ADVANCED PHARMACOLOGY TEST BANK ALL CHAP
u u u u u
TERSQUESTIONS AND ANSWERS WITH RATIONALE
u u u u
S
Chapteru01:uPrescriptiveuAuthorityuanduRoleuImplementation:uTraditionuvs.uChange
uTestuBank
MULTIPLEuCHOICE
1. Whichuofutheufollowinguhasuinfluenceduanuemphasisuonuprimaryucareueducationuinumedical
uschools?
a. ChangesuinuMedicareureimbursementumeth
odsurecommendeduinu1992
b. Competitionufromunonphysiciansudesiringu
toumeetuprimaryucareushortages
c. Theuneeduforumonopolisticucontroluinutheum
arketplaceuofuprimaryuoutpatientucare
d. Theurecognitionuthatunonphysiciansuhaveuv
ariableusuccessuprovidinguprimaryucare
ANS:u A
TheuPhysicianuPaymentuReviewuCommissionuinu1992udirectlyuincreasedufinancialureimbu
rsementutoucliniciansuwhouprovideuprimaryucare.uCoupleduwithuaushortageuofuprimaryucareu
providers,uthisuincentiveuledumedicaluschoolsutouplaceugreateruemphasisuonupreparinguprim
aryucareuphysicians.uCompetitionufromunonphysiciansuincreaseducoincidentallyuasuprofessi
onalsufromuotherudisciplinesusteppeduuputoumeetutheuneeds.
Nonphysiciansuhaveuhaduincreasingusuccessuatuprovidinguprimaryucareuanduhaveubeenusho
wnutoubeusafeuandueffective.
DIF: CognitiveuLevel:uRememberingu(Knowledge) REF:u2
2. Whichuofutheufollowingustatementsuisutrueuaboututheuprescribingupracticesuofuphysicians?
a. Olderuphysiciansutendutouprescribeumoreuap
propriateumedicationsuthanuyounger
physicians.
b. Antibioticumedicationsuremainuinutheutopufi
veuclassificationsuofumedicationsuprescribe
d.
c. Mostuphysiciansurelyuonuau“therapeuticuar
mamentarium”uthatuconsistsuofulessuthanu1
00udrugupreparationsuperuphysician.
d. Theudominantuformuofudruguinformationuu
sedubyuprimaryucareuphysiciansucontinuesut
oubeuthatuprovidedubyupharmaceuticalucom
panies.
, ANS:u D
Evenuthoughumostuphysiciansuclaimutouplaceulittleuweightuonudruguadvertisements,
pharmaceuticalurepresentatives,uandupatientupreferenceuandustateuthatutheyurelyuonuacadem
icusourcesuforudruguinformation,uaustudyushoweduthatucommercialuratheruthanuscientificuso
urcesuofudruguinformationudominatedutheirudruguinformationumaterials.uYoungeruphysician
sutendutouprescribeufeweruandumoreuappropriateudrugs.uAntibioticsuhaveudroppeduoutuofutheu
topufiveuclassificationsuofudrugsuprescribed.uMostuphysiciansuhaveuautherapeuticuarmament
ariumuofuaboutu144udrugs.
DIF: CognitiveuLevel:uRememberingu(Knowledge) REF:u3
3. Asuprimaryucareunurseupractitionersu(NPs)ucontinueutoudeveloputheiruroleuasuprescribersuof
umedications,uituwillubeuimportantuto:
a. attainutheusameuleveluofuexpertiseuas
uphysiciansuwhoucurrentlyuprescribe
umedications.
b. learnufromutheuexperiencesuofuphysiciansua
ndudevelopuexpertiseubaseduonuevidence-
ubasedupractice.
c. maintainucollaborativeuandusupervisorialure
lationshipsuwithuphysiciansuwhouwilluover
seeuprescribingupractices.
d. developurelationshipsuwithupharmaceutical
urepresentativesutoulearnuaboutunewumedic
ationsuasutheyuareudeveloped.
