ADVANCEDPHARMACOLOGYTEST BANKALL CHAP
t t t t t
TERS QUESTIONS AND ANSWERS WITH RATIONALES
t t t t t
Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change Te
t t t t t t t t t t
st Bank
t
MULTIPLEtCHOICE
1. Whichtoftthetfollowingthastinfluencedtantemphasistontprimarytcareteducationtintmedicaltscho
ols?
a. ChangestintMedicaretreimbursementtmetho
dstrecommendedtint1992
b. Competitiontfromtnonphysicianstdesiringtt
otmeettprimarytcaretshortages
c. Thetneedtfortmonopolistictcontroltintthetmar
ketplacetoftprimarytoutpatienttcare
d. Thetrecognitiontthattnonphysiciansthavetvar
iabletsuccesstprovidingtprimarytcare
ANS:t A
ThetPhysiciantPaymenttReviewtCommissiontint1992tdirectlytincreasedtfinancialtreimburse
mentttotclinicianstwhotprovidetprimarytcare.tCoupledtwithtatshortagetoftprimarytcaretprovide
rs,tthistincentivetledtmedicaltschoolsttotplacetgreatertemphasistontpreparingtprimarytcaretphy
sicians.tCompetitiontfromtnonphysicianstincreasedtcoincidentallytastprofessionalstfromtoth
ertdisciplineststeppedtupttotmeettthetneeds.
Nonphysiciansthavethadtincreasingtsuccesstattprovidingtprimarytcaretandthavetbeentshowntto
tbetsafetandteffective.
DIF: CognitivetLevel:tRememberingt(Knowledge) REF:t2
2. Whichtoftthetfollowingtstatementstisttruetabouttthetprescribingtpracticestoftphysicians?
a. Oldertphysiciansttendttotprescribetmoretappr
opriatetmedicationstthantyounger
physicians.
b. Antibiotictmedicationstremaintintthettoptfive
tclassificationstoftmedicationstprescribed.
c. Mosttphysicianstrelytontat“therapeutictarma
mentarium”tthattconsiststoftlesstthant100tdru
gtpreparationstpertphysician.
d. Thetdominanttformtoftdrugtinformationtuse
dtbytprimarytcaretphysicianstcontinuesttotbet
thattprovidedtbytpharmaceuticaltcompanies
.
, ANS:t D
Eventthoughtmosttphysicianstclaimttotplacetlittletweighttontdrugtadvertisements,
pharmaceuticaltrepresentatives,tandtpatienttpreferencetandtstatetthatttheytrelytontacademicts
ourcestfortdrugtinformation,tatstudytshowedtthattcommercialtrathertthantscientifictsourcestoft
drugtinformationtdominatedttheirtdrugtinformationtmaterials.tYoungertphysiciansttendttotpre
scribetfewertandtmoretappropriatetdrugs.tAntibioticsthavetdroppedtouttoftthettoptfivetclassific
ationstoftdrugstprescribed.tMosttphysiciansthavetattherapeutictarmamentariumtoftaboutt144td
rugs.
DIF: CognitivetLevel:tRememberingt(Knowledge) REF:t3
3. Astprimarytcaretnursetpractitionerst(NPs)tcontinuettotdevelopttheirtroletastprescriberstoftmed
ications,tittwilltbetimportanttto:
a. attaintthetsametleveltoftexpertisetastp
hysicianstwhotcurrentlytprescribetm
edications.
b. learntfromtthetexperiencestoftphysicianstan
dtdeveloptexpertisetbasedtontevidence-
tbasedtpractice.
c. maintaintcollaborativetandtsupervisorialtrel
ationshipstwithtphysicianstwhotwilltoverse
etprescribingtpractices.
d. developtrelationshipstwithtpharmaceuticaltr
epresentativesttotlearntabouttnewtmedicati
onstasttheytaretdeveloped.
