Chapter 1: The Role of the Nurse Practitioner as Prescriber

Nurse practitioners (NPs) play a crucial role in healthcare, particularly in prescribing medications. The authority to prescribe medications for nurse practitioners is regulated by the State Board of Nursing for each state. This means that each state has its own set of rules and regulations that govern how NPs can prescribe medications.

Similarly, Physician Assistants (PAs) have their prescriptive authority regulated by the State Board of Medical Examiners. This board sets the guidelines and limitations on what PAs can prescribe and under what circumstances.

When it comes to clinical judgment in prescribing, several factors must be considered. One important aspect is the cost of the medication to the patient. This involves evaluating the financial burden on the patient and trying to find cost-effective options. It is not always about prescribing the newest medication available; rather, it involves careful consideration of the patient’s condition and the most suitable treatment option. Handing out drug samples or prescribing all generic medications are not always the best practices and should be considered carefully within the context of the patient’s needs and circumstances.

Choosing an effective drug for a disorder involves consulting nationally recognized guidelines for disease management. These guidelines provide evidence-based recommendations for the treatment of various conditions and help ensure that patients receive the best possible care. It is not about asking patients what drug they think would work best or prescribing medications just because they are available as samples.

Nurse practitioner practice is expected to thrive under healthcare reform due to several reasons. One significant factor is the demonstrated ability of nurse practitioners to control costs and improve patient outcomes. NPs have been shown to provide high-quality care that is cost-effective. Additionally, healthcare reform may allow NPs to practice independently, increasing access to care for many patients. Full reimbursement under healthcare reform and the ability to shift accountability for Medicaid to the state level are also factors that may contribute to the thriving practice of NPs.

Multiple Choice Questions:

Nurse practitioner prescriptive authority is regulated by:
- A. The National Council of State Boards of Nursing
- B. The U.S. Drug Enforcement Administration
- C. The State Board of Nursing for each state
- D. The State Board of Pharmacy
Physician Assistant (PA) prescriptive authority is regulated by:
- A. The National Council of State Boards of Nursing
- B. The U.S. Drug Enforcement Administration
- C. The State Board of Nursing
- D. The State Board of Medical Examiners
Clinical judgment in prescribing includes:
- A. Factoring in the cost to the patient of the medication prescribed
- B. Always prescribing the newest medication available for the disease process
- C. Handing out drug samples to poor patients
- D. Prescribing all generic medications to cut costs
Criteria for choosing an effective drug for a disorder include:
- A. Asking the patient what drug they think would work best for them
- B. Consulting nationally recognized guidelines for disease management
- C. Prescribing medications that are available as samples before writing a prescription
- D. Following U.S. Drug Enforcement Administration (DEA) guidelines for prescribing
Nurse practitioner practice may thrive under healthcare reform due to:
- A. The demonstrated ability of nurse practitioners to control costs and improve patient outcomes
- B. The fact that nurse practitioners will be able to practice independently
- C. The fact that nurse practitioners will have full reimbursement under healthcare reform
- D. The ability to shift accountability for Medicaid to the state level