,Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change
g g g g g g g g g g
Test Bank
g
MULTIPLEgCHOICE
1. Whichgofgthegfollowingghasginfluencedgangemphasisgongprimarygcaregeducationgingmedicalgs
chools?
a. ChangesgingMedicaregreimbursementgmeth
odsgrecommendedging1992
b. Competitiongfromgnonphysiciansgdesiringgt
ogmeetgprimarygcaregshortages
c. Thegneedgforgmonopolisticgcontrolgingthegm
arketplacegofgprimarygoutpatientgcare
d. Thegrecognitiongthatgnonphysiciansghavegv
ariablegsuccessgprovidinggprimarygcare
ANS:g A
ThegPhysiciangPaymentgReviewgCommissionging1992gdirectlygincreasedgfinancialgreimbur
sementgtogcliniciansgwhogprovidegprimarygcare.gCoupledgwithgagshortagegofgprimarygcaregpr
oviders,gthisgincentivegledgmedicalgschoolsgtogplaceggreatergemphasisgongpreparinggprimaryg
caregphysicians.gCompetitiongfromgnonphysiciansgincreasedgcoincidentallygasgprofessional
sgfromgothergdisciplinesgsteppedgupgtogmeetgthegneeds.
Nonphysiciansghaveghadgincreasinggsuccessgatgprovidinggprimarygcaregandghavegbeengshow
ngtogbegsafegandgeffective.
DIF: CognitivegLevel:gRememberingg(Knowledge) REF:g g 2
2. Whichgofgthegfollowinggstatementsgisgtruegaboutgthegprescribinggpracticesgofgphysicians?
a. Oldergphysiciansgtendgtogprescribegmoregap
propriategmedicationsgthangyoungergphysic
ians.
b. Antibioticgmedicationsgremaingingthegtopgfi
vegclassificationsgofgmedicationsgprescribe
d.
c. Mostgphysiciansgrelygongag“therapeuticgarm
amentarium”gthatgconsistsgofglessgthang100g
druggpreparationsgpergphysician.
d. Thegdominantgformgofgdrugginformationgus
edgbygprimarygcaregphysiciansgcontinuesgtog
begthatgprovidedgbygpharmaceuticalgcompa
nies.
ANS:g D
Evengthoughgmostgphysiciansgclaimgtogplaceglittlegweightgongdruggadvertisements,
, pharmaceuticalgrepresentatives,gandgpatientgpreferencegandgstategthatgtheygrelygongacademi
cgsourcesgforgdrugginformation,gagstudygshowedgthatgcommercialgrathergthangscientificgsour
cesgofgdrugginformationgdominatedgtheirgdrugginformationgmaterials.gYoungergphysiciansgt
endgtogprescribegfewergandgmoregappropriategdrugs.gAntibioticsghavegdroppedgoutgofgthegtopg
fivegclassificationsgofgdrugsgprescribed.gMostgphysiciansghavegagtherapeuticgarmamentariu
mgofgaboutg144gdrugs.
DIF: CognitivegLevel:gRememberingg(Knowledge) REF:g g 3
3. Asgprimarygcaregnursegpractitionersg(NPs)gcontinuegtogdevelopgtheirgrolegasgprescribersgofg
medications,gitgwillgbegimportantgto:
a. attaingthegsameglevelgofgexpertisegasg
physiciansgwhogcurrentlygprescribeg
medications.
b. learngfromgthegexperiencesgofgphysiciansga
ndgdevelopgexpertisegbasedgongevidence-
gbasedgpractice.
c. maintaingcollaborativegandgsupervisorialgre
lationshipsgwithgphysiciansgwhogwillgovers
eegprescribinggpractices.
d. developgrelationshipsgwithgpharmaceuticalg
representativesgtoglearngaboutgnewgmedicat
ionsgasgtheygaregdeveloped.
ANS:g B
Asgnonphysiciansgdevelopgthegrolesgassociatedgwithgprescriptivegauthority,gitgwillgbegimport
antgtoglearngfromgthegpastgexperiencesgofgphysiciansgandgtogdevelopgprescribinggpracticesgba
sedgongevidence-
basedgmedicine.gItgisghopedgthatgallgprescribers,gincludinggphysiciansgandgnursegpractitioner
s,gwillgstrivegtogdogbettergthangingthegpast.gNPsgshouldgworkgtowardgprescriptivegauthoritygan
dgforgpracticegthatgisgnotgsupervisedgbyganothergprofessional.gPharmaceuticalgrepresentative
sgprovideginformationgthatgcarriesgsomegbias.gAcademicgsourcesgaregbetter.
