ADVANCEDPHARMACOLOGY TEST BANKALL
l l l l
CHAPTERSQUESTIONS AND ANSWERS WITH
l l l l
RATIONALES l
Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change
l l l l l l l l l
Test Bank
l l
MULTIPLE lCHOICE
1. Which lof lthe lfollowing lhas linfluenced lan lemphasis lon lprimary lcare leducation lin
medical lschools?
l
a. Changes lin lMedicare lreimbursement
lmethods lrecommended lin l1992
b. Competition lfrom lnonphysicians ldesiring
lto lmeet lprimary lcare lshortages
c. The lneed lfor lmonopolistic lcontrol lin lthe
lmarketplace lof lprimary loutpatient lcare
d. The lrecognition lthat lnonphysicians lhave
lvariable lsuccess lproviding lprimary lcare
ANS: l A
The lPhysician lPayment lReview lCommission lin l1992 ldirectly lincreased lfinancial
lreimbursement lto lclinicians lwho lprovide lprimary lcare. lCoupled lwith la lshortage lof
lprimary lcare lproviders, lthis lincentive lled lmedical lschools lto lplace lgreater lemphasis lon
lpreparing lprimary lcare lphysicians. lCompetition lfrom lnonphysicians lincreased
lcoincidentally las lprofessionals lfrom lother ldisciplines lstepped lup lto lmeet lthe lneeds.
Nonphysicians lhave lhad lincreasing lsuccess lat lproviding lprimary lcare land lhave lbeen
lshown lto lbe lsafe land leffective.
DIF: Cognitive lLevel: lRemembering l(Knowledge) REF: l2
2. Which lof lthe lfollowing lstatements lis ltrue labout lthe lprescribing lpractices lof lphysicians?
a. Older lphysicians ltend lto lprescribe lmore
lappropriate lmedications lthan lyounger
physicians.
b. Antibiotic lmedications lremain lin lthe ltop
lfive lclassifications lof lmedications
lprescribed.
c. Most lphysicians lrely lon la l“therapeutic
larmamentarium” lthat lconsists lof lless lthan
l100 ldrug lpreparations lper lphysician.
d. The ldominant lform lof ldrug linformation
lused lby lprimary lcare lphysicians lcontinues
lto lbe lthat lprovided lby lpharmaceutical
lcompanies.
, ANS: l D
Even lthough lmost lphysicians lclaim lto lplace llittle lweight lon ldrug ladvertisements,
pharmaceutical lrepresentatives, land lpatient lpreference land lstate lthat lthey lrely lon
lacademic lsources lfor ldrug linformation, la lstudy lshowed lthat lcommercial lrather lthan
lscientific lsources lof ldrug linformation ldominated ltheir ldrug linformation lmaterials.
lYounger lphysicians ltend lto lprescribe lfewer land lmore lappropriate ldrugs. lAntibiotics lhave
ldropped lout lof lthe ltop lfive lclassifications lof ldrugs lprescribed. lMost lphysicians lhave la
ltherapeutic larmamentarium lof labout l144 ldrugs.
DIF: Cognitive lLevel: lRemembering l(Knowledge) REF: l3
3. As lprimary lcare lnurse lpractitioners l(NPs) lcontinue lto ldevelop ltheir lrole las lprescribers
l of lmedications, lit lwill lbe limportant lto:
a. attain lthe lsame llevel lof lexpertise las
lphysicians lwho lcurrently
lprescribe lmedications.
b. learn lfrom lthe lexperiences lof lphysicians
land ldevelop lexpertise lbased lon levidence-
lbased lpractice.
c. maintain lcollaborative land lsupervisorial
lrelationships lwith lphysicians lwho lwill
loversee lprescribing lpractices.
d. develop lrelationships lwith lpharmaceutical
lrepresentatives lto llearn labout lnew
lmedications las lthey lare ldeveloped.
