,Chapter f01: fPrescriptive fAuthority fand fRole fImplementation: fTradition fvs. fChange
fTest fBank
MULTIPLE fCHOICE
1. Which fof fthe ffollowing fhas finfluenced fan femphasis fon fprimary fcare feducation fin
f medicalfschools?
a. Changes fin fMedicare
freimbursementfmethods
frecommended fin f1992
b. Competition ffrom fnonphysicians fdesiring
fto fmeet fprimary fcare fshortages
c. The fneed ffor fmonopolistic fcontrol fin
fthefmarketplace fof fprimary foutpatient
fcare
d. The frecognition fthat fnonphysicians
fhavefvariable fsuccess fproviding fprimary
fcare
ANS: f A
The fPhysician fPayment fReview fCommission fin f1992 fdirectly fincreased ffinancial
freimbursement fto fclinicians fwho fprovide fprimary fcare. fCoupled fwith fa fshortage fof
fprimary fcare fproviders, fthis fincentive fled fmedical fschools fto fplace fgreater femphasis
fonfpreparing fprimary fcare fphysicians. fCompetition ffrom fnonphysicians fincreased
fcoincidentally fas fprofessionals ffrom fother fdisciplines fstepped fup fto fmeet fthe fneeds.
Nonphysicians fhave fhad fincreasing fsuccess fat fproviding fprimary fcare fand fhave
fbeenfshown fto fbe fsafe fand feffective.
DIF: Cognitive fLevel: fRemembering f(Knowledge) REF: f 2
2. Which fof fthe ffollowing fstatements fis ftrue fabout fthe fprescribing fpractices fof fphysicians?
a. Older fphysicians ftend fto fprescribe
fmorefappropriate fmedications fthan
fyounger fphysicians.
b. Antibiotic fmedications fremain fin fthe
ftopffive fclassifications fof fmedications
fprescribed.
c. Most fphysicians frely fon fa f“therapeutic
farmamentarium” fthat fconsists fof fless
fthanf100 fdrug fpreparations fper fphysician.
d. The fdominant fform fof fdrug finformation
fused fby fprimary fcare fphysicians
fcontinuesfto fbe fthat fprovided fby
fpharmaceutical fcompanies.
ANS: f D
Even fthough fmost fphysicians fclaim fto fplace flittle fweight fon fdrug fadvertisements,
, pharmaceutical frepresentatives, fand fpatient fpreference fand fstate fthat fthey frely fon
facademic fsources ffor fdrug finformation, fa fstudy fshowed fthat fcommercial frather fthan
fscientific fsources fof fdrug finformation fdominated ftheir fdrug finformation fmaterials.
fYounger fphysicians ftend fto fprescribe ffewer fand fmore fappropriate fdrugs. fAntibiotics
fhavefdropped fout fof fthe ftop ffive fclassifications fof fdrugs fprescribed. fMost fphysicians
fhave fa ftherapeutic farmamentarium fof fabout f144 fdrugs.
DIF: Cognitive fLevel: fRemembering f(Knowledge) REF: f 3
3. As fprimary fcare fnurse fpractitioners f(NPs) fcontinue fto fdevelop ftheir frole fas fprescribers
f offmedications, fit fwill fbe fimportant fto:
a. attain fthe fsame flevel fof fexpertise
fas fphysicians fwho fcurrently
fprescribe fmedications.
b. learn ffrom fthe fexperiences fof fphysicians
fand fdevelop fexpertise fbased fon
fevidence-fbased fpractice.
c. maintain fcollaborative fand
fsupervisorialfrelationships fwith
fphysicians fwho fwill foversee
fprescribing fpractices.
d. develop frelationships fwith fpharmaceutical
frepresentatives fto flearn fabout fnew
fmedications fas fthey fare fdeveloped.
ANS: f B
As fnonphysicians fdevelop fthe froles fassociated fwith fprescriptive fauthority, fit fwill fbe
fimportant fto flearn ffrom fthe fpast fexperiences fof fphysicians fand fto fdevelop fprescribing
fpractices fbased fon fevidence-based fmedicine. fIt fis fhoped fthat fall fprescribers, fincluding
fphysicians fand fnurse fpractitioners, fwill fstrive fto fdo fbetter fthan fin fthe fpast. fNPs fshould
fwork ftoward fprescriptive fauthority fand ffor fpractice fthat fis fnot fsupervised fby fanother
fprofessional. fPharmaceutical frepresentatives fprovide finformation fthat fcarries fsome
fbias.fAcademic fsources fare fbetter.
