Ch 1-3 / Lehne’s 2nd Ed

Question 1

Prescriptive authority

Answer 1

The legal right to prescribe drugs

Question 2

Full prescriptive authority

Answer 2

Affords the legal right to prescribe independently and without limitation.

Question 3

What are the two components of prescriptive authority?

Answer 3

The right to prescribe without limitation and the right to prescribe independently

Question 4

True or false: prescriptive authority is determined by state law

Answer 4

True

Question 5

True or false: APRNs are NOT educated to practice and prescribe independently without supervision

Answer 5

False

APRNs are educated to practice and prescribe independently without supervision however some state laws require that they practice in collaboration with or under the supervision of a physician.

Question 6

TRUE OR FALSE

In Texas, APRNs can prescribe schedule III - V under a collaborative agreement with a physician.

Answer 6

TRUE

Question 7

Name 7 ways to keep your pt and yourself safe when prescribing

Answer 7

1. Be prudent & deliberate in decision making
2. Have a provider / pt relationship documented
3. Don’t prescribe to friends / family
4. Document thorough H&P
5. Document pt teaching
6. Document monitoring plan / consultants
7. Use reliable references to assist in decision making

Question 8

What are the nine things to consider when making a drug selection?

Answer 8

Cost
Treatment guidelines 
Availability 
Interactions
Side effects 
Allergies
Hepatic / renal function 
Need for monitoring
Special populations

Question 9

Name the required elements of a prescription for an APRN in Texas

Answer 9

Name / NPI / contact info of APRN and collaborating physician (DEA if applicable)

Pt Name / DOB / Allergies

Name of med/ indication

Med strength / dose / frequency

to dispense (quantity) / # refills

Question 10

What schedule category of medication cannot be prescribed or refilled by telephone?

Answer 10

Schedule II except for emergency for a limited quantity and a written script must be presented within 7 days.

Question 11

Describe some unsafe practices when writing prescriptions

Answer 11

Using abbreviations
Having prescriptions pre-signed
Not using a tamper resistant or security feature on prescription pads

Question 12

What is the Meaningful Use program?

Answer 12

It is a program by CMS to provide incentives for prescribers to use an electronic medical record (EMR) when prescribing

Question 13

Name some helpful applications and websites for safe prescribing

Answer 13

Epocrates
LexiComp
Pepcid
PDR
UptoDate

Question 14

Name the nine teaching components when prescribing a new medication

Answer 14

Medication name, purpose, dosing regimen, administration, adverse effects, any special storage needs, associated lab testing, food or drug interactions, and duration of therapy

Question 15

What principles need to be discussed with patient when teaching about drug monitoring?

Answer 15

And patients need to know: what, when, where , why and how regarding the testing

Question 16

What are some alternative methods for education for patients with low literacy or vision problems?

Answer 16

Video or audio instructions

Question 17

Name three ways that drugs can be monitored

Answer 17

Determining the therapeutic dose or the therapeutic index

evaluating medication adequacy

Identifying any adverse effects

Question 18

This is an agreement made between the patient and the provider on medication regimen that will be taken as prescribed for the amount of time indicated at the prescribed frequency

Answer 18

Medication Adherence

Question 19

True or False: Medication adherence and medication compliance are the same things

Answer 19

False: medication compliance has fallen out of favor because it views the provider from an authoritarian perspective who dictate treatment

Question 20

Name five reasons that patients do not adhere to their medication regimen

Answer 20

Forgetfulness, lack of planning, cost, dissatisfaction, and altered dosing