NUR 601 Essentials for Role Development TB Que with Ans 2023, Exams of Nursing

Download NUR 601 Essentials for Role Development TB Que with Ans 2023 and more Exams Nursing in PDF only on Docsity! nur 601 essentials for role development tb que with ans 2023 MULTIPLE CHOICE 1. The nurse manager of a pediatric clinic could confirm that the new nurse recognized the purpose of the HEADSS Adolescent Risk Profile when the new nurse responds that it is used to assess for needs related to a. anticipatory guidance. b. low-risk adolescents. c. physical development. d. sexual development. ANS: A The HEADSS Adolescent Risk Profile is a psychosocial assessment screening tool which assesses home, education, activities, drugs, sex, and suicide for the purpose of identifying high- risk adolescents and the need for anticipatory guidance. It is used to identify high-risk, not low-risk, adolescents. Physical development is assessed with anthropometric data. Sexual development is assessed using physical examination. REF: 6 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 2. The nurse preparing a teaching plan for a preschooler knows that, according to Piaget, the expected stage of development for a preschooler is a. concrete operational. b. formal operational. c. preoperational. d. sensorimotor. ANS: C nur 601 essentials for role development tb que with ans 2023 The expected stage of development for a preschooler (3 to 4 years old) is preoperational. Concrete operational describes the thinking of a school-age child (7 to 11 years old). Formal operational describes the thinking of an individual after about 11 years of age. Sensorimotor describes the earliest pattern of thinking from birth to 2 years old. REF: 5 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 3. The school nurse talking with a high school class about the difference between growth and development would best describe growth as a. processes by which early cells specialize. b. psychosocial and cognitive changes. c. qualitative changes associated with aging. d. quantitative changes in size or weight. ANS: D Growth is a quantitative change in which an increase in cell number and size results in an increase in overall size or weight of the body or any of its parts. The processes by which early cells specialize are referred to asdifferentiation. Psychosocial and cognitive changes are referred to as development. Qualitative changes associated with aging are referred to as maturation. REF: 2 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 4. The most appropriate response of the nurse when a mother asks what the Denver II does is that it a. can diagnose developmental disabilities. b. identifies a need for physical therapy. c. is a developmental screening tool. d. provides a framework for health teaching. ANS: C The Denver II is the most commonly used measure of developmental status used by health care professionals; it is a screening tool. Screening tools do not provide a diagnosis. Diagnosis requires a thorough neurodevelopment history and physical examination. Developmental delay, which is nur 601 essentials for role development tb que with ans 2023 development and would be the focus of preventive interventions. Environment is considered to significantly affect development. Nutrition is considered to significantly affect development. REF: 1 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 7. A mother complains to the nurse at the pediatric clinic that her 4-year-old child always talks to her toys and makes up stories. The mother wants her child to have a psychologic evaluation. The nurses best initial response is to a. refer the child to a psychologist. b. explain that playing make believe with dolls and people is normal at this age. c. complete a developmental screening. d. separate the child from the mother to get more information. ANS: B By the end of the fourth year, it is expected that a child will engage in fantasy, so this is normal at this age. A referral to a psychologist would be premature based only on the complaint of the mother. Completing a developmental screening would be very appropriate but not the initial response. The nurse would certainly want to get more information, but separating the child from the mother is not necessary at this time. REF: 5 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 8. A 17-year-old girl is hospitalized for appendicitis, and her mother asks the nurse why she is so needy and acting like a child. The best response of the nurse is that in the hospital, adolescents a. have separation anxiety. b. rebel against rules. c. regress because of stress. d. want to know everything. ANS: C Regression to an earlier stage of development is a common response to stress. Separation anxiety is nur 601 essentials for role development tb que with ans 2023 most common in infants and toddlers. Rebellion against hospital rules is usually not an issue if the adolescent understands the rules and would not create childlike behaviors. An adolescent may want to know everything with their logical thinking and deductive reasoning, but that would not explain why they would act like a child. Chapter 2. Emerging Roles of the Advanced Practice Nurse Test Bank Multiple Choice 1. An APRN is about to examine a patient in the emergency department. A colleague states to the APRN “This patient is probably just seeking pain medication.” Regardless of his or her colleague’s comment he or she enter the examination room and treat the patient as if he or she is trustworthy and has good motives. Which of the ten essential elements of dignity is the APRN utilizing? a. Inclusion b. Benefit of the doubt c. Acceptance of identity d. Recognition ANS: B Treating others as if they are trustworthy, starting with the premise that they have good motives and are acting with integrity are all key points of benefit of the doubt. Benefit of the doubt is one of the ten essential elements of dignity. 2. An APRN approaches his or her patients as neither inferior nor superior and gives others the freedom to express their authentic selves without being judged. Which of the ten essential elements of dignity is the APRN utilizing? a. Safety b. Accountability c. Acceptance of identity d. Benefit of doubt ANS: C The acceptance of identity is one of the ten essential elements of dignity. Approaching people as neither inferior nor superior to you, giving others the freedom to express their authentic selves without fear of being negatively judged, interacting without prejudice or bias, accepting how race, religion, gender, class, sexual orientation, age, disability, and so on are at the core of nur 601 essentials for role development tb que with ans 2023 someone’s identities, and assuming they have integrity are all included in the essential elements of acceptance of identity. nur 601 essentials for role development tb que with ans 2023 ANS: A The core competency of ethical decision making for APRNs is best organized into four key elements: knowledge development, knowledge application, creating an ethical environment, and promoting social justice. 8. Which of the following examples best describes the knowledge development element of core competency development for ethical decision making? a. Analyzing the policymaking process b. Using self-reflection during patient case reviews c. Applying ethical decision-making model to a clinical problem d. Mentoring others to develop ethical practice ANS: B The use of knowledge development is a key element of core competency development for ethical decision making. It involves gaining knowledge of ethical theories and developing the ability to distinguish a true ethical dilemma from a situation of moral distress or other clinically problematic situation. Becoming sensitive to ethical dimensions of clinical practice and fidelity conflicts, developing values clarification (self-reflection), and interpreting reactions and emotions of others are all elements of knowledge development and moral sensitivity. 9. An APRN joins a group promoting awareness about abuse in long-term nursing care facilities. He or she advocates for policies that protect the health care rights of individuals who are not able to care for themselves independently. The APRN most likely employed which of the following elements of core competency development for ethical decision making? a. Promoting social justice b. Knowledge development c. Creating an ethical environment d. Knowledge application ANS: A Skills or behaviors for promoting social justice within a health care system include the ability to analyze the policy process and advocacy, communication, and leadership skills that promote involvement in health policy initiatives supporting social justice. 10. An APRN interacts with a patient and another colleague to achieve the best outcome ofan ethical dilemma. The APRN most likely used which of the following elements of core nur 601 essentials for role development tb que with ans 2023 competency development for ethical decision making? nur 601 essentials for role development tb que with ans 2023 a. Knowledge application b. Creating an ethical environment c. Promoting social justice d. Knowledge development ANS: A Applying ethical decision-making models to clinical problems, using skilled communication regarding ethical issues, and facilitating decision making by using select strategies are involved in the use of knowledge application. 