ANS:u B
Asunonphysiciansudeveloputheurolesuassociateduwithuprescriptiveuauthority,uituwillubeuimpo
rtantutoulearnufromutheupastuexperiencesuofuphysiciansuandutoudevelopuprescribingupractice
subaseduonuevidence-
basedumedicine.uItuisuhopeduthatualluprescribers,uincludinguphysiciansuandunurseupractition
ers,uwillustriveutoudoubetteruthanuinutheupast.uNPsushoulduworkutowarduprescriptiveuauthorit
yuanduforupracticeuthatuisunotusupervisedubyuanotheruprofessional.uPharmaceuticalurepresen
tativesuprovideuinformationuthatucarriesusomeubias.uAcademicusourcesuareubetter.
DIF: CognitiveuLevel:uApplyingu(Application) REF:u4
Chapteru02:uHistoricaluReviewu ofuPrescriptiveuAuthority:uTheuRoleu ofuNursesu(NPs,u
CNMs,uCRNAs,uanduCNSs)uanduPhysicianuAssistants
TestuBank
MULTIPLEuCHOICE
1. AuprimaryucareuNPuwillubeginupracticinguinuaustateuinuwhichutheugovernoruhasuopteduoutuof
utheufederalufacilityureimbursementurequirement.uTheuNPushouldubeuawareuthatuthisudefine
suhowuNPsumayuwriteuprescriptions:
, a. withoutuphysicianusupervisionuinuprivateupr
actice.
b. asuCRNAsuwithoutuphysicianusupervisionui
nuauhospitalusetting.
c. inuanyusituationubutuwillunotubeureimbursed
uforuthisubyugovernmentuinsurers.
d. onlyuwithuphysicianusupervisionuinubothupri
vateupracticeuanduauhospitalusetting.
ANS:u B
Inu2001,utheuCentersuforuMedicareuanduMedicaiduServicesuchangedutheufederaluphysicianus
upervisionuruleuforuCRNAsutouallowustateugovernorsutouoptuout,uallowinguCRNAsutouwriteu
prescriptionsuandudispenseudrugsuwithoutuphysicianusupervision.
DIF: CognitiveuLevel:uUnderstandingu(Comprehension) REF:u9
2. CRNAsuinumostustates:
a. mustuhaveuauDruguEnforcementuAdministr
ationu(DEA)unumberutoupractice.
b. mustuhaveuprescriptiveuauthorityutoupractic
e.
c. orderuanduadministerucontrolledusubstancesu
butudounotuhaveufulluprescriptiveuauthority.
d. administerumedications,uincludingu
controlledusubstances,uunderudirect
uphysicianusupervision.
ANS:u C
OnlyufiveustatesugrantuindependentuprescriptiveuauthorityutouCRNAs.uCRNAsudounoturequi
reuprescriptiveuauthorityubecauseutheyudispenseuaudruguimmediatelyutouaupatientuandudounot
uprescribe.uWithoutuprescriptive uauthority,utheyudounotuneeduauDEAunumber.
DIF: CognitiveuLevel:uUnderstandingu(Comprehension) REF:u9
3. AuCNM:
a. mayutreatuonlyuwomen.
b. hasuprescriptiveuauthorityuinuallu50ustates.
c. mayuadministeruonlyudrugsuuseduduringulab
oruandudelivery.
d. mayupracticeuonlyuinubirthingucentersuanduh
omeubirthusettings.
ANS:u B
, CNMsuhaveuprescriptiveuauthorityuinuallu50ustates.uTheyumayutreatupartnersuofuwomenuforu
sexuallyutransmittedudiseases.uTheyuhaveufulluprescriptiveuauthorityuanduareunotulimiteduto
udrugsuuseduduringuchildbirth.uTheyupracticeuinumanyuotherutypesuofusettings.
DIF:u u CognitiveuLevel:uRememberingu(Knowledge) REF:u9
4. Inueveryustate,uprescriptiveuauthorityuforuNPsuincludesutheuabilityutouwriteuprescriptions:
a. forucontrolledusubstances.
b. foruspecifieduclassificationsuofumedicatio
ns.
c. withoutuphysician-mandateduinvolvement.
d. withufull,uindependentuprescriptiveuauthorit
y.
