an antihistamine cream.
D.Assess for respiratory compromise.
10.ANS: B
Prior to adding medications to the treatment regimen, it is essential to assess for any
potential drug- drug interactions through a complete medical histo- ry. Baseline
laboratory values are not necessary for COPD treatment. Liver enzyme levels may
give insight into the possibility of altered metabolism but would not be the first
action. The presence of insurance coverage would affect the patient's access to
treatment but may not affect the type of medication