ANS: l B
As lnonphysicians ldevelop lthe lroles lassociated lwith lprescriptive lauthority, lit lwill lbe
limportant lto llearn lfrom lthe lpast lexperiences lof lphysicians land lto ldevelop lprescribing
lpractices lbased lon levidence-based lmedicine. lIt lis lhoped lthat lall lprescribers, lincluding
lphysicians land lnurse lpractitioners, lwill lstrive lto l do lbetter lthan lin lthe lpast. lNPs lshould
lwork ltoward lprescriptive lauthority land lfor lpractice lthat lis lnot lsupervised lby lanother
lprofessional. lPharmaceutical lrepresentatives lprovide linformation lthat lcarries lsome lbias.
lAcademic lsources lare lbetter.
DIF: Cognitive lLevel: lApplying l(Application) REF: l4
Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs,
l l l l l l l l l l l
CNMs, CRNAs, and CNSs) and Physician Assistants
l l l l l l l
Test Bank
l
MULTIPLE lCHOICE
1. A lprimary lcare lNP lwill lbegin lpracticing lin la lstate lin lwhich lthe lgovernor lhas lopted lout
l of lthe lfederal lfacility lreimbursement lrequirement. lThe lNP lshould lbe laware lthat lthis
l defines lhow lNPs lmay lwrite lprescriptions:
, a. without lphysician lsupervision lin lprivate
lpractice.
b. as lCRNAs lwithout lphysician lsupervision
lin la lhospital lsetting.
c. in lany lsituation lbut lwill lnot lbe lreimbursed
lfor lthis lby lgovernment linsurers.
d. only lwith lphysician lsupervision lin lboth
lprivate lpractice land la lhospital lsetting.
ANS: l B
In l2001, lthe lCenters lfor lMedicare land lMedicaid lServices lchanged lthe lfederal
lphysician lsupervision lrule lfor lCRNAs lto lallow lstate lgovernors lto lopt lout, lallowing
lCRNAs lto lwrite lprescriptions land ldispense ldrugs lwithout lphysician lsupervision.
DIF: Cognitive lLevel: lUnderstanding l(Comprehension) REF: l9
2. CRNAs lin lmost lstates:
a. must lhave la lDrug lEnforcement
lAdministration l(DEA) lnumber lto lpractice.
b. must lhave lprescriptive lauthority lto
lpractice.
c. order land ladminister lcontrolled lsubstances
lbut ldo lnot lhave lfull lprescriptive lauthority.
d. administer lmedications, lincluding
lcontrolled lsubstances, lunder ldirect
lphysician lsupervision.
ANS: l C
Only lfive lstates lgrant lindependent lprescriptive lauthority lto lCRNAs. lCRNAs ldo lnot
lrequire lprescriptive lauthority lbecause lthey ldispense la ldrug limmediately lto la lpatient land
ldo lnot lprescribe. lWithout lprescriptive lauthority, lthey ldo lnot lneed la lDEA lnumber.
DIF: Cognitive lLevel: lUnderstanding l(Comprehension) REF: l9
3. A lCNM:
a. may ltreat lonly lwomen.
b. has lprescriptive lauthority lin lall l50 lstates.
c. may ladminister lonly ldrugs lused lduring
llabor land ldelivery.
d. may lpractice lonly lin lbirthing lcenters land
lhome lbirth lsettings.
ANS: l B
, CNMs lhave lprescriptive lauthority lin lall l50 lstates. lThey lmay ltreat lpartners lof lwomen
lfor lsexually ltransmitted ldiseases. lThey lhave lfull lprescriptive lauthority land lare lnot
llimited lto ldrugs lused lduring lchildbirth. lThey lpractice lin lmany lother ltypes lof lsettings.
DIF: l l Cognitive lLevel: lRemembering l(Knowledge) REF: l9
4. In levery lstate, lprescriptive lauthority lfor lNPs lincludes lthe lability lto lwrite lprescriptions:
a. for lcontrolled lsubstances.
b. for lspecified lclassifications lof
lmedications.
c. without lphysician-mandated linvolvement.
d. with lfull, lindependent lprescriptive
lauthority.
