Opposition to Mandatory DNP Degree for Advanced Practice Nurses: Care or Professionalizati, Exams of Nursing

Download Opposition to Mandatory DNP Degree for Advanced Practice Nurses: Care or Professionalizati and more Exams Nursing in PDF only on Docsity! FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE CHAPTER1: ANSWERS AND RATIONALES 1. Which change represents the primary impetus for the end of the era of the female lay healer? 1. Perception of health promotion as an obligation 2. Development of a clinical nurse specialist position statement 3. Foundation of the American Association of Nurse-Midwives 4. Emergence of a medical establishment Page: 4 Feedback 1. This is incorrect. Lay healers traditionally viewed their role as being a function of their community obligations; however, the emerging medical establishment viewed healing as a commodity. The emergence of a male medical establishment represents the primary impetus for the end of the era of the female lay healer. 2. This is incorrect. The American Nurses Association (ANA) position statement on educational requirements for the clinical nurse specialist (CNS) was developed in 1965; the ANA’s position statement on the role of the CNS was issued in 1976. The emergence of a male medical establishment represents the primary impetus for the end of the era of the female lay healer. 3. This is incorrect. The American Association of Nurse-Midwives (AANM) was founded in 1928. The emergence of a male medical establishment represents the primary impetus for the end of the era of the female lay healer. 4. This is correct. The emergence of a male medical establishment represents the primary impetus for the end of the era of the female lay healer. Whereas lay healers viewed their role as being a function of their community obligations, the emerging medical establishment viewed healing as a commodity. The era of the female lay healer began and ended in the 19th century. The American Association of Nurse-Midwives (AANM) was founded in 1928. The American Nurses Association (ANA) position statement on educational requirements for the clinical nurse specialist (CNS) was developed in 1965; the ANA’s position statement on the role of the CNS was issued in 1976. 2. The beginning of modern nursing is traditionally considered to have begun with which event? 1. Establishment of the first school of nursing 2. Incorporation of midwifery by the lay healer 3. Establishment of the Frontier Nursing Service (FNS) 4. Creation of the American Association of Nurse-Midwives (AANM) FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Answer: 1 Pages: 4–5 Feedback 1. This is correct. Traditionally, modern nursing is considered to have begun in 1873, when the first three U.S. training schools for nurses opened. The role of the lay healer as a midwife is documented to have occurred in the 19th century, before the establishment of schools of nursing. The Frontier Nursing Service (FNS), which provided nurse-midwifery services, was established in 1925. In 1928, the Kentucky State Association of Midwives, which was an outgrowth of the FNS, became the American Association of Nurse-Midwives (AANM). 2. This is incorrect. The role of the lay healer as a midwife is documented to have occurred in the 19th century, before the establishment of schools of nursing. Traditionally, modern nursing is considered to have begun in 1873, when the first three U.S. training schools for nurses opened. 3. This is incorrect. The Frontier Nursing Service (FNS), which provided nurse- midwifery services, was established in 1925. Traditionally, modern nursing is considered to have begun in 1873, when the first three U.S. training schools for nurses opened. 4. This is incorrect. In 1928, the Kentucky State Association of Midwives, which was an outgrowth of the FNS, became the American Association of Nurse- Midwives (AANM). Modern nursing is considered to have begun in 1873, at which time the first three U.S. training schools for nurses opened. 3. In 1910, which factors most significantly influenced the midwifery profession? Select all that apply. 1. Strict licensing requirements 2. Negative public perception 3. Dedicated funding for training 4. Poor maternal-child outcomes 5. Mandatory professional supervision Answer: 2, 4 Pages: 6–7 Feedback 1. This is incorrect. In 1910, the midwifery profession was significantly influenced by poor maternal-child outcomes and a public perception as unprofessional. Though legislation ultimately was passed to tighten requirements related to licensing and supervision of midwives, in the early 20th century, midwives were largely unregulated and generally perceived as unprofessional. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Answer: 4 Page: 9 Feedback 1. This is incorrect. The role of the certified nurse-midwife (CNM) is unique in that the CNM views the practice role as combining two disciplines: nursing and midwifery. 2. This is incorrect. The role of the certified nurse-midwife (CNM) is unique in that the CNM views the practice role as combining two disciplines: nursing and midwifery. 3. This is incorrect. The role of the certified nurse-midwife (CNM) is unique in that the CNM views the practice role as combining two disciplines: nursing and midwifery. 4. This is correct. The role of the certified nurse-midwife (CNM) is unique in that the CNM views the practice role as combining two disciplines: nursing and midwifery. 5. In the 19th century, which factors led to the administration of anesthesia by nurses? Select all that apply. 1. Surgeon entitlement to collecting anesthesia fees 2. Collaborative practice between physician-anesthetists and nurses 3. Lack of recognition of anesthesiology as a medical specialty 4. Opposition to anesthesia administration by physicians 5. Formation of a national organization by nurse anesthetists Answer: 1, 3 Pages: 10–11 Feedback 1. This is correct. In the 19th century, anesthesia was in its early stages. Because of a lack of recognition as a medical specialty and the surgeon’s entitlement to collecting anesthesia fees, other physicians had little to no interest in anesthesia administration. However, physicians were not opposed to administering anesthesia; rather, anesthesia was viewed as a means by which to transform surgery into a scientific modality for treating health alterations. Collaboration between physicians and nurses did not contribute to administration of anesthesia by nurses; contentiousness is a hallmark of the relationship between nurse anesthetists and anesthesiologists even in the present day. In the 19th century, no national organization of nurse anesthetists yet existed. The National Association of Nurse Anesthetists, which was renamed the American Association of Nurse Anesthetists (AANA), was founded in 1931. 2. This is incorrect. With the introduction of anesthesia, collaboration between physicians and nurses did not contribute to administration of anesthesia by FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE nurses. By contrast, contentiousness is a hallmark of the relationship between nurse anesthetists and anesthesiologists even in the present day. In the 19th century, anesthesia was in its early stages. Administration of anesthesia by nurses occurred primarily because of anesthesiology’s lack of recognition as a medical specialty and the surgeon’s entitlement to collecting anesthesia fees. 3. This is correct. In the 19th century, anesthesia was in its early stages. Because of a lack of recognition as a medical specialty and the surgeon’s entitlement to collecting anesthesia fees, other physicians had little to no interest in anesthesia administration. However, physicians were not opposed to administering anesthesia; rather, anesthesia was viewed as a means by which to transform surgery into a scientific approach to treating with health alterations. Collaboration between physicians and nurses did not contribute to administration of anesthesia by nurses; contentiousness is a hallmark of the relationship between nurse anesthetists and anesthesiologists even in the present day. In the 19th century, no national organization of nurse anesthetists yet existed. The National Association of Nurse Anesthetists, which was renamed the American Association of Nurse Anesthetists (AANA), was founded in 1931. 4. This is incorrect. In the 19th century, anesthesia was in its early stages. Physicians were in favor of the administration of anesthesia, viewing this advancement as a means by which to transform surgery into a scientific modality for treating health alterations. Because of a lack of recognition as a medical specialty and the surgeon’s entitlement to collecting anesthesia fees, other physicians had little to no interest in anesthesia administration. As such, the administration of anesthesia was assigned to nurses. 5. This is incorrect. The National Association of Nurse Anesthetists, which was renamed the American Association of Nurse Anesthetists (AANA), was founded in 1931. In the 19th century, anesthesia was in its early stages. Because of a lack of recognition as a medical specialty and the surgeon’s entitlement to collecting anesthesia fees, other physicians had little to no interest in anesthesia administration. Thus, anesthesia administration was performed by nurses. 6. Which factor contributed to expansion of the role of the clinical nurse specialist (CNS) during the 1960s? 1. Increased numbers of practicing physicians 2. Tightening of female role definitions 3. Return of nurses from military conflict 4. Lack of medical specialization Answer: 3 Page: 17 FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Feedback 1. This is incorrect. During the 1960s, a shortage of physicians occurred. The role of the CNS was expanded in part because of the return of nurses from the Vietnam War. Nurse veterans searched for opportunities to increase their knowledge and skills, and practiced in advanced roles as well as nontraditional specialties (such as anesthesia and trauma or anesthesia). 2. This is incorrect. During the 1960s, role definitions for women became less restrictive. The role of the CNS was expanded in part because of the return of nurses from the Vietnam War. Nurse veterans searched for opportunities to increase their knowledge and skills, and practiced in advanced roles as well as nontraditional specialties (such as anesthesia and trauma or anesthesia). 3. This is correct. Expansion of the CNS role during the 1960s occurred in part because of the return of nurse veterans from the Vietnam War who sought to increase their knowledge and skills, and to work in advanced roles and nontraditional fields, such as anesthesia and trauma. 4. This is incorrect. In the 1960s, medical specialization was prevalent, and the need for competent nurses who were proficient at caring for patients with complex health needs increased. Thus, the CNS role expanded. The role of the CNS also expanded because of the return of nurses from the Vietnam War. Many of these nurse veterans searched for opportunities to increase their knowledge and skills, and practiced in advanced roles as well as nontraditional specialties (such as anesthesia and trauma or anesthesia). 7. Differentiation between the role of the clinical nurse specialist (CNS) and the nurse practitioner (NP) is primarily based on which premise? 1. Designation as an advanced practice nurse 2. Diagnosis of patient health conditions 3. Nature of practice setting environments 4. Authority to prescribe medications Answer: 3 Pages: 20–21 Feedback 1. This is incorrect. Both the clinical nurse specialist (CNS) and the nurse practitioner (NP) are designated as advanced practice nurses (APNs). A primary differentiation between the roles of CNS and NP centers on the nature of the practice setting. Although the CNS most often practices in a secondary or tertiary care setting, the NP often practices in a primary care setting. 2. This is incorrect. Both the clinical nurse specialist (CNS) and the nurse practitioner (NP) are prepared to diagnose patient health alterations. A primary differentiation between the roles of CNS and NP centers on the FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE reimbursement mechanisms in the United States, and prescriptive privilege. At present, NPs still face challenges related to autonomy, as well as consumer recognition in health care. 3. This is incorrect. At present, nurse practitioners (NPs) still face challenges related to consumer recognition in health care. The 2008 adoption of the Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation by the National Council of State Boards of Nursing prompted gains related to several aspects of the role and function of the NP, including legal authority, reimbursement mechanisms in the United States, and prescriptive privilege. 4. This is correct. Adoption of the Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation in 2008 by the National Council of State Boards of Nursing prompted gains related to several aspects of the role and function of the nurse practitioner (NP), including legal authority, reimbursement mechanisms in the United States, and prescriptive privilege. At present, NPs still face challenges related to autonomy, as well as consumer recognition in health care. 5. This is incorrect. At present, nurse practitioners (NPs) still face challenges related to autonomy. The 2008 adoption of the Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation by the National Council of State Boards of Nursing prompted gains related to several aspects of the role and function of the NP, including legal authority, reimbursement mechanisms in the United States, and prescriptive privilege. At present, NPs still face challenges related to autonomy, as well as consumer recognition in health care. 9. The doctor of nursing practice (DNP) degree was developed to support the achievement of which goal related to advanced practice nursing education? 1. Eliminating master’s degree programs 2. Promoting excellence in clinical practice 3. Replacing doctor of philosophy programs 4. Emphasizing the generation of nursing research Answer: 2 Pages: 31, 33 Feedback 1. This is incorrect. Rather than seeking to eliminate master’s degree programs designed to prepare advanced practice registered nurses (APRNs), current legislation exists to preserve such programs. The doctor of nursing practice (DNP) is focused on preparing the nurse clinician to demonstrate excellence in nursing practice. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 2. This is correct. The doctor of nursing practice (DNP) is not intended to replace the doctor of philosophy (PhD). Whereas the PhD emphasizes research, the FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE seeking certification as an advanced practice registered nurse (APRN) based on a perception that the need for care providers should be prioritized over professionalization of APRNs. 4. This is correct. National nursing leaders have opposed a mandate that would require completion of a doctor of nursing practice (DNP) degree before seeking certification as an advanced practice registered nurse (APRN) based on a perception that the need for care providers should be prioritized over professionalization of APRNs. National nursing leaders have neither sought to limit graduate nursing education programs for APRNs nor recommended that advanced practice nurses (APNs) be required to complete a doctor of philosophy (PhD) degree. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Chapter 2: Emerging Roles of the Advanced Practice Nurse ANSWERS AND RATIONALES 1. Entry into which advanced practice nursing specialty will require a doctoral degree by 2022? 1. Clinical nurse specialist (CNS) 2. Certified registered nurse anesthetist (CRNA) 3. Nurse practitioner (NP) 4. Certified nurse-midwife (CNM) Answer: 2 Page: 5 Feedback 1. This is incorrect. Clinical nurse specialists (CNSs) are not required to complete a doctoral degree. However, the American Association of Nurse Anesthetists (AANA) has set forth a mandate requiring all graduates to complete a doctoral degree. Beginning in 2022, a doctorate will be the minimum requirement to enter practice as a certified registered nurse anesthetist (CRNA) (AANA, 2016). 2. This is correct. Beginning in 2022, the American Association of Nurse Anesthetists (AANA) will require a doctoral degree as a minimum requirement to enter practice as a certified registered nurse anesthetist (CRNA) (AANA, 2016). 3. This is incorrect. Nurse practitioners (NPs) are not currently required to complete a doctoral degree. Presently, only the American Association of Nurse Anesthetists (AANA) has set forth a mandate requiring all graduates to complete a doctoral degree. Beginning in 2022, a doctorate will be the minimum requirement to enter practice as a certified registered nurse anesthetist (CRNA) (AANA, 2016). 4. This is incorrect. At present, certified nurse-midwives (CNMs) are not required to obtain a doctoral degree. Only the American Association of Nurse Anesthetists (AANA) has set forth a mandate requiring all graduates to complete a doctoral degree. Beginning in 2022, a doctorate will be the minimum requirement to enter practice as a certified registered nurse anesthetist (CRNA) (AANA, 2016). 2. According to the Consensus Model for APRN Regulation, advanced practice nursing should abide by which recommendation? 1. Emphasizing state-based regulation of advanced practice nursing standards 2. Ensuring regulation of advanced practice registered nurses (APRNs) as a unified, collective group 3. Preparing clinical nurse specialists (CNSs) to function primarily in acute care 4. Changing the population focus of adult nurse practitioners to adult gerontology Answer: 4 FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Pages: 6, 20 Feedback 1. This is incorrect. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education was developed by the APRN Consensus Work Group and the National Council of State Boards of Nursing (Consensus Model, 2008). Rather than emphasizing state-based regulation of advanced practice nursing, general goals of the Consensus Model include promoting consistency of advanced practice nursing standards to increase the potential for interstate licensure reciprocity. The Consensus Model recommends shifting the population focus of adult nurse practitioners (NPs) to adult gerontology. 2. This is incorrect. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education was developed by the APRN Consensus Work Group and the National Council of State Boards of Nursing (Consensus Model, 2008). Instead of ensuring regulation of advanced practice registered nurses (APRNs) as a collective group, the Consensus Model recommends regulation of APRNs in one of four accepted roles. Recommendations also include shifting the population focus of adult nurse practitioners (NPs) to adult gerontology. 3. This is incorrect. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education was developed by the APRN Consensus Work Group and the National Council of State Boards of Nursing (Consensus Model, 2008). Based on the Consensus Model, the practice of clinical nurse specialist (CNS) practices occurs across both acute and primary care settings. The Consensus Model also recommends shifting the population focus of adult nurse practitioners (NPs) to adult gerontology. 4. This is correct. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education was developed by the APRN Consensus Work Group and the National Council of State Boards of Nursing (Consensus Model, 2008). Per the Consensus Model, the population focus of adult nurse practitioners (NPs) has shifted to adult gerontology. As opposed to emphasizing state-based regulation of advanced practice nursing, broad goals of the Consensus Model include developing more consistent standards for advanced practice nurses (APNs) that promote eligibility for interstate licensure reciprocity. Instead of ensuring regulation of advanced practice registered nurses (APRNs) as a collective group, the Consensus Model recommends regulation of APRNs in one of four accepted roles. The Consensus Model describes the practice of clinical nurse specialists (CNSs) as including both acute and primary care settings. 3. The relationship to which aspect of the function of the clinical nurse specialist (CNS) shows the greatest need for research? 1. Patient satisfaction 2. Care outcomes FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE practitioners (NPs) has included uninsured immigrants, as well as low-income individuals who receive Medicaid. Factors that have promoted evolution of the FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE NP’s role include an increase in the number of walk-in, retail, and urgent care clinics, as well as the provision of services to patients who live in urban and suburban outpatient settings. 6. Which consideration led to designation of the nurse practitioner (NP) rather than the clinical nurse specialist (CNS) as the advanced practice nurse (APN) who would deliver care related to psychiatric or mental health services? 1. Level of educational preparation 2. Eligibility for prescriptive authority 3. Ability to serve in community settings 4. Practice based on core competencies Answer: 2 Page: 15 Feedback 1. This is incorrect. Both the clinical nurse specialist (CNS) and the nurse practitioner (NP) may be prepared at either the master’s or doctoral level. Because of a heightened emphasis on a biopsychological approach to treating clients with psychiatric/mental health needs, the importance of prescriptive authority for this advanced practice nursing role has been underscored. At present, 40 states grant prescriptive privileges to CNSs and NPs (National Association of Clinical Nurse Specialists [NACNS], 2015). However, all 50 states grant prescriptive privileges to NPs. Therefore, the psychiatric/mental health nurse practitioner has become the sole means of educational preparation for this advanced practice role. 2. This is correct. A heightened emphasis on a biopsychological approach to treating clients with psychiatric/mental health needs has underscored the importance of prescriptive authority for this advanced practice nursing role. At present, 40 states grant prescriptive privileges to clinical nurse specialists (CNSs) and nurse practitioners (NPs) (National Association of Clinical Nurse Specialists [NACNS], 2015). However, as all 50 states grant prescriptive privileges to NPs, the psychiatric/mental health NP has become the sole means of educational preparation for this advanced practice role. Both the CNS and the NP may be prepared at either the master’s or doctoral level. Likewise, both the CNS and the NP may practice in a community setting. Core competencies guide the practice of both the CNS and the NP. 3. This is incorrect. Both the clinical nurse specialist (CNS) and the nurse practitioner (NP) may practice in a community setting. With a heightened emphasis on a biopsychological approach to treating clients with psychiatric/mental health need, the importance of prescriptive authority for this advanced practice nursing role became apparent. At present, 40 states grant prescriptive privileges to CNSs and NPs (National Association of Clinical Nurse Specialists [NACNS], 2015). However, as all 50 states grant prescriptive privileges to NPs, the psychiatric/mental health NP has become FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Feedback 1. This is correct. Most certified nurse-midwives (CNMs) practice in hospitals (29.5%) and physician-owned practices (21.7%). However, care settings for the CNM also may include midwife-owned practices, educational institutions, community health centers, birthing centers, nonprofit health agencies, and military or federal government agencies (Schuiling, Sipe, & Fullerton, 2013). 2. This is incorrect. The majority of certified nurse-midwives (CNMs) practice in hospitals (29.5%), followed by physician-owned practices (21.7%). Additional care settings for the CNM also may include midwife-owned practices, educational institutions, community health centers, birthing centers, nonprofit health agencies, and military or federal government agencies (Schuiling, Sipe, & Fullerton, 2013). 3. This is incorrect. Predominantly, certified nurse-midwives (CNMs) practice in hospitals (29.5%) and physician-owned practices (21.7%). However, care settings for the CNM also may include midwife-owned practices, educational institutions, community health centers, birthing centers, nonprofit health agencies, and military or federal government agencies (Schuiling, Sipe, & Fullerton, 2013). 4. This is incorrect. Certified nurse-midwives (CNMs) most often practice in hospitals (29.5%) and physician-owned practices (21.7%). However, CNMs also may practice in a variety of other settings, including midwife-owned practices, educational institutions, community health centers, birthing centers, nonprofit health agencies, and military or federal government agencies (Schuiling, Sipe, & Fullerton, 2013). 9. Which function of the certified registered nurse anesthetist (CRNA) is prohibited in certain states? 1. Induction of general anesthesia 2. Pain management procedures 3. Administration of spinal anesthesia 4. Provision of post-anesthesia care Answer: 2 Page: 27 Feedback 1. This is incorrect. All 50 states and the District of Columbia authorize certified registered nurse anesthetists (CRNAs) to provide induction of general anesthesia, as well as numerous other anesthesia-related services (Department of Health and Human Services [DHHS], Public Health Service [PHS] Division of Acquisition Management, 1995). However, the CRNA’s capacity to provide pain management procedures, such as epidural steroid injections, is regulated at the state level. Therefore, not all CRNAs are authorized to provide pain management services (American Association of Nurse Anesthetists [AANA], 2014). 2. This is correct. Pain management procedures, such as epidural steroid FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE injections, are regulated at the state level; therefore, not all certified registered nurse anesthetists (CRNAs) are authorized to provide pain management services (American Association of Nurse Anesthetists [AANA], 2014). All 50 states and the District of Columbia authorize CRNAs to provide induction of general anesthesia, administration of spinal anesthetics, and delivery of post- anesthesia care (Department of Health and Human Services [DHHS], Public Health Service [PHS] Division of Acquisition Management, 1995). 3. This is incorrect. All 50 states and the District of Columbia authorize certified registered nurse anesthetists (CRNAs) to administer spinal anesthetics, as well as to provide several other anesthesia-related services (Department of Health and Human Services [DHHS], Public Health Service [PHS] Division of Acquisition Management, 1995). However, the CRNA’s capacity to provide pain management procedures, such as epidural steroid injections, is regulated at the state level. Therefore, not all CRNAs are authorized to provide pain management services (American Association of Nurse Anesthetists [AANA], 2014). 4. This is incorrect. All 50 states and the District of Columbia authorize certified registered nurse anesthetists (CRNAs) to provide post-anesthesia care, as well as to deliver several other anesthesia-related services (Department of Health and Human Services [DHHS], Public Health Service [PHS] Division of Acquisition Management, 1995). However, the CRNA’s capacity to provide pain management procedures, such as epidural steroid injections, is regulated at the state level. Therefore, not all CRNAs are authorized to provide pain management services (American Association of Nurse Anesthetists [AANA], 2014). 10. Implementation of the anesthesia care team (ACT) model yielded which direct effect on anesthesia services? 1. Regulation of conditions related to reimbursable services 2. Mandatory direction of certified registered nurse anesthetists (CRNAs) by an anesthesiologist 3. Reduction in charges related to fraudulent anesthesia care 4. Increased accountability for physicians who employ CRNAs Answer: 2 Pages: 28–29 Feedback 1. This is incorrect. Regulations set forth by the Tax Equity and Fiscal Responsibility Act (TEFRA) mandated conditions for reimbursable services that appeared to require physician leadership for anesthesia delivery as a standard of care. The 1982 implementation of the anesthesia care team (ACT) model by the American Society of Anesthesiologists (ASA) resulted in mandatory direction of anesthetic administration by an anesthesiologist (Shumway & Del Risco, 2000). 2. This is correct. The 1982 implementation of the anesthesia care team (ACT) FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Chapter 3: Role Development: A Theoretical Perspective ANSWERS AND RATIONALES 1. Nurses working in a Magnet facility have low staff turnover rates and report high job satisfaction, making others aspire to have the longevity in employment experienced by those at the Magnet facility. Which of the following reference groups is this an example of? 1. Evaluative 2. Normative 3. Comparison 4. Audience Answer: 3 Page: 4 1. This is incorrect. The comparison group sets its own standards and becomes a comparison group only when an individual accepts it as such. Nurses at a Magnet facility are considered a comparison group. 2. This is incorrect. The normative group sets explicit standards and expects compliance, and it rewards or punishes relative to that degree of compliance. The church, community, and family are examples of normative groups. 3. This is correct. The comparison group sets its own standards and becomes a comparison group only when an individual accepts it as such. Nurses at a Magnet facility are considered a comparison group. 4. This is incorrect. The audience group is a collective group whose attention an individual wishes to attract. The audience group holds certain values but does not demand compliance from the person for whom they serve as a referent. 2. Which action should the advanced practice nurse (APN) take to be successful in socialization? 1. Be better at multitasking. 2. Develop a rapport with colleagues. 3. Develop skills in empathic communication. 