, Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change
Test Bank
understanding organizational processes. A typical business program might cover topics like accounting, finance, marketing, management, economics, entrepreneurship, and international business.1.2. Structure of Business
ExamsBusiness exams are often a mix of theoretical knowledge and practical application. Depending on the subject area, these exams can vary significantly in format. Common types of business exams and
Writing Skills: Business exams may require students to present ideas clearly
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 understanding organizational processes. A typical business
program might cover topics like accounting, finance, marketing, management, economics, entrepreneurship, and international business.1.2. Structure of Business ExamsBusiness exams are often a
mix of theoretical knowledge and practical application. Depending on the subject area, these exams can vary significantly in format. Common types of business exams and Writing Skills:
Business exams may require students to present ideas clearly
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: CognitiveLevel:Applying (Application) REF: 4
, Chapter02: Historical Review of PrescriptiveAuthority: The Role of Nurses(NPs,
CNMs, CRNAs, and CNSs) and Physician Assistants
Test Banki
MULTIPLECHOICE
1. Aprimary care NP will begin practicing in a state in which the governor has opted out of the
federal facility reimbursement requirement. The NPshould be aware that this defines how
NPs may write prescriptions:
understanding organizational processes. A typical business program might cover topics like accounting, finance, marketing, management, economics, entrepreneurship, and international business.1.2. Structure of Business
ExamsBusiness exams are often a mix of theoretical knowledge and practical application. Depending on the subject area, these exams can vary significantly in format. Common types of business exams and
Writing Skills: Business exams may require students to present ideas clearly
a. withoutphysiciansupervisioninprivate
practice.
b. asCRNAswithoutphysiciansupervision in
i i
a hospital setting.
c. inanysituation butwill notbereimbursed
for this by government insurers.
d. onlywithphysiciansupervisioninboth
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. CRNAsin most states:
a. must have a Drug Enforcement
Administration(DEA)numbertopractice.
b. musthaveprescriptiveauthorityto practice.
c. orderandadministercontrolledsubstances
but do not have full prescriptive authority.
d. administer medications, including
controlledsubstances,underdirect
physician supervision.
ANS: C
Only five states grant independent prescriptive authority to CRNAs. CRNAs do not
require prescriptive authoritybecause theydispense a drug immediately to a patient and do
not prescribe. Without prescriptive authority, they do not need a DEAnumber.
DIF: Cognitive Level: Understanding(Comprehension) REF: 9
3. ACNM:
a. maytreat only women.
b. has prescriptive authorityin all 50 states.
c. mayadministeronlydrugsusedduring
labor and delivery.
Test Bank
understanding organizational processes. A typical business program might cover topics like accounting, finance, marketing, management, economics, entrepreneurship, and international business.1.2. Structure of Business
ExamsBusiness exams are often a mix of theoretical knowledge and practical application. Depending on the subject area, these exams can vary significantly in format. Common types of business exams and
Writing Skills: Business exams may require students to present ideas clearly
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 understanding organizational processes. A typical business
program might cover topics like accounting, finance, marketing, management, economics, entrepreneurship, and international business.1.2. Structure of Business ExamsBusiness exams are often a
mix of theoretical knowledge and practical application. Depending on the subject area, these exams can vary significantly in format. Common types of business exams and Writing Skills:
Business exams may require students to present ideas clearly
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: CognitiveLevel:Applying (Application) REF: 4
, Chapter02: Historical Review of PrescriptiveAuthority: The Role of Nurses(NPs,
CNMs, CRNAs, and CNSs) and Physician Assistants
Test Banki
MULTIPLECHOICE
1. Aprimary care NP will begin practicing in a state in which the governor has opted out of the
federal facility reimbursement requirement. The NPshould be aware that this defines how
NPs may write prescriptions:
understanding organizational processes. A typical business program might cover topics like accounting, finance, marketing, management, economics, entrepreneurship, and international business.1.2. Structure of Business
ExamsBusiness exams are often a mix of theoretical knowledge and practical application. Depending on the subject area, these exams can vary significantly in format. Common types of business exams and
Writing Skills: Business exams may require students to present ideas clearly
a. withoutphysiciansupervisioninprivate
practice.
b. asCRNAswithoutphysiciansupervision in
i i
a hospital setting.
c. inanysituation butwill notbereimbursed
for this by government insurers.
d. onlywithphysiciansupervisioninboth
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. CRNAsin most states:
a. must have a Drug Enforcement
Administration(DEA)numbertopractice.
b. musthaveprescriptiveauthorityto practice.
c. orderandadministercontrolledsubstances
but do not have full prescriptive authority.
d. administer medications, including
controlledsubstances,underdirect
physician supervision.
ANS: C
Only five states grant independent prescriptive authority to CRNAs. CRNAs do not
require prescriptive authoritybecause theydispense a drug immediately to a patient and do
not prescribe. Without prescriptive authority, they do not need a DEAnumber.
DIF: Cognitive Level: Understanding(Comprehension) REF: 9
3. ACNM:
a. maytreat only women.
b. has prescriptive authorityin all 50 states.
c. mayadministeronlydrugsusedduring
labor and delivery.