DIF: Cognitive fLevel: fApplying f(Application) REF: f 4
Chapter f02: fHistorical fReview fof fPrescriptive fAuthority: fThe fRole fof fNurses f(NPs,
fCNMs, fCRNAs, fand fCNSs) fand fPhysician fAssistants
Test fBank
MULTIPLE fCHOICE
1. A fprimary fcare fNP fwill fbegin fpracticing fin fa fstate fin fwhich fthe fgovernor fhas fopted fout
of fthe ffederal ffacility freimbursement frequirement. fThe fNP fshould fbe faware fthat fthis
f
definesfhow fNPs fmay fwrite fprescriptions:
f
, a. without fphysician fsupervision fin
fprivatefpractice.
b. as fCRNAs fwithout fphysician
fsupervisionfin fa fhospital fsetting.
c. in fany fsituation fbut fwill fnot fbe
freimbursedffor fthis fby fgovernment
finsurers.
d. only fwith fphysician fsupervision fin
fbothfprivate fpractice fand fa fhospital
fsetting.
ANS: f B
In f2001, fthe fCenters ffor fMedicare fand fMedicaid fServices fchanged fthe ffederal fphysician
fsupervision frule ffor fCRNAs fto fallow fstate fgovernors fto fopt fout, fallowing fCRNAs fto
fwritefprescriptions fand fdispense fdrugs fwithout fphysician fsupervision.
DIF: Cognitive fLevel: fUnderstanding f(Comprehension) REF: f 9
2. CRNAs fin fmost fstates:
a. must fhave fa fDrug fEnforcement
fAdministration f(DEA) fnumber fto
fpractice.
b. must fhave fprescriptive fauthority
ftofpractice.
c. order fand fadminister fcontrolled
fsubstancesfbut fdo fnot fhave ffull
fprescriptive fauthority.
d. administer fmedications, fincluding
fcontrolled fsubstances, funder
fdirectfphysician fsupervision.
ANS: f C
Only ffive fstates fgrant findependent fprescriptive fauthority fto fCRNAs. fCRNAs fdo fnot
frequire fprescriptive fauthority fbecause fthey fdispense fa fdrug fimmediately fto fa fpatient
fandfdo fnot fprescribe. fWithout fprescriptive fauthority, fthey fdo fnot fneed fa fDEA fnumber.
DIF: Cognitive fLevel: fUnderstanding f(Comprehension) REF: f 9
3. A fCNM:
a. may ftreat fonly fwomen.
b. has fprescriptive fauthority fin fall f50 fstates.
c. may fadminister fonly fdrugs fused
fduringflabor fand fdelivery.
d. may fpractice fonly fin fbirthing fcenters
fandfhome fbirth fsettings.
ANS: f B
fTest fBank
MULTIPLE fCHOICE
1. Which fof fthe ffollowing fhas finfluenced fan femphasis fon fprimary fcare feducation fin
f medicalfschools?
a. Changes fin fMedicare
freimbursementfmethods
frecommended fin f1992
b. Competition ffrom fnonphysicians fdesiring
fto fmeet fprimary fcare fshortages
c. The fneed ffor fmonopolistic fcontrol fin
fthefmarketplace fof fprimary foutpatient
fcare
d. The frecognition fthat fnonphysicians
fhavefvariable fsuccess fproviding fprimary
fcare
ANS: f A
The fPhysician fPayment fReview fCommission fin f1992 fdirectly fincreased ffinancial
freimbursement fto fclinicians fwho fprovide fprimary fcare. fCoupled fwith fa fshortage fof
fprimary fcare fproviders, fthis fincentive fled fmedical fschools fto fplace fgreater femphasis
fonfpreparing fprimary fcare fphysicians. fCompetition ffrom fnonphysicians fincreased
fcoincidentally fas fprofessionals ffrom fother fdisciplines fstepped fup fto fmeet fthe fneeds.
Nonphysicians fhave fhad fincreasing fsuccess fat fproviding fprimary fcare fand fhave
fbeenfshown fto fbe fsafe fand feffective.
DIF: Cognitive fLevel: fRemembering f(Knowledge) REF: f 2
2. Which fof fthe ffollowing fstatements fis ftrue fabout fthe fprescribing fpractices fof fphysicians?
a. Older fphysicians ftend fto fprescribe
fmorefappropriate fmedications fthan
fyounger fphysicians.
b. Antibiotic fmedications fremain fin fthe
ftopffive fclassifications fof fmedications
fprescribed.
c. Most fphysicians frely fon fa f“therapeutic
farmamentarium” fthat fconsists fof fless
fthanf100 fdrug fpreparations fper fphysician.
d. The fdominant fform fof fdrug finformation
fused fby fprimary fcare fphysicians
fcontinuesfto fbe fthat fprovided fby
fpharmaceutical fcompanies.