4. Practice sympathetic listening. Answer: 3 Page: 6 1. This is incorrect. Better multitasking does not lead to successful socialization. The individual must project him- or herself into the circumstances of another and then step back to imagine how he or she would feel in the other’s situation. If there is accurate determination of the motives and feelings of the other, the actor can modify his or her own behavior to sustain or alter the other’s response. 2. This is incorrect. Developing a rapport does not lead to successful socialization. The individual must project him- or herself into the circumstances of another and then step back to imagine how he or she would feel in the other’s situation. If there is accurate determination of the motives and feelings of the other, the actor can modify his or her own behavior to sustain or alter the other’s response. 3. This is correct. Developing skill in empathic communication does lead to successful socialization. The individual must project him- or herself into the circumstances of another and then step back to imagine how he or she would feel in the other’s situation. If there is accurate determination of the motives and feelings of the other, the actor can modify his or her own behavior to sustain or alter the other’s response. 4. This is incorrect. Practicing sympathetic listening does not lead to successful socialization. The individual must project him- or herself into the circumstances of another and then step back FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE to imagine how he or she would feel in the other’s situation. If there is accurate determination of the motives and feelings of the other, the actor can modify his or her own behavior to sustain or alter the other’s response. 3. An advanced practice nurse (APN) consistently identifies each client by the five rights upon every encounter. This behavior is an example of which of the following? 1. First-order change 2. Second-order change 3. Role-making 4. Subrole internalization Answer: 2 Page: 6 1. This is incorrect. First-order changes are behavioral shifts that do not permanently achieve a desired result. Old preferences keep resurfacing. 2. This is correct. Second-order change leads to permanent change. Old behaviors and patterns are gone and are not replaced by a new version. 3. This is incorrect. Role-making is bidirectional and interactive, with both actors presenting behaviors that are interpreted reciprocally for the purpose of creating and modifying their own roles. 4. This is incorrect. Second-order change leads to permanent change. Old behaviors and patterns are gone and are not replaced by a new version. 4. Which action by the advanced practice nurse (APN) demonstrates role-making? 1. Practicing autonomy when working in a busy practice 2. Suggesting a change in treatment to the supervising physician 3. Changing a client’s medication to a lower dosage 4. Teaching a client how to self-administer insulin Answer: 2 Page: 7 1. This is incorrect. Although important, this does not demonstrate role-making. 2. This is correct. This demonstrates role-making, which is bidirectional and interactive. 3. This is incorrect. Although part of the advanced practice nurse (APN)’s role, this is not a demonstration of role-making. 4. This is incorrect. Although part of the advanced practice nurse (APN)’s role, this is not a demonstration of role-making. 5. The advanced practice nurse (APN) is mentoring an APN student. The APN recognizes that the student is having a hard time adjusting to the new role. Which action should the mentor take? 1. Allow the student to work through the process. 2. Listen sympathetically to the student. 3. Refer the student to a colleague with similar experiences. 4. Treat each failure as a learning opportunity. Answer: 4 Page: 10 1. This is incorrect. Although the student should be allowed to work through the process, the advanced practice nurse (APN) should be present as a guide. 2. This is incorrect. The advanced practice nurse (APN) should listen empathetically to the student. 3. This is incorrect. The advanced practice nurse (APN) should work closely with the client to FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Chapter 4: Educational Preparation of Advanced Practice Nurses: Looking to the Future ANSWERS AND RATIONALES 1. Which activity does the advanced practice nurse (APN) anticipate when completing a doctor of philosophy (PhD) research residency? 1. Literature review in nursing science 2. Participation in quality improvement 3. Presentation at practice conferences 4. Development of capstone with mentors Answer: 1 Page: 16 Feedback 1. This is correct. When completing a doctor of philosophy (PhD) research residency, the advanced practice nurse (APN) anticipates completing a literature review in nursing science. 2. This is incorrect. This activity is anticipated for a doctor of nursing practice (DNP) degree, not a doctor of philosophy (PhD). 3. This is incorrect. This activity is anticipated for a doctor of nursing practice (DNP) degree, not a doctor of philosophy (PhD). 4. This is incorrect. This activity is anticipated for a doctor of nursing practice (DNP) degree, not a doctor of philosophy (PhD). 2. Which activity is completed for both a doctor of nursing practice (DNP) and doctor of philosophy (PhD) program? 1. Interprofessional education (IPE) collaborative experiences 2. Participation in full scope research 3. Presentation at practice conferences 4. Submission of research grant proposals Answer: 1 Page: 16 Feedback 1. This is correct. Both the doctor of nursing practice (DNP) and doctor of philosophy (PhD) candidate will participate in interprofessional education (IPE) collaborative experiences. 2. This is incorrect. This activity is anticipated during a doctor of philosophy (PhD) research residency. 3. This is incorrect. This activity is anticipated during a doctor of nursing practice (DNP) residency. 4. This is incorrect. This activity is anticipated during a doctor of philosophy (PhD) research residency. 3. Which type of grant proposal does the advanced practice nurse (APN) submit when completing a doctor of philosophy (PhD) residency? Select all that apply. 1. Practice 2. Business 3. Research 4. Leadership FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Answer: 3 Page: 16 Feedback 1. This is incorrect. A practice research proposal is completed when pursing a doctor of nursing practice (DNP) degree. 2. This is incorrect. A business proposal is not completed when pursing a doctor of philosophy (PhD) degree. 3. This is correct. The advanced practice nurse (APN) will complete a research proposal when pursing a doctor of philosophy (PhD) degree. 4. This is incorrect. A leadership research proposal is completed when pursing a doctor of nursing practice (DNP) degree. 4. Which activity does the advanced practice nurse (APN) complete when participating in a doctor of nursing practice (DNP) residency? 1. Participate in quality improvement 2. Present at research conferences 3. Pilot research projects for dissertation 4. Submit research grant proposals Answer: 1 Page: 16 Feedback 1. This is correct. When completing a doctor of nursing practice (DNP) residency, the advanced practice nurse (APN) anticipates participation in quality improvement. 2. This is incorrect. The advanced practice nurse (APN) participates in this activity when completing a doctor of philosophy (PhD) research residency. 3. This is incorrect. The advanced practice nurse (APN) participates in this activity when completing a doctor of philosophy (PhD) research residency. 4. This is incorrect. The advanced practice nurse (APN) participates in this activity when completing a doctor of philosophy (PhD) research residency. 5. Which is the predominant route to certification for the advanced practice nurse (APN)? 1. Doctor of philosophy (PhD) 2. Doctor of nursing practice (DNP) 3. Master of science in nursing (MSN) 4. Bachelor of science in nursing (BSN) Answer: 3 Page: 3 Feedback 1. This is incorrect. The doctor of philosophy (PhD) degree is not the predominant route of certification for the advanced practice nurse (APN). 2. This is incorrect. The doctor of nursing practice (DNP) degree is not the predominant route of certification for the advanced practice nurse (APN). 3. This is correct. The master of science in nursing (MSN) degree continues to be the predominant route of certification for the advanced practice nurse (APN). 4. This is incorrect. The bachelor of science in nursing (BSN) degree is one route of certification for entry-level nursing. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 6. Which doctoral degree may be inappropriate for the nurse educator who seeks a tenure track position in the university setting? 1. Doctor of medicine (MD) 2. Doctor of philosophy (PhD) 3. Educational doctorate (EdD) 4. Doctor of nursing practice (DNP) Answer: 4 Page: 11 Feedback 1. This is incorrect. A nurse educator is unlikely to have a doctor of medicine (MD) degree; however, this degree is not inappropriate for tenure track positions in the university setting. 2. This is incorrect. A doctor of philosophy (PhD) is an acceptable doctoral degree for the nurse educator who is seeking a tenure track position in the university setting. 3. This is incorrect. An educational doctorate (EdD) is an acceptable doctoral degree for the nurse educator who is seeking a tenure track position in the university setting. 4. This is correct. Most universities do not accept the doctor of nursing practice (DNP) for tenure track positions. 7. The doctor of nursing practice (DNP) student will complete a final project referred to as a requirement. Answer: capstone Page: 13 Feedback: The advanced practice nurse (APN) completing a doctor of nursing practice (DNP) program will complete a final project that is often referred to as a capstone requirement. 8. The doctor of philosophy student will complete a as part of the educational process. Answer: dissertation Page: 13 Feedback: The doctor of philosophy (PhD) student will complete a research-based dissertation as part of the educational process. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE development. 2. This is incorrect. This is a noted obstacle on factors influencing advanced practice nursing development. 3. This is incorrect. This is a noted obstacle on factors influencing advanced practice nursing development. 4. This is correct. This is a noted support on factors influencing advanced practice nursing development. 7. Which is considered an obstacle by the World Health Organization's Eastern Mediterranean Region (WHO-EMR) Consensus on factors that influence advanced practice nursing development? Select all that apply. 1. Desire in the region to improve access to care 2. An increase in the community need for health-care services 3. An absence of nursing leadership at the policy level 4. Research studies that don’t support advanced nursing practice 5. Lack of feasibility studies for advanced practice nursing needs Answer: 3, 5 Page: 29 Feedback 1. This is incorrect. This is a noted support factor that influences the development of advanced practice nursing. 2. This is incorrect. This is a noted support factor that influences the development of advanced practice nursing. 3. This is correct. This is a noted obstacle for the development of advanced practice nursing. 4. This is incorrect. This is a noted support factor that influences the development of advanced practice nursing. 5. This is correct. This is a noted obstacle for the development of advanced practice nursing. 8. Which is supportive, per the World Health Organization's Eastern Mediterranean Region (WHO-EMR) Consensus, on factors influencing the advanced practice nursing development? 1. Role ambiguity 2. Absence of regulatory systems 3. Lack of feasibility studies for needs 4. Research studies from outside the region 5. Commitment to the development of nursing roles Answer: 4, 5 Page: 29 Feedback 1. This is incorrect. Role ambiguity is not a supportive factor influencing the development of advanced practice nursing. This is a noted obstacle. 2. This is incorrect. The absence of regulatory development is not a supportive factor influencing the development of advanced practice nursing. This is a noted obstacle. 3. This is incorrect. The lack of feasibility studies for needs is not a supportive factor influencing the development of advanced practice nursing. This is a noted obstacle. 4. This is correct. This is a supportive factor that influences the development of advanced practice nursing. 5. This is correct. This is a supportive factor that influences the development of advanced practice nursing. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 9. Which is an example of the educational preparation needed for an advanced practice nurse (APN) according to the International Council of Nurses (ICN)? 1. Right to diagnose 2. Case management 3. Formal system of licensure 4. Authority to refer to other professionals Answer: 3 Page: 4 Feedback 1. This is incorrect. The right to diagnose is an example of a regulatory mechanism, not educational preparation, for the advanced practice nurse (APN) according to the International Council of Nurses (ICN). 2. This is incorrect. Case management is an example of the nature of practice, not educational preparation, for the advanced practice nurse (APN) according to the International Council of Nurses (ICN). 3. This is correct. 4. This is incorrect. The authority to refer to other professionals is an example of a regulatory mechanism, not educational preparation, for the advanced practice nurse (APN) according to the International Council of Nurses (ICN). 10. According to the International Council of Nurses (ICN), the nature of practice includes the ability of the advanced practice nurse (APN) to integrate research, , and clinical management. Answer: education Page: 4 Feedback: According to the International Council of Nurses (ICN), the nature of practice includes the ability of the advanced practice nurse (APN) to integrate research, education, and clinical management. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Chapter 6: Advanced Practice Nurses and Prescriptive Authority ANSWERS AND RATIONALES 1. Which of the following changed the ability of all advanced practice nurses (APNs) to prescribe medications? 