LEHNE’S PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSES AND
PHYSICIAN ASSISTANTS 2ND EDITION ROSENTHAL TEST BANK
Chapter 1: Prescriptive Authority
Test Bank
Multiple Choice
1. An APRN works in a urology clinic under the supervision of a physician who does not restrict
the types of medications the APRN is allowed to prescribe. State law does not require the
APRN to practice under physician supervision. How would the APRN’s prescriptive authority
be described?
a. Full authority
b. Independent
c. Without limitation
d. Limited authority
ANS: B
The APRN has independent prescriptive authority because the regulating body does not require
that the APRN work under physician supervision. Full prescriptive authority gives the provider
the right to prescribe independently and without limitation. Limited authority places restrictions
on the types of drugs that can be prescribed.DIF: Cognitive Level: ComprehensionREF: p. 1TOP:
Nursing Process: I MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic
and Parenteral Therapies
2. Which factors increase the need for APRNs to have full prescriptive authority?
a. More patients will have access to health care.
b. Enrollment in medical schools is predicted to decrease.
c. Physician’s assistants are being utilized less often.
d. APRN education is more complex than education for physicians.
ANS: A
Implementation of the Affordable Care Act has increased the number of individuals with health
care coverage, and thus the number who have access to health care services. The increase in the
number of patients creates the need for more providers with prescriptive authority. APRNs can fill
this practice gap.DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and
Parenteral Therapies
3. Which factors could be attributed to limited prescriptive authority for APRNs?
Select all that apply.
, a. Inaccessibility of patient care
b. Higher health care costs
c. Higher quality medical treatment
d. Improved collaborative care
e. Enhanced health literacy
ANS: A , B
Limiting prescriptive authority for APRNs can create barriers to quality, affordable, and accessible
patient care. It may also lead to poor collaboration among providers and higher health care costs.
It would not directly impact patient’s health literacy.DIF: Cognitive Level: ComprehensionREF:
p. 2TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
4. Which aspects support the APRN’s provision for full prescriptive authority?
Select all that apply.
a. Clinical education includes prescription of medications and disease processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN’s ability to provide safecare.
d. Licensure ensures compliance with health care and safety standards.
e. Limiting provision can decrease health care affordability.
ANS: A , C , D
APRNs are educated to practice and prescribe independently without supervision. National
examinations validate the ability to provide safe and competent care. Licensure ensures
compliance with standards to promote public health and safety. Limited prescriptive authority
creates numerous barriers to quality, affordable, and accessible patient care.DIF: Cognitive Level:
ComprehensionREF: pp. 1-2TOP: Nursing Process: Implementation MSC: NCLEX Client Needs
Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
5. Which aspects support the APRN’s provision for full prescriptive authority?
Select all that apply.
a. Clinical education includes prescription of medications and disease processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN’s ability to provide safecare.
d. Licensure ensures compliance with health care and safety standards.
ANS: A , C , D
APRNs are educated to practice and prescribe independently without supervision. National
examinations validate the ability to provide safe and competent care. Licensure ensures
compliance with standards to promote public health and safety. Limited prescriptive authority
creates numerous barriers to quality, affordable, and accessible patient care.DIF: Cognitive Level:
,ComprehensionREF: pp. 1-2TOP: Nursing Process: Implementation u y u y u y u y u y
MSC: NCLEX Client uy uy uy
Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
uy uy uy uy uy uy uy
6. A family nurse practitioner practicing in Maine is hired at a practice across state lines in
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
Virginia. Which aspect of practice may change for the APRN?
uy uy uy uy uy uy uy uy uy
a. The APRN will have less prescriptive authority in the new position.
uy uy uy uy uy uy uy uy uy uy
b. The APRN will have more prescriptive authority in the new position.
uy uy uy uy uy uy uy uy uy uy
c. The APRN will have equal prescriptive authority in the newposition.
uy uy uy uy uy uy uy uy uy
d. The APRN’s authority will depend on federalregulations.
uy uy uy uy uy uy
ANS: A uy
Virginia allows limited prescriptive authority, while Maine gives full authority to certified nurse
uy uy uy uy uy uy uy uy uy uy uy uy uy
practitioners. The federal government does not regulate prescriptive authority.DIF: Cognitive Le
uy uy uy uy uy uy uy uy uy uy
vel: ComprehensionREF: p. 3TOP: Nursing Process: Implementation MSC: NCLEX Client Nee
uy uy uy uy uy uy uy uy uy uy
ds Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
uy uy uy uy uy uy uy
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, 2nd Ed. Chapte
uy uy uy uy uy uy uy uy uy
r 2: Rational Drug Selection and Prescription Writing
uy uy uy uy uy uy uy
Test Bank Mult uy uy
iple Choice uy
7. How can collaboration with a pharmacist improve positive outcomes for patients?
uy uy uy uy uy uy uy uy uy uy uy
Select all that apply. uy uy uy
a. Pharmacists can suggest foods that will help with the patient’s condition.
