Chapter 01: Prescriptive Authority and Role Implementation: Tradition vs. Change

Answer: a. Changes in Medicare reimbursement methods recommended in 1992
- 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
Answer: d. The dominant form of drug information used by primary care physicians continues to be that provided by pharmaceutical companies.
- 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.
Answer: b. learn from the experiences of physicians and develop expertise based on evidence-based practice.
- 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.

Chapter 02: Historical Review of Prescriptive Authority: The Role of Nurses (NPs, CNMs, CRNAs, and CNSs) and Physician Assistants

Answer: b. as CRNAs without physician supervision in a hospital setting.
- 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.
Answer: c. order and administer controlled substances but do not have full prescriptive authority.
- 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.
Answer: b. has prescriptive authority in all 50 states.
- 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.

Chapter 03: General Pharmacokinetic and Pharmacodynamic Principles

Answer: b. pharmacokinetics.
- a. bioavailability.
- b. pharmacokinetics.
- c. pharmacodynamics.
- d. anatomy and physiology.
Answer: c. acetaminophen.
- a. APAP.
- b. Tylenol.
- c. acetaminophen.
- d. any over-the-counter pain product.
Answer: d. may vary in the amount of drug that reaches the site of action in the body.
- a. may cause different adverse effects.
- b. does not necessarily have the same therapeutic effect.
- c. is likely to be less safe than the brand specified in the prescription.
- d. may vary in the amount of drug that reaches the site of action in the body.

Chapter 04: Special Populations: Geriatrics

Answer: a. select drugs that can be given once or twice daily.
- a. select drugs that can be given once or twice daily.
- b. provide detailed written instructions for each medication.
- c. order medications that can be given on an empty stomach.
- d. instruct the patient to take a lower dose if side effects occur.
Answer: d. perform a thorough evaluation of cognitive and motor abilities.
- a. assess this patient’s usual sleeping patterns.
- b. ask the patient about problems with constipation.
- c. obtain a baseline creatinine clearance test before the first dose.
- d. perform a thorough evaluation of cognitive and motor abilities.
Answer: b. write the initial prescription at the lowest possible dose.
- a. obtain a baseline liver function test (LFT) before starting the drug.
- b. write the initial prescription at the lowest possible dose.
- c. encourage the patient to consume a diet high in fat and protein.
- d. counsel the patient to take the drug with food to enhance absorption.

Chapter 05: Special Populations: Pediatrics

Answer: d. follow the drug manufacturer’s recommendations for medication dosing.
- a. calculate the dose at one third of the recommended adult dose.
- b. estimate the child’s body surface area (BSA) to calculate the medication dose.
- c. divide the recommended adult dose by the child’s weight in kilograms (kg).
- d. follow the drug manufacturer’s recommendations for medication dosing.
Answer: a. 20
- a. 20
- b. 10
- c. 14
- d. 9.3
Answer: b. 100 mg tid.
- a. 100 mg daily.
- b. 100 mg tid.
- c. 300 mg daily.
- d. 300 mg tid.

Chapter 06: Special Populations: Pregnant and Nursing Women

Answer: c. encourage the patient to increase daily water intake and to wear only cotton underwear.
- a. prescribe a low-dose sulfonamide antibiotic for urinary tract infection prophylaxis.
- b. order nitrofurantoin daily to minimize the patient’s risk of urinary tract infection late in her pregnancy.
- c. encourage the patient to increase daily water intake and to wear only cotton underwear.
- d. order a voiding cystourethrogram to rule out structural anomalies that may cause urinary tract infection.