ANS: l B
All lstates lnow lhave lsome ldegree lof lprescriptive lauthority lgranted lto lNPs, lbut lnot lall
lstates lallow lauthority lto lprescribe lcontrolled lsubstances. lMany lstates lstill lrequire lsome
ldegree lof lphysician linvolvement lwith lcertain ltypes lof ldrugs.
DIF: Cognitive lLevel: lUnderstanding l(Comprehension) REF: l12
5. The lcurrent ltrend ltoward ltransitioning lNP lprograms lto lthe ldoctoral llevel lwill lmean lthat:
a. NPs llicensed lin lone lstate lmay lpractice lin
lother lstates.
b. full lprescriptive lauthority lwill lbe lgranted
lto lall lNPs lwith ldoctoral ldegrees.
c. NPs lwill lbe lbetter lprepared lto lmeet
lemerging lhealth lcare lneeds lof lpatients.
d. requirements lfor lphysician lsupervision lof
lNPs lwill lbe lremoved lin lall l states.
ANS: l C
The lAmerican lAssociation lof lColleges lof lNursing lhas lrecommended ltransitioning
lgraduate llevel lNP lprograms lto lthe ldoctoral llevel l as la lresponse lto lchanges lin lhealth
lcare ldelivery land lemerging lhealth lcare lneeds. lNPs lwith ldoctoral ldegrees lwill lnot
lnecessarily lhave lfull lprescriptive lauthority lor lbe lfreed lfrom lrequirements labout
lphysician lsupervision lbecause lthose lare lsubject lto lindividual lstate llaws. lNPs lwill lstill lbe
lrequired lto lmeet llicensure lrequirements lof leach l state.
DIF: Cognitive lLevel: lUnderstanding l(Comprehension) REF: l12
6. An limportant ldifference lbetween lphysician lassistants l(PAs) land lNPs lis lPAs:
a. always lwork lunder lphysician lsupervision.
b. are lnot lrequired lto lfollow ldrug ltreatment
l l l l
CHAPTERSQUESTIONS AND ANSWERS WITH
l l l l
RATIONALES l
Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change
l l l l l l l l l
Test Bank
l l
MULTIPLE lCHOICE
1. Which lof lthe lfollowing lhas linfluenced lan lemphasis lon lprimary lcare leducation lin
medical lschools?
l
a. Changes lin lMedicare lreimbursement
lmethods lrecommended lin l1992
b. Competition lfrom lnonphysicians ldesiring
lto lmeet lprimary lcare lshortages
c. The lneed lfor lmonopolistic lcontrol lin lthe
lmarketplace lof lprimary loutpatient lcare
d. The lrecognition lthat lnonphysicians lhave
lvariable lsuccess lproviding lprimary lcare
ANS: l A
The lPhysician lPayment lReview lCommission lin l1992 ldirectly lincreased lfinancial
lreimbursement lto lclinicians lwho lprovide lprimary lcare. lCoupled lwith la lshortage lof
lprimary lcare lproviders, lthis lincentive lled lmedical lschools lto lplace lgreater lemphasis lon
lpreparing lprimary lcare lphysicians. lCompetition lfrom lnonphysicians lincreased
lcoincidentally las lprofessionals lfrom lother ldisciplines lstepped lup lto lmeet lthe lneeds.
Nonphysicians lhave lhad lincreasing lsuccess lat lproviding lprimary lcare land lhave lbeen
lshown lto lbe lsafe land leffective.
DIF: Cognitive lLevel: lRemembering l(Knowledge) REF: l2
2. Which lof lthe lfollowing lstatements lis ltrue labout lthe lprescribing lpractices lof lphysicians?
a. Older lphysicians ltend lto lprescribe lmore
lappropriate lmedications lthan lyounger
physicians.
b. Antibiotic lmedications lremain lin lthe ltop
lfive lclassifications lof lmedications
lprescribed.
c. Most lphysicians lrely lon la l“therapeutic
larmamentarium” lthat lconsists lof lless lthan
l100 ldrug lpreparations lper lphysician.
d. The ldominant lform lof ldrug linformation
lused lby lprimary lcare lphysicians lcontinues
lto lbe lthat lprovided lby lpharmaceutical
lcompanies.
