ADVANCED PHARMACOLOGY TEST BANK, QUESTIONS AND ANSWERS WITH RATIONALES

ADVANCEDPHARMACOLOGYTEST BANKALL n n n n




CHAPTERS QUESTIONS AND ANSWERS WITH
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RATIONALES n




Chapter 01: Prescriptive Authority and Role 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 in Medicare reimbursement n n n



methods recommended in 1992
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b. Competition from nonphysicians desiring n n n



to meet primary care shortages
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c. The need for monopolistic control in the
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marketplace of primary outpatient care
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d. The recognition that nonphysicians 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
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primary care providers, this incentive led medical schools to place greater emphasis on
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preparing primary care physicians. Competition from nonphysicians increased
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coincidentally as 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
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to be safe and effective.
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DIF: Cognitive Level: Remembering (Knowledge)
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2. Which of the following statements is true about the prescribing practices of physicians?
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a. Older physicians tend to prescribe more n n n n n



appropriate medications than younger
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physicians.
b. Antibiotic medications remain in the top n n n n n



five classifications of medications
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prescribed.
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c. Most physicians rely on a “therapeutic
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armamentarium” that consists of less than
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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 by primary care physicians continues
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to 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
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sources of drug information dominated their drug information materials. Younger
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physicians tend to prescribe fewer and more appropriate drugs. Antibiotics have dropped out
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of the top five classifications of drugs prescribed. Most physicians have a therapeutic
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armamentarium of 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 on evidence-
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based practice.
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c. maintain collaborative and supervisorial n n n



relationships with physicians who will
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oversee prescribing practices.
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d. develop relationships with pharmaceutical 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
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work toward prescriptive authority and for practice that is not supervised by another
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professional. Pharmaceutical representatives provide information that carries some bias.
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Academic 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 in private n n n n



practice.
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b. as CRNAs without physician supervision in
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a hospital setting.
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c. in any situation but will not be reimbursed
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for this by government insurers.
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d. only with physician 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 Enforcement n n n n



Administration (DEA) number to practice.
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b. must have prescriptive authority to practice.
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c. order and 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. may administer only drugs used during
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labor and delivery.
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d. may practice only in 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. for specified classifications of
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medications.
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c. without physician-mandated involvement. n n




d. with full, independent prescriptive
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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 authority will be granted 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 care needs of patients.
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d. requirements for physician supervision of 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
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graduate level NP programs to the doctoral level as a response to changes in health care
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delivery and emerging health care needs. NPs with doctoral degrees will not necessarily
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have full prescriptive authority or be freed from requirements about physician supervision
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because 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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