ANS:t B
Astnonphysicianstdeveloptthetrolestassociatedtwithtprescriptivetauthority,tittwilltbetimportan
tttotlearntfromtthetpasttexperiencestoftphysicianstandttotdeveloptprescribingtpracticestbasedto
ntevidence-
basedtmedicine.tIttisthopedtthattalltprescribers,tincludingtphysicianstandtnursetpractitioners,t
willtstrivettotdotbettertthantintthetpast.tNPstshouldtworkttowardtprescriptivetauthoritytandtfort
practicetthattistnottsupervisedtbytanothertprofessional.tPharmaceuticaltrepresentativestprovi
detinformationtthattcarriestsometbias.tAcademictsourcestaretbetter.
DIF: CognitivetLevel:tApplyingt(Application) REF:t4
Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs, CN
t t t t t t t t t t t t
Ms, CRNAs, and CNSs) and Physician Assistants
t t t t t t
Test Bank
t
MULTIPLEtCHOICE
1. AtprimarytcaretNPtwilltbegintpracticingtintatstatetintwhichtthetgovernorthastoptedtouttoftthetfe
deraltfacilitytreimbursementtrequirement.tThetNPtshouldtbetawaretthattthistdefinesthowtNPst
maytwritetprescriptions:
, a. withouttphysiciantsupervisiontintprivatetpra
ctice.
b. astCRNAstwithouttphysiciantsupervisiontint
athospitaltsetting.
c. intanytsituationtbuttwilltnottbetreimbursedtfo
rtthistbytgovernmenttinsurers.
d. onlytwithtphysiciantsupervisiontintbothtpriv
atetpracticetandtathospitaltsetting.
ANS:t B
Int2001,tthetCenterstfortMedicaretandtMedicaidtServicestchangedtthetfederaltphysiciantsuper
visiontruletfortCRNAsttotallowtstatetgovernorsttotopttout,tallowingtCRNAsttotwritetprescripti
onstandtdispensetdrugstwithouttphysiciantsupervision.
DIF: CognitivetLevel:tUnderstandingt(Comprehension) REF:t9
2. CRNAstintmosttstates:
a. mustthavetatDrugtEnforcementtAdministrat
iont(DEA)tnumberttotpractice.
b. mustthavetprescriptivetauthorityttotpractice.
c. ordertandtadministertcontrolledtsubstancestb
uttdotnotthavetfulltprescriptivetauthority.
d. administertmedications,tincludingt
controlledtsubstances,tundertdirectt
physiciantsupervision.
ANS:t C
OnlytfivetstatestgranttindependenttprescriptivetauthorityttotCRNAs.tCRNAstdotnottrequiretp
rescriptivetauthoritytbecausettheytdispensetatdrugtimmediatelyttotatpatienttandtdotnottprescrib
e.tWithouttprescriptivetauthority,ttheytdotnottneedtatDEAtnumber.
DIF: CognitivetLevel:tUnderstandingt(Comprehension) REF:t9
3. AtCNM:
a. mayttreattonlytwomen.
b. hastprescriptivetauthoritytintallt50tstates.
c. maytadministertonlytdrugstusedtduringtlabor
tandtdelivery.
d. maytpracticetonlytintbirthingtcenterstandtho
metbirthtsettings.
ANS:t B
, CNMsthavetprescriptivetauthoritytintallt50tstates.tTheytmayttreattpartnerstoftwomentfortsexu
allyttransmittedtdiseases.tTheythavetfulltprescriptivetauthoritytandtaretnottlimitedttotdrugstus
edtduringtchildbirth.tTheytpracticetintmanytotherttypestoftsettings.
DIF:t t CognitivetLevel:tRememberingt(Knowledge) REF:t9
4. Inteverytstate,tprescriptivetauthoritytfortNPstincludestthetabilityttotwritetprescriptions:
a. fortcontrolledtsubstances.
b. fortspecifiedtclassificationstoftmedication
s.
c. withouttphysician-mandatedtinvolvement.
d. withtfull,tindependenttprescriptivetauthority
.