1. Risk of harm to patients 2. Lack of a physician on site 3. Nurse practitioner (NP) practice in primary care 4. Interruption of patient flow Answer: 3 Page: 2 Feedback 1. This is incorrect. When a physician was not on site to sign nurse practitioner (NP) prescriptions, patients had to wait for prescriptions to be signed before they could be filled. If a physician was not available for a day or more, the implications for patient safety and health care were serious. Though certified registered nurse anesthetists (CRNAs), certified nurse-midwives (CNMs), and clinical nurse specialists (CNSs) practiced in advanced roles for some time before the birth of NPs, the impetus for all advanced practice nurses (APNs) to obtain authorization to prescribe medications was the advent of NP practice in primary care. 2. This is incorrect. Nurse practitioners (NPs) assessed and diagnosed patients who needed prescription medications and treatments for their care. Depending on physicians to prescribe medications created problems in the areas of patient access to care, continuity of care, and patient flow. Though certified registered nurse anesthetists (CRNAs), certified nurse-midwives (CNMs), and clinical nurse specialists (CNSs) practiced in advanced roles for some time before the birth of NPs, the impetus for all advanced practice nurses (APNs) to obtain authorization to prescribe medications was the advent of NP practice in primary care. 3. This is correct. Though certified registered nurse anesthetists (CRNAs), certified nurse-midwives (CNMs), and clinical nurse specialists (CNSs) practiced in advanced roles for some time before the birth of NPs, the impetus for all advanced practice nurses (APNs) to obtain authorization to prescribe medications was the advent of NP practice in primary care. 4. This is incorrect. Nurse practitioners (NPs) assessed and diagnosed patients who needed prescription medications and treatments for their care. Depending on physicians to prescribe medications created problems in the areas of patient access to care, continuity of care, and patient flow. Though certified registered nurse anesthetists (CRNAs), certified nurse-midwives (CNMs), and clinical nurse specialists (CNSs) practiced in advanced roles for some time before the birth of NPs, the impetus for all advanced practice nurses (APNs) to obtain authorization to prescribe medications was the advent of NP practice in primary care. 2. Which of the following has been the main source of barriers limiting advanced practice registered nurses’ (APRNs’) prescriptive authority? 1. Limitations in state legislation and regulations 2. Concerns about patient safety and quality of care 3. Requirement for Drug Enforcement (DEA) number FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 4. Which of the following is a main reason a clinical nurse specialist (CNS) would refrain from obtaining prescriptive authority? 1. Lack of title recognition 2. Preservation of autonomy 3. Educational requirements 4. Required physician oversight Answer: 2 Page: 17 Feedback 1. This is incorrect. The lack of authorization and the desire to maintain autonomy in nursing practice led many clinical nurse specialists (CNSs) to choose not to obtain authorization in settings in which such authorization is attainable. 2. This is correct. The lack of authorization and the desire to maintain autonomy in nursing practice led many clinical nurse specialists (CNSs) to choose not to obtain authorization in settings in which such authorization is attainable. 3. This is incorrect. The lack of authorization and the desire to maintain autonomy in nursing practice led many clinical nurse specialists (CNSs) to choose not to obtain authorization in settings in which such authorization is attainable. 4. This is incorrect. The lack of authorization and the desire to maintain autonomy in nursing practice led many clinical nurse specialists (CNSs) to choose not to obtain authorization in settings in which such authorization is attainable. 5. Which of the following increased certified registered nurse anesthetists’ (CRNAs’) involvement with other advanced practice registered nurses (APRNs) to obtain prescriptive authority? 1. Limited authority 2. Legislative restrictions 3. Role in pain management 4. Required physician supervision Answer: 3 Page: 8 Feedback 1. This is incorrect. The authority of certified registered nurse anesthetists (CRNAs) to select and administer anesthesia has long been recognized. Until recently, CRNAs have been less involved in the struggle to obtain prescriptive authority than the other three disciplines. CRNAs have the need to prescribe as they are becoming more involved in pain management of patients in the practices they serve. 2. This is incorrect. Limitations set in state statutes and regulations affect the practice of all advanced practice registered nurses (APRNs). Certified registered nurse anesthetists (CRNAs) have the need to prescribe as they are becoming more involved in pain management of patients in the practices they serve. 3. This is correct. Certified registered nurse anesthetists (CRNAs), particularly in rural areas, suffer from similar problems. CRNAs have the need to prescribe as they are becoming more involved in pain management of patients in the practices they serve. 4. This is incorrect. Requirements for formalized collaborative agreements with physicians to practice and receive reimbursement have been most challenging for nurse practitioners (NPs) and certified nurse-midwives (CNMs). Certified registered FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE nurse anesthetists (CRNAs) have supervising or cooperating physicians in most states (AANA, 2016), whereas clinical nurse specialists (CNSs), in the states in which they have prescriptive authority, tend to have the same requirements as NPs. CRNAs have the need to prescribe as they are becoming more involved in pain management of patients in the practices they serve. 6. Which of the following describes the historical progression of advanced practice registered nurses’ (APRNs’) attainment of prescriptive authority? Select all that apply. 1. Standardization of educational programs 2. Lack of primary care in underserved areas 3. Complexity of the federal legislation process 4 Persuasion of legislators and state governors 5. Lack of title recognition in nurse practice acts Answer: 1, 2, 4, 5 Page: 4 Feedback 1. This is correct. Many nurse practice acts prohibited the prescribing of medication by nurses regardless of specialty or status. Changing state statutes and regulations gave title recognition and prescriptive authority to advanced practice registered nurses (APRNs). The form of regulatory rules depended largely on the persuasiveness of nurse practitioners (NPs) and the attitudes of the legislators and governors of those states. In the early days, NPs did not have title recognition other than that of registered nurse (RN) in their state regulatory systems. Except for certified nurse- midwives (CNMs) and certified registered nurse anesthetists (CRNAs) in several states, no APRNs had title recognition in statutory or regulatory language in the state nurse practice acts or administrative rules. 2. This is correct. The movement toward attainment of prescriptive authority was enhanced in the early days by an acute shortage of primary care physicians, and some states with higher primary care needs moved forward more rapidly. Rural states were more likely to initiate statutory and regulatory adjustments than states with large urban populations. 3. This is incorrect. Licensure for all professions occurs at the state rather than the federal level. 4. This is correct. In the early days, nurse practitioners (NPs) did not have title recognition other than that of registered nurse (RN) in their state regulatory systems. Except for certified nurse-midwives (CNMs) and certified registered nurse anesthetists (CRNAs) in several states, no advanced practice registered nurses (APRNs) had title recognition in statutory or regulatory language in the state nurse practice acts or administrative rules. 5. This is correct. Educational programs had to demonstrate that their curriculums prepared nurse practitioners (NPs) for an independent prescribing role. Advanced pathophysiology and pharmacology and the development of differential diagnosis and clinical decision-making skills needed to be visible in the programs. With the advent of federal grants to prepare NPs, the content and quality of the preparatory programs was increasingly standardized. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 7. Which of the following contributes to the increase in the likelihood of advanced practice registered nurses (APRNs) attaining nationwide prescriptive authority? 1. Quality of care 2. Cost-effectiveness 3. Uniform nurse practice acts 4. Designation as a midlevel practitioner 5. Endorsement of APRN Consensus Model Answer: 1, 2, 5 Page: 18 Feedback 1. This is correct. Though totally unfettered authority by all advanced practice registered nurses (APRNs) has not yet been achieved, the experience of prescribing medications for patients under the care of these providers has been found to be safe and beneficial. The practicality, the enhancement of quality of care, and the cost-effectiveness of the practice of these groups has enhanced the logic and desirability of giving prescriptive authority to APRNs nationwide. 2. This is correct. Though totally unfettered authority by all advanced practice registered nurses (APRNs) has not yet been achieved, the experience of prescribing medications for patients under the care of these providers has been found to be safe and beneficial. The practicality, the enhancement of quality of care, and the cost-effectiveness of the practice of these groups has enhanced the logic and desirability of giving prescriptive authority to APRNs nationwide. 3. This is incorrect. Because licensure for all professions occurs at the state rather than the federal level, the movement to achieve prescriptive authority does not progress equally. States with the most need make legislative changes most rapidly. Though totally unfettered authority by all advanced practice registered nurses (APRNs) has not yet been achieved, the experience of prescribing medications for patients under the care of these providers has been found to be safe and beneficial. The practicality, the enhancement of quality of care, and the cost-effectiveness of the practice of these groups has enhanced the logic and desirability of giving prescriptive authority to APRNs nationwide. This is incorrect. Confusion about the role and scope of practice of an advanced practice registered nurse (APRN) through the grouping of nurse practitioners (NPs), certified nurse-midwives (CNMs), and physician assistants (PAs) as “midlevel practitioners” has created problems for APRNs. Though totally unfettered authority by all APRNs has not yet been achieved, the experience of prescribing medications for patients under the care of these providers has been found to be safe and beneficial. The practicality, the enhancement of quality of care, and the cost- effectiveness of the practice of these groups has enhanced the logic and desirability of giving prescriptive authority to APRNs nationwide. 5. This is correct. Though totally unfettered authority by all advanced practice registered nurses (APRNs) has not yet been achieved, the experience of prescribing medications for patients under the care of these providers has been found to be safe and beneficial. The practicality, the enhancement of quality of care, and the cost- effectiveness of the practice of these groups has enhanced the logic and desirability of giving prescriptive authority to APRNs nationwide. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Chapter 7: Credentialing and Clinical Privileges for the Advanced Practice Registered Nurse ANSWERS AND RATIONALES 1. Which of the following justifies the rigor of the credentialing process for advanced practice registered nurses (APRNs)? 1. Scope of practice 2. Quality assurance 3. Regulatory oversight 4. Autonomous practice Answer: 4 Page: 2 Feedback 1. This is incorrect. The independence and autonomy of advanced practice registered nurse (APRN) services necessitates the same degree of attention to the processes of credentialing and privileging as accorded to physicians and other providers. 2. This is incorrect. The independence and autonomy of advanced practice registered nurse (APRN) services necessitates the same degree of attention to the processes of credentialing and privileging as accorded to physicians and other providers. 3. This is incorrect. The independence and autonomy of advanced practice registered nurse (APRN) services necessitates the same degree of attention to the processes of credentialing and privileging as accorded to physicians and other providers. 4. This is correct. The independence and autonomy of advanced practice registered nurse (APRN) services necessitates the same degree of attention to the processes of credentialing and privileging as accorded to physicians and other providers. 2. An advanced practice registered nurse (APRN) determines that the implementation of the Consensus Model for APRN Regulation accomplishes which of the following? 1. Scope of practice standardization 2. Joint Commission accreditation 3. Uniformity of national standards 4. Consistent provider standards Answer: 3 Page: 3 Feedback 1. This is incorrect. Scope of practice is legislated by individual states. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (NCSBN, 2008) or LACE (Licensure, Accreditation, Certification, Education of advanced practice registered nurses [APRNs]) promotes uniformity of national standards and regulation by the states to promote mobility of APRNs and access to APRN care. 2. This is incorrect. The Joint Commission sets its own standards for accreditation of health-care institutions. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (NCSBN, 2008) or LACE (Licensure, Accreditation, Certification, Education of advanced practice registered nurses [APRNs]) promotes uniformity of national standards and regulation by the states to promote mobility of APRNs and access to APRN care. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 3. This is correct. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (NCSBN, 2008) or LACE (Licensure, Accreditation, Certification, Education of advanced practice registered nurses [APRNs]) promotes uniformity of national standards and regulation by the states to promote mobility of APRNs and access to APRN care. 4. This is incorrect. Regulations were changed to ensure uniform processes and allowances for the credentialing and privileging of medical and allied health professionals. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (NCSBN, 2008) or LACE (Licensure, Accreditation, Certification, Education of advanced practice registered nurses [APRNs]) promotes uniformity of national standards and regulation by the states to promote mobility of APRNs and access to APRN care. 3. Which of the following directs legislative requirements for the advanced practice registered nurse (APRN) credentialing process? 1. Educational institutions 2. Nursing licensing boards 3. Organizational medical staff 4. Federal and state regulations Answer: 4 Page: 7 Feedback 1. This is incorrect. The types of data gathered during the credentialing process are directed by federal and state regulations; professional standards; facility requirements, policies, and procedures; and voluntary oversight bodies. 2. This is incorrect. The types of data gathered during the credentialing process are directed by federal and state regulations; professional standards; facility requirements, policies, and procedures; and voluntary oversight bodies. 3. This is incorrect. The types of data gathered during the credentialing process are directed by federal and state regulations; professional standards; facility requirements, policies, and procedures; and voluntary oversight bodies. 4. This is correct. The types of data gathered during the credentialing process are directed by federal and state regulations; professional standards; facility requirements, policies, and procedures; and voluntary oversight bodies. 