Pharmacotherapeutics for Advanced Practice
Nurse Prescribers with Davis Edge
6th Edition
Legal Authority, Clinical Judgment & Rational Drug Selection
1. A newly licensed nurse practitioner is reviewing their legal
authority to prescribe medications. Which regulatory body
primarily governs nurse practitioner prescriptive authority?
A. Federal Drug Administration (FDA)
B. State Board of Nursing
C. Drug Enforcement Administration (DEA)
D. Institutional Pharmacy and Therapeutics Committee
Correct Answer: B
Rationale: Nurse practitioner prescriptive authority is primarily
regulated by the State Board of Nursing for each state, which
defines the scope of practice, including prescribing . The FDA
regulates drug approval and safety, not individual prescriber
authority. The DEA controls prescribing of controlled substances
but does not grant the overall authority to prescribe.
Institutional committees set local formularies but do not govern
a practitioner's legal right to prescribe.
Teaching Point: Prescriptive authority is state-specific and
granted by the State Board of Nursing.
Reference: Ch. 1, Section: Legal and Professional Issues in
Prescribing
,2. When formulating a treatment plan for a patient with
hypertension, which action best demonstrates the clinical
judgment of an Advanced Practice Registered Nurse (APRN)
prescriber?
A. Selecting the newest antihypertensive medication available
on the market
B. Factoring in the patient's financial situation and the cost of
the medication
C. Prescribing the same medication that was effective for the
previous patient
D. Delegating the final drug choice to the clinical pharmacist
Correct Answer: B
Rationale: Clinical judgment in prescribing includes considering
patient-specific factors such as the cost of the medication to the
patient to enhance adherence and treatment success . Simply
choosing the newest drug or mimicking a previous prescription
does not constitute sound clinical judgment. The APRN is
responsible for the final prescribing decision and should not
delegate this responsibility.
Teaching Point: Effective clinical judgment integrates patient-
specific factors like cost to promote adherence.
Reference: Ch. 1, Section: Rational Drug Selection
3. A patient-centered benefit of having an Advanced Practice
Registered Nurse (APRN) as a prescriber is that APRNs:
A. Primarily rely on clinical protocols to ensure standardized
care for all patients.
,B. Care for the patient from a holistic approach and include the
patient in decision-making.
C. Focus exclusively on the pharmacological management of the
disease.
D. Typically schedule shorter follow-up intervals than other
providers.
Correct Answer: B
Rationale: APRNs are trained to provide holistic, patient-
centered care, which includes collaborating with patients and
involving them in decisions regarding their treatment plan .
While protocols may inform care, they are not applied rigidly
without considering individual patient needs. A focus solely on
pharmacology or scheduling more visits are not defining
benefits of the APRN role.
Teaching Point: APRN prescribers provide holistic care and
partner with patients in shared decision-making.
Reference: Ch. 1, Section: The Role of the Nurse Practitioner as
Prescriber
4. What is the most appropriate initial step in the process of
choosing an effective drug for a newly diagnosed disorder?
A. Prescribing a broad-spectrum drug to cover multiple
potential etiologies
B. Consulting nationally recognized guidelines for disease
management
C. Selecting a drug based on its extensive direct-to-consumer
advertising
, D. Choosing the drug with the fewest reported adverse effects
Correct Answer: B
Rationale: The process for choosing an effective drug includes
consulting nationally recognized, evidence-based guidelines for
disease management to ensure rational, effective, and standard
care . While avoiding adverse effects is important, it should be
considered within the context of guideline recommendations.
Prescribing broadly or based on advertising is not evidence-
based.
Teaching Point: Rational drug selection begins with consulting
evidence-based, national guidelines.
Reference: Ch. 1, Section: Rational Drug Selection
5. An APRN is preparing to prescribe a medication for a
patient. Which action is the most critical for promoting
rational pharmacotherapeutics?
A. Using the trade name of the drug to ensure brand
consistency.
B. Selecting a drug based on a single recent positive study.
C. Applying knowledge of pharmacogenetics to guide drug
choice.
D. Prescribing the same drug used by a family member with the
same condition.
