Advanced Pharmacology – Complete Test Bank with Questions, Answers & Rationales – All Chapters

ADVANCEDPHARMACOLOGYTESTBANKALL b b b b




CHAPTERS QUESTIONS AND ANSWERS WITH
b b b b b




RATIONALES b




Chapter01:PrescriptiveAuthorityandRoleImplementation:Traditionvs.Change Test
b b b b b b b b b b




Bank
b




MULTIPLE CHOICE b




1. Whichofthe followinghasinfluenced an emphasis onprimarycareeducation in medical
b b b b b b b b b b b b b




schools?
b




a. ChangesinMedicarereimbursement b b b




methods recommended in 1992
b b b b




b. Competitionfromnonphysiciansdesiring to b b b b




meet primary care shortages
b b b b




c. Theneedformonopolisticcontrolinthe
b b b b b b




marketplace of primary outpatient care
b b b b b




d. Therecognitionthatnonphysicianshave
b b b b




variablesuccess providing primarycare
b b b b b




ANS: A b




The Physician Payment Review Commission in 1992 directly increased financial
b b b b b b b b b




reimbursement to clinicians who provide primary care. Coupled with a shortage of primary
b b b b b b b b b b b b b




careproviders, this incentiveled medical schools to place greater emphasis on preparing
b b b b b b b b b b b b b




primary care physicians. Competition from nonphysicians increased coincidentally as
b b b b b b b b b




professionals from other disciplines stepped up to meet the needs.
b b b b b b b b b b




Nonphysicians havehad increasingsuccess at providingprimarycare and havebeen shown to
b b b b b b b b b b b b b




be safe and effective.
b b b b




DIF: CognitiveLevel:Remembering(Knowledge) b b b REF: 2 b




2. Whichofthe following statements is trueabout the prescribingpractices of physicians?
b b b b b b b b b b b b




a. Olderphysicianstendtoprescribemore b b b b b




appropriate medications than younger
b b b b




physicians.
b. Antibioticmedicationsremaininthetop five b b b b b b




classifications of medications prescribed.
b b b b




c. Most physicians rely on a “therapeutic b b b b b




armamentarium”thatconsistsoflessthan
b b b b b b




100 drug preparations per physician.
b b b b b




d. The dominant form of drug information used
b b b b b b




byprimarycarephysicianscontinues to be
b b b b b b b




that provided by pharmaceutical companies.
b b b b b

, ANS: D b




Eventhough most physicians claim toplacelittleweight ondrugadvertisements,
b b b b b b b b b b b




pharmaceutical representatives, and patient preference and state that they rely on academic b b b b b b b b b b b




sources for drug information, a study showed that commercial rather than scientific sources of
b b b b b b b b b b b b b b




drug information dominated their drug information materials. Youngerphysicianstendto
b b b b b b b b b b b




prescribefewerandmoreappropriatedrugs.Antibioticshave dropped out of the top five
b b b b b b b b b b b b b b




classifications of drugs prescribed. Most physicians have a therapeutic armamentarium of
b b b b b b b b b b b




about 144 drugs.
b b b




DIF: CognitiveLevel:Remembering(Knowledge) b b b REF: 3 b




3. As primary care nurse practitioners (NPs) continue to develop their role as prescribers of
b b b b b b b b b b b b b




medications, it will be important to:
b b b b b b




a. attain the same level of expertise as b b b b b b




physicians who currently prescribe
b b b b




medications.
b




b. learn from the experiences of physicians andb b b b b b




developexpertisebasedonevidence- based
b b b b b b




practice.
b




c. maintaincollaborativeandsupervisorial b b b




relationships with physicians who will
b b b b b




oversee prescribing practices.
b b b




d. developrelationshipswithpharmaceutical b b b




representatives to learn about new
b b b b b




medications as they are developed.
b b b b b




ANS: B b




As nonphysicians develop the roles associated with prescriptive authority, it will be important
b b b b b b b b b b b b




to learn from the past experiences of physicians and to develop prescribing practices based on
b b b b b b b b b b b b b b b




evidence-based medicine. It is hoped that all prescribers, including physicians and nurse
b b b b b b b b b b b b




practitioners, will strive to do better than in the past. NPs should work toward prescriptive
b b b b b b b b b b b b b b b




authority and for practice that is not supervised by another professional.Pharmaceutical
b b b b b b b b b b b b




representativesprovideinformationthatcarriessomebias. Academic sources are better.
b b b b b b b b b b b




DIF: Cognitive Level:Applying (Application) b b b REF: 4 b




Chapter 02: Historical Review of PrescriptiveAuthority: The Role of Nurses (NPs,
b b b b b b b b b b b