11. An APRN works at a hospital system that provides care to a large proportion of Asian American citizens. The APRN develops a presentation for newly hired employees about the cultural belief systems held by many in this population group. This describes the use of which of the following elements of core competency development for ethical decision making? a. Creating an ethical environment b. Promoting social justice c. Knowledge application d. Knowledge development ANS: A Creating an ethical environment may include the use of preventative ethics and awareness of environmental barriers to ethical practice. 12. Application of existing rules and doctrine as a guide for ethical decision making is best described as which ethical approach? a. Narrative ethics b. Care-based ethics c. Casuistry d. Principle-based ethics e. Virtue-based ethics ANS: D In principle-based ethical decision making, the principles or rules in contention are balanced and interpreted with the contextual elements of the situation. However, the final decision and moral justification for actions are based on principles. nur 601 essentials for role development tb que with ans 2023 a. Adapting to changing needs of patients, nurses, and health care systems b. Advanced knowledge and skills c. Lack of educational requirements d. Ability to independently practice ANS: A A hallmark of the role is the ability of the CNS to adapt to changing needs of patients, nurses, and health care systems (Kilpatrick, Tchouaket, Carter, Bryant-Lukosius, & DiCenso, 2016). This versatility allows for a CNS to transition between positions as a primary caregiver or educator depending on the environment. 17. Which of the following has complicated clarifying the work and core competency of all CNSs? a. Varying educational, competency, and practice standards b. Bureau of Labor Statistics’ failure to capture data c. Lack of interest d. Advancement of the nurse practitioner role ANS: A Varying educational, competency, and practice standards have complicated clarifying the work and core competencies of all CNSs, regardless of specialty. The failure of the Bureau of Labor Statistics to track CNS providers only creates barriers when it comes to counting the number of CNSs in the United States. 18. Which of the following is a central competency for CNSs according to the Hamric model? a. Indirect care of patients and families b. Ethical decision making c. Direct care of patients and families d. Systems leadership e. Conduct of research ANS: C Direct care of patients or clients is the central core competency of the Hamric model and links each of the other competencies. nur 601 essentials for role development tb que with ans 2023 19. According to the NACNS model, emphasis on which of the following competencies is largest? a. Indirect care of patients and families b. Ethical decision making c. Conduct of research d. Direct care of patients and families e. Systems leadership ANS: D Direct care of patients or clients is the largest competency of the three spheres according to the NACNS model and encompasses the other two. 20. A CNS relocatesto another state and begins a new job. Which ofthe following would guide his or her ability to practice certain procedures or skills? a. State scope of practice and facility policy b. American Medical Association policy c. State scope of practice d. Facility policy ANS: A The scope of practice is those activities a health care individual is allowed to perform within his or her profession. It is the responsibility of the CNS to adhere to each state’s rules in which they practice. Additionally, facilities may impose additional restrictions or limitations for a CNS to perform procedures or skills. 21. The National Association of Clinical Nurse Specialists has seven core competencies published for the CNS role. Which of the following is not included at the highest level? a. Coaching competency b. Professionalism competency c. Direct care competency d. Systems leadership competency ANS: B The National Association of Clinical Nurse Specialists’ Core Competencies include at the highest level seven competencies: direct care, consultation, systems leadership, collaboration, coaching, research, and ethical decision making, moral agency, and advocacy. nur 601 essentials for role development tb que with ans 2023 22. Each of the following is specifically described in the NACNS’s three spheres of influence for the CNS role except: a. Nurses/nursing practice b. Organization/system c. Leadership d. Patient ANS: C The NACNS has defined the CNS role as operating between the three spheres of influence: the patient, the organization/system, and the nurse/nursing practice. The CNS should employ Hamric’s seven competencies across the three spheres of influence. 23. According to a 2016 ruling, how has the Department of Veterans Affairs alleviated state based practice regulations at VA facilities? a. Allows CNS to work at full practice authority b. Allows CNS to practice according to their home state’s regulation c. Provides immediate licensures d. Provides malpractice insurance free of charge ANS: A In 2016, the Department ofVeterans Affairs alleviated state-based practice regulations by allowing CNS to work at full practice authority inside VA facilities and not within a state’sscope of practice. 24. Which of the following is major regulatory barrier for many CNS specialties in relation to the Consensus Model? a. Poor reimbursement for services b. Lack of specialty certification examinations c. Lack of education d. Poor CNS involvement in advocacy ANS: B A lack of specialty certification examinations in some areas is a major regulatory barrier for many CNS specialties in relation to the Consensus Model. 25. With regard to prescriptive authority, how did Oregon manage CNSs whose original education curriculum did not include prescription of pharmacologic agents? a. Take a specialized state-specific examination regarding prescriptive authority b. Permanent exclusion from prescriptive authority c. An advanced pharmacology course and complete 150 supervised hours d. 2080 hours involved in a collaborative agreement nur 601 essentials for role development tb que with ans 2023 a. Time spent among three spheres of influence b. Primarily involved in direct care c. Does not provide consultations d. Time spent primarily as patient advocate ANS: A One key defining difference of the CNS role is that the time spent performing competencies is across three spheres of influence. In the NP role, most time is spent in direct care management of patients. Both may provide consultations and all clinicians should act as a patient advocate. 29. Which of the following is most important to stabilize the future of the CNS role? a. Decreased educational requirements b. CNS conducted independent research c. Unity around NCSBN affirmation of CNSs being APRNs d. NP restrictions of roles ANS: C There are several important factors that influence the stability of the CNS role in the future. These include unity around NCSBN affirmations of CNSs as APRNs, articulating contributions to patients, families, and health care systems, ensuring educational curricula are upheld and helpful, partnering with others in practice and research, and seeking national recognition for the role. 30. Which of the following is provided as part of the Consensus Model? a. Decrease educational requirements b. Collaboration among physicians c. Reimbursement for services d. Title protection ANS: D The Consensus Model provides title protection for CNSs and provides for a grandfather clause to include APRNs who graduated from accredited programs and began practicing prior to the implementation of the Consensus Model. Chapter 3. Role Development: A Theoretical Perspective Test Bank Multiple Choice nur 601 essentials for role development tb que with ans 2023 31. The federal government’s criterion to establish health professionalshortage areas(HPSAs) is based on which of the following statistics? a. Average family income less than two-thirds of national poverty level b. An area in which there are less than 500 individuals for every primary care physician (PCMD) c. Average family income less than half of national poverty level d. An area in which there are more than 4500 individuals for every primary care physician (PCMD) e. An area in which there are more than 3500 individuals for every primary care physician (PCMD) ANS: E The federal government establishes health professional shortage areas (HPSAs) that are primarily based on the criterion that an area has more than 3500 individuals for every primary care physician (PCMD). 32. What is a downfall of the HPSA’s calculation? a. Is only recalculated every 10 years b. Does not include other PCP designations (PAs, NPs) c. Does not adjust for inflation d. Has a lower weighted average for NP versus MD providers ANS: B The health professional shortage areas (HPSAs) are currently only calculated based on primary care physicians (PCMDs) and do not take into account other primary care providers such as PAs and NPs. 33. Some community health centers can apply for a special designation if they are an entity that serves a population that is medically underserved or a specially medically underserved population comprised of migratory and seasonal agricultural workers, the homeless, and residents of public housing. What is this designation? a. Federally qualified health center (FQHC) b. Patient-centered medical home (PCMH) c. School-based health center (SBHC) d. Nurse-led health center (NLHC) ANS: A The HRSA Bureau of Primary Care enables these safety net organizations to receive a variety of enhanced federal support by applying for designation as a federally qualified health center nur 601 essentials for role development tb que with ans 2023 (FQHC). 