ANS:t B
AlltstatestnowthavetsometdegreetoftprescriptivetauthoritytgrantedttotNPs,tbuttnottalltstatestall
owtauthorityttotprescribetcontrolledtsubstances.tManytstateststilltrequiretsometdegreetoftphysi
ciantinvolvementtwithtcertainttypestoftdrugs.
DIF: CognitivetLevel:tUnderstandingt(Comprehension) REF:t12
5. ThetcurrentttrendttowardttransitioningtNPtprogramsttotthetdoctoraltleveltwilltmeantthat:
a. NPstlicensedtintonetstatetmaytpracticetintoth
ertstates.
b. fulltprescriptivetauthoritytwilltbetgrantedttot
alltNPstwithtdoctoraltdegrees.
c. NPstwilltbetbettertpreparedttotmeettemergin
gthealthtcaretneedstoftpatients.
d. requirementstfortphysiciantsupervisiontoftN
Pstwilltbetremovedtintalltstates.
ANS:t C
ThetAmericantAssociationtoftCollegestoftNursingthastrecommendedttransitioningtgraduatetl
eveltNPtprogramsttotthetdoctoraltleveltastatresponsettotchangestinthealthtcaretdeliverytandtem
ergingthealthtcaretneeds.tNPstwithtdoctoraltdegreestwilltnottnecessarilythavetfulltprescriptive
tauthoritytortbetfreedtfromtrequirementstabouttphysiciantsupervisiontbecausetthosetaretsubjec
tttotindividualtstatetlaws.tNPstwilltstilltbetrequiredttotmeettlicensuretrequirementstofteachtstate
.
DIF: CognitivetLevel:tUnderstandingt(Comprehension) REF:t12
6. Antimportanttdifferencetbetweentphysiciantassistantst(PAs)tandtNPstistPAs:
a. alwaystworktundertphysiciantsupervision.
b. aretnottrequiredttotfollowtdrugttreatment
t t t t t
TERS QUESTIONS AND ANSWERS WITH RATIONALES
t t t t t
Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change Te
t t t t t t t t t t
st Bank
t
MULTIPLEtCHOICE
1. Whichtoftthetfollowingthastinfluencedtantemphasistontprimarytcareteducationtintmedicaltscho
ols?
a. ChangestintMedicaretreimbursementtmetho
dstrecommendedtint1992
b. Competitiontfromtnonphysicianstdesiringtt
otmeettprimarytcaretshortages
c. Thetneedtfortmonopolistictcontroltintthetmar
ketplacetoftprimarytoutpatienttcare
d. Thetrecognitiontthattnonphysiciansthavetvar
iabletsuccesstprovidingtprimarytcare
ANS:t A
ThetPhysiciantPaymenttReviewtCommissiontint1992tdirectlytincreasedtfinancialtreimburse
mentttotclinicianstwhotprovidetprimarytcare.tCoupledtwithtatshortagetoftprimarytcaretprovide
rs,tthistincentivetledtmedicaltschoolsttotplacetgreatertemphasistontpreparingtprimarytcaretphy
sicians.tCompetitiontfromtnonphysicianstincreasedtcoincidentallytastprofessionalstfromtoth
ertdisciplineststeppedtupttotmeettthetneeds.
Nonphysiciansthavethadtincreasingtsuccesstattprovidingtprimarytcaretandthavetbeentshowntto
tbetsafetandteffective.
DIF: CognitivetLevel:tRememberingt(Knowledge) REF:t2
2. Whichtoftthetfollowingtstatementstisttruetabouttthetprescribingtpracticestoftphysicians?
a. Oldertphysiciansttendttotprescribetmoretappr
opriatetmedicationstthantyounger
physicians.
b. Antibiotictmedicationstremaintintthettoptfive
tclassificationstoftmedicationstprescribed.
c. Mosttphysicianstrelytontat“therapeutictarma
mentarium”tthattconsiststoftlesstthant100tdru
gtpreparationstpertphysician.
d. Thetdominanttformtoftdrugtinformationtuse
dtbytprimarytcaretphysicianstcontinuesttotbet
thattprovidedtbytpharmaceuticaltcompanies
.