uy uy uy uy uy uy uy uy uy uy
b. Pharmacists have additional information on drug interactions.
uy uy uy uy uy uy
c. The pharmacist can suggest adequate medication dosing.
uy uy uy uy uy uy
d. Pharmacists have firsthand knowledge of the facility formulary.
uy uy uy uy uy uy uy
e. Pharmacy can alter prescriptions when necessary to prevent patient harm.
uy uy uy uy uy uy uy uy uy
ANS: B , C , D uy uy uy uy uy
Providers should collaborate with pharmacists because they will likely have additional information o
uy uy uy uy uy uy uy uy uy uy uy uy
n formulary, drug interactions, and suggestions for adequate medication dosing. Dietitians can m
uy uy uy uy uy uy uy uy uy uy uy uy
ake foods recommendations to treat the patient’s condition. The pharmacist can contact the presc
uy uy uy uy uy uy uy uy uy uy uy uy uy
riber about questionable prescriptions, but cannot alter the prescription without notification of an
uy uy uy uy uy uy uy uy uy uy uy uy
d approval by the provider.DIF: Cognitive Level: ComprehensionREF: p. 9TOP: Nursing Proces
uy uy uy uy uy uy uy uy uy uy uy
s: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Pot
uy uy uy uy uy uy uy uy uy uy uy uy
ential
, 8. A patient presents with deliriumtremens requiring Ativan administration. The provider ofcare is
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not in the facility. Which action by the nurse is most appropriate?
uy uy uy uy uy uy uy uy uy uy uy u y
a. Obtain a telephone order. uy uy uy
b. Contact the on-call hospitalist. uy uy uy
c. Obtain an order from the charge nurse.
uy uy uy uy uy uy
d. Wait for a written Ativan order.
uy uy uy uy uy
ANS: A u y
In an emergency situation, such as delirium tremens with seizure activity, it is acceptable to provide a
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
telephone order. Contacting the on- uy uy uy uy
call hospitalist or waiting for a written order would take more time than available for a patient with
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
high seizure risk. Writing an order is outside the scope of practice for the charge nurse.DIF: Cog
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
nitive Level: ApplicationREF: p. 7TOP: Nursing Process: Implementation MSC: NCLEX Client
uy uy uy uy uy uy uy uy uy uy uy
Needs Category: Physiologic Integrity: Reduction of Risk Potential
uy uy uy uy uy uy uy
9. A patient with chronic pain calls the provider’s office to request a refill on theiroxycontin.
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
Which action is most appropriate? uy uy uy u y
a. Fax an order to the pharmacy.
uy uy uy uy uy
b. Schedule an appointment with the patient. uy uy uy uy uy
c. Verify the patient’s adherence to drug regimen.
uy uy uy uy uy uy
d. Determine the patient’s current medication dosage. uy uy uy uy uy
ANS: B u y u y
Schedule II medications are not eligible for refills, and prescriptions must be handwritten. It is im
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
portant to verify the patient’s adherence to the drug regimen and determine the current dosage of
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
medication; however, this can be accomplished by scheduling an appointment and evaluating the
uy uy uy uy uy uy uy uy uy uy uy uy uy
patient in person.DIF: Cognitive Level: ApplicationREF: p. 8TOP: Nursing Process: Implementa
uy uy uy uy uy uy uy uy uy uy
tion MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
uy uy uy uy uy uy uy uy uy uy uy
10. A patient prescribed amoxicillin for streptococcal pharyngitis reports new onset ofa flat, itchy r
uy uy uy uy uy uy uy uy uy uy uy uy uy uy
ed rash on the chest and neck. Which action is most important?
uy uy uy uy uy uy uy uy uy uy u y
a. Provide a different prescription. uy uy uy
b. Discontinue the medication. uy uy
c. Prescribe an antihistamine cream. uy uy uy
d. Assess for respiratory compromise. uy uy uy
ANS: B uy
The priority action is to discontinue the medication to prevent worsening of the patient’s sympto
uy uy uy uy uy uy uy uy uy uy uy uy uy uy
ms. A different prescription would be provided, topical antihistamine may be administered, and the
uy uy uy uy uy uy uy uy uy uy uy uy uy uy
patient would be assessed for respiratory involvement, but these actions would not be
uy uy uy uy uy uy uy uy uy uy uy u y
PHYSICIAN ASSISTANTS 2ND EDITION ROSENTHAL TEST BANK
Chapter 1: Prescriptive Authority
Test Bank
Multiple Choice
1. An APRN works in a urology clinic under the supervision of a physician who does not restrict
the types of medications the APRN is allowed to prescribe. State law does not require the
APRN to practice under physician supervision. How would the APRN’s prescriptive authority
be described?
