Test Bank for Edmunds' Pharmacology for the Primary Care
Provider 5th Edition by Visovsky, Zambroski, and Lutz
, Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change
Test Bank
MULTIPLE CHOICE
1. What factor has contributed to the growing focus on primary care training in medical schools?
a. Adjustments in Medicare payment structures introduced in 1992
b. Growing competition from nonphysician providers addressing primary care gaps
c. A push for dominant control in the outpatient primary care market
d. Awareness of inconsistent outcomes from nonphysician primary care delivery
Correct Answer: A
In 1992, the Physician Payment Review Commission recommended improved financial incentives for
clinicians offering primary care services. Combined with the shortage of such providers, this led to a stronger
focus on primary care education in medical programs. Although nonphysician competition also increased
around that time, it was a secondary influence. Studies have shown nonphysicians can provide primary care
safely and effectively.
DIF: Cognitive Level: Remembering (Knowledge) REF: 2
2. Which of the following is accurate concerning physician prescribing habits?
a. Older doctors usually choose medications more appropriately than their younger peers
b. Antibiotics are still among the top five most commonly prescribed drug categories
c. Physicians typically use a personal list of fewer than 100 drug formulations
d. The main source of drug information for primary care doctors is pharmaceutical companies
Correct Answer: D
Although physicians often claim they rely on scientific literature and discount pharmaceutical promotions,
studies reveal that industry sources still dominate their drug information. In reality, younger physicians are
more likely to prescribe suitable medications. Antibiotics are no longer in the top five prescribed drug classes,
and most physicians maintain a working list of about 144 medications.
DIF: Cognitive Level: Remembering (Knowledge) REF: 3
3. As nurse practitioners (NPs) expand their role in prescribing medications, which approach is most
important?
a. Achieving the same prescribing proficiency as physicians
b. Drawing on physicians' experiences and applying evidence-based methods
c. Maintaining collaborative, supervised relationships with doctors for prescribing
d. Building connections with drug representatives to stay informed on new treatments
Correct Answer: B
,As NPs gain more authority to prescribe, it's critical to learn from the successes and missteps of physicians
and rely on evidence-based practices. The goal is for all prescribers to improve standards, not simply mimic
past practices. NPs are encouraged to seek independent practice rights without physician oversight. While
pharmaceutical reps may offer new drug info, academic resources are generally more trustworthy.
DIF: Cognitive Level: Applying (Application) REF: 4
, Chapter02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs,
CNMs, CRNAs, and CNSs) and Physician Assistants
MULTIPLE CHOICE
1. A primary care nurse practitioner is about to begin work in a state where the governor has chosen to
opt out of the federal reimbursement rule. What does this mean for the NP’s prescribing authority?
a. They may prescribe independently in private practice settings.
b. As a CRNA, they may prescribe without a physician’s oversight in hospital settings.
c. They can prescribe in all contexts but won’t be reimbursed by government insurance programs.
d. They are only permitted to prescribe under physician supervision in both private and hospital practices.
Correct Answer: B
In 2001, the Centers for Medicare and Medicaid Services revised the federal requirement for physician
oversight of CRNAs, allowing governors to opt out and permit CRNAs to prescribe and administer
medications independently in hospitals.
DIF: Cognitive Level: Understanding (Comprehension) REF: 9
2. In the majority of U.S. states, Certified Registered Nurse Anesthetists (CRNAs):
a. Are required to have a DEA number to practice
b. Must hold full prescriptive authority to work
c. Can give and manage controlled drugs but lack full prescribing authority
d. Must administer medications, including controlled ones, under a doctor’s direct supervision
Correct Answer: C
Only a few states grant CRNAs independent prescriptive authority. CRNAs typically administer medications
directly rather than writing prescriptions, so full prescriptive authority and a DEA number are often
unnecessary.