ANS: f D
Even fthough fmost fphysicians fclaim fto fplace flittle fweight fon fdrug fadvertisements,
, pharmaceutical frepresentatives, fand fpatient fpreference fand fstate fthat fthey frely fon
facademic fsources ffor fdrug finformation, fa fstudy fshowed fthat fcommercial frather fthan
fscientific fsources fof fdrug finformation fdominated ftheir fdrug finformation fmaterials.
fYounger fphysicians ftend fto fprescribe ffewer fand fmore fappropriate fdrugs. fAntibiotics
fhavefdropped fout fof fthe ftop ffive fclassifications fof fdrugs fprescribed. fMost fphysicians
fhave fa ftherapeutic farmamentarium fof fabout f144 fdrugs.
DIF: Cognitive fLevel: fRemembering f(Knowledge) REF: f 3
3. As fprimary fcare fnurse fpractitioners f(NPs) fcontinue fto fdevelop ftheir frole fas fprescribers
f offmedications, fit fwill fbe fimportant fto:
a. attain fthe fsame flevel fof fexpertise
fas fphysicians fwho fcurrently
fprescribe fmedications.
b. learn ffrom fthe fexperiences fof fphysicians
fand fdevelop fexpertise fbased fon
fevidence-fbased fpractice.
c. maintain fcollaborative fand
fsupervisorialfrelationships fwith
fphysicians fwho fwill foversee
fprescribing fpractices.
d. develop frelationships fwith fpharmaceutical
frepresentatives fto flearn fabout fnew
fmedications fas fthey fare fdeveloped.
ANS: f B
As fnonphysicians fdevelop fthe froles fassociated fwith fprescriptive fauthority, fit fwill fbe
fimportant fto flearn ffrom fthe fpast fexperiences fof fphysicians fand fto fdevelop fprescribing
fpractices fbased fon fevidence-based fmedicine. fIt fis fhoped fthat fall fprescribers, fincluding
fphysicians fand fnurse fpractitioners, fwill fstrive fto fdo fbetter fthan fin fthe fpast. fNPs fshould
fwork ftoward fprescriptive fauthority fand ffor fpractice fthat fis fnot fsupervised fby fanother
fprofessional. fPharmaceutical frepresentatives fprovide finformation fthat fcarries fsome
fbias.fAcademic fsources fare fbetter.
DIF: Cognitive fLevel: fApplying f(Application) REF: f 4
Chapter f02: fHistorical fReview fof fPrescriptive fAuthority: fThe fRole fof fNurses f(NPs,
fCNMs, fCRNAs, fand fCNSs) fand fPhysician fAssistants
Test fBank
MULTIPLE fCHOICE
1. A fprimary fcare fNP fwill fbegin fpracticing fin fa fstate fin fwhich fthe fgovernor fhas fopted fout
of fthe ffederal ffacility freimbursement frequirement. fThe fNP fshould fbe faware fthat fthis
f
definesfhow fNPs fmay fwrite fprescriptions:
f
, a. without fphysician fsupervision fin
fprivatefpractice.
b. as fCRNAs fwithout fphysician
fsupervisionfin fa fhospital fsetting.
c. in fany fsituation fbut fwill fnot fbe
freimbursedffor fthis fby fgovernment
finsurers.
d. only fwith fphysician fsupervision fin
fbothfprivate fpractice fand fa fhospital
fsetting.
ANS: f B
In f2001, fthe fCenters ffor fMedicare fand fMedicaid fServices fchanged fthe ffederal fphysician
fsupervision frule ffor fCRNAs fto fallow fstate fgovernors fto fopt fout, fallowing fCRNAs fto
fwritefprescriptions fand fdispense fdrugs fwithout fphysician fsupervision.
DIF: Cognitive fLevel: fUnderstanding f(Comprehension) REF: f 9
2. CRNAs fin fmost fstates:
a. must fhave fa fDrug fEnforcement
fAdministration f(DEA) fnumber fto
fpractice.
b. must fhave fprescriptive fauthority
ftofpractice.
c. order fand fadminister fcontrolled
fsubstancesfbut fdo fnot fhave ffull
fprescriptive fauthority.
d. administer fmedications, fincluding
fcontrolled fsubstances, funder
fdirectfphysician fsupervision.
ANS: f C
Only ffive fstates fgrant findependent fprescriptive fauthority fto fCRNAs. fCRNAs fdo fnot
frequire fprescriptive fauthority fbecause fthey fdispense fa fdrug fimmediately fto fa fpatient
fandfdo fnot fprescribe. fWithout fprescriptive fauthority, fthey fdo fnot fneed fa fDEA fnumber.
DIF: Cognitive fLevel: fUnderstanding f(Comprehension) REF: f 9
3. A fCNM:
a. may ftreat fonly fwomen.
b. has fprescriptive fauthority fin fall f50 fstates.
c. may fadminister fonly fdrugs fused
fduringflabor fand fdelivery.
d. may fpractice fonly fin fbirthing fcenters
fandfhome fbirth fsettings.
ANS: f B