34. Which of the following is not a common characteristic of a school-based health center (SBHC)? a. No parental requirement for consent for treatment b. Close integration with the school c. Comprised of a multidisciplinary team d. Located in schools or on school grounds ANS: A Nearly all SBHCs require parental consent for full treatment of adolescents, except in states where such adolescents can consent for certain treatments like contraception, pregnancy, drug abuse, and/or sexually transmitted infections. 35. A nurse practitioner provides care at a veteran’s clinic managed by the Department of Veterans Affairs. The state in which he or she practices prohibits many procedures. Which of the following is most accurate regarding the care the NP provides? a. Additional licensure is required to practice in VA systems by the state b. NP must be supervised for all skills c. State practice regulations override VA regulations d. Full practice authority is allowed inside the VA system ANS: D In 2016, The Department of Veterans Affairs granted full practice authority to NPs, CNSs, and CNMs. This allows these providers to work at full practice authority inside VA facilities and not confined within a state’s scope of practice. 36. Medical care provided by primary care providers (PCMD, PCNP) as part of the patient centered medical home (PCMH) model encompasses the full spectrum of primary care including standards of accessibility, continuity, comprehensiveness, integrated care, and interprofessional care. This model was first defined for what population group? a. Geriatrics b. Gynecology c. Pediatrics d. Mental health ANS: C nur 601 essentials for role development tb que with ans 2023 In 2017, the average NP has been in practice for 11 years. nur 601 essentials for role development tb que with ans 2023 40. According to the American Association of Nurse Practitioners: 2017 NP Fact Sheet, which of the following is the largest area of certification? a. Pediatrics b. Acute care c. Psychiatric/mental health d. Primary care e. Tertiary Care ANS: D About 89.2% of NPs are certified in an area of primary care as of 2017 including Adult, Adult Gerontology, Family, Gerontology, Pediatric-Primary Care, and Women’s Health. 41. According to the American Association of Nurse Practitioners: 2017 NP Fact Sheet and the AANP National Nurse Practitioners Database, approximately how many NPs are licensed in the United States? a. 1,26,000 b. 2,34,000 c. 3,18,000 d. 3,81,000 e. 4,08,000 ANS: B As of 2017, there are more than 2,34,000 NPs licensed to practice in the United States. 42. Which of the following has shown promising outcomes for NPs in achievement of competence, confidence, and mastery as well as increased levels of NP satisfaction? a. NP Postgraduate Residency Programs b. Work in Underserved population areas c. Increased NP Pay d. Decreased malpractice claims e. Advancement of NP care practices ANS: A NP Postgraduate Residency Programs still need additional research on outcomes, policy considerations, and academic arrangements. Early studies have suggested that NPs who complete a residency program acquire higher achievement of competence, confidence, and mastery as well nur 601 essentials for role development tb que with ans 2023 as increased levels of NP satisfaction. 43. The Triple Aim Initiative was launched in 2007 by the Institute for Healthcare Improvement (HIT) which focused on three dimensions of health care: experience of care, per capita cost, and population health. Which fourth aim was proposed in 2014 by Bodenheimer and Sinsky in a call to redesign the initiative? a. Improved clinician experience b. Prevention c. Increased reimbursements d. Decreased adverse events ANS: A Bodenheimer and Sinsky proposed a fourth aim “improved clinician experience” which brings to light the facts that the “joy” has gone out of practicing medicine. Other studies have shown that patient outcomes suffer if providers feel overwhelmed, overworked, or powerless. 44. The American Academy of Pediatrics questioned which of the following negative outcomes of Community Care Clinics (CCCs)? (Select all that apply.) a. Uneven EHR interoperability with community primary care providers b. Lack of longitudinal relationships with providers c. Incentives to overprescribe d. Increased patient satisfaction e. Decreased wait times ANS: A, B, C In 2014, the American Academy of Pediatrics had questions regarding CCCs and their possible incentives to overprescribe, lack of longitudinal relationships with providers, and uneven EHR interoperability with community primary care providers that may negatively impact the health care system. Chapter 4. Educational Preparation of Advanced Practice Nurses: Looking to the Future 45. Which of the following is the most essential component to lead clinical staff and programs effectively as an advanced practice registered nurse? a. Clinical credibility nur 601 essentials for role development tb que with ans 2023 d. Patient education regarding medication side effects nur 601 essentials for role development tb que with ans 2023 ANS: B Indirect care or indirect clinical practice refers to those activities and responsibilities that occur outside of the patient-nurse interface. They may include consultation with other health care providers, discharge planning, care coordination, communication with insurance companies, education or supervision of other medical staff, or billing and coding for services rendered. The other options are examples of direct care. 48. Which of the following is considered direct care? a. Forming a therapeutic relationship during patient examination b. Increasing knowledge of a disease process to better care for a complex patient c. Prior authorization of prescriptions d. Consultant phone call about patient condition ANS: A Direct care or direct clinical practice refers to those activities and functions that the APRN performs within the patient-nurse interface. Examples of direct care include physical acts of diagnosis, monitoring, treatment, or direct patient education that occur in the patient-nurse interface. It can be with the patient or family members. The other options are examples of indirect care. 49. An APRN is preparing a patient to be discharged from an emergency department. Which of the following activities is considered direct care? a. Speaking with the patient’s primary care provider b. Electronically transmitting prescriptions to pharmacy c. Discharge planning documentation d. Discharge patient education ANS: D The decision to discharge a stable patient requires that the APRN evaluated the patient and his or her clinical condition and determined it to be stable; this most likely required direct clinical care including a physical examination and medical decision making and discharge-related patient education. 50. An APRN evaluates and modifies his or her clinical practice routines by reading and following updates and recommendations from various journals and organizations such as the United States Preventative Task Force (USPSTF). Which characteristic of advanced direct care practice is the APRN utilizing? nur 601 essentials for role development tb que with ans 2023 a. Use of reflective practice b. Use of a holistic perspective c. Expert clinical performance d. Use of evidence as a guide for practice ANS: D Using evidence as a guide for practice is one ofsix characteristics for advanced direct care practice. Reading research reports, searching health care databases, acquiring skills to analyze evidence, and working with colleagues regarding evidence-based improvements in care are all examples of using evidence as a guide for practice. 51. During a patient encounter the APRN remembers the patient mentioned during a previous visit that the patient’s child was applying to colleges. The APRN asks which college the patient’s child chose to attend. Discussing this at the beginning of the patient encounter utilizes what characteristic of advanced direct care practice? a. Formation of therapeutic partnerships with patients b. Expert clinical performance c. Use of a holistic perspective d. Use of reflective practice ANS: A The formation of therapeutic partnerships with patients is one of six characteristics for advanced direct care practice. The APRN is effectively using good conversational style to create a strong therapeutic relationship with the patient. Use of a holistic perspective would only be correct if this conversation was used in relation to the patient’s care. 52. An APRN starts a patient on a specific medication chosen over a compatible medication due to a decreased risk of sedation. The medication was chosen because the patient has an occupation driving a truck. Which characteristic of advanced direct care practice is the APRN utilizing? a. Formation of therapeutic partnerships with patients b. Use of a holistic perspective c. Expert clinical performance d. Use of reflective practice ANS: B Using a holistic perspective includes identifying patterns of symptoms combined with the effect of the individual patient. This may include the patient’s view of his or her own health or the impact that his or her disease or treatments may affect his or her overall quality of life. Expert nur 601 essentials for role development tb que with ans 2023 c. Use of reflective practice d. Diverse approaches to and interventions for Health and Illness Management ANS: B Systematic reviews of existing journals, health care statistics, and working with colleagues in an attempt to improve outcomes and understand clinical scenarios are examples of excellent use of evidence as a guide for practice. In this scenario the other options are incorrect; the APRN had not just discussed his or her personal beliefs, nor was specifically reviewing patient data for his or her personal knowledge development. 