ANS:u B
AllustatesunowuhaveusomeudegreeuofuprescriptiveuauthorityugrantedutouNPs,ubutunotuallustat
esuallowuauthorityutouprescribeucontrolledusubstances.uManyustatesustillurequireusomeudegre
euofuphysicianuinvolvementuwithucertainutypesuofudrugs.
DIF: CognitiveuLevel:uUnderstandingu(Comprehension) REF:u12
5. TheucurrentutrendutowardutransitioninguNPuprogramsutoutheudoctoraluleveluwillumeanuthat:
a. NPsulicenseduinuoneustateumayupracticeuinuo
therustates.
b. fulluprescriptiveuauthorityuwillubeugrantedut
oualluNPsuwithudoctoraludegrees.
c. NPsuwillubeubetterupreparedutoumeetuemerg
inguhealthucareuneedsuofupatients.
d. requirementsuforuphysicianusupervisionuofu
NPsuwillubeuremoveduinuallustates.
ANS:u C
TheuAmericanuAssociationuofuCollegesuofuNursinguhasurecommendedutransitioningugradu
ateuleveluNPuprogramsutoutheudoctoraluleveluasuauresponseutouchangesuinuhealthucareudeliver
yuanduemerginguhealthucareuneeds.uNPsuwithudoctoraludegreesuwillunotunecessarilyuhaveufu
lluprescriptiveuauthorityuorubeufreedufromurequirementsuaboutuphysicianusupervisionubecau
seuthoseuareusubjectutouindividualustateulaws.uNPsuwillustillubeurequiredutoumeetulicensureure
quirementsuofueachustate.
DIF: CognitiveuLevel:uUnderstandingu(Comprehension) REF:u12
6. Anuimportantudifferenceubetweenuphysicianuassistantsu(PAs)uanduNPsuisuPAs:
a. alwaysuworkuunderuphysicianusupervision.
b. areunoturequiredutoufollowudrugutreatment
u u u u u
TERSQUESTIONS AND ANSWERS WITH RATIONALE
u u u u
S
Chapteru01:uPrescriptiveuAuthorityuanduRoleuImplementation:uTraditionuvs.uChange
uTestuBank
MULTIPLEuCHOICE
1. Whichuofutheufollowinguhasuinfluenceduanuemphasisuonuprimaryucareueducationuinumedical
uschools?
a. ChangesuinuMedicareureimbursementumeth
odsurecommendeduinu1992
b. Competitionufromunonphysiciansudesiringu
toumeetuprimaryucareushortages
c. Theuneeduforumonopolisticucontroluinutheum
arketplaceuofuprimaryuoutpatientucare
d. Theurecognitionuthatunonphysiciansuhaveuv
ariableusuccessuprovidinguprimaryucare
ANS:u A
TheuPhysicianuPaymentuReviewuCommissionuinu1992udirectlyuincreasedufinancialureimbu
rsementutoucliniciansuwhouprovideuprimaryucare.uCoupleduwithuaushortageuofuprimaryucareu
providers,uthisuincentiveuledumedicaluschoolsutouplaceugreateruemphasisuonupreparinguprim
aryucareuphysicians.uCompetitionufromunonphysiciansuincreaseducoincidentallyuasuprofessi
onalsufromuotherudisciplinesusteppeduuputoumeetutheuneeds.
Nonphysiciansuhaveuhaduincreasingusuccessuatuprovidinguprimaryucareuanduhaveubeenusho
wnutoubeusafeuandueffective.
DIF: CognitiveuLevel:uRememberingu(Knowledge) REF:u2
2. Whichuofutheufollowingustatementsuisutrueuaboututheuprescribingupracticesuofuphysicians?
a. Olderuphysiciansutendutouprescribeumoreuap
propriateumedicationsuthanuyounger
physicians.
b. Antibioticumedicationsuremainuinutheutopufi
veuclassificationsuofumedicationsuprescribe
d.
c. Mostuphysiciansurelyuonuau“therapeuticuar
mamentarium”uthatuconsistsuofulessuthanu1
00udrugupreparationsuperuphysician.
d. Theudominantuformuofudruguinformationuu
sedubyuprimaryucareuphysiciansucontinuesut
oubeuthatuprovidedubyupharmaceuticalucom
panies.
