MN 553 exam questions with answers
|\ |\ |\ |\ |\
Prescriptive Authority - CORRECT ANSWERS ✔✔*States |\ |\ |\ |\ |\ |\
vary in their laws related to prescriptive authority for
|\ |\ |\ |\ |\ |\ |\ |\ |\
APRNs.
*Scope of practice is determined by the individual NP's
|\ |\ |\ |\ |\ |\ |\ |\ |\
license under the nurse practice act of the licensing
|\ |\ |\ |\ |\ |\ |\ |\ |\
jurisdiction. Some have a graduated scope based on |\ |\ |\ |\ |\ |\ |\ |\
experience level. New prescribers need to understand |\ |\ |\ |\ |\ |\ |\
that their employment sites may restrict this legal scope
|\ |\ |\ |\ |\ |\ |\ |\ |\
of practice but cannot extend it.
|\ |\ |\ |\ |\
Prescribing - CORRECT ANSWERS ✔✔•Ensure that |\ |\ |\ |\ |\ |\
prescribing practices meet current standards of medical|\ |\ |\ |\ |\ |\ |\
care.
•Maintain accurate and thorough documentation of
|\ |\ |\ |\ |\ |\
prescribing practices. |\
•Engage in informative and interactive informed consent
|\ |\ |\ |\ |\ |\ |\
discussions that allocate appropriate responsibility |\ |\ |\ |\ |\
between physician and patient. |\ |\ |\
•Evaluate split treatment arrangements and supervisory
|\ |\ |\ |\ |\ |\
settings to ensure that your supervisees have the
|\ |\ |\ |\ |\ |\ |\ |\
training, ability, and resources to provide high-quality
|\ |\ |\ |\ |\ |\ |\
medical care. |\
•Your State Practice Act-What are your limits in
|\ |\ |\ |\ |\ |\ |\ |\
prescribing?
,•Your State Board of Nursing
|\ |\ |\ |\
•Your Role and Licensure |\ |\ |\
•National Certification and Credentialing |\ |\ |\
*Prescribing a drug results from clinical judgment based |\ |\ |\ |\ |\ |\ |\ |\
on a thorough assessment of the patient and the patient's
|\ |\ |\ |\ |\ |\ |\ |\ |\
environment, the determination of medical and nursing
|\ |\ |\ |\ |\ |\ |\ |\
diagnoses, a review of potential alternative therapies, and |\ |\ |\ |\ |\ |\ |\
specific knowledge about the drug chosen and the
|\ |\ |\ |\ |\ |\ |\ |\ |\
disease process it is designed to treat. In general, the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
best therapy is the least invasive, least expensive, and
|\ |\ |\ |\ |\ |\ |\ |\ |\
least likely to cause adverse reactions. Frequently, the
|\ |\ |\ |\ |\ |\ |\ |\
best choice is to have lifestyle, nonpharmacological, and
|\ |\ |\ |\ |\ |\ |\ |\
pharmacological therapies working together. |\ |\ |\
Writing and Transmitting the Prescription - CORRECT
|\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔1. Use preprinted prescription |\ |\ |\ |\
pads/electronic templates that contain the name,
|\ |\ |\ |\ |\ |\ |\
address, telephone number, and NPI number of the |\ |\ |\ |\ |\ |\ |\ |\
prescriber. This will allow the pharmacist to contact the |\ |\ |\ |\ |\ |\ |\ |\ |\
prescriber if there are any questions about the |\ |\ |\ |\ |\ |\ |\ |\
prescription.
2. Designate the complete drug name, strength, dosage,
|\ |\ |\ |\ |\ |\ |\ |\
form and number to dispense.
|\ |\ |\ |\
3. Indicate the date of the prescription.
|\ |\ |\ |\ |\ |\
4. Use metric units of measure, such as milligrams and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
milliliters; avoid apothecary units of measure. |\ |\ |\ |\ |\
5. Avoid abbreviations.
|\ |\
,6. Avoid the use of "as directed" or "as needed."
|\ |\ |\ |\ |\ |\ |\ |\ |\
7. Include the general indication, such as "for infection."
|\ |\ |\ |\ |\ |\ |\ |\
8. Indicate "Dispense as Written" if generic substitution is
|\ |\ |\ |\ |\ |\ |\ |\ |\
not desired. |\
9. Include the patient weight, especially if pediatric or
|\ |\ |\ |\ |\ |\ |\ |\ |\
geriatric.
