ADVANCEDPHARMACOLOGYTEST BANKALL
| | | |
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: | B
In |2001, |the |Centers |for |Medicare |and |Medicaid |Services |changed |the |federal |physician
|supervision |rule |for |CRNAs |to |allow |state |governors |to |opt |out, |allowing |CRNAs |to |write
|prescriptions |and |dispense |drugs |without |physician |supervision.
DIF: Cognitive |Level: |Understanding |(Comprehension) REF: |9
2. CRNAs |in |most |states:
a. must |have |a |Drug |Enforcement
|Administration |(DEA) |number |to |practice.
b. must |have |prescriptive |authority|to |practice.
c. order |and |administer |controlled |substances
|but |do |not |have |full |prescriptive |authority.
d. administer |medications, |including
|controlled |substances, |under |direct
|physician |supervision.
ANS: | C
Only |five |states |grant |independent |prescriptive |authority |to |CRNAs. |CRNAs |do |not |require
|prescriptive |authority |because |they |dispense |a |drug |immediately |to |a |patient |and |do |not
|prescribe. |Without |prescriptive |authority, |they |do |not |need |a |DEA |number.
DIF: Cognitive |Level: |Understanding |(Comprehension) REF: |9
3. A |CNM:
a. may |treat |only |women.
b. has |prescriptive |authority |in |all |50 |states.
c. may|administer |only|drugs |used |during
|labor |and |delivery.
d. may|practice |only|in |birthing |centers |and
|home |birth |settings.
ANS: | B
, CNMs |have |prescriptive |authority |in |all |50 |states. |They |may |treat |partners |of |women |for
|sexually |transmitted |diseases. |They |have |full |prescriptive |authority |and |are |not |limited |to
|drugs |used |during |childbirth. |They |practice |in |many |other |types |of |settings.
DIF: | | Cognitive |Level: |Remembering |(Knowledge) REF: |9
4. In |every |state, |prescriptive |authority |for |NPs |includes |the |ability |to |write |prescriptions:
a. for |controlled |substances.
b. for |specified |classifications |of
|medications.
c. without |physician-mandated |involvement.
d. with |full, |independent |prescriptive
|authority.
ANS: | B
All |states |now |have |some |degree |of |prescriptive |authority |granted |to |NPs, |but |not |all |states
|allow |authority |to |prescribe |controlled |substances. |Many |states |still |require |some |degree |of
|physician |involvement |with |certain |types |of |drugs.
DIF: Cognitive |Level: |Understanding |(Comprehension) REF: |12
5. The |current |trend |toward |transitioning |NP |programs |to |the |doctoral |level |will |mean |that:
a. NPs |licensed |in |one |state |may|practice |in
|other |states.
b. full |prescriptive |authority|will |be |granted |to
|all |NPs |with |doctoral |degrees.
c. NPs |will |be |better |prepared |to |meet
|emerging |health |care |needs |of |patients.
d. requirements |for |physician |supervision |of
|NPs |will |be |removed |in |all |states.
ANS: | C
The |American |Association |of |Colleges |of |Nursing |has |recommended |transitioning
|graduate |level |NP |programs |to |the |doctoral |level |as |a |response |to |changes |in |health |care
|delivery |and |emerging |health |care |needs. |NPs |with |doctoral |degrees |will |not |necessarily
|have |full |prescriptive |authority |or |be |freed |from |requirements |about |physician |supervision
|because |those |are |subject |to |individual |state |laws. |NPs |will |still |be |required |to |meet |licensure
|requirements |of |each |state.
DIF: Cognitive |Level: |Understanding |(Comprehension) REF: |12
6. An |important |difference |between |physician |assistants |(PAs) |and |NPs |is |PAs:
a. always |work |under |physician |supervision.
b. are |not |required |to |follow |drug |treatment
| | | |
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: | B
In |2001, |the |Centers |for |Medicare |and |Medicaid |Services |changed |the |federal |physician
|supervision |rule |for |CRNAs |to |allow |state |governors |to |opt |out, |allowing |CRNAs |to |write
|prescriptions |and |dispense |drugs |without |physician |supervision.
DIF: Cognitive |Level: |Understanding |(Comprehension) REF: |9
2. CRNAs |in |most |states:
a. must |have |a |Drug |Enforcement
|Administration |(DEA) |number |to |practice.
b. must |have |prescriptive |authority|to |practice.
c. order |and |administer |controlled |substances
|but |do |not |have |full |prescriptive |authority.
d. administer |medications, |including
|controlled |substances, |under |direct
|physician |supervision.
ANS: | C
Only |five |states |grant |independent |prescriptive |authority |to |CRNAs. |CRNAs |do |not |require
|prescriptive |authority |because |they |dispense |a |drug |immediately |to |a |patient |and |do |not
|prescribe. |Without |prescriptive |authority, |they |do |not |need |a |DEA |number.
DIF: Cognitive |Level: |Understanding |(Comprehension) REF: |9
3. A |CNM:
a. may |treat |only |women.
b. has |prescriptive |authority |in |all |50 |states.
c. may|administer |only|drugs |used |during
|labor |and |delivery.
d. may|practice |only|in |birthing |centers |and
|home |birth |settings.
ANS: | B
, CNMs |have |prescriptive |authority |in |all |50 |states. |They |may |treat |partners |of |women |for
|sexually |transmitted |diseases. |They |have |full |prescriptive |authority |and |are |not |limited |to
|drugs |used |during |childbirth. |They |practice |in |many |other |types |of |settings.
DIF: | | Cognitive |Level: |Remembering |(Knowledge) REF: |9
4. In |every |state, |prescriptive |authority |for |NPs |includes |the |ability |to |write |prescriptions:
a. for |controlled |substances.
b. for |specified |classifications |of
|medications.
c. without |physician-mandated |involvement.
d. with |full, |independent |prescriptive
|authority.
ANS: | B
All |states |now |have |some |degree |of |prescriptive |authority |granted |to |NPs, |but |not |all |states
|allow |authority |to |prescribe |controlled |substances. |Many |states |still |require |some |degree |of
|physician |involvement |with |certain |types |of |drugs.
DIF: Cognitive |Level: |Understanding |(Comprehension) REF: |12
5. The |current |trend |toward |transitioning |NP |programs |to |the |doctoral |level |will |mean |that:
a. NPs |licensed |in |one |state |may|practice |in
|other |states.
b. full |prescriptive |authority|will |be |granted |to
|all |NPs |with |doctoral |degrees.
c. NPs |will |be |better |prepared |to |meet
|emerging |health |care |needs |of |patients.
d. requirements |for |physician |supervision |of
|NPs |will |be |removed |in |all |states.
ANS: | C
The |American |Association |of |Colleges |of |Nursing |has |recommended |transitioning
|graduate |level |NP |programs |to |the |doctoral |level |as |a |response |to |changes |in |health |care
|delivery |and |emerging |health |care |needs. |NPs |with |doctoral |degrees |will |not |necessarily
|have |full |prescriptive |authority |or |be |freed |from |requirements |about |physician |supervision
|because |those |are |subject |to |individual |state |laws. |NPs |will |still |be |required |to |meet |licensure
|requirements |of |each |state.
DIF: Cognitive |Level: |Understanding |(Comprehension) REF: |12
6. An |important |difference |between |physician |assistants |(PAs) |and |NPs |is |PAs:
a. always |work |under |physician |supervision.
b. are |not |required |to |follow |drug |treatment