, ANS:t D
Eventthoughtmosttphysicianstclaimttotplacetlittletweighttontdrugtadvertisements,
pharmaceuticaltrepresentatives,tandtpatienttpreferencetandtstatetthatttheytrelytontacademicts
ourcestfortdrugtinformation,tatstudytshowedtthattcommercialtrathertthantscientifictsourcestoft
drugtinformationtdominatedttheirtdrugtinformationtmaterials.tYoungertphysiciansttendttotpre
scribetfewertandtmoretappropriatetdrugs.tAntibioticsthavetdroppedtouttoftthettoptfivetclassific
ationstoftdrugstprescribed.tMosttphysiciansthavetattherapeutictarmamentariumtoftaboutt144td
rugs.
DIF: CognitivetLevel:tRememberingt(Knowledge) REF:t3
3. Astprimarytcaretnursetpractitionerst(NPs)tcontinuettotdevelopttheirtroletastprescriberstoftmed
ications,tittwilltbetimportanttto:
a. attaintthetsametleveltoftexpertisetastp
hysicianstwhotcurrentlytprescribetm
edications.
b. learntfromtthetexperiencestoftphysicianstan
dtdeveloptexpertisetbasedtontevidence-
tbasedtpractice.
c. maintaintcollaborativetandtsupervisorialtrel
ationshipstwithtphysicianstwhotwilltoverse
etprescribingtpractices.
d. developtrelationshipstwithtpharmaceuticaltr
epresentativesttotlearntabouttnewtmedicati
onstasttheytaretdeveloped.
ANS:t B
Astnonphysicianstdeveloptthetrolestassociatedtwithtprescriptivetauthority,tittwilltbetimportan
tttotlearntfromtthetpasttexperiencestoftphysicianstandttotdeveloptprescribingtpracticestbasedto
ntevidence-
basedtmedicine.tIttisthopedtthattalltprescribers,tincludingtphysicianstandtnursetpractitioners,t
willtstrivettotdotbettertthantintthetpast.tNPstshouldtworkttowardtprescriptivetauthoritytandtfort
practicetthattistnottsupervisedtbytanothertprofessional.tPharmaceuticaltrepresentativestprovi
detinformationtthattcarriestsometbias.tAcademictsourcestaretbetter.
DIF: CognitivetLevel:tApplyingt(Application) REF:t4
Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs, CN
t t t t t t t t t t t t
Ms, CRNAs, and CNSs) and Physician Assistants
t t t t t t
Test Bank
t
MULTIPLEtCHOICE
1. AtprimarytcaretNPtwilltbegintpracticingtintatstatetintwhichtthetgovernorthastoptedtouttoftthetfe
deraltfacilitytreimbursementtrequirement.tThetNPtshouldtbetawaretthattthistdefinesthowtNPst
maytwritetprescriptions:
, a. withouttphysiciantsupervisiontintprivatetpra
ctice.
b. astCRNAstwithouttphysiciantsupervisiontint
athospitaltsetting.
c. intanytsituationtbuttwilltnottbetreimbursedtfo
rtthistbytgovernmenttinsurers.
d. onlytwithtphysiciantsupervisiontintbothtpriv
atetpracticetandtathospitaltsetting.
ANS:t B
Int2001,tthetCenterstfortMedicaretandtMedicaidtServicestchangedtthetfederaltphysiciantsuper
visiontruletfortCRNAsttotallowtstatetgovernorsttotopttout,tallowingtCRNAsttotwritetprescripti
onstandtdispensetdrugstwithouttphysiciantsupervision.