56. An APRN is working in a rural community health center providing community health services to poverty-stricken families He or she works at government agencies and regional medical centers to coordinate care for patients who cannot afford it. At these facilities the APRN gains experience using lower cost strategies to provide effective care. Which characteristic of advanced direct care practice is the APRN utilizing? a. Expert clinical performance b. Use of reflective practice c. Diverse approaches to and interventions for Health and Illness Management d. Use of evidence as a guide for practice ANS: C Diverse approaches to and interventions for health and illness management include the interpersonal interventions to guide or coach patients, acquiring new ways to treat patients, providing preventative services, coordinating services among care sites and multiple providers, and acquiring knowledge about complementary therapies. 57. An APRN in an emergency department is utilizing a new type of IV catheter for the first time. He or she seeks out a colleague more familiar with the device for supervision. Which characteristic of advanced direct care practice is the APRN utilizing? a. Expert clinical performance b. Use of reflective practice c. Formation of therapeutic partnerships with patients d. Use of a holistic perspective ANS: A Expert clinical practice includes more than just providing excellent care at your current level. It also includes having an understanding of scenarios, situations, and procedures where you may be overwhelmed or less confident and then seeking out expert assistance or guidance. This provides nur 601 essentials for role development tb que with ans 2023 the best outcomes for the patient and furthers the clinical understanding. nur 601 essentials for role development tb que with ans 2023 58. A female patient is undergoing an elective surgery that has a risk of blood loss. She is a Jehovah’s Witness and due to her religious beliefs does not want blood transfusions to be administered. The APRN delays the patient’s surgery and recommends she donate her own blood to be administered during the surgery if needed. Which characteristic of advanced direct care practice is the APRN utilizing? a. Use of evidence as a guide for practice b. Expert clinical performance c. Use of a holistic perspective d. Formation of therapeutic partnerships with patients ANS: C Understanding the patient’s spiritual and life values, additional context of the patient’s life, possible life changes, and the effects of their disease or treatments are all factors that must be considered when using a holistic perspective. 59. Which of the following will most likely enhance the patient-APRN relationship and increase communication? a. Longer appointment duration b. Printed education guides c. Having a caregiver present at the time of examination d. Active listening ANS: D A foundation of excellent communication begins with listening to the patient. Each of the other options may improve the outcome of the patient but establishing effective therapeutic relationships with patients involves listening to their concerns to establish trust, increase patient satisfaction, increase adherence to treatment plans, and improve patient outcomes. 60. With which of the following types of patients would it be most difficult to establish a therapeutic partnership? a. Mentally disabled patient b. Toddler c. Elderly patient d. A patient with tonal hearing loss ANS: A While all of the patients in this question may be more challenging, only the mentally disabled nur 601 essentials for role development tb que with ans 2023 b. Use of an ethics committee c. Discussion when life-threatening disease/accident occurs d. Discussion upon admission of a patient to a hospital ANS: A Avoiding ethical conflicts with patients, families, and their surrogates can best be avoided by having ethical discussions as early as possible. While all scenarios will avoid ethical conflicts, discussion and documentation with a healthy patient allows for prevention of ethical conflicts in end-of-life care. Remember that prevention is always the best treatment. 66. Which of the following scenarios is the best example of the concept of moral distress? a. 75-Year-old nursing colleague fired for being too old b. 45-Year-old female diagnosed with lung cancer who refuses appropriate treatment c. 4-Year-old child who died after receiving an incorrect medication d. Amputation of the incorrect limb during a surgical procedure ANS: B The most common cause of moral distress identified in a 2004 study is patient refusal of appropriate life-saving treatment. By definition, moral distress is when a provider knows an ethically appropriate action should be taken but barriers are encountered that discourage the action from being taken. Wrong site surgeries and medication errors are negligence. The firing of a person based on age is considered discrimination. 67. Which of the following strategies has been recommended when communicating about adverse events? a. Avoid apologizing or acknowledging the error occurred b. Notify the patient immediately that an adverse event has occurred c. Complete all documentation thoroughly prior to reporting the event to anyone d. Explain all known details to the patient immediately ANS: B Four stepsrecommended by a consensus group of Harvard hospitals in 2006 include the following: (1) tell the patient what happened immediately, but leave details of how and why for later when a thorough review has occurred; (2) take responsibility for the incident; (3) apologize and communicate remorse; (4) inform the patient and family what will be done to prevent similar events. 68. Which of the following are characteristics of direct clinical care provided by APRNs? (Select all that apply.) nur 601 essentials for role development tb que with ans 2023 a. Use of reflective practice b. Use of evidence as a guide for practice c. Formation of therapeutic partnerships with patients d. Adequate supervision of others e. Use of a holistic perspective ANS: A, B, C, E The six characteristics of direct clinical care are use of a holistic perspective, formation of therapeutic partnerships with patients, expert clinical performance, use of reflective practice, use of evidence as a guide to practice, and use of diverse approaches to health and illness management. Adequate supervision of others is an example of indirect care. 69. A newly licensed APRN is working in a busy outpatient clinic. He or she continually runs late and cannot adequately gather all of the pertinent patient information during each patient encounter. This has caused the APRN to misdiagnose multiple patients. Which of the following may best alleviate the time pressures experienced by the APRN? (Select all that apply.) a. Avoid interruptions b. Increase visit length time c. Limit patient complaints allowed for each visit d. Use a systematic approach e. Set a timer to end each patient encounter ANS: A, B, D Time pressures are experienced at an even higher frequency in novice APRNs. Avoiding interruptions and increasing visit length time are the best options to alleviate time pressures. Setting a timer to end each patient encounter or limiting patient complaints would be inappropriate strategy for a novice APRN. Rushed or truncated encounters often lead to lack of therapeutic communication, incomplete physical examinations, and withholding of patient questions. Development of a systematic approach to each patient encounter is one of the best strategies to implement to increase APRN efficiency and is usually paramount as an APRN develops experience. Chapter 5. Global Perspectives on Advanced Nursing Practice 70. A nurse develops an interest in more effective medication management and seeks additional training to enhance his or her daily care of patients and for peers at the facility for which he or she works. This is an example of: nur 601 essentials for role development tb que with ans 2023 a. Specialization b. Subspecialty c. Specialty d. Advanced practice nursing ANS: A Specialization involves focusing on practice in a specific area derived fromthe field of professional nursing. Specialties can be further characterized as nursing practice that intersects with another body of knowledge, has a direct impact on nursing practice, and is supportive of the direct care provided to patients by other registered nurses (American Nurses Association [ANA], 2010a). If the nurse changed his or her focus of practice this could be considered a specialty. 