4. An advanced practice registered nurse (APRN) is reviewing medical staff standards. Which of the following are used to determine whether hospital privileges are granted? 1. Institutional policies 2. Protection of the public 3. Broadened medical scope of practice 4. Provision of medical level care Answer: 4 Page: 15 Feedback FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 1. This is incorrect. The decision to grant privileges is guided by institutional policies and procedures related to the structure of the decision-making body. Advanced practice registered nurses (APRNs) and physician assistants (PAs) who provide "medical level of care" must be credentialed and privileged through the medical staff standards process. 2. This is incorrect. Public protection is one of the purposes of cerdentialing. Advanced practice registered nurses (APRNs) and physician assistants (PAs) who provide "medical level of care" must be credentialed and privileged through the medical staff standards process. 3. This is incorrect. Limitations to advanced practice registered nurses’ (APRNs’) scope of practice continue to be a barrier to APRNs executing their full scope of practice. APRNs and physician assistants (PAs) who provide "medical level of care" must be credentialed and privileged through the medical staff standards process. 4. This is correct. Advanced practice registered nurses (APRNs) and physician assistants (PAs) who provide "medical level of care" must be credentialed and privileged through the medical staff standards process. 5. According to Medicare Conditions of Participation (CoP), which governing body grants privileges to a telemedicine practitioner? 1. Distant site 2. Originating site 3. State review board 4. State licensing board Answer: 2 Page: 16 Feedback 1. This is incorrect. Medicare Conditions of Participation (CoP) require the governing body of the originating site to grant privileges to a distant site independent practitioner. 2. This is correct. Medicare Conditions of Participation (CoP) require the governing body of the originating site to grant privileges to a distant site independent practitioner. 3. This is incorrect. Medicare Conditions of Participation (CoP) require the governing body of the originating site to grant privileges to a distant site independent practitioner. 4. This is incorrect. Medicare Conditions of Participation (CoP) require the governing body of the originating site to grant privileges to a distant site independent practitioner. 6. Which is a minimum requirement of the Joint Commission for an advanced practice registered nurse (APRN) to be granted disaster privileges? 1. Continuing education 2. Oversight of treatment 3. Occurrence of a disaster 4. Professional practice evaluation Answer: 2 Page: 16 Feedback FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 8. Which of the following may limit an advanced practice registered nurse’s (APRN’s) scope of practice within a health-care institution? 1. Excessive patient lengths of stay 2. Performance improvement strategies 3. Redundant credentialing requirements 4. Governance representation on medical staff Answer: 1 Page: 28 Feedback 1. This is correct. An advanced practice registered nurse’s (APRN’s) scope of practice may be limited when an institution finds the APRN’s clinical performance falls outside established benchmarks, such as excessive lengths of stay, repeated and lengthy delays in appointments, quality of care issues, and exposure to liability related to variations in performance. 2. This is incorrect. Performance improvement strategies initiated by advanced practice registered nurses (APRNs) are likely to enhance the APRN’s ability to achieve full scope of practice in a health-care institution. An APRN’s scope of practice may be limited when an institution finds the APRN’s clinical performance falls outside established benchmarks, such as excessive lengths of stay, repeated and lengthy delays in appointments, quality of care issues, and exposure to liability related to variations in performance. 3. This is incorrect. Redundant credentialing processes are time consuming. An advanced practice registered nurse’s (APRN’s) scope of practice may be limited when an institution finds the APRN’s clinical performance falls outside established benchmarks, such as excessive lengths of stay, repeated and lengthy delays in appointments, quality of care issues, and exposure to liability related to variations in performance. 4. This is incorrect. Governance representation on medical staff assures full advanced practice registered nurse (APRN) representation in medical staff bylaws. An APRN’s scope of practice may be limited when an institution finds the APRN’s clinical performance falls outside established benchmarks, such as excessive lengths of stay, repeated and lengthy delays in appointments, quality of care issues, and exposure to liability related to variations in performance. 9. The application for credentialing should include which of the following? Select all that apply. 1. Proof of liability insurance 2. Primary source verification 3. Evaluations of clinical performance 4. Professional licenses and certifications 5. Professional organization memberships Answer: 1, 3, 4 Pages: 25–26 Feedback 1. This is correct. Liability insurance and claims history, clinical performance, state(s) licensure history (including state-controlled substance licenses), and certifications are among required data for credentialing. 2. This is incorrect. Primary source verification is part of the application review process. Liability insurance and claims history, clinical performance, state(s) licensure history FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE (including state-controlled substance licenses), and certifications are among required data for credentialing. 3. This is correct. Liability insurance and claims history, clinical performance, state(s) licensure history (including state-controlled substance licenses), and certifications are among required data for credentialing. 4. This is correct. Liability insurance and claims history, clinical performance, state(s) licensure history (including state-controlled substance licenses), and certifications are among required data for credentialing. 5. This is incorrect. Professional organization memberships are not required. Liability insurance and claims history, clinical performance, state(s) licensure history (including state-controlled substance licenses), and certifications are among required data for credentialing. 10.An advanced practice registered nurse (APRN) is compiling the practice-based evidence component of the professional career portfolio. Which of the following documentation should the APRN include? Select all that apply. 1. Employment history 2. Insurance liability history 3. Performance outcome data 4. Current and completed research 5. Core competencies for APRN specialization Answer: 1, 3, 5 Pages: 25–26 Feedback 1. This is correct. The practice-based evidence component of the professional career portfolio should include: (a) employment history, identifying significant responsibilities; (b) performance outcome data that may have been collected at places of employment (e.g., number of patients seen per day, revenue generated, patient satisfaction); and (c) core competencies for the advanced practice registered nurse (APRN) specialty. 2. This is incorrect. Insurance liability history is included in the credentials component of the professional career portfolio. The practice-based evidence component of the professional career portfolio should include: (a) employment history, identifying significant responsibilities; (b) performance outcome data that may have been collected at places of employment (e.g., number of patients seen per day, revenue generated, patient satisfaction); and (c) core competencies for the advanced practice registered nurse (APRN) specialty. 3. This is correct. The practice-based evidence component of the professional career portfolio should include: (a) employment history, identifying significant responsibilities; (b) performance outcome data that may have been collected at places of employment (e.g., number of patients seen per day, revenue generated, patient satisfaction); and (c) core competencies for the advanced practice registered nurse (APRN) specialty. 4. This is incorrect. Current and completed research are included in the credentials component of the professional career portfolio. The practice-based evidence component of the professional career portfolio should include: (a) employment history, identifying significant responsibilities; (b) performance outcome data that may have been collected at places of employment (e.g., number of patients seen per day, revenue generated, patient satisfaction); and (c) core competencies for the advanced practice registered nurse (APRN) specialty. 5. This is correct. The practice-based evidence component of the professional career portfolio should include: (a) employment history, identifying significant responsibilities; (b) performance outcome data that may have been collected at places of employment (e.g., number of patients seen per day, revenue generated, patient satisfaction); and (c) core FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE competencies for the advanced practice registered nurse (APRN) specialty. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 1. This is incorrect. Explaining pathophysiology may be perceived as elitism. Acknowledging registered nurse (RN) roles and responsibilities reduces elitism. Nursing has been guilty of elitism and of exhibiting professional dominance both in relating to nurses with different levels of education and in working with other health-care professionals. Lack of understanding, failure to acknowledge roles and responsibilities of other professionals, and the very isolated nature of health professional education is the basis for much of the elitism still prevalent today (Glasgow, Dunphy, & Mainous, 2010; Rice et al., 2010). 2. This is correct. Acknowledging registered nurse (RN) roles and responsibilities reduces elitism. Nursing has been guilty of elitism and of exhibiting professional dominance both in relating to nurses with different levels of education and in working with other health-care professionals. Lack of understanding, failure to acknowledge roles and responsibilities of other professionals, and the very isolated nature of health professional education is the basis for much of the elitism still prevalent today (Glasgow, Dunphy, & Mainous, 2010; Rice et al., 2010). 3. This is incorrect. Demonstrating nursing skills may imply the registered nurse (RN) does not perform skills adequately and may be perceived as professional dominance. Acknowledging RN roles and responsibilities reduces elitism. Nursing has been guilty of elitism and of exhibiting professional dominance both in relating to nurses with different levels of education and in working with other health-care professionals. Lack of understanding, failure to acknowledge roles and responsibilities of other professionals, and the very isolated nature of health professional education is the basis for much of the elitism still prevalent today (Glasgow, Dunphy, & Mainous, 2010; Rice et al., 2010). 4. This is incorrect. Providing timely orders facilitates nurses’ efficiency. Acknowledging registered nurse (RN) roles and responsibilities reduces elitism. Nursing has been guilty of elitism and of exhibiting professional dominance both in relating to nurses with different levels of education and in working with other health-care professionals. Lack of understanding, failure to acknowledge roles and responsibilities of other professionals, and the very isolated nature of health professional education is the basis for much of the elitism still prevalent today (Glasgow, Dunphy, & Mainous, 2010; Rice et al., 2010). 5. Which of the following is vital to the attainment of transdisciplinary collaboration? 1. Dialogue 2. Discipline 3. Discussion 4. Partnership Answer: 1 Page: 24 Feedback 1. This is correct. The key to the success of transdisciplinary collaboration is communication through dialogue as it allows for free exploration of ideas, issues, and innovations, and the ability to suspend personal viewpoints without a sense of defensiveness. 2. This is incorrect. Discipline refers to the body of scientific knowledge that is the basis of that profession’s practice. The key to the success of transdisciplinary collaboration is communication through dialogue as it allows for free exploration of ideas, issues, and innovations, and the ability to suspend personal viewpoints without a sense of defensiveness. 3. This is incorrect. Discussion implies a hard exchange of ideas bouncing back and forth, presented and defended with the need to come to a decision. The key to the success of transdisciplinary collaboration is communication through dialogue as it allows for free exploration of ideas, issues, and innovations, and the ability to suspend personal viewpoints without a sense of defensiveness. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 4. This is incorrect. The key to the success of transdisciplinary collaboration is communication through dialogue as it allows for free exploration of ideas, issues, and innovations, and the ability to suspend personal viewpoints without a sense of defensiveness. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 6. A group of advanced practice registered nurses (APRNs) is developing a proposal to present to the board of trustees outlining strategies to improve collaboration and patient care. Which of the following is the priority to include in the proposal? 1. Patient autonomy 2. Shared knowledge 3. Institutional support 4. Multidisciplinary practice Answer: 2 Page: 62 Feedback 1. This is incorrect. Including patients in their health-care decisions is important, but is not the priority. Shared knowledge and the free flow of information is the priority to include in the proposal. Clinicians and patients should communicate effectively and share information. 2. This is correct. Shared knowledge and the free flow of information is the priority to improve collaboration. Clinicians and patients should communicate effectively and share information. 3. This is incorrect. Institutional support is required to implement the strategies. Shared knowledge and the free flow of information is the priority to include in the proposal. Clinicians and patients should communicate effectively and share information. 4. This is incorrect. Multidisciplinary practice is a level of information exchange, with no presumption of shared planning. Shared knowledge and the free flow of information is the priority to include in the proposal. Clinicians and patients should communicate effectively and share information. 7. Which of the following is a primary reason for medical opposition to the nurse practitioner (NP) role? 1. Patient safety 2. Lack of knowledge 3. Prescriptive authority 4. Competition for patients Answer: 1 Page: 15 Feedback 1. This is correct. Medical opposition, which existed from the beginning, is often couched in terms of patient safety, despite the fact that it often is more related to issues of control and competition in practice. 