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FOR PRIMARY PROVIDER 4TH
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EDITION EDMUNDS
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EDITION Il`
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EDMUNDS
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PHARMACOlOGY
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PROVIDER 4 Il`
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Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change Test
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Bank
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MULTIPLE CHOICE Il`
1. Which of the following has influenced an emphasis on primary care education in medical
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Il` schools?
a. Changes in Medicare reimbursement Il` Il` Il` Il`
methods recommended in 1992 Il` Il` Il`
b. Competition from nonphysicians desiring Il` Il` Il` Il`
to meet primary care shortages
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c. The need for monopolistic control in the
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marketplace of primary outpatient care Il` Il` Il` Il`
d. The recognition that nonphysicians have
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variable success providing primary care Il` Il` Il` Il`
ANS: A Il`
The Physician Payment Review Commission in 1992 directly increased financial
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reimbursement to clinicians who provide primary care. Coupled with a shortage of
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primary care providers, this incentive led medical schools to place greater emphasis on
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preparing primary care physicians. Competition from nonphysicians increased
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coincidentally as professionals from other disciplines stepped up to meet the needs.
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Nonphysicians have had increasing success at providing primary care and have been
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shown to be safe and effective.
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DIF: Cognitive Level: Remembering (Knowledge) Il` Il` Il` REF: 2
2. Which of the following statements is true about the prescribing practices of physicians?
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a. Older physicians tend to prescribe more Il` Il` Il` Il` Il` Il`
appropriate medications than younger Il` Il` Il`
physicians.
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b. Antibiotic medications remain in the top Il` Il` Il` Il` Il` Il`
five classifications of medications
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prescribed.
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c. Most physicians rely on a “therapeutic Il` Il` Il` Il` Il` Il`
armamentarium” that consists of less than Il` Il` Il` Il` Il`
100 drug preparations per physician.
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d. The dominant form of drug information
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used by primary care physicians continues Il` Il` Il` Il` Il`
to be that provided by pharmaceutical
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companies.
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ANS: D Il`
Even though most physicians claim to place little weight on drug advertisements,
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pharmaceutical representatives, and patient preference and state that they rely on
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academic sources for drug information, a study showed that commercial rather than
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scientific sources of drug information dominated their drug information materials.
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Younger physicians tend to prescribe fewer and more appropriate drugs. Antibiotics have
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dropped out of the top five classifications of drugs prescribed. Most physicians have a
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therapeutic armamentarium of about 144 drugs.
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DIF: Cognitive Level: Remembering (Knowledge) Il` Il` Il` REF: 3
3. As primary care nurse practitioners (NPs) continue to develop their role as prescribers of
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Il` medications, it will be important to: Il` Il` Il` Il` Il`
a. attain the same level of expertise as Il` Il` Il` Il` Il` Il` Il`
physicians who currently prescribe Il` Il` Il`
medications.
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b. learn from the experiences of physicians Il` Il` Il` Il` Il` Il`
and develop expertise based on Il` Il` Il` Il`
evidencebased practice.
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c. maintain collaborative and supervisorial Il` Il` Il` Il`
relationships with physicians who will Il` Il` Il` Il`
oversee prescribing practices.
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d. develop relationships with pharmaceutical Il` Il` Il`
representatives to learn about new Il` Il` Il` Il`
medications as they are developed.
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ANS: B Il`
As nonphysicians develop the roles associated with prescriptive authority, it will be
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important to learn from the past experiences of physicians and to develop prescribing
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practices based on evidence-based medicine. It is hoped that all prescribers, including
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physicians and nurse practitioners, will strive to do better than in the past. NPs should
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work toward prescriptive authority and for practice that is not supervised by another
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professional. Pharmaceutical representatives provide information that carries some bias.
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Academic sources are better.
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DIF: Cognitive Level: Applying (Application) Il` Il` Il` REF: 4
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