71. A nurse develops an interest in effective medication management and seeks additional training. The nurse then focuses the majority of his or her time on medication management aspects of nursing. This is an example of: a. Advanced practice nursing b. Subspecialty c. Specialization d. Specialty ANS: D The termspecialty suggeststhat the focus of practice is limited to parts ofthe whole (ANA, 2010b). Since this nurse has refocused his or her care entirely on medication management as part of the nursing role it is considered a specialty. 72. A registered nurse is planning to extend his or her education beyond baccalaureate education into an advanced practice role. When choosing between CRNA, CNM, and NP these are delineations of which type? a. Reasoning b. Subspecialty c. Specialty d. Specialization ANS: C The termspecialty suggeststhat the focus of practice is limited to parts ofthe whole (ANA, nur 601 essentials for role development tb que with ans 2023 a. Specialty organizes b. Specialty standardizes c. Specialty begins d. Specialty matures and grows interprofessionally ANS: C Specialty stages are not concrete, but specialties that are in the beginning of development are in stage I: specialty beginning. Stage II: specialty organization is typically considered when a professional organization of like-minded individuals is officially formed. 76. A clinical transplant coordinator works with many aspects of the patient transplant process. Two national organizations currently provide education and preparation for certification of nurses. Which stage of organization is this specialty? a. Stage IV b. Stage II c. Stage I d. Stage III ANS: B The clinical transplant coordinator is currently a stage II specialty as it organizes and begins plans for standardization of care. 77. A national specialty committee is formed for a specific nursing specialty. This is an example of what stage of evolution of advanced practice nursing? a. Stage II: specialty organizes b. Stage I: specialty begins c. Stage IV: specialty matures d. Stage III: specialty standardizes ANS: A As national organizations form around specific specialties they are considered to be in stage II of the evolution of advanced practice nursing. 78. Two organizations are formed for a specific advanced practice nursing specialty. As interest in the specialty grows, legislation is required to govern aspects of care. To answer this call, the organizations must meet what stage of evolution of advanced practice nursing? a. Stage I: specialty begins b. Stage IV: specialty matures c. Stage III: specialty standardizes nur 601 essentials for role development tb que with ans 2023 d. Stage II: specialty organization ANS: C As pressures mount for standardization, often for curriculum development or legislative pressure, standardization of practice must be obtained. This is often a difficult and lengthy process of stage III of the evolution of advanced practice nursing. 79. Hospitalist practice by advanced practice nurses are in significant need. What stage of development is hospitalist practice? a. Specialty standardizes b. Specialty begins c. Specialty matures and grows interprofessionally d. Specialty organizes ANS: B Hospitalist practice is a relatively new field for advanced practice nursing and has yet to be organized. Hospitalist practice is a stage I specialty. 80. Which ofthe following specialties is classified asstage II, organized but yet to be standardized? a. Wound and Ostomy Nursing b. Interventional Pain Specialist c. Advanced Diabetes Manager d. Clinical Transplant Coordinator ANS: D The clinical transplant coordinator is currently a stage II specialty as it organizes and begins plans for standardization of care. Wound and Ostomy nursing and Interventional Pain Practice are both stage III specialties. Advanced Diabetes manager and Genetics Advanced Practice are stage IV specialties. 81. As first addressed in 1985 at Surgeon General’s workshop on Violence and Public Health, the need for which specialty began? a. CRNA b. Forensic Nursing c. Public Health Nursing d. Wound and Ostomy Nursing ANS: B The need for Forensic Nursing specialty was first addressed in 1985 at Surgeon nur 601 essentials for role development tb que with ans 2023 General’s workshop on Violence and Public Health. nur 601 essentials for role development tb que with ans 2023 ANS: B An AG-ACNP can provide care to patients aged 13 and older unless additional state or facility specific restrictions exist. The age ranges are grouped into young adults, middle-age adults, and older adults. 3. As identified in a 2012 study by the ANCC, which of the following top workactivities for the AG-ACNP was number one when arranged by criticality? a. Conducting history and physical examinations b. Maintaining patient privacy and confidentiality c. Evaluating patients for safety and efficacy of interventions d. Assessing patients for urgent and emergent conditions ANS: B In 2012, the ANCC surveyed ACNP clinicians and identified top work activities for the AG- ACNP role. These activities were organized by criticality, or importance of the skill and determined by the requirement to perform the skill accurately each time, as a novice NP, and based on the risk of harm by performing the skill incorrectly. Maintaining patient privacy and confidentiality scored at the top. 4. Based on a survey of ACNPs, the following procedures are performed in a hospital- based setting most commonly by ACNPs except: a. Vasoactive intravenous drips b. Lumbar puncture c. Sutures d. Radiologic studies ANS: B Based on survey data, procedures that are formed least routinely by ACNPs include lumbar punctures, surgical first assist, thoracostomy tubes, cutdowns, paracentesis, joint aspirations, and bladder aspirations. 5. Based on a survey of ACNPs, which of the following procedures are performed in a hospital based setting most commonly by ACNPs? a. Defibrillation nur 601 essentials for role development tb que with ans 2023 b. Lumbar puncture c. Pacemakers d. Chest tubes ANS: A Based on survey data, procedures that are formed most commonly by ACNPs include radiologic studies, vasoactive intravenous drips, resuscitative efforts, defibrillation, wound care, sutures, incisions, and ventilation. 6. Which of the following is more commonly attributed to the AG-ACNP role versus that of a CNS? a. Patient-centered care b. System change responsibilities c. Performing procedures d. Staff education and development ANS: C The AG-ACNP and CNS both focus on patient-centered care. The AG-ACNP is more likely to spend a larger percentage of his or her time at the bedside using clinical skills to assess, diagnose, and treat patients with complex or acute medical conditions including performing procedures. Staff education and development and system change responsibilities are typically a larger portion of the CNS role. 7. Which of the following locations would be most appropriate for an AG-ACNP? a. Tertiary care management b. Billing and coding c. Primary care management d. Secondary care management ANS: A Tertiary care management includes the intensive care unit or emergency department and would be the best choice for this question. Although secondary care management is common, such as an inpatient unit or hospitalist position, most acute scenarios are encountered in the ICU or ED and more appropriate for the specialized skills of the AG-ACNP. It is important to note that any NP should have working knowledge of all practice areas, regardless of clinical specialty. 8. Educational programs that prepare students for AG-ACNP practice adhere to which nur 601 essentials for role development tb que with ans 2023 ofthe following? nur 601 essentials for role development tb que with ans 2023 c. Single charge per calendar day of service d. The number of critical care minutes spent ANS: D Critical care involves high-complexity decision making in the care of patients. Reimbursement is based on the number of critical care time in minutes spent by the provider and must be billed separately because care provided by NPs and PAs is billed at a lower rate. The first 30-74 minutes are billed and then separate billing for each additional 30 minutes of critical care time spent with the patient. 12. An AG-ACNP is part of a practice group that employs both physicians and AG-ACNPs. The NP and a physician in the group both evaluate a patient in the intensive care unit. The NP assesses and evaluatesthe patient first for 32 minutes followed by the physician for 20 minutes. How should the initial critical care time be billed? a. Combined and billed under the NP’s provider number b. Combined and billed under the physician’s provider number c. Billed under the AG-ACNP’s provider number d. Billed under the physician’s provider number ANS: C Billing of critical care time for the initial 30 minutes is billed under the provider number of whoever provided the service. It cannot be combined. Subsequent critical care minutes should be billed separately and also cannot be combined or linked. 13. Which of the following is a specialization opportunity most appropriate for an AG-ACNP? a. Rapid response ream b. Advanced diabetes manager c. Outpatient clinic supervisor d. Wound ostomy nurse ANS: A Although the AG-ACNP may be eligible to specialize in all of the areas, he or she would best be suited for a specialization that utilizes the acute care nature of his or her skills. Chapter 7. Credentialing and Clinical Privileges for the Advanced Practice Registered Nurse 1. Which of the following is the primary mission of the National Organization of Nurse Practitioner Faculties (NONPF)? nur 601 essentials for role development tb que with ans 2023 a. Provide leadership in promoting quality NP education nur 601 essentials for role development tb que with ans 2023 b. NP Faculty training program assistance c. Provide financial assistance to NP students d. Lobbying legislature on behalf of NPs ANS: A The NONPF’s primary mission is to provide leadership in promoting quality NP education. The organization has published domains and core competencies for primary care and these serve as a framework for NP education and practice. 