ADVANCED PHARMACOLOGY TEST BANK ALL
CHAPTERS QUESTIONS AND ANSWERS WITH
RATIONALES
Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change
Test Bank
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
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: Cognitive Level: Applying (Application) REF: 4
Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs,
CNMs, CRNAs, and CNSs) and Physician Assistants
Test Bank
MULTIPLE CHOICE
1. A primary care NP will begin practicing in a state in which the governor has opted out of
the federal facility reimbursement requirement. The NP should be aware that this defines
how NPs may write prescriptions:
, a. without physician supervision in private
practice.
b. as CRNAs without physician supervision
in a hospital setting.
c. in any situation but will not be reimbursed
for this by government insurers.
d. only with physician supervision in both
private practice and a hospital setting.
ANS: i B
In i2001, ithe iCenters ifor iMedicare iand iMedicaid iServices ichanged ithe ifederal
iphysician isupervision irule ifor iCRNAs ito iallow istate igovernors ito iopt iout, iallowing
iCRNAs ito iwrite iprescriptions iand idispense idrugs iwithout iphysician isupervision.
DIF: Cognitive iLevel: iUnderstanding i(Comprehension) REF: i9
2. CRNAs iin imost istates:
a. must ihave ia iDrug iEnforcement
iAdministration i(DEA) inumber ito
ipractice.
b. must ihave iprescriptive iauthority ito
ipractice.
c. order iand iadminister icontrolled isubstances
ibut ido inot ihave ifull iprescriptive
iauthority.
d. administer imedications, iincluding
icontrolled isubstances, iunder
idirect iphysician isupervision.
ANS: i C
Only ifive istates igrant iindependent iprescriptive iauthority ito iCRNAs. iCRNAs ido inot
irequire iprescriptive iauthority ibecause ithey idispense ia idrug iimmediately ito ia ipatient
iand ido inot iprescribe. iWithout iprescriptive iauthority, ithey ido inot ineed ia iDEA
inumber.
DIF: Cognitive iLevel: iUnderstanding i(Comprehension) REF: i9
3. A iCNM:
a. may itreat ionly iwomen.
b. has iprescriptive iauthority iin iall i50 istates.
c. may iadminister ionly idrugs iused iduring
ilabor iand idelivery.
d. may ipractice ionly iin ibirthing icenters iand
ihome ibirth isettings.
ANS: i B
, CNMs ihave iprescriptive iauthority iin iall i50 istates. iThey imay itreat ipartners iof iwomen
ifor isexually itransmitted idiseases. iThey ihave ifull iprescriptive iauthority iand iare inot
ilimited ito idrugs iused iduring ichildbirth. iThey ipractice iin imany iother itypes iof
isettings.
DIF: i i Cognitive iLevel: iRemembering i(Knowledge) REF: i9
4. In ievery istate, iprescriptive iauthority ifor iNPs iincludes ithe iability ito iwrite iprescriptions:
a. for icontrolled isubstances.
b. for ispecified iclassifications iof
imedications.
c. without iphysician-mandated iinvolvement.
d. with ifull, iindependent iprescriptive
iauthority.
ANS: i B
All istates inow ihave isome idegree iof iprescriptive iauthority igranted ito iNPs, ibut inot iall
istates iallow iauthority ito iprescribe icontrolled isubstances. iMany istates istill irequire isome
idegree iof iphysician iinvolvement iwith icertain itypes iof idrugs.
DIF: Cognitive iLevel: iUnderstanding i(Comprehension) REF: i12
5. The icurrent itrend itoward itransitioning iNP iprograms ito ithe idoctoral ilevel iwill imean ithat:
a. NPs ilicensed iin ione istate imay ipractice iin
iother istates.
b. full iprescriptive iauthority iwill ibe igranted
ito iall iNPs iwith idoctoral idegrees.
c. NPs iwill ibe ibetter iprepared ito imeet
iemerging ihealth icare ineeds iof ipatients.
d. requirements ifor iphysician isupervision iof
iNPs iwill ibe iremoved iin iall istates.
ANS: i C
The iAmerican iAssociation iof iColleges iof iNursing ihas irecommended itransitioning
igraduate ilevel iNP iprograms ito ithe idoctoral ilevel ias ia iresponse ito ichanges iin ihealth
icare idelivery iand iemerging ihealth icare ineeds. iNPs iwith idoctoral idegrees iwill inot
inecessarily ihave ifull iprescriptive iauthority ior ibe ifreed ifrom irequirements iabout
iphysician isupervision ibecause ithose iare isubject ito iindividual istate ilaws. iNPs iwill istill
ibe irequired ito imeet ilicensure irequirements iof ieach istate.
