Prescription Case Study
View the presentation How to Write a Prescription to have a better understanding on how prescriptions
should be completed.
Each prescription written in these case studies need to include:
Patient Name, Date of Birth and/or Gender and/or address (Typically either DOB or Gender or Address is
acceptable, but the prescription MUST have at least 2 patient identifiers and one identifier must be the
patient’s name).
The prescription must include name of the drug, dose, frequency, duration, and, if the prescription if for an
as needed drug (prn), the reason for the prn drug needs to be documented.
The prescriber must indicate the exact number of pills or volume of drug to be dispensed. Write this after
the drug, dose and duration by indicating # (and fill in the exact number you want).
The prescriber must also indicate the “range” of the number of pills to be dispensed.
Lastly, the prescriber’s name and the number of prescription written on that prescription must be
indicated.
Read case studies 1 – 4 below and consider the prescription needs of the patient.
Type in the prescription information for each patient using the template following the case study. In NP
practice, you may write out or electronically input your prescriptions but for this exercise, you will have to
type in the information.
For the area asking for a signature, type your signature.
Submit your completed Prescription Case Study document.
, Sample Written Prescription & Sample Case Study
Jackie Jones, date of birth 8/27/1955, has been diagnosed with a complicated UTI. She reports burning
pain and frequency when voiding. She has no allergies to medications.
You order Bactrim DS for her for 7days. Look up the dose and frequency for this patient. She needs no
refills.
Enter her prescriptions using medical terminology on the form below.
PRACTICE NAME
Prescriber Name 1, Degree Lic # 1234567 DEA# MX1234567
12345 Street Address – City Name, State 12345 (555) 123-4567
Tracking # 123456789123
Name Jackie Jones DOB 8/27/1955
Address/Allergies: NKDA Date 7/1/2019
Quantity ☒ 1-24 ☐25-49 ☐ 50-74
Bactrim DS 100 mg BID X 7 days. #14 ☐ 75-100 ☐ 101-150
NR ☐ 151+ units
☐ Do not substitute
Rx1 Refills: 0
Quantity ☒ 1-24 ☐25-49 ☐ 50-74
Pyridium 200 mg TID with food prn urinary pain ☐ 75-100 ☐ 101-150
X 2 days # 6 NR ☐ 151+ units
☐ Do not substitute
Rx2 Refills: 0
Quantity ☐ 1-24 ☐25-49 ☐ 50-74
☐ 75-100 ☐ 101-150
☐ 151+ units
☐ Do not substitute
Rx3 Refills: 0-1-2-3-4
Signature Terry Deane Dauwalder, NP
.
Prescription is void if the number of drugs prescribed above is not noted on this line 2 .
View the presentation How to Write a Prescription to have a better understanding on how prescriptions
should be completed.
Each prescription written in these case studies need to include:
Patient Name, Date of Birth and/or Gender and/or address (Typically either DOB or Gender or Address is
acceptable, but the prescription MUST have at least 2 patient identifiers and one identifier must be the
patient’s name).
The prescription must include name of the drug, dose, frequency, duration, and, if the prescription if for an
as needed drug (prn), the reason for the prn drug needs to be documented.
The prescriber must indicate the exact number of pills or volume of drug to be dispensed. Write this after
the drug, dose and duration by indicating # (and fill in the exact number you want).
The prescriber must also indicate the “range” of the number of pills to be dispensed.
Lastly, the prescriber’s name and the number of prescription written on that prescription must be
indicated.
Read case studies 1 – 4 below and consider the prescription needs of the patient.
Type in the prescription information for each patient using the template following the case study. In NP
practice, you may write out or electronically input your prescriptions but for this exercise, you will have to
type in the information.
For the area asking for a signature, type your signature.
Submit your completed Prescription Case Study document.
, Sample Written Prescription & Sample Case Study
Jackie Jones, date of birth 8/27/1955, has been diagnosed with a complicated UTI. She reports burning
pain and frequency when voiding. She has no allergies to medications.
You order Bactrim DS for her for 7days. Look up the dose and frequency for this patient. She needs no
refills.
Enter her prescriptions using medical terminology on the form below.
PRACTICE NAME
Prescriber Name 1, Degree Lic # 1234567 DEA# MX1234567
12345 Street Address – City Name, State 12345 (555) 123-4567
Tracking # 123456789123
Name Jackie Jones DOB 8/27/1955
Address/Allergies: NKDA Date 7/1/2019
Quantity ☒ 1-24 ☐25-49 ☐ 50-74
Bactrim DS 100 mg BID X 7 days. #14 ☐ 75-100 ☐ 101-150
NR ☐ 151+ units
☐ Do not substitute
Rx1 Refills: 0
Quantity ☒ 1-24 ☐25-49 ☐ 50-74
Pyridium 200 mg TID with food prn urinary pain ☐ 75-100 ☐ 101-150
X 2 days # 6 NR ☐ 151+ units
☐ Do not substitute
Rx2 Refills: 0
Quantity ☐ 1-24 ☐25-49 ☐ 50-74
☐ 75-100 ☐ 101-150
☐ 151+ units
☐ Do not substitute
Rx3 Refills: 0-1-2-3-4
Signature Terry Deane Dauwalder, NP
.
Prescription is void if the number of drugs prescribed above is not noted on this line 2 .