2. This is incorrect. Medical opposition, which existed from the beginning, is often couched in terms of patient safety, despite the fact that it often is more related to issues of control and competition in practice. 3. This is incorrect. Medical opposition, which existed from the beginning, is often couched in terms of patient safety, despite the fact that it often is more related to issues of control and competition in practice. 4. This is incorrect. Medical opposition, which existed from the beginning, is often couched in terms of patient safety, despite the fact that it often is more related to issues of control and competition in practice. 8. The APRN Consensus Model indicates which of the following decreases obstacles to establishing collaborative practice? Select all that apply. 1. Role clarity 2. Advanced education 3. Consumer satisfaction 4. Common practice elements 5. Clearly delineated scope of practice FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Chapter 9: Participation of the Advanced Practice Nurse in Health Plans and Quality Initiatives ANSWERS AND RATIONALES 1. The nurse educator is presenting a lecture on health-care costs to a group of nursing students. Which statement indicates that the teaching has been effective? 1. “Fee-for-service is the primary source of pricing.” 2. “The approach to health-care delivery has undergone significant changes in health- care reimbursement.” 3. “Providers no longer take liability for service costs.” 4. “Financial risk to the provider has decreased.” Answer: 2 Page: 2 Feedback 1. This is incorrect. Fee-for-service is no longer the primary source of pricing. Common methods are global pricing, capitation, and value-based purchasing. 2. This is correct. Health-care delivery has undergone significant changes in reimbursement and contracting in order to decrease overall health-care costs. 3. This is incorrect. Providers have taken on a role of liability for service costs and levels of care. 4. This is incorrect. Financial risks to the provider have increased. 2. A nurse manager is working with a group of advanced practice nurses (APNs) in a busy surgical center. Which interpretation of the role of the APN is the most accurate? 1. APNs are important for the client to see, in addition to the physician. 2. Fewer APNs are needed now that the physician shortage is resolving. 3. APNs are somewhat cost effective. 4. APNs are responsible for decreased hospital admission rates. Answer: 4 Page: 3 Feedback 1. This is incorrect. Advanced practice nurses (APNs) function as an equivalent to the physician. 2. This is incorrect. The physician shortage is not resolving. More advanced practice nurses (APNs) are filling in this role. 3. This is incorrect. Advanced practice nurses (APNs) are highly cost-effective. 4. This is correct. Advanced practice nurses (APNs) are responsible for decreased hospital admission rates. 3. The nurse is listening to a lecture on the mechanisms of managed care costs. How should the nurse interpret the benefit of managed care costs? 1. Decreased beneficiary cost sharing helps manage costs. 2. Flexible hospital stays decrease costs. 3. The denial of high-cost care cases reduces care costs. 4. Economic incentives to physicians assist in managing care costs. Answer: 4 Page: 4 Feedback 1. This is incorrect. Increased beneficiary cost sharing helps manage costs. 2. This is incorrect. Controls on inpatient admissions and length of stay assist in managing costs. 3. This is incorrect. Close management of high-cost care cases assists in managing care costs. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 4. This is correct. Economic incentives for physicians who choose low-cost care options assist in managing care. 4. An advanced practice nurse (APN) is working with a client who needs a procedure to correct blood flow. Upon reviewing the health plan, which should the nurse expect before the procedure takes place? 1. The client may need preauthorization for this procedure. 2. The client needs the administration of an antihypertensive. 3. The client will avoid use of a hot tub or swimming pool. 4. The client will initiate an exercise plan. Answer: 1 Page: 4 Feedback 1. This is correct. The client may need preauthorization for this procedure. 2. This is incorrect. There is no indication that the client would need an antihypertensive. Clients are kept NPO before procedures. 3. This is incorrect. The client will be instructed to avoid use of hot tubs and swimming pools after the procedure has been completed. 4. This is incorrect. The nurse would not expect this after reviewing the health plan. 5. An advanced practice nurse (APN) is explaining the benefit of managed care to a health-care provider. Which information should the nurse include? 1. “The burden of risk is shared in managed care.” 2. “The most common type of health plan is point-of-service.” 3. “The main goal of managed care is to improve quality of care.” 4. “Managed care decreases the use of preventative medicine.” Answer: 1 Page: 5 Feedback 1. This is correct. In managed care, the burden of risk is shared. 2. This is incorrect. The most common types of health plans are HMOs and PPOs. 3. This is incorrect. The initial main goal of managed care was to improve quality of care. 4. This is incorrect. Managed care increases the use of preventative medicine as cost saving. 6. Which skill should the advanced practice nurse (APN) incorporate in order to be successful? 1. Ask staff nurses to follow through on client requests. 2. Follow rules and protocols without question. 3. Take on the case manager role effectively. 4. Enhance communication methods with other health-care personnel. Answer: 4 Page: 7 Feedback 1. This is incorrect. The advanced practice nurse (APN) should follow through with FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE commitments, delegating to other staff when necessary. 2. This is incorrect. The advanced practice nurse (APN) should be creative and flexible, and adapt care to each client’s needs. 3. This is incorrect. The advanced practice nurse (APN) should work closely with the case manager to provide quality care to each client. 4. This is correct. The advanced practice nurse (APN) should enhance communication methods with other health-care personnel. 7. Which of the following has been a barrier to advanced practice nurses (APNs)? 1. Inclusion of APNs on provider panels 2. Full Medicare reimbursement for services 3. Denial of claims from third-party payers 4. Decreased employment of APNs Answer: 3 Page: 10 Feedback 1. This is incorrect. Exclusion of advanced practice nurses (APNs) on provider panels has been a barrier. 2. This is incorrect. Lack of full Medicare reimbursement has been a barrier. 3. This is correct. Denial of claims from third-party payers has been a barrier for advanced practice nurses (APNs) and is based upon misinformation. 4. This is incorrect. Employment of advanced practice nurses (APNs) has increased, not decreased. 8. An advanced practice nurse (APN) is caring for an elderly client with mildly elevated blood pressure. Focusing on health promotion and prevention, which initial intervention should the nurse suggest? 1. Cardiac stress test 2. Low sodium diet 3. Amlodipine 5mg daily 4. Increased fluid intake Answer: 2 Page: 23 Feedback 1. This is incorrect. A cardiac stress test is a focus of health promotion, because this test assesses for a problem. 2. This is correct. The advanced practice nurse (APN) would recommend changing the client’s diet to a low sodium diet. This action aims to prevent a problem from occurring. 3. This is incorrect. The advanced practice nurse (APN) would not order an antihypertensive for this client as an initial action. 4. This is incorrect. Increased fluid intake would not help this client, and would likely increase blood pressure further. 9. Using marketing principles, which nursing action displays an understanding of promotion? 1. Focusing on the physical assessment of the client FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Chapter 10: Public Policy and the Advanced Practice Registered Nurse ANSWERS AND RATIONALES 1. Upon moving to a new city, an advanced practice registered nurse (APRN) notices there are many county regulations that expand children’s access to health-care services. Which of the following influenced the development of the regulations? Select all that apply. 1. A significant percentage of children in the county lacked health insurance. 2. Community members developed policies to provide accessible health care. 3. The incidence of vaccine-preventable illness among children was increasing. 4. Key stakeholders and policy makers viewed children as a vulnerable population. 5. The county board held a town hall meeting to discuss children’s health-care services. Answer: 1, 3, 4, 5 Pages: 1–2 Feedback 1. This is correct. Public policy is about communities trying to achieve something as a community. 2. This is incorrect. Public policy is made in the legislative, executive, or judicial branches of government, at either the state or federal level, within the jurisdiction of those entities. 3. This is correct. Public policy is for the good and/or protection of the community. Access to health care for children and requiring vaccines increase immunization rates. 4. This is correct. Policy development reflects the values of those making the policy. 5. This is correct. Public policy is about communities trying to achieve something. A component of the policy making process is the formulation of the problem and the identification of viable solutions. 2. Which of the following best explains an advanced practice registered nurse’s (APRN’s) decision to ask a legislator to support a bill that eliminates the requirement for collaborative agreements? 1. Limited scope of practice 2. Obligation to social contract 3. Responsibility to lead others 4. Ability to influence health policy Answer: 4 Page: 2 Feedback 1. This is incorrect. Advanced practice registered nurses (APRNs) recognize the responsibility to contribute to the development of health policy through political action. 2. This is incorrect. Advanced practice registered nurses (APRNs) recognize the responsibility to contribute to the development of health policy through political action. 3. This is incorrect. Advanced practice registered nurses (APRNs) recognize the responsibility to contribute to the development of health policy through political action. 4. This is correct. Advanced practice registered nurses (APRNs) recognize the responsibility to contribute to the development of health policy through political action. 3. A nurse practitioner (NP) is moving to a state that requires physician supervision of all advanced practice registered nurses (APRNs) and has a strong medical lobbying group. The lobbying group’s influence represents which of the following? 1. Barriers to independent practice FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 2. Physician resistance to APRN autonomy 3. Effect of political processes on health-care policy 4. Legislators’ lack of understanding of APRN roles Answer: 4 Page: 6 Feedback 1. This is incorrect. The process of health policy development includes the ability to influence policy makers and influences the delivery of care. 2. This is incorrect. The process of health policy development includes the ability to influence policy makers and influences the delivery of care. 3. This is incorrect. The process of health policy development includes the ability to influence policy makers and influences the delivery of care. 4. This is correct. The process of health policy development includes the ability to influence policy makers and influences the delivery of care. 4. Which requirement of the Affordable Care Act (ACA) improves access to health-care services provided by nurse practitioners (NPs)? 1. Face-to-face certification 2. Medicare reimbursement 3. Collaborative agreements 4. Nondiscrimination provision Answer: 4 Page: 11 Feedback 1. This is incorrect. Though advanced practice registered nurses (APRNs) have been authorized Part B Medicare providers since 1998, patients needing home health-care services must have a physician to certify the APRN has conducted the required face-to- face certification examination. 2. This is incorrect. Advanced practice registered nurses (APRNs) have been recognized Part B Medicare providers since 1998. 3. This is incorrect. The Affordable Care Act (ACA) does not mandate collaborative agreements. Each state legislates whether APRNs must have a collaborative agreement, which limits APRNs’ ability to practice to the full extent of their preparation. 4. This is correct. The nondiscrimination provision of the Affordable Care Act (ACA) acknowledged advanced practice registered nurses (APRNs) as primary care providers. 5. An advanced practice registered nurse (APRN) is talking with a legislator about the need for a primary care clinic in an underserved area. Which of the following points should the APRN include to gain the legislator’s support? Select all that apply. 1. Access to a regular primary care provider improves chronic disease management. 2. Primary care reduces costs related to complications of untreated health conditions. 3. APRNs are educated to provide the same level of care as primary care physicians. 4. Direct reimbursement of APRNs by third-party payers reduces costs to the state. 5. Improved access to care enables APRNs to address environmental causes of disease. Answer: 1, 2, 5 Pages: 9–12 FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Feedback 1. This is correct. Advanced practice registered nurses (APRNs) increase availability of primary care, which is associated with more effective provision of preventive services and better management of chronic disease. 2. This is correct. Advanced practice registered nurses (APRNs) increase availability of primary care, which is associated with more effective provision of preventive services and better management of chronic disease. 3. This is incorrect. Advanced practice registered nurses (APRNs) are mid-level care providers and practice within the limits of their nurse practice act. 4. This is incorrect. Though advanced practice registered nurses (APRNs) are recognized as qualified health-care providers, differences in the reimbursement and coverage policies, restrictions within states and policies related to direct reimbursement, and supervisory requirements by another health-care provider create challenges in reimbursement. 5. This is correct. Advanced practice registered nurses (APRNs) increase access to care for underserved populations and are educated to address social, economic, and environmental factors that influence health. 6. An advanced practice registered nurse (APRN) working in a primary care clinic identifies the need for an additional health-care provider. Which of the following indicates the reason the APRN recommends hiring a nurse practitioner (NP) over other providers? 1. NPs are reimbursed at a higher rate. 2. NPs have a broader scope of practice. 3. NPs expand access to care at a lower cost. 4. NPs’ malpractice insurance is less expensive. Answer: 3 Page: 9 Feedback 1. This is incorrect. Increased use of advanced practice registered nurses (APRNs) expands the availability of health care at a lower price. 