, ANS:u D
Evenuthoughumostuphysiciansuclaimutouplaceulittleuweightuonudruguadvertisements,
pharmaceuticalurepresentatives,uandupatientupreferenceuandustateuthatutheyurelyuonuacadem
icusourcesuforudruguinformation,uaustudyushoweduthatucommercialuratheruthanuscientificuso
urcesuofudruguinformationudominatedutheirudruguinformationumaterials.uYoungeruphysician
sutendutouprescribeufeweruandumoreuappropriateudrugs.uAntibioticsuhaveudroppeduoutuofutheu
topufiveuclassificationsuofudrugsuprescribed.uMostuphysiciansuhaveuautherapeuticuarmament
ariumuofuaboutu144udrugs.
DIF: CognitiveuLevel:uRememberingu(Knowledge) REF:u3
3. Asuprimaryucareunurseupractitionersu(NPs)ucontinueutoudeveloputheiruroleuasuprescribersuof
umedications,uituwillubeuimportantuto:
a. attainutheusameuleveluofuexpertiseuas
uphysiciansuwhoucurrentlyuprescribe
umedications.
b. learnufromutheuexperiencesuofuphysiciansua
ndudevelopuexpertiseubaseduonuevidence-
ubasedupractice.
c. maintainucollaborativeuandusupervisorialure
lationshipsuwithuphysiciansuwhouwilluover
seeuprescribingupractices.
d. developurelationshipsuwithupharmaceutical
urepresentativesutoulearnuaboutunewumedic
ationsuasutheyuareudeveloped.
ANS:u B
Asunonphysiciansudeveloputheurolesuassociateduwithuprescriptiveuauthority,uituwillubeuimpo
rtantutoulearnufromutheupastuexperiencesuofuphysiciansuandutoudevelopuprescribingupractice
subaseduonuevidence-
basedumedicine.uItuisuhopeduthatualluprescribers,uincludinguphysiciansuandunurseupractition
ers,uwillustriveutoudoubetteruthanuinutheupast.uNPsushoulduworkutowarduprescriptiveuauthorit
yuanduforupracticeuthatuisunotusupervisedubyuanotheruprofessional.uPharmaceuticalurepresen
tativesuprovideuinformationuthatucarriesusomeubias.uAcademicusourcesuareubetter.
DIF: CognitiveuLevel:uApplyingu(Application) REF:u4
Chapteru02:uHistoricaluReviewu ofuPrescriptiveuAuthority:uTheuRoleu ofuNursesu(NPs,u
CNMs,uCRNAs,uanduCNSs)uanduPhysicianuAssistants
TestuBank
MULTIPLEuCHOICE
1. AuprimaryucareuNPuwillubeginupracticinguinuaustateuinuwhichutheugovernoruhasuopteduoutuof
utheufederalufacilityureimbursementurequirement.uTheuNPushouldubeuawareuthatuthisudefine
suhowuNPsumayuwriteuprescriptions:
, a. withoutuphysicianusupervisionuinuprivateupr
actice.
b. asuCRNAsuwithoutuphysicianusupervisionui
nuauhospitalusetting.
c. inuanyusituationubutuwillunotubeureimbursed
uforuthisubyugovernmentuinsurers.
d. onlyuwithuphysicianusupervisionuinubothupri
vateupracticeuanduauhospitalusetting.
ANS:u B
Inu2001,utheuCentersuforuMedicareuanduMedicaiduServicesuchangedutheufederaluphysicianus
upervisionuruleuforuCRNAsutouallowustateugovernorsutouoptuout,uallowinguCRNAsutouwriteu
prescriptionsuandudispenseudrugsuwithoutuphysicianusupervision.
