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

1. 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
2. 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.
3. 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

1. 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.
2. 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.
3. 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

1. Answer: b. pharmacokinetics.
   • a. bioavailability.
   • b. pharmacokinetics.
   • c. pharmacodynamics.
   • d. anatomy and physiology.
2. Answer: c. acetaminophen.
   • a. APAP.
   • b. Tylenol.
   • c. acetaminophen.
   • d. any over-the-counter pain product.
3. 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

1. 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.
2. 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.
3. 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

1. 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.
2. Answer: a. 20
   • a. 20
   • b. 10
   • c. 14
   • d. 9.3
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

1. 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.