Correct Answer: C
Rationale: Rational drug selection involves using the best
available evidence, which now includes applying
pharmacogenetics to personalize therapy and improve efficacy
Nurse Prescribers with Davis Edge
6th Edition
Legal Authority, Clinical Judgment & Rational Drug Selection
1. A newly licensed nurse practitioner is reviewing their legal
authority to prescribe medications. Which regulatory body
primarily governs nurse practitioner prescriptive authority?
A. Federal Drug Administration (FDA)
B. State Board of Nursing
C. Drug Enforcement Administration (DEA)
D. Institutional Pharmacy and Therapeutics Committee
Correct Answer: B
Rationale: Nurse practitioner prescriptive authority is primarily
regulated by the State Board of Nursing for each state, which
defines the scope of practice, including prescribing . The FDA
regulates drug approval and safety, not individual prescriber
authority. The DEA controls prescribing of controlled substances
but does not grant the overall authority to prescribe.
Institutional committees set local formularies but do not govern
a practitioner's legal right to prescribe.
Teaching Point: Prescriptive authority is state-specific and
granted by the State Board of Nursing.
Reference: Ch. 1, Section: Legal and Professional Issues in
Prescribing
,2. When formulating a treatment plan for a patient with
hypertension, which action best demonstrates the clinical
judgment of an Advanced Practice Registered Nurse (APRN)
prescriber?
A. Selecting the newest antihypertensive medication available
on the market
B. Factoring in the patient's financial situation and the cost of
the medication
C. Prescribing the same medication that was effective for the
previous patient
D. Delegating the final drug choice to the clinical pharmacist
Correct Answer: B
Rationale: Clinical judgment in prescribing includes considering
patient-specific factors such as the cost of the medication to the
patient to enhance adherence and treatment success . Simply
choosing the newest drug or mimicking a previous prescription
does not constitute sound clinical judgment. The APRN is
responsible for the final prescribing decision and should not
delegate this responsibility.
Teaching Point: Effective clinical judgment integrates patient-
specific factors like cost to promote adherence.
Reference: Ch. 1, Section: Rational Drug Selection
3. A patient-centered benefit of having an Advanced Practice
Registered Nurse (APRN) as a prescriber is that APRNs:
A. Primarily rely on clinical protocols to ensure standardized
care for all patients.
,B. Care for the patient from a holistic approach and include the
patient in decision-making.
C. Focus exclusively on the pharmacological management of the
disease.
D. Typically schedule shorter follow-up intervals than other
providers.
Correct Answer: B
Rationale: APRNs are trained to provide holistic, patient-
centered care, which includes collaborating with patients and
involving them in decisions regarding their treatment plan .
While protocols may inform care, they are not applied rigidly
without considering individual patient needs. A focus solely on
pharmacology or scheduling more visits are not defining
benefits of the APRN role.
Teaching Point: APRN prescribers provide holistic care and
partner with patients in shared decision-making.
Reference: Ch. 1, Section: The Role of the Nurse Practitioner as
Prescriber
4. What is the most appropriate initial step in the process of
choosing an effective drug for a newly diagnosed disorder?
A. Prescribing a broad-spectrum drug to cover multiple
potential etiologies
B. Consulting nationally recognized guidelines for disease
management
C. Selecting a drug based on its extensive direct-to-consumer
advertising
, D. Choosing the drug with the fewest reported adverse effects
Correct Answer: B
Rationale: The process for choosing an effective drug includes
consulting nationally recognized, evidence-based guidelines for
disease management to ensure rational, effective, and standard
care . While avoiding adverse effects is important, it should be
considered within the context of guideline recommendations.
Prescribing broadly or based on advertising is not evidence-
based.
Teaching Point: Rational drug selection begins with consulting
evidence-based, national guidelines.
Reference: Ch. 1, Section: Rational Drug Selection
5. An APRN is preparing to prescribe a medication for a
patient. Which action is the most critical for promoting
rational pharmacotherapeutics?
A. Using the trade name of the drug to ensure brand
consistency.
B. Selecting a drug based on a single recent positive study.
C. Applying knowledge of pharmacogenetics to guide drug
choice.
D. Prescribing the same drug used by a family member with the
same condition.
Correct Answer: C
Rationale: Rational drug selection involves using the best
available evidence, which now includes applying
pharmacogenetics to personalize therapy and improve efficacy