2. This is incorrect. Increased use of advanced practice registered nurses (APRNs) expands the availability of health care at a lower price. 3. This is correct. Increased use of advanced practice registered nurses (APRNs) expands the availability of health care at a lower price. 4. This is incorrect. Increased use of advanced practice registered nurses (APRNs) expands the availability of health care at a lower price. 7. A nurse practitioner (NP) identifies advanced practice registered nurses (APRNs) in the state have reduced practice authority. The NP recognizes full practice authority includes which of the following? Select all that apply. 1. Title recognition 2. Prescriptive authority 3. Physician supervision 4. Collaborative agreement 5. Ability to diagnose patients Answer: 2, 5 Page: 13 Feedback FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 1. Political competence FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 2. Self-governing licensure 3. Reimbursement from third-party payers 4. Accreditation of advanced practice nursing programs Answer: 2 Page: 14 Feedback 1. This is incorrect. Collaborative agreements directly limit the advanced practice registered nurse’s (APRN’s) ability to have a self-governing license. 2. This is correct. Collaborative agreements directly limit the advanced practice registered nurse’s (APRN’s) ability to have a self-governing license. 3. This is incorrect. Collaborative agreements directly limit the advanced practice registered nurse’s (APRN’s) ability to have a self-governing license. 4. This is incorrect. Collaborative agreements directly limit the advanced practice registered nurse’s (APRN’s) ability to have a self-governing license. 10. Which of the following may limit a nurse practitioner’s (NP’s) ability to establish a practice? 1. Scope of practice 2. Reimbursement policies 3. Accreditation requirements 4. Access to sufficient patient volume Answer: 2 Page: 15 Feedback 1. This is incorrect. Advanced practice registered nurse (APRN) practice increases accessibility for patient populations. 2. This is correct. Full practice authority allows for independent practice in the state. 3. This is incorrect. Accreditation requirements focus on nursing and certification programs. 4. This is incorrect. Reimbursement policies make it difficult for nurse practitioners (NPs) to serve as primary care providers (PCPs) because of differences in coverage policies, state regulatory restrictions, and supervisory requirements by another health-care provider. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Chapter 11: Resource Management ANSWERS AND RATIONALES 1. When reviewing a client’s medical record, which hospital-acquired condition (HAC) would be considered Medicare reimbursable? 1. Air embolism 2. Stage II pressure ulcer 3. Surgical infection post bariatric surgery 4. Catheter-associated urinary tract infection Answer: 2 Page: 6 Feedback 1. This is incorrect. An air embolism is a hospital-acquired condition (HAC) that is not reimbursable by Medicare. 2. This is correct. A stage II pressure ulcer is reimbursable by Medicare. Stage III and Stage IV pressure ulcers, however, are hospital-acquired conditions (HACs) that are not reimbursable by Medicare. 3. This is incorrect. A surgical infection post bariatric surgery is a hospital-acquired condition (HAC) that is not reimbursable by Medicare. 4. This is incorrect. A catheter-associated urinary tract infection is a hospital-acquired condition (HAC) that is not reimbursable by Medicare. 2. The nurse practitioner (NP) is reviewing the medical records for several clients who are diagnosed with hospital-acquired conditions (HACs). Which HAC diagnoses are ineligible for Medicare reimbursement? Select all that apply. 1. Blood incompatibility 2. Diabetic ketoacidosis 3. Stage I pressure ulcer 4. Deep vein thrombosis post hip replacement 5. Peripherally inserted central catheter infection Answer: 1, 2, 4, 5 Page: 6 Feedback 1. This is correct. Blood incompatibility is a hospital-acquired condition (HAC) that is ineligible for Medicare reimbursement. 2. This is correct. Diabetic ketoacidosis, a manifestation of poor glycemic control, is a hospital- acquired condition (HAC) that is ineligible for Medicare reimbursement. 3. This is incorrect. A stage I pressure injury is eligible for Medicare reimbursement. Stage III and Stage IV pressure injuries, however, are hospital-acquired conditions (HACs) that are ineligible for Medicare reimbursement. 4. This is correct. A deep vein thrombosis post hip replacement is a hospital-acquired condition (HAC) that is ineligible for Medicare reimbursement. 5. This is correct. A peripherally inserted central catheter infection is a hospital-acquired condition (HAC) that is ineligible for Medicare reimbursement. 3. Which is categorized as an account code when tracking and managing the health-care facility’s financial systems? 1. Blood bank 2. Cancer care center 3. Treatment hemodialysis 4. Nurse practitioner (NP) salary FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Answer: strategic Page: 12 Feedback: Strategic planning is likely to be translated into a long-range budget that addresses the direction of the organization during the next 3 to 5 years or more. 10. The measurement for identifying the individual practitioner’s contribution to the organization most frequently is based on billed. Answer: services Page: 23 Feedback: The measurement for identifying the individual practitioner’s contribution to the organization most frequently is based on services billed. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Chapter 12: Mediated Roles: Working With and Through Other People ANSWERS AND RATIONALES 1. When acting as a mentor, which core competency is the nurse practitioner (NP) exemplifying? 1. Research 2. Coaching 3. Consultation 4. Collaboration Answer: 2 Pages: 5–6 Feedback 1. This is incorrect. Acting as a mentor does not exemplify the core competency of research. 2. This is correct. Acting as a mentor exemplifies the core competency of coaching. 3. This is incorrect. Acting as a mentor does not exemplify the core competency of consultation. 4. This is incorrect. Acting as a mentor does not exemplify the core competency of collaboration. 2. Which interpersonal attributes must the advanced practice nurse (APN) possess in order for successful collaboration to occur with other health-care providers? Select all that apply. 1. Trust 2. Empathy 3. Optimism 4. Knowledge 5. Cooperation Answer: 1, 3, 4, 5 Page: 8 Feedback 1. This is correct. Trust is an interpersonal attribute the advanced practice nurse (APN) must possess for successful collaboration to occur. 2. This is incorrect. Empathy is not an interpersonal attribute the advanced practice nurse (APN) must possess for successful collaboration to occur. 3. This is correct. Optimism is an interpersonal attribute the advanced practice nurse (APN) must possess for successful collaboration to occur. 4. This is correct. Knowledge is an interpersonal attribute the advanced practice nurse (APN) must possess for successful collaboration to occur. 5. This is correct. Cooperation is an interpersonal attribute the advanced practice nurse (APN) must possess for successful collaboration to occur. 3. When implementing the Parallel Model of collaborative practice, which action by the advanced practice nurse (APN) is most appropriate? 1. Diagnosing patients 2. Managing stable patients 3. Performing intake assessments 4. Managing medically complex patients Answer: 2 Page: 11 Feedback 1. This is incorrect. This action is appropriate by the physician when implementing the Sequential Model of collaborative practice. 2. This is correct. Managing stable patients is the advanced practice nurse’s (APN’s) role when implementing the Parallel Model of collaborative practice. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 3. This is incorrect. This action exemplifies the advanced practice nurse (APN) implementing the Sequential Model of collaborative practice. 4. This is incorrect. This is the physician’s role when implementing the Parallel Model of collaborative practice. 4. When implementing the Sequential Model of collaborative practice, which action by the advanced practice nurse (APN) is appropriate? 1. Diagnosing patients 2. Managing stable patients 3. Performing intake assessments 4. Managing medically complex patients Answer: 3 Page: 11 Feedback 1. This is incorrect. This action is appropriate by the physician when implementing the Sequential Model of collaborative practice. 2. This is incorrect. Managing stable patients is the advanced practice nurse’s (APN’s) role when implementing the Parallel Model of collaborative practice. 3. This is correct. This action exemplifies the advanced practice nurse (APN) implementing the Sequential Model of collaborative practice. 4. This is incorrect. This is the physician’s role when implementing the Parallel Model of collaborative practice. 5. An advanced practice nurse (APN) wants to implement interdisciplinary team relationships. Which of the following is an example of a skill that the APN would need? 1. Group dynamics 2. Conflict resolution 3. Respect for other disciplines 4. Awareness of outcomes-based practice Answer: 2 Page: 17 Feedback 1. This is incorrect. This is not a skill needed to implement interdisciplinary team relationships. This is an example of knowledge that is needed to implement interdisciplinary team relationships. 2. This is correct. Conflict resolution is a skill needed to implement interdisciplinary team relationships. 3. This is incorrect. This is not a skill needed to implement interdisciplinary team relationships. This is an example of the attitude that is needed to implement interdisciplinary team relationships. 4. This is incorrect. This is not a skill needed to implement interdisciplinary team relationships. This is an example of the attitude that is needed to implement interdisciplinary team relationships. 6. An advanced practice nurse (APN) wants to implement interdisciplinary team relationships. Which of the following is an example of knowledge that the APN would need? 1. Group dynamics 2. Conflict resolution 3. Respect for other disciplines 4. Awareness of outcomes-based practice FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Chapter 13: Evidence-Based Practice ANSWERS AND RATIONALES 1. Which phase of Tanner’s clinical judgment model involves the integration of evidence-based practice, clinical knowledge, and knowledge of the patient? 1. Noticing 2. Reflecting 3. Responding 4. Interpreting Answer: 1 Page: 16 Feedback 1. This is correct. During the “noticing” phase, the clinician’s expectations of the situation are formed using knowledge of the patient, clinical or practical knowledge of similar patients, and textbook- and research-based knowledge. 2. This is incorrect. During the “reflecting” phase, the clinician observes the patient’s responses to the action taken. 3. This is incorrect. During the “responding” phase, the clinician may act or choose not to act depending on the situation. 4. This is incorrect. During the “interpreting” phase, the clinician forms an understanding of the situation by using one or more reasoning patterns. 2. Which knowledge enables the advanced practice registered nurse (APRN) to recognize phenomena associated with specific health problems? 1. Practical 2. Scientific 3. Theoretical 4. Research-based Answer: 4 Page: 9 Feedback 1. This is incorrect. Practical knowledge, also known as knowledge from clinical experience, is acquired through working with many patients. 2. This is incorrect. Scientifically derived knowledge is a component of theoretical knowledge. 3. This is incorrect. Theoretical knowledge is acquired through understanding of scientifically derived knowledge and theory and is used in a situation as a specific application of an abstract rule or principle. 4. This is correct. Research-based knowledge is directed toward describing phenomena which can contribute to the clinician’s overall knowledge base for assessing risks. 3. An advanced practice registered nurse (APRN) is reviewing the literature for current treatment guidelines of hypertension. Which of the following should the APRN use to develop a client’s treatment plan? 1. Clinical experience 2. Local practice data 3. Research evidence 4. Patient preferences FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Answer: 3 Page: 7 Feedback 1. This is incorrect. Advanced practice registered nurses (APRNs) use clinical experience and research evidence to inform their clinical judgment and make patient care decisions. Review of the literature for current guidelines represents use of research evidence. 2. This is incorrect. Local practice data are not part of a literature review that informs advanced practice registered nurses’ (APRNs’) clinical judgment. 3. This is correct. Advanced practice registered nurses (APRNs) are expected to utilize conscientious, explicit, and judicious use of research evidence to inform their clinical judgment and make decisions that maximize the well-being of their patients. 4. This is incorrect. Though the advanced practice registered nurse (APRN) considers patient preferences, these are not part of a literature review. 4. Which of the following are included in the revised definition of evidence-based practice? Select all that apply. 1. Clinical expertise 2. Standards of care 3. Practical knowledge 4. Outcomes management 5. Systematic research evidence Answer: 1, 4, 5 Page: 5 Feedback 1. This is correct. The definition of evidence-based medicine was revised to be more comprehensive. Clinicians must integrate their personal clinical expertise with the best available evidence from systematic research, the local context of care, and the internal evidence generated there such as patient assessment, outcomes management, and quality improvement data and apply this within the context of their patient’s unique values and circumstances. 2. This is incorrect. The definition of evidence-based medicine was revised to be more comprehensive. Clinicians must integrate their personal clinical expertise with the best available evidence from systematic research, the local context of care, and the internal evidence generated there such as patient assessment, outcomes management, and quality improvement data and apply this within the context of their patient’s unique values and circumstances. 3. This is incorrect. The definition of evidence-based medicine was revised to be more comprehensive. Clinicians must integrate their personal clinical expertise with the best available evidence from systematic research, the local context of care, and the internal evidence generated there such as patient assessment, outcomes management, and quality improvement data and apply this within the context of their patient’s unique values and circumstances. 4. This is correct. The definition of evidence-based medicine was revised to be more comprehensive. Clinicians must integrate their personal clinical expertise with the best available evidence from systematic research, the local context of care, and the internal evidence generated there such as patient assessment, outcomes management, and quality improvement data and apply this within the context of their patient’s unique values and circumstances. 