DIF: CognitiveuLevel:uUnderstandingu(Comprehension) REF:u9
2. CRNAsuinumostustates:
a. mustuhaveuauDruguEnforcementuAdministr
ationu(DEA)unumberutoupractice.
b. mustuhaveuprescriptiveuauthorityutoupractic
e.
c. orderuanduadministerucontrolledusubstancesu
butudounotuhaveufulluprescriptiveuauthority.
d. administerumedications,uincludingu
controlledusubstances,uunderudirect
uphysicianusupervision.
ANS:u C
OnlyufiveustatesugrantuindependentuprescriptiveuauthorityutouCRNAs.uCRNAsudounoturequi
reuprescriptiveuauthorityubecauseutheyudispenseuaudruguimmediatelyutouaupatientuandudounot
uprescribe.uWithoutuprescriptive uauthority,utheyudounotuneeduauDEAunumber.
DIF: CognitiveuLevel:uUnderstandingu(Comprehension) REF:u9
3. AuCNM:
a. mayutreatuonlyuwomen.
b. hasuprescriptiveuauthorityuinuallu50ustates.
c. mayuadministeruonlyudrugsuuseduduringulab
oruandudelivery.
d. mayupracticeuonlyuinubirthingucentersuanduh
omeubirthusettings.
ANS:u B
, CNMsuhaveuprescriptiveuauthorityuinuallu50ustates.uTheyumayutreatupartnersuofuwomenuforu
sexuallyutransmittedudiseases.uTheyuhaveufulluprescriptiveuauthorityuanduareunotulimiteduto
udrugsuuseduduringuchildbirth.uTheyupracticeuinumanyuotherutypesuofusettings.
DIF:u u CognitiveuLevel:uRememberingu(Knowledge) REF:u9
4. Inueveryustate,uprescriptiveuauthorityuforuNPsuincludesutheuabilityutouwriteuprescriptions:
a. forucontrolledusubstances.
b. foruspecifieduclassificationsuofumedicatio
ns.
c. withoutuphysician-mandateduinvolvement.
d. withufull,uindependentuprescriptiveuauthorit
y.
ANS:u B
AllustatesunowuhaveusomeudegreeuofuprescriptiveuauthorityugrantedutouNPs,ubutunotuallustat
esuallowuauthorityutouprescribeucontrolledusubstances.uManyustatesustillurequireusomeudegre
euofuphysicianuinvolvementuwithucertainutypesuofudrugs.
DIF: CognitiveuLevel:uUnderstandingu(Comprehension) REF:u12
5. TheucurrentutrendutowardutransitioninguNPuprogramsutoutheudoctoraluleveluwillumeanuthat:
a. NPsulicenseduinuoneustateumayupracticeuinuo
therustates.
b. fulluprescriptiveuauthorityuwillubeugrantedut
oualluNPsuwithudoctoraludegrees.
c. NPsuwillubeubetterupreparedutoumeetuemerg
inguhealthucareuneedsuofupatients.
d. requirementsuforuphysicianusupervisionuofu
NPsuwillubeuremoveduinuallustates.
ANS:u C
TheuAmericanuAssociationuofuCollegesuofuNursinguhasurecommendedutransitioningugradu
ateuleveluNPuprogramsutoutheudoctoraluleveluasuauresponseutouchangesuinuhealthucareudeliver
yuanduemerginguhealthucareuneeds.uNPsuwithudoctoraludegreesuwillunotunecessarilyuhaveufu
lluprescriptiveuauthorityuorubeufreedufromurequirementsuaboutuphysicianusupervisionubecau
seuthoseuareusubjectutouindividualustateulaws.uNPsuwillustillubeurequiredutoumeetulicensureure
quirementsuofueachustate.
DIF: CognitiveuLevel:uUnderstandingu(Comprehension) REF:u12
6. Anuimportantudifferenceubetweenuphysicianuassistantsu(PAs)uanduNPsuisuPAs:
a. alwaysuworkuunderuphysicianusupervision.
b. areunoturequiredutoufollowudrugutreatment
