Advanced Pharmacology Final Exam UTA Questions and Answers (Graded A)

ADVANCEDPHARMACOLOGYTESTBANKALL n n n n




CHAPTERS QUESTIONS AND ANSWERS WITH
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RATIONALES n




Chapter 01: Prescriptive Authority andRole Implementation: Tradition vs. Change
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Test Bank
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MULTIPLE CHOICE n




1. Which of the following has influenced an emphasis on primary care education in medical
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n schools?
a. Changes inMedicarereimbursement n n n




methods recommended in 1992
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b. Competitionfrom nonphysicians desiring to n n n n




meet primary care shortages
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c. Theneed for monopolistic control in the
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marketplace of primary outpatient care
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d. Therecognition thatnonphysicians have
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variable success providing primary care
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ANS: A n




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 primary
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care providers, this incentive led medical schools to place greater emphasis on preparing
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primary care physicians. Competition from nonphysicians increased coincidentally as
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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 shown to
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be safe and effective.
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DIF: Cognitive Level: Remembering (Knowledge) n n n REF: 2 n




2. Which of the following statements is true about the prescribing practices of physicians?
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a. Olderphysicians tend to prescribemore
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appropriate medications than younger
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physicians.
b. Antibioticmedications remain inthetop five n n n n n n




classifications of medications prescribed.
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c. Most physicians rely on a “therapeutic
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armamentarium”that consists oflessthan
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100 drug preparations per physician.
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d. The dominant form of drug information
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used byprimarycarephysicians continues to
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be that provided by pharmaceutical
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companies.
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, ANS: D n




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 academic n n n n n n n n n n n




sources for drug information, a study showed that commercial rather than scientific sources
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of drug information dominated their drug information materials. Youngerphysicians tend to
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prescribe fewer and more appropriate drugs.Antibiotics have dropped out of the top five
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classifications of drugs prescribed. Most physicians have a therapeutic armamentarium of
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about 144 drugs.
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DIF: Cognitive Level: Remembering (Knowledge) n n n REF: 3 n




3. As primary care nurse practitioners (NPs) continue to develop their role as prescribers of
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n medications, it will be important to: n n n n n




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




physicians who currently prescribe
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medications.
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b. learn from the experiences of physicians
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and develop expertise based onevidence-
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based practice.
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c. maintaincollaborative andsupervisorial n n n




relationships with physicians who will
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oversee prescribing practices.
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d. develop relationships withpharmaceutical n n n




representatives to learn about new
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medications as they are developed.
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ANS: B n




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 work
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toward prescriptive authority and for practice that is not supervised by another professional.
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Pharmaceutical representatives provide information that carries some bias. Academic
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sources are better.
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DIF: Cognitive Level: Applying (Application) n n n REF: 4 n




Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs,
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CNMs, CRNAs, and CNSs) and Physician Assistants
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Test Bank
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MULTIPLE CHOICE n




1. A primary care NP will begin practicing in a state in which the governor has opted out of the
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federal facility reimbursement requirement. The NP should be aware that this defines how
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NPs may write prescriptions:
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, a. without physician supervision inprivate n n n n




practice.
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b. as CRNAswithoutphysician supervision in
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a hospital setting.
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c. in anysituation but will not be reimbursed for
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this by government insurers.
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d. only withphysician supervision in both
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private practice and a hospital setting.
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ANS: B n




In 2001, the Centers for Medicare and Medicaid Services changed the federal physician
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supervision rule for CRNAs to allow state governors to opt out, allowing CRNAs to write
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prescriptions and dispense drugs without physician supervision.
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DIF: Cognitive Level: Understanding (Comprehension)
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2. CRNAs in most states: n n n




a. must have a Drug Enforcementn n n n




Administration(DEA)numbertopractice.
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b. musthaveprescriptiveauthority to practice.
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c. orderand administer controlled substances
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but do not have full prescriptive authority.
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d. administer medications, including n n




controlled substances, under direct
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physician supervision.
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ANS: C n




Only five states grant independent prescriptive authority to CRNAs. CRNAs do not require
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prescriptive authority because they dispense a drug immediately to a patient and do not
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prescribe. Without prescriptive authority, they do not need a DEA number.
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DIF: Cognitive Level: Understanding (Comprehension)
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3. A CNM:
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a. may treat only women. n n n




b. has prescriptive authority in all 50 states.
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c. mayadministeronly drugs used during labor
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and delivery.
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d. maypracticeonlyin birthing centers and
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home birth settings.
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ANS: B n

, CNMs have prescriptive authority in all 50 states. They may treat partners of women for
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sexually transmitted diseases. They have full prescriptive authority and are not limited to
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drugs used during childbirth. They practice in many other types of settings.
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DIF: n n Cognitive Level: Remembering (Knowledge) n n n REF: 9 n




4. In every state, prescriptive authority for NPs includes the ability to write prescriptions:
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a. for controlled substances.
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b. forspecified classifications of
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medications.
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c. without physician-mandated involvement. n n




d. with full,independent prescriptive n n n




authority.
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ANS: B n




All states now have some degree of prescriptive authority granted to NPs, but not all states
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allow authority to prescribe controlled substances. Many states still require some degree of
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physician involvement with certain types of drugs.
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DIF: Cognitive Level: Understanding (Comprehension) n n n REF: 12 n




5. The current trend toward transitioning NP programs to the doctoral level will mean that:
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a. NPs licensed in one state may practice in
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other states.
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b. full prescriptive authoritywill begranted to
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all NPs with doctoral degrees.
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c. NPs will be better prepared to meet
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emerging health careneeds ofpatients.
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d. requirements forphysician supervisionof n n n n




NPs will be removed in all states.
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ANS: C n




The American Association of Colleges of Nursing has recommended transitioning graduate
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level NP programs to the doctoral level as a response to changes in health care delivery and
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emerging health care needs. NPs with doctoral degrees will not necessarily have full
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prescriptive authority or be freed from requirements about physician supervision because
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those are subject to individual state laws. NPs will still be required to meet licensure
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requirements of each state.
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DIF: Cognitive Level: Understanding (Comprehension) n n n REF: 12 n




6. An important difference between physician assistants (PAs)and NPs is PAs:
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a. always work under physician supervision. n n n n




b. are not required to follow drug treatment
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