10. Indicate if a safety cap is not required, as medications
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
will be dispensed with them by default.
|\ |\ |\ |\ |\ |\ |\
ETHICAL ASPECTS OF PRESCRIBING - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\
✔✔Informed Consent |\
-The notion of informed consent is shorthand for the
|\ |\ |\ |\ |\ |\ |\ |\ |\
patient's right to make informed decisions about those
|\ |\ |\ |\ |\ |\ |\ |\
things that will affect him or her.
|\ |\ |\ |\ |\ |\
Prescribing for Self, Family, or Friends |\ |\ |\ |\ |\
-State law varies regarding whether an NP can prescribe
|\ |\ |\ |\ |\ |\ |\ |\ |\
for family or friends. For a prescription to be clinically
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
legitimate, a patient must be assessed and there must be |\ |\ |\ |\ |\ |\ |\ |\ |\
a record of his or her assessment. It is clearly unethical to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
prescribe for oneself, and many states punish this with
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
significant fines or board action. Although it may be |\ |\ |\ |\ |\ |\ |\ |\ |\
technically legal to prescribe for family or friends, an NP |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
needs to consider whether it is ethical. If the clinical
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
circumstance requires a controlled substance, the |\ |\ |\ |\ |\ |\
judicious prescriber will refer a friend or family member to
|\ |\ |\ |\ |\ |\ |\ |\ |\
, a colleague for confidential assessment and treatment. It
|\ |\ |\ |\ |\ |\ |\ |\ |\
is never considered ethical for a mental health provider to
|\ |\ |\ |\ |\ |\ |\ |\ |\
engage a family member or close friend in a clinically
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
therapeutic relationship, whether or not prescribing is |\ |\ |\ |\ |\ |\ |\
involved.
Sale of Pharmaceuticals and Supplements
|\ |\ |\ |\
-It is illegal to sell pharmaceuticals that are designated as
|\ |\ |\ |\ |\ |\ |\ |\ |\
samples and provided to a clinic for free distribution to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
patients. Depending on the dispensing laws of the state, |\ |\ |\ |\ |\ |\ |\ |\ |\
it may be permissible to stock and sell limited amounts of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
commonly prescribed medications within the practice
|\ |\ |\ |\ |\ |\ |\
setting. It may also be permissible to sell supplements
|\ |\ |\ |\ |\ |\ |\ |\ |\
such as prenatal vitamins or fish oil, especially if the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
prescriber is able to order them at a discount and pass |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the savings on to the patient. It may not be technically
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
illegal but can be ethically questionable if the prescriber
|\ |\ |\ |\ |\ |\ |\ |\ |\
is selling medications with a broad profit margin to
|\ |\ |\ |\ |\ |\ |\ |\ |\
patients who may be perceived as vulnerable. |\ |\ |\ |\ |\ |\
First Pass effect - CORRECT ANSWERS ✔✔•Oral meds are
|\ |\ |\ |\ |\ |\ |\ |\ |\
generally absorbed by the GI tract and carried to the liver. |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Drug may undergo extensive metabolism leaving little for
|\ |\ |\ |\ |\ |\ |\ |\
systemic use. This is called the first pass effect.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Are rapidly metabolized by the liver & may have little if
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
any desired action.
|\ |\
|\ |\ |\ |\ |\
Prescriptive Authority - CORRECT ANSWERS ✔✔*States |\ |\ |\ |\ |\ |\
vary in their laws related to prescriptive authority for
|\ |\ |\ |\ |\ |\ |\ |\ |\
APRNs.
*Scope of practice is determined by the individual NP's
|\ |\ |\ |\ |\ |\ |\ |\ |\
license under the nurse practice act of the licensing
|\ |\ |\ |\ |\ |\ |\ |\ |\
jurisdiction. Some have a graduated scope based on |\ |\ |\ |\ |\ |\ |\ |\
experience level. New prescribers need to understand |\ |\ |\ |\ |\ |\ |\
that their employment sites may restrict this legal scope
|\ |\ |\ |\ |\ |\ |\ |\ |\
of practice but cannot extend it.
|\ |\ |\ |\ |\
Prescribing - CORRECT ANSWERS ✔✔•Ensure that |\ |\ |\ |\ |\ |\
prescribing practices meet current standards of medical|\ |\ |\ |\ |\ |\ |\
care.
•Maintain accurate and thorough documentation of
|\ |\ |\ |\ |\ |\
prescribing practices. |\
•Engage in informative and interactive informed consent
|\ |\ |\ |\ |\ |\ |\
discussions that allocate appropriate responsibility |\ |\ |\ |\ |\
between physician and patient. |\ |\ |\
•Evaluate split treatment arrangements and supervisory
|\ |\ |\ |\ |\ |\
settings to ensure that your supervisees have the
|\ |\ |\ |\ |\ |\ |\ |\
training, ability, and resources to provide high-quality
|\ |\ |\ |\ |\ |\ |\
medical care. |\
•Your State Practice Act-What are your limits in
|\ |\ |\ |\ |\ |\ |\ |\
prescribing?