CNMs, CRNAs, and CNSs) and Physician Assistants
b b b b b b b




TestBank
b




MULTIPLE CHOICE b




1. A primary care NP will begin practicing in a state in which the governor has opted out of the
b b b b b b b b b b b b b b b b b b




federal facility reimbursement requirement. The NP should be aware that this defines how NPs
b b b b b b b b b b b b b b




may write prescriptions:
b b b

, a. withoutphysiciansupervisioninprivate b b b b




practice.
b




b. asCRNAswithoutphysiciansupervision in a
b b b b b b




hospital setting.
b b




c. inanysituationbutwillnotbereimbursed for
b b b b b b b b




this by government insurers.
b b b b




d. onlywithphysiciansupervisioninboth b b b b b




private practice and a hospital setting.
b b b b b b




ANS: B b




In 2001, the Centers for Medicare and Medicaid Services changed the federal physician
b b b b b b b b b b b b




supervision ruleforCRNAstoallowstategovernors to optout, allowingCRNAstowrite
b b b b b b b b b b b b b b b




prescriptions and dispense drugs without physician supervision.
b b b b b b b




DIF: CognitiveLevel:Understanding(Comprehension)
b b b REF: 9 b




2. CRNAs in moststates: b b b




a. must have a Drug Enforcement b b b b




Administration(DEA)numbertopractice.
b b b b b




b. musthaveprescriptiveauthorityto practice.b b b b b




c. orderandadministercontrolledsubstances b b b b




butdonothavefullprescriptiveauthority.
b b b b b b b




d. administer medications, including b b




controlled substances, under direct
b b b b




physician supervision.
b b




ANS: C b




Only five states grant independent prescriptive authority to CRNAs. CRNAs do not require
b b b b b b b b b b b b




prescriptive authoritybecausetheydispenseadrugimmediatelyto apatient and do not
b b b b b b b b b b b b b b




prescribe. Without prescriptive authority, they do not need a DEAnumber.
b b b b b b b b b b b




DIF: CognitiveLevel:Understanding(Comprehension)
b b b REF: 9 b




3. ACNM:b




a. maytreat onlywomen. b b b




b. has prescriptive authorityin all 50 states.
b b b b b b




c. mayadministeronlydrugsusedduring labor
b b b b b b




and delivery.
b b




d. maypracticeonlyinbirthingcentersand
b b b b b b




home birth settings.
b b b




ANS: B b

, CNMs have prescriptive authority in all 50 states. They may treat partners of women for
b b b b b b b b b b b b b b




sexually transmitted diseases. They have full prescriptive authority and are not limited to drugs
b b b b b b b b b b b b b b




used during childbirth. They practice in many other types of settings.
b b b b b b b b b b b




DIF: CognitiveLevel:Remembering(Knowledge)
b b b b b REF: 9 b




4. Ineverystate, prescriptive authorityfor NPs includes the abilitytowriteprescriptions:
b b b b b b b b b b b b




a. forcontrolled substances. b b




b. forspecifiedclassificationsof b b b




medications.
b




c. withoutphysician-mandatedinvolvement. b b




d. withfull,independentprescriptive authority. b b b b




ANS: B b




All states now have some degree of prescriptive authority granted to NPs, but not all statesallow
b b b b b b b b b b b b b b b b




authorityto prescribecontrolledsubstances. Manystatesstill requiresome degree of physician
b b b b b b b b b b b b b




involvement with certain types of drugs.
b b b b b b




DIF: CognitiveLevel:Understanding(Comprehension) b b b REF: 12 b




5. Thecurrent trendtoward transitioningNPprograms to thedoctorallevel will mean that:
b b b b b b b b b b b b b




a. NPslicensedinonestatemaypracticein other b b b b b b b b




states.
b




b. fullprescriptiveauthoritywillbegranted to
b b b b b b




all NPs with doctoral degrees.
b b b b b




c. NPs will be better prepared to meet emerging b b b b b b b




healthcareneedsofpatients.
b b b b b




d. requirementsforphysiciansupervisionof b b b b




NPs will be removed in all states.
b b b b b b b




ANS: C b




The American Association of Colleges of Nursing has recommended transitioning graduate
b b b b b b b b b b




level NP programs to the doctoral level as a response to changes in health care delivery and
b b b b b b b b b b b b b b b b b




emerging health care needs. NPs with doctoral degrees will not necessarily have full
b b b b b b b b b b b b b




prescriptive authority or be freed from requirements about physician supervision because
b b b b b b b b b b b




thosearesubject toindividual state laws.NPswill stillberequired to meet licensure
b b b b b b b b b b b b b b b




requirements of each state.
b b b b




DIF: CognitiveLevel:Understanding(Comprehension) b b b REF: 12 b




6. Animportantdifference betweenphysicianassistants(PAs)andNPsisPAs:
b b b b b b b b b b




a. always workunderphysiciansupervision. b b b b




b. arenot requiredto follow drugtreatment
b b b b b b