a. Full authority
b. Independent
c. Without limitation
d. Limited authority
ANS: B
The APRN has independent prescriptive authority because the regulating body does not require
that the APRN work under physician supervision. Full prescriptive authority gives the provider
the right to prescribe independently and without limitation. Limited authority places restrictions
on the types of drugs that can be prescribed.DIF: Cognitive Level: ComprehensionREF: p. 1TOP:
Nursing Process: I MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic
and Parenteral Therapies
2. Which factors increase the need for APRNs to have full prescriptive authority?
a. More patients will have access to health care.
b. Enrollment in medical schools is predicted to decrease.
c. Physician’s assistants are being utilized less often.
d. APRN education is more complex than education for physicians.
ANS: A
Implementation of the Affordable Care Act has increased the number of individuals with health
care coverage, and thus the number who have access to health care services. The increase in the
number of patients creates the need for more providers with prescriptive authority. APRNs can fill
this practice gap.DIF: Cognitive Level: ComprehensionREF: p. 2TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and
Parenteral Therapies
3. Which factors could be attributed to limited prescriptive authority for APRNs?
Select all that apply.
, a. Inaccessibility of patient care
b. Higher health care costs
c. Higher quality medical treatment
d. Improved collaborative care
e. Enhanced health literacy
ANS: A , B
Limiting prescriptive authority for APRNs can create barriers to quality, affordable, and accessible
patient care. It may also lead to poor collaboration among providers and higher health care costs.
It would not directly impact patient’s health literacy.DIF: Cognitive Level: ComprehensionREF:
p. 2TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
4. Which aspects support the APRN’s provision for full prescriptive authority?
Select all that apply.
a. Clinical education includes prescription of medications and disease processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN’s ability to provide safecare.
d. Licensure ensures compliance with health care and safety standards.
e. Limiting provision can decrease health care affordability.
ANS: A , C , D
APRNs are educated to practice and prescribe independently without supervision. National
examinations validate the ability to provide safe and competent care. Licensure ensures
compliance with standards to promote public health and safety. Limited prescriptive authority
creates numerous barriers to quality, affordable, and accessible patient care.DIF: Cognitive Level:
ComprehensionREF: pp. 1-2TOP: Nursing Process: Implementation MSC: NCLEX Client Needs
Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
5. Which aspects support the APRN’s provision for full prescriptive authority?
Select all that apply.
a. Clinical education includes prescription of medications and disease processes.
b. Federal regulations support the provision of full authority for APRNs.
c. National examinations provide validation of the APRN’s ability to provide safecare.
d. Licensure ensures compliance with health care and safety standards.
ANS: A , C , D
APRNs are educated to practice and prescribe independently without supervision. National
examinations validate the ability to provide safe and competent care. Licensure ensures
compliance with standards to promote public health and safety. Limited prescriptive authority
creates numerous barriers to quality, affordable, and accessible patient care.DIF: Cognitive Level:
,ComprehensionREF: pp. 1-2TOP: Nursing Process: Implementation u y u y u y u y u y
MSC: NCLEX Client uy uy uy
Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
uy uy uy uy uy uy uy
6. A family nurse practitioner practicing in Maine is hired at a practice across state lines in
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
Virginia. Which aspect of practice may change for the APRN?
uy uy uy uy uy uy uy uy uy
a. The APRN will have less prescriptive authority in the new position.
uy uy uy uy uy uy uy uy uy uy
b. The APRN will have more prescriptive authority in the new position.
uy uy uy uy uy uy uy uy uy uy
c. The APRN will have equal prescriptive authority in the newposition.
uy uy uy uy uy uy uy uy uy
d. The APRN’s authority will depend on federalregulations.
uy uy uy uy uy uy
ANS: A uy
Virginia allows limited prescriptive authority, while Maine gives full authority to certified nurse
uy uy uy uy uy uy uy uy uy uy uy uy uy
practitioners. The federal government does not regulate prescriptive authority.DIF: Cognitive Le
uy uy uy uy uy uy uy uy uy uy
vel: ComprehensionREF: p. 3TOP: Nursing Process: Implementation MSC: NCLEX Client Nee
uy uy uy uy uy uy uy uy uy uy
ds Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
uy uy uy uy uy uy uy
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, 2nd Ed. Chapte
uy uy uy uy uy uy uy uy uy
r 2: Rational Drug Selection and Prescription Writing
uy uy uy uy uy uy uy
Test Bank Mult uy uy
iple Choice uy
7. How can collaboration with a pharmacist improve positive outcomes for patients?
uy uy uy uy uy uy uy uy uy uy uy
Select all that apply. uy uy uy
a. Pharmacists can suggest foods that will help with the patient’s condition.