, ANS: l D
Even lthough lmost lphysicians lclaim lto lplace llittle lweight lon ldrug ladvertisements,
pharmaceutical lrepresentatives, land lpatient lpreference land lstate lthat lthey lrely lon
lacademic lsources lfor ldrug linformation, la lstudy lshowed lthat lcommercial lrather lthan
lscientific lsources lof ldrug linformation ldominated ltheir ldrug linformation lmaterials.
lYounger lphysicians ltend lto lprescribe lfewer land lmore lappropriate ldrugs. lAntibiotics lhave
ldropped lout lof lthe ltop lfive lclassifications lof ldrugs lprescribed. lMost lphysicians lhave la
ltherapeutic larmamentarium lof labout l144 ldrugs.
DIF: Cognitive lLevel: lRemembering l(Knowledge) REF: l3
3. As lprimary lcare lnurse lpractitioners l(NPs) lcontinue lto ldevelop ltheir lrole las lprescribers
l of lmedications, lit lwill lbe limportant lto:
a. attain lthe lsame llevel lof lexpertise las
lphysicians lwho lcurrently
lprescribe lmedications.
b. learn lfrom lthe lexperiences lof lphysicians
land ldevelop lexpertise lbased lon levidence-
lbased lpractice.
c. maintain lcollaborative land lsupervisorial
lrelationships lwith lphysicians lwho lwill
loversee lprescribing lpractices.
d. develop lrelationships lwith lpharmaceutical
lrepresentatives lto llearn labout lnew
lmedications las lthey lare ldeveloped.
ANS: l B
As lnonphysicians ldevelop lthe lroles lassociated lwith lprescriptive lauthority, lit lwill lbe
limportant lto llearn lfrom lthe lpast lexperiences lof lphysicians land lto ldevelop lprescribing
lpractices lbased lon levidence-based lmedicine. lIt lis lhoped lthat lall lprescribers, lincluding
lphysicians land lnurse lpractitioners, lwill lstrive lto l do lbetter lthan lin lthe lpast. lNPs lshould
lwork ltoward lprescriptive lauthority land lfor lpractice lthat lis lnot lsupervised lby lanother
lprofessional. lPharmaceutical lrepresentatives lprovide linformation lthat lcarries lsome lbias.
lAcademic lsources lare lbetter.
DIF: Cognitive lLevel: lApplying l(Application) REF: l4
Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs,
l l l l l l l l l l l
CNMs, CRNAs, and CNSs) and Physician Assistants
l l l l l l l
Test Bank
l
MULTIPLE lCHOICE
1. A lprimary lcare lNP lwill lbegin lpracticing lin la lstate lin lwhich lthe lgovernor lhas lopted lout
l of lthe lfederal lfacility lreimbursement lrequirement. lThe lNP lshould lbe laware lthat lthis
l defines lhow lNPs lmay lwrite lprescriptions:
, a. without lphysician lsupervision lin lprivate
lpractice.
b. as lCRNAs lwithout lphysician lsupervision
lin la lhospital lsetting.
c. in lany lsituation lbut lwill lnot lbe lreimbursed
lfor lthis lby lgovernment linsurers.
d. only lwith lphysician lsupervision lin lboth
lprivate lpractice land la lhospital lsetting.
ANS: l B
In l2001, lthe lCenters lfor lMedicare land lMedicaid lServices lchanged lthe lfederal
lphysician lsupervision lrule lfor lCRNAs lto lallow lstate lgovernors lto lopt lout, lallowing
lCRNAs lto lwrite lprescriptions land ldispense ldrugs lwithout lphysician lsupervision.