DIF: Cognitive Level: Understanding (Comprehension) REF: 9
3. Certified Nurse-Midwives (CNMs):
a. Can only care for female patients
b. Are authorized to prescribe medications in every U.S. state
c. Are limited to administering drugs used during labor
d. Practice solely in home or birthing center environments
Correct Answer: B
CNMs have the legal authority to prescribe medications in all 50 states. They can also treat male partners for
Provider 5th Edition by Visovsky, Zambroski, and Lutz
, Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change
Test Bank
MULTIPLE CHOICE
1. What factor has contributed to the growing focus on primary care training in medical schools?
a. Adjustments in Medicare payment structures introduced in 1992
b. Growing competition from nonphysician providers addressing primary care gaps
c. A push for dominant control in the outpatient primary care market
d. Awareness of inconsistent outcomes from nonphysician primary care delivery
Correct Answer: A
In 1992, the Physician Payment Review Commission recommended improved financial incentives for
clinicians offering primary care services. Combined with the shortage of such providers, this led to a stronger
focus on primary care education in medical programs. Although nonphysician competition also increased
around that time, it was a secondary influence. Studies have shown nonphysicians can provide primary care
safely and effectively.
DIF: Cognitive Level: Remembering (Knowledge) REF: 2
2. Which of the following is accurate concerning physician prescribing habits?
a. Older doctors usually choose medications more appropriately than their younger peers
b. Antibiotics are still among the top five most commonly prescribed drug categories
c. Physicians typically use a personal list of fewer than 100 drug formulations
d. The main source of drug information for primary care doctors is pharmaceutical companies
Correct Answer: D
Although physicians often claim they rely on scientific literature and discount pharmaceutical promotions,
studies reveal that industry sources still dominate their drug information. In reality, younger physicians are
more likely to prescribe suitable medications. Antibiotics are no longer in the top five prescribed drug classes,
and most physicians maintain a working list of about 144 medications.
DIF: Cognitive Level: Remembering (Knowledge) REF: 3
3. As nurse practitioners (NPs) expand their role in prescribing medications, which approach is most
important?
a. Achieving the same prescribing proficiency as physicians
b. Drawing on physicians' experiences and applying evidence-based methods
c. Maintaining collaborative, supervised relationships with doctors for prescribing
d. Building connections with drug representatives to stay informed on new treatments
Correct Answer: B
,As NPs gain more authority to prescribe, it's critical to learn from the successes and missteps of physicians
and rely on evidence-based practices. The goal is for all prescribers to improve standards, not simply mimic
past practices. NPs are encouraged to seek independent practice rights without physician oversight. While
pharmaceutical reps may offer new drug info, academic resources are generally more trustworthy.
DIF: Cognitive Level: Applying (Application) REF: 4
, Chapter02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs,
CNMs, CRNAs, and CNSs) and Physician Assistants
MULTIPLE CHOICE
1. A primary care nurse practitioner is about to begin work in a state where the governor has chosen to
opt out of the federal reimbursement rule. What does this mean for the NP’s prescribing authority?
a. They may prescribe independently in private practice settings.
b. As a CRNA, they may prescribe without a physician’s oversight in hospital settings.
c. They can prescribe in all contexts but won’t be reimbursed by government insurance programs.
d. They are only permitted to prescribe under physician supervision in both private and hospital practices.
Correct Answer: B
In 2001, the Centers for Medicare and Medicaid Services revised the federal requirement for physician
oversight of CRNAs, allowing governors to opt out and permit CRNAs to prescribe and administer
medications independently in hospitals.
DIF: Cognitive Level: Understanding (Comprehension) REF: 9
2. In the majority of U.S. states, Certified Registered Nurse Anesthetists (CRNAs):
a. Are required to have a DEA number to practice
b. Must hold full prescriptive authority to work
c. Can give and manage controlled drugs but lack full prescribing authority
d. Must administer medications, including controlled ones, under a doctor’s direct supervision
Correct Answer: C
Only a few states grant CRNAs independent prescriptive authority. CRNAs typically administer medications
directly rather than writing prescriptions, so full prescriptive authority and a DEA number are often
unnecessary.
DIF: Cognitive Level: Understanding (Comprehension) REF: 9
3. Certified Nurse-Midwives (CNMs):
a. Can only care for female patients
b. Are authorized to prescribe medications in every U.S. state
c. Are limited to administering drugs used during labor
d. Practice solely in home or birthing center environments
Correct Answer: B
CNMs have the legal authority to prescribe medications in all 50 states. They can also treat male partners for