uy uy uy uy uy uy uy uy uy uy
b. Pharmacists have additional information on drug interactions.
uy uy uy uy uy uy
c. The pharmacist can suggest adequate medication dosing.
uy uy uy uy uy uy
d. Pharmacists have firsthand knowledge of the facility formulary.
uy uy uy uy uy uy uy
e. Pharmacy can alter prescriptions when necessary to prevent patient harm.
uy uy uy uy uy uy uy uy uy
ANS: B , C , D uy uy uy uy uy
Providers should collaborate with pharmacists because they will likely have additional information o
uy uy uy uy uy uy uy uy uy uy uy uy
n formulary, drug interactions, and suggestions for adequate medication dosing. Dietitians can m
uy uy uy uy uy uy uy uy uy uy uy uy
ake foods recommendations to treat the patient’s condition. The pharmacist can contact the presc
uy uy uy uy uy uy uy uy uy uy uy uy uy
riber about questionable prescriptions, but cannot alter the prescription without notification of an
uy uy uy uy uy uy uy uy uy uy uy uy
d approval by the provider.DIF: Cognitive Level: ComprehensionREF: p. 9TOP: Nursing Proces
uy uy uy uy uy uy uy uy uy uy uy
s: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Pot
uy uy uy uy uy uy uy uy uy uy uy uy
ential
, 8. A patient presents with deliriumtremens requiring Ativan administration. The provider ofcare is
uy uy uy uy uy uy uy uy uy uy uy uy uy
not in the facility. Which action by the nurse is most appropriate?
uy uy uy uy uy uy uy uy uy uy uy u y
a. Obtain a telephone order. uy uy uy
b. Contact the on-call hospitalist. uy uy uy
c. Obtain an order from the charge nurse.
uy uy uy uy uy uy
d. Wait for a written Ativan order.
uy uy uy uy uy
ANS: A u y
In an emergency situation, such as delirium tremens with seizure activity, it is acceptable to provide a
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
telephone order. Contacting the on- uy uy uy uy
call hospitalist or waiting for a written order would take more time than available for a patient with
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
high seizure risk. Writing an order is outside the scope of practice for the charge nurse.DIF: Cog
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
nitive Level: ApplicationREF: p. 7TOP: Nursing Process: Implementation MSC: NCLEX Client
uy uy uy uy uy uy uy uy uy uy uy
Needs Category: Physiologic Integrity: Reduction of Risk Potential
uy uy uy uy uy uy uy
9. A patient with chronic pain calls the provider’s office to request a refill on theiroxycontin.
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
Which action is most appropriate? uy uy uy u y
a. Fax an order to the pharmacy.
uy uy uy uy uy
b. Schedule an appointment with the patient. uy uy uy uy uy
c. Verify the patient’s adherence to drug regimen.
uy uy uy uy uy uy
d. Determine the patient’s current medication dosage. uy uy uy uy uy
ANS: B u y u y
Schedule II medications are not eligible for refills, and prescriptions must be handwritten. It is im
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
portant to verify the patient’s adherence to the drug regimen and determine the current dosage of
uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy uy
medication; however, this can be accomplished by scheduling an appointment and evaluating the
uy uy uy uy uy uy uy uy uy uy uy uy uy
patient in person.DIF: Cognitive Level: ApplicationREF: p. 8TOP: Nursing Process: Implementa
uy uy uy uy uy uy uy uy uy uy
tion MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
uy uy uy uy uy uy uy uy uy uy uy
10. A patient prescribed amoxicillin for streptococcal pharyngitis reports new onset ofa flat, itchy r
uy uy uy uy uy uy uy uy uy uy uy uy uy uy
ed rash on the chest and neck. Which action is most important?
uy uy uy uy uy uy uy uy uy uy u y
a. Provide a different prescription. uy uy uy
b. Discontinue the medication. uy uy
c. Prescribe an antihistamine cream. uy uy uy
d. Assess for respiratory compromise. uy uy uy
ANS: B uy
The priority action is to discontinue the medication to prevent worsening of the patient’s sympto
uy uy uy uy uy uy uy uy uy uy uy uy uy uy
ms. A different prescription would be provided, topical antihistamine may be administered, and the
uy uy uy uy uy uy uy uy uy uy uy uy uy uy
patient would be assessed for respiratory involvement, but these actions would not be
uy uy uy uy uy uy uy uy uy uy uy u y
