TEST BANK FOR PHARMACOLOGY FOR PRIMARY PROVIDER 4TH EDITION EDMUNDS//UPDATED

TEST BANK FOR
ix ix




PHARMACOLOGY
ix




FOR PRIMARY
x
i ix




PROVIDER 4TH
ix ix




EDITION
ix




EDMUNDS
ix

,Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change
ix ix ix ix ix ix ix ix ix


Test Bank
ix ix




MULTIPLE CHOICE ix




1. Which of the following has influenced an emphasis on primary care education in
ix ix ix ix ix ix ix ix ix ix ix ix


medical schools?
ix ix



a. Changes in Medicare reimbursement ix ix ix


methods recommended in 1992
ix ix ix ix




b. Competition from nonphysicians desiring ix ix ix


to meet primary care shortages
ix ix ix ix ix




c. The need for monopolistic control in the
ix ix ix ix ix ix


marketplace of primary outpatient care
ix ix ix ix ix




d. The recognition that nonphysicians have
ix ix ix ix


variable success providing primary care
ix ix ix ix ix




ANS: A ix


The Physician Payment Review Commission in 1992 directly increased financial
ix ix ix ix ix ix ix ix ix


reimbursement to clinicians who provide primary care. Coupled with a shortage of
ix ix ix ix ix ix ix ix ix ix ix ix


primary care providers, this incentive led medical schools to place greater emphasis on
ix ix ix ix ix ix ix ix ix ix ix ix ix


preparing primary care physicians. Competition from nonphysicians increased
ix ix ix ix ix ix ix ix


coincidentally as professionals from other disciplines stepped up to meet the needs.
ix ix ix ix ix ix ix ix ix ix ix ix


Nonphysicians have had increasing success at providing primary care and have
ix ix ix ix ix ix ix ix ix ix


been shown to be safe and effective.
ix ix ix ix ix ix ix




DIF: Cognitive Level: Remembering (Knowledge)
ix ix ix REF: i x 2

2. Which of the following statements is true about the prescribing practices of physicians?
ix ix ix ix ix ix ix ix ix ix ix ix



a. Older physicians tend to prescribe more
ix ix ix ix ix


appropriate medications than younger
ix ix ix ix


physicians.
ix




b. Antibiotic medications remain in the top ix ix ix ix ix


five classifications of medications
ix ix ix ix


prescribed.
ix




c. Most physicians rely on a “therapeutic
ix ix ix ix ix


armamentarium” that consists of less than
ix ix ix ix ix ix


100 drug preparations per physician.
ix ix ix ix



d. The dominant form of drug information
ix ix ix ix ix


used by primary care physicians
ix ix ix ix ix


continues to be that provided by
ix ix ix ix ix ix


pharmaceutical companies.
ix ix




ANS: D ix


Even though most physicians claim to place little weight on drug advertisements,
ix ix ix ix ix ix ix ix ix ix ix




1

, pharmaceutical representatives, and patient preference and state that they rely on
ix ix ix ix ix ix ix ix ix ix


academic sources for drug information, a study showed that commercial rather than
ix ix ix ix ix ix ix ix ix ix ix ix


scientific sources of drug information dominated their drug information materials.
ix ix ix ix ix ix ix ix ix ix


Younger physicians tend to prescribe fewer and more appropriate drugs. Antibiotics have
ix ix ix ix ix ix ix ix ix ix ix ix


dropped out of the top five classifications of drugs prescribed. Most physicians have a
ix ix ix ix ix ix ix ix ix ix ix ix ix ix


therapeutic armamentarium of about 144 drugs.
ix ix ix ix ix ix




DIF: Cognitive Level: Remembering (Knowledge) ix ix ix REF: i x 3

3. As primary care nurse practitioners (NPs) continue to develop their role as prescribers
ix ix ix ix ix ix ix ix ix ix ix ix


