1
NR565 Midterm Study Guide
Week 1
Which schedule drugs can APRNs prescribe? II-IV depending on which
state. Who determines and regulates prescriptive authority?
The extent to which they can accomplish this as an autonomous practice component is
determined by legislation that varies depending on professional licensure, physician
affiliation requirements, and state laws.
How does limited prescriptive authority impact patients within the healthcare system?
Limited prescriptive authority creates numerous barriers to quality, affordable, and
accessible patient care. For example, restrictions on the distance of the APRN or PA
from the physician providing supervision or collaboration may prevent outreach to areas
of greatest need. A requirement to obtain the physician's cosignature on prescriptions can
increase patient waits. Despite the use of terms such as collaborative arrangement, these
relationships create a situation in which one partner holds the power. In the event
of dissolution of the arrangement, the ultimate loss is commonly assumed by the
advanced practice provider rather than the physician.
What are the key responsibilities of prescribing?
What should be used to make prescribing decisions?
Prescription writing requires prudent and deliberate decision-making processes to maintain
patient safety and reduce liability, including:
documentation of a provider-patient relationship for the recipient of the prescribed
medications documentation of a thorough history and physical examination for the
recipient
documentation of discussions regarding risk factors, side effects, or therapy
options documentation of drug monitoring or titration plan, if applicable
documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Be familiar with pharmacokinetic and pharmacodynamic changes of older adults and
how that would translate to baseline information needed to prescribe.
Absorption of Drugs
Increased gastric pH, Decreased absorptive surface area, Decreased splanchnic blood
flow, Decreased gastrointestinal motility, Delayed gastric emptying
Distribution of Drugs
Increased body fat, Decreased lean body mass, Decreased total body water, Decreased
serum albumin, Decreased cardiac output
Metabolism of Drugs
Decreased hepatic blood flow, Decreased hepatic mass, Decreased activity of hepatic
enzymes
)
, 2
NR565 Midterm Study Guide
NR565 Midterm Study Guide
Week 1
Which schedule drugs can APRNs prescribe? II-IV depending on which
state. Who determines and regulates prescriptive authority?
The extent to which they can accomplish this as an autonomous practice component is
determined by legislation that varies depending on professional licensure, physician
affiliation requirements, and state laws.
How does limited prescriptive authority impact patients within the healthcare system?
Limited prescriptive authority creates numerous barriers to quality, affordable, and
accessible patient care. For example, restrictions on the distance of the APRN or PA
from the physician providing supervision or collaboration may prevent outreach to areas
of greatest need. A requirement to obtain the physician's cosignature on prescriptions can
increase patient waits. Despite the use of terms such as collaborative arrangement, these
relationships create a situation in which one partner holds the power. In the event
of dissolution of the arrangement, the ultimate loss is commonly assumed by the
advanced practice provider rather than the physician.
What are the key responsibilities of prescribing?
What should be used to make prescribing decisions?
Prescription writing requires prudent and deliberate decision-making processes to maintain
patient safety and reduce liability, including:
documentation of a provider-patient relationship for the recipient of the prescribed
medications documentation of a thorough history and physical examination for the
recipient
documentation of discussions regarding risk factors, side effects, or therapy
options documentation of drug monitoring or titration plan, if applicable
documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Be familiar with pharmacokinetic and pharmacodynamic changes of older adults and
how that would translate to baseline information needed to prescribe.
Absorption of Drugs
Increased gastric pH, Decreased absorptive surface area, Decreased splanchnic blood
flow, Decreased gastrointestinal motility, Delayed gastric emptying
Distribution of Drugs
Increased body fat, Decreased lean body mass, Decreased total body water, Decreased
serum albumin, Decreased cardiac output
Metabolism of Drugs
Decreased hepatic blood flow, Decreased hepatic mass, Decreased activity of hepatic
enzymes
)
, 2
NR565 Midterm Study Guide
