Nurse Practitioner's Business Practice and
Legal Guide 6th Ed. Testbank / Study Guide
Chapter 1 What Is a Nurse Practitioner?
1. Are NPs now considered “prescribers”?
ANS. For the purpose of obtaining a DEA number for (ordering) Schedule II, III, IV, V the
NP with a furnishing number is considered by the DEA to be a prescriber.
2. Does the NP need a furnishing number issued by the BRN to obtain a DEA number?
ANS. Yes, an nurse practitioner furnishing number is required to obtain a DEA number for
Schedule II through V Controlled Substances
3. Can a nurse practitioner request and sign for complimentary samples of dangerous drugs
and devices from a manufacture’s sales representative?
ANS. Yes, the certified nurse practitioner and the certified nurse midwife may sign for the
request and receipt of complimentary samples of dangerous drugs and devices identified
in their standardized procedures or protocol that has been approved by the physician.
4. May I call myself a nurse practitioner once I have completed my nurse practitioner
program?
ANS. No. You cannot use the title nurse practitioner until you have been certified by the
BRN as a nurse practitioner. Furthermore, registered nurses who use the title NP without
BRN certification may subject their RN license to possible discipline.
5. Can a nurse practitioner function in the emergency department?
ANS.Yes. Nurse practitioners are permitted to perform consultation and treatment in an
emergency department under certain conditions. Section 1317.1 of the Health and Safety
Code, relating to emergency services was repealed and amended September 26, 2011,
changing definition of emergency service and care to include appropriately licensed
persons, nurse practitioners and physician assistants, under the supervision of a physician
and surgeon, to include medical screening, examination, and evaluation by a physician, or
to the extent permitted by applicable law, by other appropriate personnel (NP&PA) under
the supervision of a physician and surgeon, to determine care, treatment, and surgery by
physician necessary to relieve or eliminate the emergency medical condition or active
labor, within the capability of the facility.
6. What are the roles of a Family Nurse Practitioner?
ANS. Family nurse practitioners (FNPs) are graduate-educated, nationally-certified and
state licensed advanced practice registered nurses (APRNs) who care for medically stable

patients across the lifespan, from infants to geriatric patients. “Family” in this case
describes the NP’s chosen patient population focus and denotes national certification
through one of two certifying bodies that certify NPs as having the specialized skills
necessary to work with this patient group: the American Nurses Credentialing Center
(AACN) or the American Academy of Nurse Practitioners (AANP).

Chapter 2 Legal Nurse Practitioner Scope of Practice
1. What is the nurse practitioners scope of practice?
ANS. “Nurse practitioners are licensed, independent practitioners who practice in
ambulatory, acute and long-term care as primary and/or specialty care providers. Nurse
practitioners assess, diagnose, treat, and manage acute episodic and chronic illnesses.
Nurse practitioners are experts in health promotion and disease prevention. They order,
conduct, supervise, and interpret diagnostic and laboratory tests, prescribe
pharmacological agents and non-pharmacologic therapies, as well as teach and counsel
patients, among other services.As licensed, independent clinicians, Nurse practitioners
practice autonomously and in coordination with healthcare professionals and other
individuals. They may serve as healthcare researchers, interdisciplinary consultants, and
patient advocates. Nurse practitioners provide a wide-range of healthcare services to
individuals, families, groups, and communities.”
2. What is the patient centered nature of an NP?
ANS. The patient-centered nature of the NP role requires a career-long commitment to
meet the evolving needs of society and advances in health care science. NPs are responsible
to the public and adaptable to changes in health care. As leaders in health care, NPs
combine the roles of provider, mentor, educator, researcher, and administrator. NPs take
responsibility for continued professional development, involvement in professional
organizations, and participation in health policy activities at the local, state, national and
international levels. Five decades of research affirms that NPs provide safe, high-quality
care.
3. What element of education is required to be an NP?
ANS. NPs are advanced practice registered nurses who obtain graduate education, post-
master’s certificates, and doctoral degrees. Educational preparation provides NPs with
specialized knowledge and clinical competency which enable them to practice in various
health care settings, make differential diagnoses, manage and initiate treatment plans and
prescribe medications and treatment. National NP education program accreditation
requirements and competency-based standards ensure that NPs are equipped to provide
safe, high-quality patient care from the point of graduation. Clinical competency and
professional development are hallmarks of NP education.
4. What are the professional roles of a nurse practioner?
ANS. Nurse practitioners (NPs) are licensed, independent practitioners who practice in
ambulatory, acute and long-term care as primary and/or specialty care providers. Nurse
practitioners assess, diagnose, treat, and manage acute episodic and chronic illnesses. NPs
are experts in health promotion and disease prevention. They order, conduct, supervise,
and interpret diagnostic and laboratory tests, prescribe pharmacological agents and non-
pharmacologic therapies, as well as teach and counsel patients, among other services. As
licensed, independent clinicians, NPs practice autonomously and in coordination with
health care professionals and other individuals. They may serve as health care researchers,