of medications, it will be important to:
ix ix ix ix ix ix ix



a. attain the same level of expertise as
ix ix ix ix ix ix


physicians who currently prescribe ix ix ix


medications.
ix




b. learn from the experiences of physicians
ix ix ix ix ix


and develop expertise based on evidence-
ix ix ix ix ix ix


based practice.
ix ix




c. maintain collaborative and supervisorial ix ix ix


relationships with physicians who will
ix ix ix ix ix


oversee prescribing practices.
ix ix ix




d. develop relationships with pharmaceutical ix ix ix


representatives to learn about new
ix ix ix ix ix


medications as they are developed.
ix ix ix ix ix




ANS: B ix


As nonphysicians develop the roles associated with prescriptive authority, it will be
ix ix ix ix ix ix ix ix ix ix ix


important to learn from the past experiences of physicians and to develop prescribing
ix ix ix ix ix ix ix ix ix ix ix ix ix


practices based on evidence-based medicine. It is hoped that all prescribers, including
ix ix ix ix ix ix ix ix ix ix ix ix


physicians and nurse practitioners, will strive to do better than in the past. NPs should
ix ix ix ix ix ix ix ix ix ix ix ix ix ix ix


work toward prescriptive authority and for practice that is not supervised by another
ix ix ix ix ix ix ix ix ix ix ix ix ix


professional. Pharmaceutical representatives provide information that carries some bias.
ix ix ix ix ix ix ix ix ix


Academic sources are better.
ix ix ix ix




DIF: Cognitive Level: Applying (Application) ix ix ix REF: i x 4

Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs,
ix ix ix ix ix ix ix ix ix ix ix


CNMs, CRNAs, and CNSs) and Physician Assistants
ix ix ix ix ix ix ix


Test Bank
ix




MULTIPLE CHOICE ix




1. A primary care NP will begin practicing in a state in which the governor has opted out
ix ix ix ix ix ix ix ix ix ix ix ix ix ix ix ix


of the federal facility reimbursement requirement. The NP should be aware that this
ix ix ix ix ix ix ix ix ix ix ix ix ix


defines how NPs may write prescriptions:
ix ix ix ix ix ix




2

, a. without physician supervision in private ix ix ix ix


practice.
ix




b. as CRNAs without physician supervision
ix ix ix ix


in a hospital setting.
ix ix ix ix




c. in any situation but will not be reimbursed
ix ix ix ix ix ix ix


for this by government insurers.
ix ix ix ix ix




d. only with physician supervision in both
ix ix ix ix ix


private practice and a hospital setting.
ix ix ix ix ix ix




ANS: B ix


In 2001, the Centers for Medicare and Medicaid Services changed the federal
ix ix ix ix ix ix ix ix ix ix ix


physician supervision rule for CRNAs to allow state governors to opt out, allowing
ix ix ix ix ix ix ix ix ix ix ix ix ix


CRNAs to write prescriptions and dispense drugs without physician supervision.
ix ix ix ix ix ix ix ix ix ix




DIF: Cognitive Level: Understanding (Comprehension)
ix ix ix REF: i x 9

2. CRNAs in most states: ix ix ix



a. must have a Drug Enforcement
ix ix ix ix


Administration (DEA) number to practice.
ix ix ix ix ix




b. must have prescriptive authority to
ix ix ix ix


practice.
ix




c. order and administer controlled substances
ix ix ix ix


but do not have full prescriptive
ix ix ix ix ix ix


authority.
ix



d. administer medications, including ix ix


controlled substances, under
ix ix ix


direct physician supervision.
ix ix ix




ANS: C ix


Only five states grant independent prescriptive authority to CRNAs. CRNAs do not
ix ix ix ix ix ix ix ix ix ix ix


require prescriptive authority because they dispense a drug immediately to a patient
ix ix ix ix ix ix ix ix ix ix ix ix


and do not prescribe. Without prescriptive authority, they do not need a DEA number.
ix ix ix ix ix ix ix ix ix ix ix ix ix ix




DIF: Cognitive Level: Understanding (Comprehension)
ix ix ix REF: i x 9

3. A CNM:
ix



a. may treat only women.ix ix ix



b. has prescriptive authority in all 50 states.
ix ix ix ix ix ix



c. may administer only drugs used during
ix ix ix ix ix


labor and delivery.
ix ix ix




d. may practice only in birthing centers and
ix ix ix ix ix ix


home birth settings.
ix ix ix




ANS: B ix




3