DIF: CognitivetLevel:tUnderstandingt(Comprehension) REF:t9
2. CRNAstintmosttstates:
a. mustthavetatDrugtEnforcementtAdministrat
iont(DEA)tnumberttotpractice.
b. mustthavetprescriptivetauthorityttotpractice.
c. ordertandtadministertcontrolledtsubstancestb
uttdotnotthavetfulltprescriptivetauthority.
d. administertmedications,tincludingt
controlledtsubstances,tundertdirectt
physiciantsupervision.
ANS:t C
OnlytfivetstatestgranttindependenttprescriptivetauthorityttotCRNAs.tCRNAstdotnottrequiretp
rescriptivetauthoritytbecausettheytdispensetatdrugtimmediatelyttotatpatienttandtdotnottprescrib
e.tWithouttprescriptivetauthority,ttheytdotnottneedtatDEAtnumber.
DIF: CognitivetLevel:tUnderstandingt(Comprehension) REF:t9
3. AtCNM:
a. mayttreattonlytwomen.
b. hastprescriptivetauthoritytintallt50tstates.
c. maytadministertonlytdrugstusedtduringtlabor
tandtdelivery.
d. maytpracticetonlytintbirthingtcenterstandtho
metbirthtsettings.
ANS:t B
, CNMsthavetprescriptivetauthoritytintallt50tstates.tTheytmayttreattpartnerstoftwomentfortsexu
allyttransmittedtdiseases.tTheythavetfulltprescriptivetauthoritytandtaretnottlimitedttotdrugstus
edtduringtchildbirth.tTheytpracticetintmanytotherttypestoftsettings.
DIF:t t CognitivetLevel:tRememberingt(Knowledge) REF:t9
4. Inteverytstate,tprescriptivetauthoritytfortNPstincludestthetabilityttotwritetprescriptions:
a. fortcontrolledtsubstances.
b. fortspecifiedtclassificationstoftmedication
s.
c. withouttphysician-mandatedtinvolvement.
d. withtfull,tindependenttprescriptivetauthority
.
ANS:t B
AlltstatestnowthavetsometdegreetoftprescriptivetauthoritytgrantedttotNPs,tbuttnottalltstatestall
owtauthorityttotprescribetcontrolledtsubstances.tManytstateststilltrequiretsometdegreetoftphysi
ciantinvolvementtwithtcertainttypestoftdrugs.
DIF: CognitivetLevel:tUnderstandingt(Comprehension) REF:t12
5. ThetcurrentttrendttowardttransitioningtNPtprogramsttotthetdoctoraltleveltwilltmeantthat:
a. NPstlicensedtintonetstatetmaytpracticetintoth
ertstates.
b. fulltprescriptivetauthoritytwilltbetgrantedttot
alltNPstwithtdoctoraltdegrees.
c. NPstwilltbetbettertpreparedttotmeettemergin
gthealthtcaretneedstoftpatients.
d. requirementstfortphysiciantsupervisiontoftN
Pstwilltbetremovedtintalltstates.
ANS:t C
ThetAmericantAssociationtoftCollegestoftNursingthastrecommendedttransitioningtgraduatetl
eveltNPtprogramsttotthetdoctoraltleveltastatresponsettotchangestinthealthtcaretdeliverytandtem
ergingthealthtcaretneeds.tNPstwithtdoctoraltdegreestwilltnottnecessarilythavetfulltprescriptive
tauthoritytortbetfreedtfromtrequirementstabouttphysiciantsupervisiontbecausetthosetaretsubjec
tttotindividualtstatetlaws.tNPstwilltstilltbetrequiredttotmeettlicensuretrequirementstofteachtstate
.
DIF: CognitivetLevel:tUnderstandingt(Comprehension) REF:t12
6. Antimportanttdifferencetbetweentphysiciantassistantst(PAs)tandtNPstistPAs:
a. alwaystworktundertphysiciantsupervision.
b. aretnottrequiredttotfollowtdrugttreatment