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Chapter 3 State Regulation of Nurse Practitioner Practice
1. Can nurse practioners practice outside of the United States?
ANS. Nurse practitioners and physician assistants can alleviate some of the primary
care shortage facing the United States, but their scope-of-practice is limited by state
regulation.
2. How are NPs scope of practice specified?
ANS. Nurse practitioner scope-of-practice is specified by statute or regulation. In some
states, state legislatures enact SOP statutes, and in other states, the board of nursing defines
the NP SOP. Regulations and statutes are similarly enforceable. . According to the 2016
AANP National Nurse Practitioner Sample Survey, about 75% of NPs accept new
Medicare patients and 77.9% of NPs accept new Medicaid patients, 49.9% of NPs hold
hospital privileges and 11.3% have long term care privileges. Furthermore, NPs hold
prescriptive privileges containing controlled substances in 50 states and D.C., 95.8% of
NPs prescribe medications, and “those in full-time practice write an average of 23
prescriptions per day”
3. How are NP’s regulated by state?
ANS. Depending on the NP practice issue, certain functions of NPs are regulated by state
NP SOP regulations and/or federal law. The NP practice issues that come under state
regulation are requirements for licensure, scope-of-practice, prescriptive authority,
requirement of collaboration or supervision, basis for license suspension, revocation, or
nonrenewal, reimbursement under Medicaid, by indemnity insurances, requirements of
educational programs, standards of practice110. There is also federal regulation of the NP
profession and federal law prevails over state law if there is any conflict between state and
federal law. Federal regulation entails: care of patients covered by Medicare, Medicaid;
billing Medicare; care of hospitalized patients insofar as participation by hospitals in the
Medicare program; care of residents in nursing homes; in-office and hospital laboratories,
under the Clinical Laboratory Improvement Amendments; self-referral by healthcare
providers, under the Stark Acts; prescription of controlled substances under the Drug
Enforcement Administration (DEA); reporting of successful malpractice lawsuits against
NPs to the National Practitioner Data Bank; confidentiality of information about patients
under the Health Insurance Portability and Accountability Act; discrimination in hiring and
firing; facility access for disabled people; e-prescribing and electronic medical records

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Chapter 4 Federal Regulation of the Nurse Practitioner Profession
1. What is practice authority regarding Nurse Pracitoner Profession?
ANS.Practice authority is the regulation of the duties a nurse can perform, and under which
circumstances. Primarily originating at the state legislative level, this results in a patchwork
of different criteria that nurses must meet, varying significantly by geographical location.
According to the American Association of Nurse Practitioners (AANP), practice authority,
by state, falls into three categories: full practice, reduced practice, and restricted practice.
In a full practice state, nurse practitioners can evaluate and diagnose patients, order and
interpret diagnostic tests, initiate and manage treatments, and prescribe medications. In a
reduced practice setting, state laws reduce the ability of nurse practitioners to perform at
least one element of practice, requiring them to seek a collaborative agreement with an
outside health discipline to provide components of patient care. In a restricted setting, at
least one part of nursing practice is restricted by the state and requires supervision,
delegation, or team management to provide patient care.
2. How does the scope of practice relate to federal regulations for NP’s?
ANS.The scope of practice acts as a system of regulation and standardization for the
nursing community, but instead of relying on physician organizations and state legislatures
to determine a nurse’s practice authority state by state, groups such as the ANA believe
that nurses are competent at determining what tasks nurses can complete. They believe that
what nurses are skilled to do in Missouri could easily be the same as what they are qualified
to do across the border in Iowa. Limited practice authority, as determined by states, can
cause talented nurses to take their skills to states with broader practice authority, which
can, in effect, create a brain drain from restrictive states and negatively impact patient
outcomes there.
3. What are rhe goals of the ACA towards primary care?
ANS. The goals of the ACA to increase access to primary care services are linked to
efficient use of NPs as care providers. These goals rely on federal initiatives and reliable
funding to support NP training and education as well as models of care where NPs practice.
However, the full benefit of federal efforts may be hampered by restrictions occurring at
the state-level, including scope-of-practice barriers. Examining federal policies in tandem
with state-level regulations is essential to achieving increased NP workforce supply and
improved access to care.

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Chapter 5 Prescribing
1. Can nurse practioners prescribe medications?
ANS. Yes. Nurse practitioners can prescribe medication, including controlled substances,
in all 50 states and Washington DC. That said, the degree of independence with which they
can prescribe drugs, medical devices (e.g., crutches) or medical services varies by state NP
practice authority.
2. What type of education is required for the prescription of medications?
ANS. During graduate programs in nursing, NP students undergo extensive education in
assessment, diagnosis, and treatment. They take advanced courses in pharmacotherapeutics
and complete rigorous patient simulations, as well as supervised clinical hours. They study
pharmacokinetics and pharmacodynamics while learning how to safely and effectively
prescribe and monitor medication in different patient populations. In sum, NP education
and subsequent credentialing prepares them for full prescriptive authority, but there are
still differing regional laws regarding NP autonomy.
3. Can Nurse Practitioners Prescribe Medication Without Physicans?
ANS. In 21 states and Washington DC, nurse practitioners have the explicit legal authority
to prescribe. The application for prescriptive authority may be separate from NP state
credentialing, and NPs prescribing controlled substances generally must register with the
DEA. In 29 states, NPs can prescribe medication but must have a “collaborative
relationship” or “protocol agreement” with a specific, supervising physician. In all 50 states
and Washington DC, nurse practitioners can prescribe controlled substances with the
appropriate supervision (i.e., collaborative agreement, if required) and credentialing.

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