DIF: CognitivegLevel:gApplyingg(Application) REF:g g 4
Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs, C
g g g g g g g g g g g g
NMs, CRNAs, and CNSs) and Physician Assistants
g g g g g g
Test Bank
g
MULTIPLEgCHOICE
1. AgprimarygcaregNPgwillgbegingpracticinggingagstategingwhichgtheggovernorghasgoptedgoutgofgt
hegfederalgfacilitygreimbursementgrequirement.gThegNPgshouldgbegawaregthatgthisgdefinesgh
owgNPsgmaygwritegprescriptions:
, a. withoutgphysiciangsupervisiongingprivategpr
actice.
b. asgCRNAsgwithoutgphysiciangsupervisiongi
ngaghospitalgsetting.
c. inganygsituationgbutgwillgnotgbegreimbursedg
forgthisgbyggovernmentginsurers.
d. onlygwithgphysiciangsupervisiongingbothgpri
vategpracticegandgaghospitalgsetting.
ANS:g B
Ing2001,gthegCentersgforgMedicaregandgMedicaidgServicesgchangedgthegfederalgphysiciangsu
pervisiongrulegforgCRNAsgtogallowgstateggovernorsgtogoptgout,gallowinggCRNAsgtogwritegpre
scriptionsgandgdispensegdrugsgwithoutgphysiciangsupervision.
DIF: CognitivegLevel:gUnderstandingg(Comprehension) REF:g g 9
2. CRNAsgingmostgstates:
a. mustghavegagDruggEnforcementgAdministr
ationg(DEA)gnumbergtogpractice.
b. mustghavegprescriptivegauthoritygtogpractice
.
c. ordergandgadministergcontrolledgsubstancesg
butgdognotghavegfullgprescriptivegauthority.
d. administergmedications,gincludinggcontroll
edgsubstances,gundergdirectgphysiciangsuper
vision.
ANS:g C
OnlygfivegstatesggrantgindependentgprescriptivegauthoritygtogCRNAs.gCRNAsgdognotgrequir
egprescriptivegauthoritygbecausegtheygdispensegagdruggimmediatelygtogagpatientgandgdognotgp
rescribe.gWithoutgprescriptivegauthority,gtheygdognotgneedgagDEAgnumber.
DIF: CognitivegLevel:gUnderstandingg(Comprehension) REF:g g 9
3. AgCNM:
a. maygtreatgonlygwomen.
b. hasgprescriptivegauthoritygingallg50gstates.
c. maygadministergonlygdrugsgusedgduringglab
organdgdelivery.
d. maygpracticegonlygingbirthinggcentersgandgh
omegbirthgsettings.
ANS:g B
g g g g g g g g g g
Test Bank
g
MULTIPLEgCHOICE
1. Whichgofgthegfollowingghasginfluencedgangemphasisgongprimarygcaregeducationgingmedicalgs
chools?
a. ChangesgingMedicaregreimbursementgmeth
odsgrecommendedging1992
b. Competitiongfromgnonphysiciansgdesiringgt
ogmeetgprimarygcaregshortages
c. Thegneedgforgmonopolisticgcontrolgingthegm
arketplacegofgprimarygoutpatientgcare
d. Thegrecognitiongthatgnonphysiciansghavegv
ariablegsuccessgprovidinggprimarygcare
ANS:g A
ThegPhysiciangPaymentgReviewgCommissionging1992gdirectlygincreasedgfinancialgreimbur
sementgtogcliniciansgwhogprovidegprimarygcare.gCoupledgwithgagshortagegofgprimarygcaregpr
oviders,gthisgincentivegledgmedicalgschoolsgtogplaceggreatergemphasisgongpreparinggprimaryg
caregphysicians.gCompetitiongfromgnonphysiciansgincreasedgcoincidentallygasgprofessional
sgfromgothergdisciplinesgsteppedgupgtogmeetgthegneeds.
Nonphysiciansghaveghadgincreasinggsuccessgatgprovidinggprimarygcaregandghavegbeengshow
ngtogbegsafegandgeffective.
DIF: CognitivegLevel:gRememberingg(Knowledge) REF:g g 2
2. Whichgofgthegfollowinggstatementsgisgtruegaboutgthegprescribinggpracticesgofgphysicians?
a. Oldergphysiciansgtendgtogprescribegmoregap
propriategmedicationsgthangyoungergphysic
ians.
b. Antibioticgmedicationsgremaingingthegtopgfi
vegclassificationsgofgmedicationsgprescribe
d.
c. Mostgphysiciansgrelygongag“therapeuticgarm
amentarium”gthatgconsistsgofglessgthang100g
druggpreparationsgpergphysician.
d. Thegdominantgformgofgdrugginformationgus
edgbygprimarygcaregphysiciansgcontinuesgtog
begthatgprovidedgbygpharmaceuticalgcompa
nies.