2. A model of competencies that are encompassed around three spheres of influence known as patient, nurses and nursing practice, and organization and influence is known as? a. NACNS Model of clinical nurse specialist competencies b. Fenton’s and Brykczynski’s Expert Practice c. Calkin’s model of Advanced Nursing Practice d. Shuler’s Model of NP Practice ANS: A The NACNS’s initial 2008 statement was revised in 2004. The statement outlined competencies that aligned to each of the three spheres of influence: patient, nurses and nursing practice, and organization and influence. 3. Building upon Benner’s seven domains of expert nursing practice, which conceptual model adds an additional domain “The consulting role of the nurse”? a. Calkin’s model of Advanced Nursing Practice nur 601 essentials for role development tb que with ans 2023 a. Ethics nur 601 essentials for role development tb que with ans 2023 b. Culture c. Informatics d. Education ANS: A The TAPP model added two additional domains: quality and safety, and credentialing and regulatory practice, to the Strong model. It additionally added professional ethics as a unifying conceptual strand. 7. Poghosyan, Boyd, and Clarke (2016) proposed a comprehensive conceptual model including three factors: scope of practice regulations, institutional policies, and practice environments. What was their primary purpose? a. To discourage role ambiguity among CNS providers b. To enhance patient education provided by the APRN c. To maximize NP Contributions to primary care d. To provide educational practice guidelines to enhance NP education ANS: C The 2016 model provided a comprehensive review of literature and described potential factorsthat affect NP care and patient outcomes. This included scope of practice regulations that often cause barriers for NP provided primary care. 8. Which model of practice intended to impact the NP domain at four levels: theoretical, clinical, educational, and research in 1993? a. Hamric’s model b. Calkin’s model of Advanced Nursing Practice c. Strong Memorial Hospital’s Model of Advanced Nursing Practice d. Shuler’s Model of NP Practice ANS: D Shuler’s Model of NP Practice is a holistic and wellness oriented model that was designed to impact the NP domain at four levels: theoretical, clinical, educational, and research. It is designed to elaborate the NP’s expanded knowledge and skills into medicine including a template for conducting a visit. 9. Which model for APRN practice addresses all four APRN roles: CNS, CRNA, CNM, and NP? nur 601 essentials for role development tb que with ans 2023 a. Calkin’s model of Advanced Nursing Practice nur 601 essentials for role development tb que with ans 2023 b. Strong Memorial Hospital’s Model of Advanced Nursing Practice c. Donabedian Model d. Calkin’s model of Advanced Nursing Practice ANS: D Calkin’s model of Advanced Nursing Practice outlines skills and knowledge of beginning nurses, experienced nurses, and advance practice nurses as they relate the patient responses for health care problems. 13. The 2005 Donabedian model has been used to evaluate the quality of APRN care using which conceptual outline? a. Assessment, diagnosis, planning, intervention, and evaluation b. Structure, process, and outcome c. Diagnosis and outcome d. Diagnosis, morbidity, and mortality ANS: D The Donabedian model encompasses structure (health care systems and facilities), process (diagnosis, treatment, education), and outcomes. 14. Which of the following are the functions of a conceptualization ofadvanced practice nursing? (Select all that apply.) a. Basis for furthermore development of knowledge b. Articulate professional role identity and function c. Identify specific procedures to provide d. Deliver holistic and collaborative care e. Provide guidelines on billing ANS: A, B, D Conceptual models allow for articulation of professional role identity, provide a basis for furthermore development of knowledge and assist in clinical practice for the delivery of holistic, comprehensive, and collaborative care. Models may assist but in general do not provide assistance with clinical decision making or billing. Chapter 8. The Kaleidoscope of Collaborative Practice 1. A 45-year-old female is being prepared for elective surgery. A registered nurse goes over the patient’s medication list and allergies and then the patient is seen by a CRNA prior to nur 601 essentials for role development tb que with ans 2023 surgery who also goes over the patient’s medication list. The registered nurse and the CRNA do not nur 601 essentials for role development tb que with ans 2023 work together to form a medication list for the patient. This is best defined as: a. Collaboration b. Parallel communication c. Parallel functioning d. Faux collaboration e. Information exchange ANS: B Parallel communication occurs when two clinicians do not talk together prior to seeing the patient, see the patient separately, and have no expectation of joint interactions. If the two made separate plans of care for the same aspect of the patient’s care this could be defined as parallel functioning. 2. Which of the following has the highest likelihood for medical errors and decrease patient outcomes? a. Collaboration b. Parallel functioning c. Referral d. Consultation ANS: B Parallel functioning is when providers are caring for patients and address the same clinical problems without joint or collaborative planning. This could lead to additional interventions, confusion for the patient, medication errors, and poor outcomes. 3. Two APRNs work together to evaluate a patient, develop a plan of care, and implement different aspects of care while communicating about the patient’s overall clinical course.This is an example of: a. Parallel communication b. Collaboration c. Coordination d. Referral e. Parallel functioning ANS: B Collaboration with other team members involves the facilitation of teamwork to ensure the delivery of safe, effective, high-quality care leading to positive outcomes. 4. A novice APRN begins working at a cardiovascular outpatient clinic with a more senior APRN. The novice APRN always goes along with recommendations of the other APRN due to a feeling of a lack of skill to engage in conversations about the patient’s care. Which of the nur 601 essentials for role development tb que with ans 2023 7. An APRN suspects a patient has tuberculosis and has the patient placed in isolation in a negative pressure room. The APRN notifies the nurse caring for the patient that anyone entering the room must wear a special mask. This example is best defined by which of the following? a. Collaboration b. Comanagement c. Information exchange d. Faux collaboration e. Parallel communication ANS: C Information exchange or informing may be one-sided or two-sided and may or may not require an action or decision making. Information exchange that requires decision making is typically unilateral and risks a negative outcome if the situation actually required joint planning and information exchange. 8. An APRN callsthe laboratory and medical imaging department regarding his or her patient. The APRN informs the medical imaging department that they must wait to perform imaging until after the laboratory has completed with the patient. This example best represents which of the following? a. Collaboration b. Coordination c. Parallel communication d. Faux collaboration e. Parallel functioning ANS: B Coordination is a form of communication that lends structure to an encounter and often includes actions that minimize duplication of efforts or ensure continuity of care. 9. Which of the following is necessary to create an environment of collaboration? a. Common purpose b. Similar ideologies c. Poor communication d. Ineffective methods e. Poor patient outcomes nur 601 essentials for role development tb que with ans 2023 ANS: A Although all of the responses may lend to collaboration, only the presence of a common purpose or goal will facilitate ease of collaboration, as it is one of the key elements for collaboration. The most common goal in health care is to improve patient outcomes. Poor outcomes do not need to be present to have collaboration. 10. Which of the following strategies is most likely to facilitate organizational collaboration? a. Understanding another person’s viewpoint b. Cooperation without losing integrity c. Collaborative research d. Interprofessional education programs ANS: D A strategy to facilitate organizational collaboration would be interprofessional education programs. These programs allow different providers to meet face to face in an educational environment with a common goal of learning. Collaborative research is a strategy for team building. 