N677 2024 UPDATE COMPREHENSIVE QUESTIONS AND
CORRECT ANSWERS VERIFIED STUDY GUIDE [GRADED
A+]
Based on your research from your planned practice state, what drugs and
devices can NPs prescribe, furnish, or order?
In California, NPs can prescribe, furnish, or order Schedule II through Schedule V
controlled substances. However, NPs must obtain a furnishing license through the CA
BRN and a DEA number through the United States Drug Enforcement Administration
before having furnishing authority to prescribe controlled substances. One of the
requirements for a furnishing license is that NPs must complete a BRN approved course
for Schedule II Controlled Substance
In your planned practice state, do you need to be supervised to prescribe? Yes or
No?
In California, NPs require physician supervision for prescriptive authority.
If applicable in your state, what is the "physician supervision" description and
requirements for the NP's ability to prescribe, furnish or order?
Nurse practitioners and supervising physicians will need to establish a standardized
protocols for what drugs and devices, including controlled substances, that nurse
practitioners can prescribe to patients. This collaboration takes into account the
competency of the practitioners, the scope of practice, and the current standardized
protocols. Physicians do not need to be physically present, but supervising physicians
should be available for consultation if needed during patient encounter
What are the requirements of furnishing (prescribing) controlled substances in
your planned practice state?
In California, nurse practitioners are required to have a furnishing license from the
Board of Registered Nursing and a DEA number to prescribed controlled substances.
Nurse practitioners must complete an approved course about Schedule II controlled
substances in order to apply for a furnishing license from the BRN and a DEA number.
With both furnishing license and DEA number, NPs can prescribe controlled
substances, Schedule II to V.
Are there any limitations or guidelines about or of controlled substances
mentioned in your state's practice regulations for NP's? If so, what are those
limitations?
The only limitations are the ones set by the supervising physicians in the standardized
protocols
What is the NP required to do if allowed to distribute pharmaceutical samples in
your state? Is there a specific procedure your state requires you to follow?
In California, certified furnishing NPs are allowed to request, accept, and distribute
pharmaceutical samples as long as it is within the specifications of the standardized
protocols that are agreed upon with the supervising physicians. Nurse practitioners
must have a protocol for patient follow-up if they are prescribing pharmaceutical
samples to their patients (General Information: Nurse Practitioner
What does the licensing body in your state say about the NP offering patient
education related to prescribing drugs, if anything?
, California Board of Registered Nursing states that appropriate education about the
drugs must be provided to patient before furnishing the drugs (Criteria for furnishing
number, n.d.). Patient education includes the purpose of the drugs, expected side
effects, and adverse effects of the drugs. Nurse practitioners should provide information
on the treatment plans including laboratory studies and follow ups.
Nurse Practitioner Prescriptive Authority
"The American Association of Nurse Practitioners® (AANP) recognizes that the scope
and practice of a nurse practitioner (NP) includes prescribing. Prescribing is not a
distinct act outside of or differentiated from NP practice. It is the position of AANP that
NP prescriptive authority be solely regulated by state boards of nursing and in
accordance with the NP role, education and certification. The authorization of NPs to
prescribe legend and controlled medications, devices, health care services, durable
medical equipment and other equipment and supplies is essential to providing timely,
cost-effective, quality health care."
What are 3 common side effects from opioid medications?
Constipation, drowsiness, nausea, and vomiting, itching, respiratory depression,
confusion
Can Nurse Practitioners furnish drugs or devices to family members or friends?
An NP, however, should never prescribe controlled substances for himself or herself or
for family members, as it is expressly illegal in many states.
Prescribing controlled substances and other legend drugs for self and family raises
many ethical questions. Prescribing for self and family member has inherent risks
related to lack of objectivity. Effort should be made to discuss the condition with the
collaborating physician.
Even if it is not expressly illegal under many state laws to prescribe a controlled
substance for a family member, it is always inadvisable. Drug Enforcement
Administration (DEA) numbers are specific to a practice setting, so an NP who
prescribes a controlled substance for a family member who does not come to the
practice setting may be violating 2 laws.
Certified NPs who hold active furnishing licenses and valid DEA registration
numbers can furnish/order controlled substances from what schedules?
In CA,
The amended B&P Code Section 2836.1 extends the NPs' furnishing authority to
include Schedule II through V controlled substance furnished or ordered that can be
considered the same as an order initiated by the physician. The NP must obtain a DEA
registration number to furnish Schedule II through V.
Is physical dependence the same as addiction?
Physical dependence to opioids means that the body relies on an external source of
opioids to prevent withdrawal. Physical dependence is predictable, easily managed with
medication, and is ultimately resolved with a slow taper off of the opioid. Normally, the
body can produce enough endogenous opioids (example: endorphins) to prevent
withdrawal. But as tolerance increases, eventually the body's ability to maintain this
equilibrium is exceeded and the body becomes dependent on that external source.
Unlike physical dependence addiction is abnormal and classified as a disease.
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