DIF: Cognitive lLevel: lUnderstanding l(Comprehension) REF: l9
2. CRNAs lin lmost lstates:
a. must lhave la lDrug lEnforcement
lAdministration l(DEA) lnumber lto lpractice.
b. must lhave lprescriptive lauthority lto
lpractice.
c. order land ladminister lcontrolled lsubstances
lbut ldo lnot lhave lfull lprescriptive lauthority.
d. administer lmedications, lincluding
lcontrolled lsubstances, lunder ldirect
lphysician lsupervision.
ANS: l C
Only lfive lstates lgrant lindependent lprescriptive lauthority lto lCRNAs. lCRNAs ldo lnot
lrequire lprescriptive lauthority lbecause lthey ldispense la ldrug limmediately lto la lpatient land
ldo lnot lprescribe. lWithout lprescriptive lauthority, lthey ldo lnot lneed la lDEA lnumber.
DIF: Cognitive lLevel: lUnderstanding l(Comprehension) REF: l9
3. A lCNM:
a. may ltreat lonly lwomen.
b. has lprescriptive lauthority lin lall l50 lstates.
c. may ladminister lonly ldrugs lused lduring
llabor land ldelivery.
d. may lpractice lonly lin lbirthing lcenters land
lhome lbirth lsettings.
ANS: l B
, CNMs lhave lprescriptive lauthority lin lall l50 lstates. lThey lmay ltreat lpartners lof lwomen
lfor lsexually ltransmitted ldiseases. lThey lhave lfull lprescriptive lauthority land lare lnot
llimited lto ldrugs lused lduring lchildbirth. lThey lpractice lin lmany lother ltypes lof lsettings.
DIF: l l Cognitive lLevel: lRemembering l(Knowledge) REF: l9
4. In levery lstate, lprescriptive lauthority lfor lNPs lincludes lthe lability lto lwrite lprescriptions:
a. for lcontrolled lsubstances.
b. for lspecified lclassifications lof
lmedications.
c. without lphysician-mandated linvolvement.
d. with lfull, lindependent lprescriptive
lauthority.
ANS: l B
All lstates lnow lhave lsome ldegree lof lprescriptive lauthority lgranted lto lNPs, lbut lnot lall
lstates lallow lauthority lto lprescribe lcontrolled lsubstances. lMany lstates lstill lrequire lsome
ldegree lof lphysician linvolvement lwith lcertain ltypes lof ldrugs.
DIF: Cognitive lLevel: lUnderstanding l(Comprehension) REF: l12
5. The lcurrent ltrend ltoward ltransitioning lNP lprograms lto lthe ldoctoral llevel lwill lmean lthat:
a. NPs llicensed lin lone lstate lmay lpractice lin
lother lstates.
b. full lprescriptive lauthority lwill lbe lgranted
lto lall lNPs lwith ldoctoral ldegrees.
c. NPs lwill lbe lbetter lprepared lto lmeet
lemerging lhealth lcare lneeds lof lpatients.
d. requirements lfor lphysician lsupervision lof
lNPs lwill lbe lremoved lin lall l states.
ANS: l C
The lAmerican lAssociation lof lColleges lof lNursing lhas lrecommended ltransitioning
lgraduate llevel lNP lprograms lto lthe ldoctoral llevel l as la lresponse lto lchanges lin lhealth
lcare ldelivery land lemerging lhealth lcare lneeds. lNPs lwith ldoctoral ldegrees lwill lnot
lnecessarily lhave lfull lprescriptive lauthority lor lbe lfreed lfrom lrequirements labout
lphysician lsupervision lbecause lthose lare lsubject lto lindividual lstate llaws. lNPs lwill lstill lbe
lrequired lto lmeet llicensure lrequirements lof leach l state.
DIF: Cognitive lLevel: lUnderstanding l(Comprehension) REF: l12
6. An limportant ldifference lbetween lphysician lassistants l(PAs) land lNPs lis lPAs:
a. always lwork lunder lphysician lsupervision.
b. are lnot lrequired lto lfollow ldrug ltreatment