11. Which of the following strategies is most likely to increase individual collaboration? a. Knowledge of what is negotiable and nonnegotiable b. Team-building exercises c. Interprofessional education programs d. Collaborative research ANS: A There are many strategies to promote effective communication and collaboration on an individual basis. These include being respectful and professional, listening, acknowledging others’ viewpoints, knowing what is negotiable, knowing the bottom line, and not taking things personally among many others. 12. Which of the following decreases defensiveness, relieves tension, and deflects anger as part of the collaborative process? a. Common purpose b. Humor c. Clinical competence d. Accountability nur 601 essentials for role development tb que with ans 2023 ANS: B Humor helps individuals maintain perspective and acknowledge the lack of perfection needed. It also sets the tone for trust and acceptance among colleagues during difficult situations so that defensiveness and tensions can be relieved. 13. Which of the following are restraining forces on interprofessional practice, education, or research? (Select all that apply.) a. Shared competencies b. Culturalsilos c. Lack of expertise d. Physician-based reimbursement e. Care of older adults and their families ANS: B, C, D Restraining forces for interprofessional practice, education, and research include lack of expertise, cultural silos, existing infrastructure, and reimbursement. Driving forces for interprofessional practice, education, and research include older adults and their families, professions (shared competencies), business (workforce shortages), and policy (health care reform). 14. Which of the following are driving forces on interprofessional practice, education, or research? (Select all that apply.) a. Lack of expertise b. Workforce shortages c. Shared competencies d. Care of older adults and their families e. Physician-based reimbursement ANS: B, C, D Driving forces for interprofessional practice, education, and research include older adults and their families, professions (shared competencies), business (workforce shortages), and policy (health care reform). Restraining forces for interprofessional practice, education, and research include lack of expertise, cultural silos, existing infrastructure, and reimbursement. Chapter 9. Participation of the Advanced Practice Nurse in Health Plans and Quality Initiatives 86. In 1990, Cooper and Sparacino postulate than an APRN’s maximum potential may not be nur 601 essentials for role development tb que with ans 2023 b. Role acquisition c. Role confusion d. Role conflict ANS: B The changes occurring during role transitions experienced during the educational component of an APN role are classified as role acquisition. Additionally, role transition is described as when an APRN begins to practice for the first time in a new role. 88. A new NP student is completing a rotation at an outpatient urgent care clinic and completes an examination on a patient with chest pain. The nursing assistant hands a 12-lead ECG to the NP student and asks: “What should we do?” The NP student’s preceptor did not provide clear instructions on the role of the NP student at this time even though the student is capable of interpreting ECGs. This is an example of: a. Role ambiguity b. Role transition c. Role strain d. Role supplementation ANS: A Role ambiguity is created by unclear expectations, diffuse responsibilities, and uncertainty of subroles. The NP student’s preceptor did not provide clear roles to the NP student about what he or she should do in the absence of the preceptor. If the NP student was placed in a role where he or she was unaware of how to interpret ECGs this would be an example of role incongruity. 89. An NP is completing the first month in his or her first job. He or she receives a phone call from an administrator telling him or her that he or she will need to see 30% more patients starting next week. He or she is told that this is the minimum requirement of all NPs in the same position. The NP has difficulty using the electronic health record (EHR) software efficiently and feels overwhelmed. This is an example of: a. Role supplementation b. Role ambiguity c. Role conflict d. Role insufficiency ANS: D Role insufficiency is often seen as APRN graduates’ transition to the workforce or change positions. This may include feelings of inadequacy or slow speed due to the new role or barriers nur 601 essentials for role development tb que with ans 2023 such as electronic health record documentation requirements. nur 601 essentials for role development tb que with ans 2023 90. Which of the following is an example of role acquisition? a. NP student learning leadership roles in the classroom b. NP student on graduation day from his or her program c. NP student beginning a new job as a family nurse practitioner d. A practicing NP advancing central line skills ANS: A The changes occurring during role transitions experienced during the educational component of an APN role are classified as role acquisition. All of the others are examples of role implementation. 91. The changes occurring as an APRN performs procedures during job duties are classified as? a. Role supplementation b. Role transition c. Role implementation d. Role acquisition ANS: C The job duties and responsibilities performed by the APRN are an example of role implementation. Role transition is the transition from student to practicing NP. 92. Which of the following is best classified as roll stress? a. Maintaining family responsibilities while in school b. An APN’s feelings of poor self-esteem c. Starting a first job as an NP d. Multiple failed attempts to master a procedure during education ANS: A There are many examples of role stress. Role stress may include any situation that requires increased performance above and beyond the expectation of others. This is easily classified as examples of things that require additional demand in addition to school or work such as work/family responsibilities or keeping up with new and advancing technologies. Starting a first job as an NP is an example of role transition. 93. Which of the following is best classified as role strain? nur 601 essentials for role development tb que with ans 2023 examination. The overwhelming feeling and stress of learning additional skills is most likely classified by the studies of Anderson, Leonard, and Yates in 1974 as: nur 601 essentials for role development tb que with ans 2023 a. Independence b. Developing competence c. Interdependence d. Complete dependence ANS: D The initial learning of skills and additional techniques experienced by NPs in the beginning of their training has been described as complete dependence. 97. A trained NP is working at an outpatient care clinic. He or she encounters a difficult patient, is unaware of treatment options, and consults one of his or her colleagues for advice. This is best classified as: a. Independence b. Interdependence c. Developing competence d. Complete dependence ANS: B As initially defined by Anderson, Leonard, and Yates in 1974, NP roles as they transition to the workplace as seasoned practitioners transition to interdependence as they work with colleagues to enhance patient care. 98. Fleming and Carberry’s research in 2011 studied two cohorts of critical care nurse advanced practice trainees in Scotland. They found that transition occurred in which four areas? a. Complete dependence, developing competence, independence, interdependence b. Developing competence, partial independence, complete independence, interdependence c. Coping with pressures, feeling competent, internalizing the role, leading others d. Finding a niche, overcoming obstacles, advanced practice, interdependence e. Finding a niche, coping with pressures, feeling competent, internalizing the role ANS: E Fleming and Carberry’s research in 2011 studied two cohorts of critical care nurse advanced practice trainees in Scotland showing transition occurred in four areas: finding a niche, coping with pressures, feeling competent, internalizing the role. 99. A strategy to promote role acquisition in school that involves a ceremony at the beginning nur 601 essentials for role development tb que with ans 2023 of the NP students training is the best example of: nur 601 essentials for role development tb que with ans 2023 105. In 2010, researchers Sullivan-Bentz et al. used Brown and Olshansky’s four-stage transition model to study recent NP graduates as they undergo role transition to practicing NPs. What did the study demonstrate? a. New NPs transitioned from feeling overwhelmed to feeling confident in 6 months only with support networks b. New NPs did not transition from feeling overwhelmed to feeling confident in the study c. New NPs transitioned from feeling overwhelmed to feeling confident in 1 year only with support networks d. New NPs transitioned from feeling overwhelmed to feeling confident in 1 year e. New NPs transitioned from feeling overwhelmed to feeling confident in 6 months ANS: D APRN role development processes have been supported by a number of studies identifying that the first year is most likely to be observed as the transition from feeling overwhelmed to feeling confident. 