5. This is correct. The definition of evidence-based medicine was revised to be more comprehensive. Clinicians must integrate their personal clinical expertise with the best available evidence from systematic research, the local context of care, and the internal evidence generated there such as patient assessment, outcomes management, and quality FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE improvement data and apply this within the context of their patient’s unique values and circumstances. 5. Which of the following would an advanced practice nurse (APN) use to create topics for key articles related to clinical practice? 1. MEDLINE 2. PICOT format 3. CATmaker critical appraisal tool 4. Cochrane Database of Systematic Reviews Answer: 3 Page: 24 Feedback 1. This is incorrect. MEDLINE is an electronic database used to identify relevant citations in the clinical literature. 2. This is incorrect. The PICOT format (the population/problem, intervention, comparison, outcome, time) is a useful framework to help novice searchers organize electronic database searches. 3. This is correct. The CATmaker critical appraisal tool can be downloaded from the Center for Evidence-Based Medicine (CEBM) to help the APN create Critically Appraised Topics (CATs) for key articles about therapy, diagnosis, prognosis, etiology/harm, and systematic reviews of therapy. 4. This is incorrect. The Cochrane Database of Systematic Reviews is an electronic database comprised of evidence summaries, which takes the user directly to primary or secondary publications of the relevant clinical evidence. 6. An advanced practice registered nurse (APRN) is providing care for patients with type 2 diabetes. Which criteria would an APRN use to evaluate research articles related to diabetes? Select all that apply. 1. Randomization 2. Narrative review 3. Treatment effect 4. Outcome variation 5. Clarity of research question Answer: 1, 3, 5 Page: 32 Feedback 1. This is correct. Considerations for appraising therapy articles include: (a) randomization of treatment groups, (b) size of the treatment effect, and (c) presence of a clearly defined research question. 2. This is incorrect. A narrative review article provides a summary of an area or topic written by an expert in the field. 3. This is correct. Considerations for appraising therapy articles include: (a) randomization of treatment groups, (b) size of the treatment effect, and (c) presence of a clearly defined research question. 4. This is incorrect. Consideration of outcome variations is among the four steps which focus on the use of outcomes to make medical decisions. 5. This is correct. Considerations for appraising therapy articles include: (a) randomization of treatment groups, (b) size of the treatment effect, and (c) presence of a clearly defined research question. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Chapter 14: Advocacy and the Advanced Practice Registered Nurse ANSWERS AND RATIONALES 1. Which action shows the advanced practice nurse (APN) effectively coaching a client? 1. Teaching the client self-advocacy 2. Referring the client to a specialist 3. Telling the client to talk to a pharmacist about new medications 4. Requesting the visiting nurse set up a medication box for a client Answer: 1 Page: 3 Feedback 1. This is correct. The nurse who teaches the client to advocate for himself or herself is effectively coaching. 2. This is incorrect. Referring the client to a specialist is not an example of coaching. Coaching enables the client to be independent with care. 3. This is incorrect. Referring the client to a pharmacist is not an example of coaching. Coaching enables the client to be independent with care. 4. This is incorrect. Requesting a nurse to set up a medication box is not an example of coaching. Coaching enables the client to be independent with care. 2. Which action by the advanced practice nurse (APN) shows public policy advocacy? 1. Encouraging clients to speak up for their needs 2. Teaching clients how to self-administer insulin 3. Meeting with a lawmaker to discuss current practices 4. Discussing a concern in practices with a manager Answer: 3 Page: 3 Feedback 1. This is incorrect. Public policy involves influencing legislators and lawmakers to change policies affecting health care. Encouraging clients to speak up for themselves is autonomy. 2. This is incorrect. Public policy involves influencing legislators and lawmakers to change policies affecting health care. Encouraging clients to self-administer insulin is autonomy. 3. This is correct. Meeting with a lawmaker to influence change is an example of public policy advocacy. 4. This is incorrect. Discussing client needs with a manager reflects client advocacy. 3. Which skill should the advanced practice nurse (APN) master in order to successfully advocate for clients? 1. Clinical experience 2. Communication 3. Medication dosing 4. Referral practices Answer: 2 Page: 5 FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE Feedback 1. This is incorrect. Although important in decision making, clinical experience does not increase the advanced practice nurse’s (APN’s) ability to advocate for clients. 2. This is correct. Communication is imperative to the advanced practice nurse (APN) when advocating for clients. 3. This is incorrect. Medication dosing does not help the advanced practice nurse (APN) advocate for the client. 4. This is incorrect. Referral practices do not help the advanced practice nurse (APN) advocate for the client. 4. Which action by the advanced practice nurse (APN) is an example of systems-level advocacy? 1. Working with a company to obtain free diabetic testing supplies 2. Discussing the importance of diabetic monitoring and care with a client 3. Teaching a client how to self-administer insulin 4. Assisting a client in signing up for a free diabetes education class Answer: 1 Page: 9 Feedback 1. This is correct. System-level advocacy occurs at a population of community level. 2. This is incorrect. This is one-on-one care of a client. System-level advocacy occurs at a population of community level. 3. This is incorrect. This is one-on-one care of a client. System-level advocacy occurs at a population of community level. 4. This is incorrect. This is one-on-one care of a client. System-level advocacy occurs at a population of community level. 5. During systems-level advocacy, which action occurs in the final stages? 1. Implementing a program 2. Creating action agendas 3. Identifying a problem 4. Developing policy options Answer: 1 Page: 10 Feedback 1. This is correct. Program implementation and evaluation occur in the final stages. 2. This is incorrect. Creating action agendas occurs in the beginning stages. 3. This is incorrect. Identifying a problem occurs in the beginning stages. 4. This is incorrect. Developing policy concerns occurs in the beginning stages. 6. The advanced practice nurse (APN) is working with a nursing student who has been assigned to the surgical unit for the day. Which action by the APN would be most beneficial to help the student learn about advocacy? 1. Lecture the student on the benefits of advocacy. 2. Have the nursing student read an article on the topic. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 3. Ask the nursing student to discuss advocacy with a client. 4. Engage in a discussion about advocacy with the nursing student. Answer: 4 Page: 14 Feedback 1. This is incorrect. Providing a lecture on the topic will not assist the student in gaining new knowledge in the clinical setting. The advanced practice nurse (APN) should model advocacy in the clinical setting. 2. This is incorrect. The advanced practice nurse (APN) should model advocacy in the clinical setting. 3. This is incorrect. The clinical setting is ideal for seeing and participating in learning experiences, such as seeing advocacy in action. 4. This is correct. Discussing advocacy with the nursing student, and other positive experiences, enhance learning. 7. Which action by the advanced practice nurse (APN) is an example of advocacy? 1. Teaching the client’s wife how to prepare a cardiac diet 2. Educating a client and family why it is important to monitor glucose levels 3. Requesting that a physician meet with a client to discuss concerns before surgery 4. Repeating discharge education to a client Answer: 3 Page: 9 Feedback 1. This is incorrect. Although educating clients is important, this is not an example of advocacy. 2. This is incorrect. Although educating clients and their families are important, this is not an example of advocacy. 3. This is correct. Requesting the physician to clarify information on the client’s behalf is an example of advocacy. 4. This is incorrect. Although educating clients and ensuring the understanding of discharge information is important, this is not an example of advocacy. 8. The advanced practice nurse (APN) is working on a busy pediatric unit, caring for a child who was injured by a parent. The child is now in custody of the grandmother. Which action by the APN demonstrates advocacy for the welfare of the child? 1. Assisting the grandmother in navigating the health-care system 2. Setting up an appointment with the child’s pediatrician 3. Obtaining laboratory reports for the grandmother 4. Allowing the child to go to the playroom Answer: 1 Page: 9 Feedback 1. This is correct. Advocacy includes helping clients navigate the health-care system. 2. This is incorrect. This does not involve the client’s grandmother in the process of navigating the health-care system. 3. This is incorrect. This does not include the grandmother in the care of the client. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE and nursing knowledge. Advanced practice registered nurses (APRNs) have expert knowledge regarding the specific clinical populations for which standards and pathways are written, understand clients’ needs on a continuum-of-care basis, and have the additional requirement of outcome accountability. 4. This is correct. Advanced practice registered nurses (APRNs) have expert knowledge regarding the specific clinical populations for which standards and pathways are written, understand clients’ needs on a continuum-of-care basis, and have the additional requirement of outcome accountability. 3. Community-based case managers are experiencing an increased need for which of the following skills and knowledge? Select all that apply. 1. Cost containment 2. Discharge planning 3. Reimbursement systems 4. Extensive clinical expertise 5. Chronic disease management Answer: 3, 4 Page: 17 Feedback 1. This is incorrect. Community-based models have experienced an increasing need for a high level of clinical expertise in their case managers, as well as the traditional knowledge of community resources and health-care reimbursement methodologies. 2. This is incorrect. Hospital-based case managers have an increased need for an intense discharge planning model. 3. This is correct. Community-based models have experienced an increasing need for a high level of clinical expertise in their case managers, as well as the traditional knowledge of community resources and health-care reimbursement methodologies. 4. This is correct. Community-based models have experienced an increasing need for a high level of clinical expertise in their case managers, as well as the traditional knowledge of community resources and health-care reimbursement methodologies. 5. This is incorrect. Community-based models have experienced an increasing need for a high level of clinical expertise in their case managers, as well as the traditional knowledge of community resources and health-care reimbursement methodologies. 4. Which of the following best addresses the needs of older adults? Select all that apply. 1. Predictive Model 2. Guided Care Model 3. Transitional Care Model 4. Patient-Centered Medical Home 5. Accountable Care Organizations Answer: 2, 3, 4 Pages: 16, 19 Feedback 1. This is incorrect. Predictive modeling is used to manage the health risk of the small percentage of individuals who drive a significant percentage of health-care expenditures. 2. This is correct. The Johns Hopkins Bloomberg School of Public Health designed the Guided Care Model for the better care of older people with chronic conditions. 3. This is correct. The Transitional Care Model has improved care for older adults at risk for readmission within the 30-day post discharge window. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 4. This is correct. The Patient-Centered Medical Home (PCMH) Model focuses on providing health care to older adults by combining skills of the multidisciplinary team, family, caregivers, and patient. 5. This is incorrect. Accountable Care Organizations address the needs of chronically ill members. 5. Which of the following is essential to document financial outcomes of value-based purchasing agreements? 1. Predictive models 2. Risk management 3. Shared systems data 4. Reimbursement methods Answer: 3 Page: 15 Feedback 1. This is incorrect. Sharing data between disparate systems has become a major emphasis for health-care providers and payers as they assume accountability for financial outcomes in value-based purchasing agreements with the Centers for Medicaid and Medicare Services (CMS). 2. This is incorrect. Sharing data between disparate systems has become a major emphasis for health-care providers and payers as they assume accountability for financial outcomes in value-based purchasing agreements with the Centers for Medicaid and Medicare Services (CMS). 3. This is correct. Sharing data between disparate systems has become a major emphasis for health-care providers and payers as they assume accountability for financial outcomes in value-based purchasing agreements with the Centers for Medicaid and Medicare Services (CMS). 4. This is incorrect. Sharing data between disparate systems has become a major emphasis for health-care providers and payers as they assume accountability for financial outcomes in value-based purchasing agreements with the Centers for Medicaid and Medicare Services (CMS). 6. An advanced practice registered nurse (APRN) is providing care for a client with diabetes who is having difficulty adhering to the proposed plan of care. A successful APRN should possess which skill to procure the necessary items or services that will enable this patient to manage an illness? 1. Negotiation 2. Fiscal advocacy 3. Follow through 4. Use management Answer: 1 Page: 28 Feedback 1. This is correct. Negotiation is necessary to procure what a patient requires for health purposes. 2. This is incorrect. Fiscal advocacy is the ability to demonstrate the monetary effect of case management on care. Negotiation is necessary to procure what a patient requires for health purposes. 3. This is incorrect. Follow through is necessary to ensure optimum care within available resources. Negotiation is necessary to procure what a patient requires for health purposes. FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560 2024 NEW UPDATE 4. This is incorrect. Use management is the appropriate use of resources. Negotiation is necessary to procure what a patient requires for health purposes.