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Test Bank - Pharmacology for the Primary Care Provider, 4th Edition (Edmunds, 2014), Chapter 1-73 | All Chapters

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Test Bank - Pharmacology for the Primary Care Provider, 4th Edition (Edmunds, 2014), Chapter 1-73 | All Chapters

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Pharmacology For The Primary Care Provider, 4e
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Pharmacology for the Primary Care Provider, 4e











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Material




Test Bank - Pharmacology for the Primary
Care Provider, 4th Edition (Edmunds, 2014),
Chapter 1-73 | All Chapters

Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change
p3 p3 p3 p3 p3 p3 p3 p3 p3




Test Bank
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MULTIPLE CHOICE p3




1. Which of the following has influenced an emphasis on primary care education in
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medical schools?
p3 p3




a. Changes in Medicare reimbursement p3 p3 p3



methods recommended in 1992
p3 p3 p3 p3




b. Competition from nonphysicians desiring p3 p3 p3



to meet primary care shortages
p3 p3 p3 p3 p3




c. The need for monopolistic control in the
p3 p3 p3 p3 p3 p3



marketplace of primary outpatient care
p3 p3 p3 p3 p3




d. The recognition that nonphysicians have
p3 p3 p3 p3



variable success providing primary care
p3 p3 p3 p3 p3




ANS: A p3



The Physician Payment Review Commission in 1992 directly increased financial
p3 p3 p3 p3 p3 p3 p3 p3 p3



reimbursement to clinicians who provide primary care. Coupled with a shortage of
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



primary care providers, this incentive led medical schools to place greater emphasis on
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



preparing primary care physicians. Competition from nonphysicians increased
p3 p3 p3 p3 p3 p3 p3 p3



coincidentally as professionals from other disciplines stepped up to meet the needs.
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



Nonphysicians have had increasing success at providing primary care and have been
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



shown to be safe and effective.
p3 p3 p3 p3 p3 p3




DIF: Cognitive Level: Remembering (Knowledge)
p3 p3 p3 REF: p 3 2

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
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appropriate medications than younger
p3 p3 p3 p3



physicians.
p3




b. Antibiotic medications remain in the top p3 p3 p3 p3 p3



five classifications of medications
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prescribed.
p3




c. Most physicians rely on a ―therapeutic
p3 p3 p3 p3 p3



armamentarium‖ that consists of less than
p3 p3 p3 p3 p3 p3



100 drug preparations per physician.
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d. The dominant form of drug information
p3 p3 p3 p3 p3



used by primary care physicians continues
p3 p3 p3 p3 p3 p3



to be that provided by pharmaceutical
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companies.
p3




ANS: D p3




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p3



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p3 p3 p3 p3 p3 p3 p3 p3 p3



p3 p3
Material
Even though most physicians
p3 claim to place little weight on drug advertisements,
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Downloaded by: SuperA |
p3 p3 p3



p3



Distribution of this document is illegal

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p3 p3 p3 p3 p3 p3 p3 p3 p3


Material




Pharmaceutical representatives, and patient preference and state that they rely on
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



academic sources for drug information, a study showed that commercial rather than
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



scientific sources of drug information dominated their drug information materials.
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



Younger physicians tend to prescribe fewer and more appropriate drugs. Antibiotics have
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dropped out of the top five classifications of drugs prescribed. Most physicians have a
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



therapeutic armamentarium of about 144 drugs.
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DIF: Cognitive Level: Remembering (Knowledge) p3 p3 p3 REF: p 3 3

3. As primary care nurse practitioners (NPs) continue to develop their role as prescribers
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of medications, it will be important to:
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a. attain the same level of expertise as
p3 p3 p3 p3 p3 p3



physicians
p3 who currently p3 p3



prescribe medications.
p3 p3




b. learn from the experiences of physicians
p3 p3 p3 p3 p3



and develop expertise based on evidence-
p3 p3 p3 p3 p3 p3



based practice.
p3 p3




c. maintain collaborative and supervisorial p3 p3 p3



relationships with physicians who will
p3 p3 p3 p3 p3



oversee prescribing practices.
p3 p3 p3




d. develop relationships with pharmaceutical p3 p3 p3



representatives to learn about new
p3 p3 p3 p3 p3



medications as they are developed.
p3 p3 p3 p3 p3




ANS: B p3



As nonphysicians develop the roles associated with prescriptive authority, it will be
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



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
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



physicians and nurse practitioners, will strive to do better than in the past. NPs should
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



work toward prescriptive authority and for practice that is not supervised by another
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



professional. Pharmaceutical representatives provide information that carries some bias.
p3 p3 p3 p3 p3 p3 p3 p3 p3



Academic sources are better.
p3 p3 p3 p3




DIF: Cognitive Level: Applying (Application) p3 p3 p3 REF: p 3 4

Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs,
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3




CNMs, CRNAs, and CNSs) and Physician Assistants
p3 p3 p3 p3 p3 p3 p3



Test Bank
p3




MULTIPLE CHOICE p3




1. A primary care NP will begin practicing in a state in which the governor has opted out
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of the federal facility reimbursement requirement. The NP should be aware that this
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defines how NPs may write prescriptions:
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Downloaded by: SuperA | p3 p3 p3



p3



Distribution of this document is illegal

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p3 p3 p3 p3 p3 p3 p3 p3 p3


Material




a. without physician supervision in private p3 p3 p3 p3



practice.
p3




b. as CRNAs without physician supervision
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in 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.
p3 p3 p3 p3 p3




d. only with physician supervision in both
p3 p3 p3 p3 p3



private practice and a hospital setting.
p3 p3 p3 p3 p3 p3




ANS: B p3



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
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write prescriptions and dispense drugs without physician supervision.
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DIF: Cognitive Level: Understanding (Comprehension)
p3 p3 p3 REF: p 3 9

2. CRNAs in most states: p3 p3 p3




a. must have a Drug Enforcement p3 p3 p3 p3



Administration (DEA) number to practice.
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b. must have prescriptive authority to
p3 p3 p3 p3



practice.
p3




c. order and administer controlled substances
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but do not have full prescriptive
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authority.
p3




d. administer medications, including p3 p3



controlled substances, under direct
p3 p3 p3 p3



physician supervision.
p3 p3




ANS: C p3



Only five states grant independent prescriptive authority to CRNAs. CRNAs do not
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require prescriptive authority because they dispense a drug immediately to a patient and
p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3 p3



do not prescribe. Without prescriptive authority, they do not need a DEA number.
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DIF: Cognitive Level: Understanding (Comprehension)
p3 p3 p3 REF: p 3 9

3. A CNM:
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a. may treat only women. p3 p3 p3




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.
p3 p3 p3




ANS: B p3




Downloaded by: SuperA | p3 p3 p3



p3





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