DIF: Cognitive iLevel: iUnderstanding i(Comprehension) REF: i12
6. An iimportant idifference ibetween iphysician iassistants i(PAs) iand iNPs iis iPAs:
a. always iwork iunder iphysician isupervision.
b. are inot irequired ito ifollow idrug itreatment
CHAPTERS QUESTIONS AND ANSWERS WITH
RATIONALES
Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change
Test Bank
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
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: Cognitive Level: Applying (Application) REF: 4
Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs,
CNMs, CRNAs, and CNSs) and Physician Assistants
Test Bank
MULTIPLE CHOICE
1. A primary care NP will begin practicing in a state in which the governor has opted out of
the federal facility reimbursement requirement. The NP should be aware that this defines
how NPs may write prescriptions:
, a. without physician supervision in private
practice.
b. as CRNAs without physician supervision
in a hospital setting.
c. in any situation but will not be reimbursed
for this by government insurers.
d. only with physician supervision in both
private practice and a hospital setting.
ANS: i B
In i2001, ithe iCenters ifor iMedicare iand iMedicaid iServices ichanged ithe ifederal
iphysician isupervision irule ifor iCRNAs ito iallow istate igovernors ito iopt iout, iallowing
iCRNAs ito iwrite iprescriptions iand idispense idrugs iwithout iphysician isupervision.
DIF: Cognitive iLevel: iUnderstanding i(Comprehension) REF: i9
2. CRNAs iin imost istates:
a. must ihave ia iDrug iEnforcement
iAdministration i(DEA) inumber ito
ipractice.
b. must ihave iprescriptive iauthority ito
ipractice.
c. order iand iadminister icontrolled isubstances
ibut ido inot ihave ifull iprescriptive
iauthority.
d. administer imedications, iincluding
icontrolled isubstances, iunder
idirect iphysician isupervision.
ANS: i C
Only ifive istates igrant iindependent iprescriptive iauthority ito iCRNAs. iCRNAs ido inot
irequire iprescriptive iauthority ibecause ithey idispense ia idrug iimmediately ito ia ipatient
iand ido inot iprescribe. iWithout iprescriptive iauthority, ithey ido inot ineed ia iDEA
inumber.
DIF: Cognitive iLevel: iUnderstanding i(Comprehension) REF: i9
3. A iCNM:
a. may itreat ionly iwomen.
b. has iprescriptive iauthority iin iall i50 istates.
c. may iadminister ionly idrugs iused iduring
ilabor iand idelivery.
d. may ipractice ionly iin ibirthing icenters iand
ihome ibirth isettings.
ANS: i B
, CNMs ihave iprescriptive iauthority iin iall i50 istates. iThey imay itreat ipartners iof iwomen
ifor isexually itransmitted idiseases. iThey ihave ifull iprescriptive iauthority iand iare inot
ilimited ito idrugs iused iduring ichildbirth. iThey ipractice iin imany iother itypes iof
isettings.
DIF: i i Cognitive iLevel: iRemembering i(Knowledge) REF: i9
4. In ievery istate, iprescriptive iauthority ifor iNPs iincludes ithe iability ito iwrite iprescriptions:
a. for icontrolled isubstances.
b. for ispecified iclassifications iof
imedications.
c. without iphysician-mandated iinvolvement.
d. with ifull, iindependent iprescriptive
iauthority.
ANS: i B
All istates inow ihave isome idegree iof iprescriptive iauthority igranted ito iNPs, ibut inot iall
istates iallow iauthority ito iprescribe icontrolled isubstances. iMany istates istill irequire isome
idegree iof iphysician iinvolvement iwith icertain itypes iof idrugs.
DIF: Cognitive iLevel: iUnderstanding i(Comprehension) REF: i12
5. The icurrent itrend itoward itransitioning iNP iprograms ito ithe idoctoral ilevel iwill imean ithat:
a. NPs ilicensed iin ione istate imay ipractice iin
iother istates.
b. full iprescriptive iauthority iwill ibe igranted
ito iall iNPs iwith idoctoral idegrees.
c. NPs iwill ibe ibetter iprepared ito imeet
iemerging ihealth icare ineeds iof ipatients.
d. requirements ifor iphysician isupervision iof
iNPs iwill ibe iremoved iin iall istates.
ANS: i C
The iAmerican iAssociation iof iColleges iof iNursing ihas irecommended itransitioning
igraduate ilevel iNP iprograms ito ithe idoctoral ilevel ias ia iresponse ito ichanges iin ihealth
icare idelivery iand iemerging ihealth icare ineeds. iNPs iwith idoctoral idegrees iwill inot
inecessarily ihave ifull iprescriptive iauthority ior ibe ifreed ifrom irequirements iabout
iphysician isupervision ibecause ithose iare isubject ito iindividual istate ilaws. iNPs iwill istill
ibe irequired ito imeet ilicensure irequirements iof ieach istate.
DIF: Cognitive iLevel: iUnderstanding i(Comprehension) REF: i12
6. An iimportant idifference ibetween iphysician iassistants i(PAs) iand iNPs iis iPAs:
a. always iwork iunder iphysician isupervision.
b. are inot irequired ito ifollow idrug itreatment
