Test Bank for Edmunds' Pharmacology for the Primary Care
Provider 5th Edition by Visovsky, Zambroski, and Lutz
1
,Chapter 01: Prescriptive Authority and Role Implementation:
Tradition vs. Change Test Bank
MULTIPLE CHOICE
1. Which of these has influenced an emphasis on primary care education in medical
schools?
a. Changes in Medicare
reimbursement methods
recommended in 1992
b. Competition from nonphysicians
desiring to meet primary care shortages
c. The need for monopolistic control in
the marketplace of primary outpatient
care
d. The recognition that nonphysicians
have variable success providing
primary care
CORRECT
CHOICE✔✔ A
The Physician Payment Review Commission in 1992 directly increased financial
reimbursement to clinicians who provide primary care. Coupled with a shortage of
primary care providers, this incentive led medical schools to place greater emphasis on
preparing primary care physicians. Competition from nonphysicians increased
coincidentally as professionals from other disciplines stepped up to meet the needs.
Nonphysicians have had increasing success at providing primary care and have been
shown to be safe and effective.
2. Which of these statements is true about the prescribing practices of physicians?
a. Older physicians tend to prescribe
more appropriate medications than
younger physicians.
b. Antibiotic medications remain in the
top five classifications of medications
prescribed.
c. Most physicians rely on a “therapeutic
armamentarium” that consists of less
than
100 drug preparations per physician.
d. The dominant form of drug information
used by primary care physicians
continues to be that provided by
pharmaceutical companies.
CORRECT
CHOICE✔✔ D
Even though most physicians claim to place little weight on drug advertisements,
2
, pharmaceutical representatives, and patient preference and state that they rely on
academic sources for drug information, a study showed that commercial rather than
scientific sources of drug information dominated their drug information materials.
Younger physicians tend to prescribe fewer and more appropriate drugs. Antibiotics
have dropped out of the top five classifications of drugs prescribed. Most physicians
have a therapeutic armamentarium of about 144 drugs.
3. As primary care nurse practitioners (NPs) continue to develop their role as prescribers
of medications, it will be important to:
a. attain the same level of expertise
as physicians who currently
prescribe
medications.
b. learn from the experiences of
physicians and develop expertise based
on evidence- based practice.
c. maintain collaborative and
supervisorial relationships with
physicians who will oversee
prescribing practices.
d. develop relationships with
pharmaceutical representatives to learn
about new medications as they are
developed.
CORRECT
CHOICE✔✔ B
As nonphysicians develop the roles associated with prescriptive authority, it will be
important to learn from the past experiences of physicians and to develop prescribing
practices based on evidence-based medicine. It is hoped that all prescribers, including
physicians and nurse practitioners, will strive to do better than in the past. NPs should
work toward prescriptive authority and for practice that is not supervised by another
professional. Pharmaceutical representatives provide information that carries some
bias. Academic sources are better.
Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs,
CNMs, CRNAs, and CNSs) and Physician Assistants
Test Bank
MULTIPLE CHOICE
1. A primary care NP will begin practicing in a state in which the governor has opted out
of the federal facility reimbursement requirement. The NP should be aware that this
defines how NPs may write prescriptions:
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, a. without physician supervision in
private practice.
b. as CRNAs without physician
supervision in a hospital setting.
c. in any situation but will not be
reimbursed for this by government
insurers.
d. only with physician supervision in
both private practice and a hospital
setting.
CORRECT CHOICE✔✔ B
In 2001, the Centers for Medicare and Medicaid Services changed the federal
physician supervision rule for CRNAs to allow state governors to opt out, allowing
CRNAs to write prescriptions and dispense drugs without physician supervision.
2. CRNAs in most states:
a. must have a Drug Enforcement
Administration (DEA) number to
practice.
b. must have prescriptive authority
to practice.
c. order and administer controlled
substances but do not have full
prescriptive authority.
d. administer medications,
including controlled substances,
under direct physician
supervision.
CORRECT CHOICE✔✔ C
Only five states grant independent prescriptive authority to CRNAs. CRNAs do not
require prescriptive authority because they dispense a drug immediately to a patient
and do not prescribe. Without prescriptive authority, they do not need a DEA number.
3. A CNM:
a. may treat only women.
b. has prescriptive authority in all 50 states.
c. may administer only drugs used
during labor and delivery.
d. may practice only in birthing centers
and home birth settings.
CORRECT CHOICE✔✔ B
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