,•Your State Board of Nursing
|\ |\ |\ |\
•Your Role and Licensure |\ |\ |\
•National Certification and Credentialing |\ |\ |\
*Prescribing a drug results from clinical judgment based |\ |\ |\ |\ |\ |\ |\ |\
on a thorough assessment of the patient and the patient's
|\ |\ |\ |\ |\ |\ |\ |\ |\
environment, the determination of medical and nursing
|\ |\ |\ |\ |\ |\ |\ |\
diagnoses, a review of potential alternative therapies, and |\ |\ |\ |\ |\ |\ |\
specific knowledge about the drug chosen and the
|\ |\ |\ |\ |\ |\ |\ |\ |\
disease process it is designed to treat. In general, the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
best therapy is the least invasive, least expensive, and
|\ |\ |\ |\ |\ |\ |\ |\ |\
least likely to cause adverse reactions. Frequently, the
|\ |\ |\ |\ |\ |\ |\ |\
best choice is to have lifestyle, nonpharmacological, and
|\ |\ |\ |\ |\ |\ |\ |\
pharmacological therapies working together. |\ |\ |\
Writing and Transmitting the Prescription - CORRECT
|\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔1. Use preprinted prescription |\ |\ |\ |\
pads/electronic templates that contain the name,
|\ |\ |\ |\ |\ |\ |\
address, telephone number, and NPI number of the |\ |\ |\ |\ |\ |\ |\ |\
prescriber. This will allow the pharmacist to contact the |\ |\ |\ |\ |\ |\ |\ |\ |\
prescriber if there are any questions about the |\ |\ |\ |\ |\ |\ |\ |\
prescription.
2. Designate the complete drug name, strength, dosage,
|\ |\ |\ |\ |\ |\ |\ |\
form and number to dispense.
|\ |\ |\ |\
3. Indicate the date of the prescription.
|\ |\ |\ |\ |\ |\
4. Use metric units of measure, such as milligrams and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
milliliters; avoid apothecary units of measure. |\ |\ |\ |\ |\
5. Avoid abbreviations.
|\ |\
,6. Avoid the use of "as directed" or "as needed."
|\ |\ |\ |\ |\ |\ |\ |\ |\
7. Include the general indication, such as "for infection."
|\ |\ |\ |\ |\ |\ |\ |\
8. Indicate "Dispense as Written" if generic substitution is
|\ |\ |\ |\ |\ |\ |\ |\ |\
not desired. |\
9. Include the patient weight, especially if pediatric or
|\ |\ |\ |\ |\ |\ |\ |\ |\
geriatric.
10. Indicate if a safety cap is not required, as medications
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
will be dispensed with them by default.
|\ |\ |\ |\ |\ |\ |\
ETHICAL ASPECTS OF PRESCRIBING - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\
✔✔Informed Consent |\
-The notion of informed consent is shorthand for the
|\ |\ |\ |\ |\ |\ |\ |\ |\
patient's right to make informed decisions about those
|\ |\ |\ |\ |\ |\ |\ |\
things that will affect him or her.
|\ |\ |\ |\ |\ |\
Prescribing for Self, Family, or Friends |\ |\ |\ |\ |\
-State law varies regarding whether an NP can prescribe
|\ |\ |\ |\ |\ |\ |\ |\ |\
for family or friends. For a prescription to be clinically
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
legitimate, a patient must be assessed and there must be |\ |\ |\ |\ |\ |\ |\ |\ |\
a record of his or her assessment. It is clearly unethical to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
prescribe for oneself, and many states punish this with
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
significant fines or board action. Although it may be |\ |\ |\ |\ |\ |\ |\ |\ |\
technically legal to prescribe for family or friends, an NP |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
needs to consider whether it is ethical. If the clinical
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
circumstance requires a controlled substance, the |\ |\ |\ |\ |\ |\
judicious prescriber will refer a friend or family member to
|\ |\ |\ |\ |\ |\ |\ |\ |\
, a colleague for confidential assessment and treatment. It
|\ |\ |\ |\ |\ |\ |\ |\ |\
is never considered ethical for a mental health provider to
|\ |\ |\ |\ |\ |\ |\ |\ |\
engage a family member or close friend in a clinically
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
therapeutic relationship, whether or not prescribing is |\ |\ |\ |\ |\ |\ |\
involved.
Sale of Pharmaceuticals and Supplements
|\ |\ |\ |\
-It is illegal to sell pharmaceuticals that are designated as
|\ |\ |\ |\ |\ |\ |\ |\ |\
samples and provided to a clinic for free distribution to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
patients. Depending on the dispensing laws of the state, |\ |\ |\ |\ |\ |\ |\ |\ |\
it may be permissible to stock and sell limited amounts of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
commonly prescribed medications within the practice
|\ |\ |\ |\ |\ |\ |\
setting. It may also be permissible to sell supplements
|\ |\ |\ |\ |\ |\ |\ |\ |\
such as prenatal vitamins or fish oil, especially if the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
prescriber is able to order them at a discount and pass |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the savings on to the patient. It may not be technically
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
illegal but can be ethically questionable if the prescriber
|\ |\ |\ |\ |\ |\ |\ |\ |\
is selling medications with a broad profit margin to
|\ |\ |\ |\ |\ |\ |\ |\ |\
patients who may be perceived as vulnerable. |\ |\ |\ |\ |\ |\
First Pass effect - CORRECT ANSWERS ✔✔•Oral meds are
|\ |\ |\ |\ |\ |\ |\ |\ |\
generally absorbed by the GI tract and carried to the liver. |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Drug may undergo extensive metabolism leaving little for
|\ |\ |\ |\ |\ |\ |\ |\
systemic use. This is called the first pass effect.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Are rapidly metabolized by the liver & may have little if
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
any desired action.
|\ |\