106. A questionnaire study conducted by Hart and Macnee (2007) at two national NP conferences found that 51% of NPs perceived that they were only somewhat or minimally prepared for actual practice. Which of the following would most likely facilitate the role transition issues for a beginning NP? a. Clinical NP residency program b. Additional time requirement as a practicing registered nurse c. Longer NP education program d. Additional NP clinical training hours ANS: A As many studies have shown the role transition issues of APRN graduates, clinical residency programs have been developed to address these issues. Clinical residency programs ease new graduate transition into practice and increase NP retention and overall satisfaction. Chapter 10. Public Policy and the Advanced Practice Registered Nurse 107. Which of the following are components ofthe LACE network that support implementation of the Consensus Model for APRN regulation? a. Licensure, acceptance, certification, and education b. Liability, acknowledgment, compliance, and excellence c. Licensure, accreditation, compliance, and education nur 601 essentials for role development tb que with ans 2023 d. Licensure, accreditation, certification, and education ANS: D The organizations that make up the LACE network include those for licensure, accreditation, certification, and education. They work together to move forward the process of implementation of the Consensus Model. 108. Which of the following is an optional process for educational organizations to obtain? a. Licensure b. Certification c. Credentialing d. Accreditation ANS: D Accreditation is an optional process for educational institutions in many instances. Accreditation is performed by outside agencies that review the processes and strategies of the institution thereby creating a metric of the quality of education. 109. Which of the following provides authorization through a state agency to engage in the APRN role? a. Licensure b. Certification c. Accreditation nur 601 essentials for role development tb que with ans 2023 d. Regulation e. Credentialing ANS: A Licensure is completed by state agencies to provide authorization to engage in the APRN role. Certification is often a prerequisite to licensure. 110. Which of the following must an APRN undergo to validate their knowledge, skills, and abilities to perform their desired role? a. Credentialing b. Regulation c. Accreditation d. Licensure e. Certification ANS: E Certification involves a formal process to review a candidate’s knowledge, skills, and abilities to perform a specific role. This formal process is often completed through examination in the APRN nur 601 essentials for role development tb que with ans 2023 regulation ANS: C DEA numbers authorize the prescription of controlled substances but are still regulated by both federal and state regulations. APRNs may be subjected to additional regulation in the state where he or she practices. 114. All of the factors must be present for a malpractice case to demonstrate negligence by an APRN except: a. Direct causation must be linked to the APRN b. The patient must be under the direct care of the APRN c. A duty of care must be owed to the injured party d. Damages or sustained injuries to the patient e. The accepted standard of care was breached ANS: B Four factors must be established for the basis of a malpractice claim including a duty of care being owed, a breach of accepted standards of care, resulting damages or injury to the patient, and direct causation that is linked to the APRN. The patient does not have to be under the direct care of the provider to be included in a malpractice suit. 115. Which of the following requires compliance with HIPAA while functioning as an APRN? a. Transmission of health information for payment of medical claims b. All of the above c. Transmission of health information in any form d. Regular care of patients e. Discussion of patient conditions with consultants ANS: B The Health Insurance Portability and Accountability Act (HIPPA) originally became law in 1996 and mandates all medical professionals adhere to patient privacy standards when pertaining to personally identifiable patient information, regardless of transmission method. Chapter 11. Resource Management 1. After teaching a group of students about the various types of advanced practice nurses, the instructor determines that the teaching was successful when the students state which of the nur 601 essentials for role development tb que with ans 2023 following as the most common type? nur 601 essentials for role development tb que with ans 2023 A) Nurse practitioners (NPs) B) Clinical nurse specialists (CNS) C) Certified nurse midwives (CNMs) D) Certified registered nurse anesthetists (CRNAs) Ans: A 2. A group of nurses is attending a presentation about advanced practice nursing. Which of the following would the group expect to hear about the scope of practice? A) It has been standardized for all 50 states in the United States. B) It includes prescribing or furnishing drugs in only about one half of the states in the United States. C) It is dependent upon if the national certifying exam has been taken for the specialty practice area. D) It differs greatly among the various types of advanced practice. Ans: D 3. A nurse is considering becoming a clinical nurse specialist (CNS). Which activities would the nurse expect to be involved in? Select all that apply. A) Managing complex medical conditions B) Providing expert consultation with nursing staffs C) Administering anesthesia D) Providing specialized direct care E) Providing pregnancy care Ans: B, D 4. Which of the following best reflects the doctor of nursing practice degree? A) Required as mandatory for nurse practitioners and clinical nurse specialists as of the year 2012 B) Focused concentration on assessment and diagnostic skills with little or no emphasis on nursing theory and health-policy components common to most current masters degree programs C) Endorsed by the American Association of Colleges of Nursing (AACN) as the appropriate degree for advanced practice nurses to gain entry to practice D) Awarded the doctor of nursing (ND) degree after successful completion of the program Ans: C 5. A nurse is looking into a doctoral degree with an interest in direct-care provision and policies. Which of the following would be most appropriate for this nurse to obtain? nur 601 essentials for role development tb que with ans 2023 A) PhD graduates are better prepared to teach as the collegiate level than DNP graduates. B) Both graduates must pursue additional coursework that focuses on teaching. C) DNP and PhD graduates can apply research findings that focus on educational settings. D) PhD graduates understand curriculum development while DNP graduates do not. Ans: B 10. A nurse is preparing to become a clinical nurse leader. At which level would this nurse expect to practice? A) Microsystems level B) Population-based level C) Community-based level D) Macrosystem level Ans: A 11. Which of the following would be the most appropriate response to critics of the DNP who are concerned that the curriculum does not include theory? A) DNP programs focus primarily on nursing theories, which are essential to advanced practice nurses. B) Since nurses work as part of an interdisciplinary team, they need to understand many types of theories. C) DNP programs focus on using appropriate research methodologies to generate new nursing theories. D) The DNP graduate would be able to make decisions based on expertise and practice rather than on theory. Ans: B 12. A group of nursing students are reviewing the two types of doctoral degrees for nursing. The students demonstrate a need for additional study when they identify which of the following as a research-focused doctorate? A) PhD B) DNS C) DNP D) DNSc Ans: C 13. After teaching a class about the views of medicine and the DNP, the instructor determines that additional teaching is necessary when the students identify which of the nur 601 essentials for role development tb que with ans 2023 following as nur 601 essentials for role development tb que with ans 2023 a current belief supported by the American Medical Association? A) The physician has the final authority for the patient. B) Doctors of nursing practice can practice independently. C) Medicine has the right to regulate advanced practice nurses. D) Medicine can identify the roles and functions of a DNP. Ans: B 14. Which of the following would best characterize the clinical nurse leader (CNL) role? A) Masters-prepared advanced practice specialist nurse B) Focus on management systems for institutional health care delivery C) Integration of the care provided by each of the disciplines involved in patient care D) Limited focus on health promotion with greater emphasis on population-based care Ans: C 15. A group of students is reviewing information about the clinical nurse leader role (CNL) and how it differs from other advanced practice roles. The students demonstrate understanding of the information when they state which of the following about the CNL role? A) Focuses on a specific group of patients in a particular setting B) Picks up care where the role of the clinical nurse specialist ends C) Participates in care before admission and after discharge D) Is a consistent figure to act as a point person for those involved Ans: D 16. When describing the functions of the nurse practitioner (NP), which of the following would be included? A) Prescribing medications for treatment B) Administering anesthesia during labor C) Providing care during pregnancy D) Providing expert consultation for nursing staffs Ans: A 17. According to the AACN, which role would assume guardianship for the nursing profession? A) Nurse practitioners B) Clinical nurse leaders C) Doctors of nursing practice D) Clinical nurse specialists