ANS:g D
Evengthoughgmostgphysiciansgclaimgtogplaceglittlegweightgongdruggadvertisements,
, pharmaceuticalgrepresentatives,gandgpatientgpreferencegandgstategthatgtheygrelygongacademi
cgsourcesgforgdrugginformation,gagstudygshowedgthatgcommercialgrathergthangscientificgsour
cesgofgdrugginformationgdominatedgtheirgdrugginformationgmaterials.gYoungergphysiciansgt
endgtogprescribegfewergandgmoregappropriategdrugs.gAntibioticsghavegdroppedgoutgofgthegtopg
fivegclassificationsgofgdrugsgprescribed.gMostgphysiciansghavegagtherapeuticgarmamentariu
mgofgaboutg144gdrugs.
DIF: CognitivegLevel:gRememberingg(Knowledge) REF:g g 3
3. Asgprimarygcaregnursegpractitionersg(NPs)gcontinuegtogdevelopgtheirgrolegasgprescribersgofg
medications,gitgwillgbegimportantgto:
a. attaingthegsameglevelgofgexpertisegasg
physiciansgwhogcurrentlygprescribeg
medications.
b. learngfromgthegexperiencesgofgphysiciansga
ndgdevelopgexpertisegbasedgongevidence-
gbasedgpractice.
c. maintaingcollaborativegandgsupervisorialgre
lationshipsgwithgphysiciansgwhogwillgovers
eegprescribinggpractices.
d. developgrelationshipsgwithgpharmaceuticalg
representativesgtoglearngaboutgnewgmedicat
ionsgasgtheygaregdeveloped.
ANS:g B
Asgnonphysiciansgdevelopgthegrolesgassociatedgwithgprescriptivegauthority,gitgwillgbegimport
antgtoglearngfromgthegpastgexperiencesgofgphysiciansgandgtogdevelopgprescribinggpracticesgba
sedgongevidence-
basedgmedicine.gItgisghopedgthatgallgprescribers,gincludinggphysiciansgandgnursegpractitioner
s,gwillgstrivegtogdogbettergthangingthegpast.gNPsgshouldgworkgtowardgprescriptivegauthoritygan
dgforgpracticegthatgisgnotgsupervisedgbyganothergprofessional.gPharmaceuticalgrepresentative
sgprovideginformationgthatgcarriesgsomegbias.gAcademicgsourcesgaregbetter.
DIF: CognitivegLevel:gApplyingg(Application) REF:g g 4
Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs, C
g g g g g g g g g g g g
NMs, CRNAs, and CNSs) and Physician Assistants
g g g g g g
Test Bank
g
MULTIPLEgCHOICE
1. AgprimarygcaregNPgwillgbegingpracticinggingagstategingwhichgtheggovernorghasgoptedgoutgofgt
hegfederalgfacilitygreimbursementgrequirement.gThegNPgshouldgbegawaregthatgthisgdefinesgh
owgNPsgmaygwritegprescriptions:
, a. withoutgphysiciangsupervisiongingprivategpr
actice.
b. asgCRNAsgwithoutgphysiciangsupervisiongi
ngaghospitalgsetting.
c. inganygsituationgbutgwillgnotgbegreimbursedg
forgthisgbyggovernmentginsurers.
d. onlygwithgphysiciangsupervisiongingbothgpri
vategpracticegandgaghospitalgsetting.
ANS:g B
Ing2001,gthegCentersgforgMedicaregandgMedicaidgServicesgchangedgthegfederalgphysiciangsu
pervisiongrulegforgCRNAsgtogallowgstateggovernorsgtogoptgout,gallowinggCRNAsgtogwritegpre
scriptionsgandgdispensegdrugsgwithoutgphysiciangsupervision.
DIF: CognitivegLevel:gUnderstandingg(Comprehension) REF:g g 9
2. CRNAsgingmostgstates:
a. mustghavegagDruggEnforcementgAdministr
ationg(DEA)gnumbergtogpractice.
b. mustghavegprescriptivegauthoritygtogpractice
.
c. ordergandgadministergcontrolledgsubstancesg
butgdognotghavegfullgprescriptivegauthority.
d. administergmedications,gincludinggcontroll
edgsubstances,gundergdirectgphysiciangsuper
vision.
ANS:g C
OnlygfivegstatesggrantgindependentgprescriptivegauthoritygtogCRNAs.gCRNAsgdognotgrequir
egprescriptivegauthoritygbecausegtheygdispensegagdruggimmediatelygtogagpatientgandgdognotgp
rescribe.gWithoutgprescriptivegauthority,gtheygdognotgneedgagDEAgnumber.
DIF: CognitivegLevel:gUnderstandingg(Comprehension) REF:g g 9
3. AgCNM:
a. maygtreatgonlygwomen.
b. hasgprescriptivegauthoritygingallg50gstates.
c. maygadministergonlygdrugsgusedgduringglab
organdgdelivery.
d. maygpracticegonlygingbirthinggcentersgandgh
omegbirthgsettings.
ANS:g B
