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Advanced Practice Nursing- Essentials for Role
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AdvancedvPracticevNursingv:vEssentialsvforvRolevDevelopmentv4thvEditionvJoelTestv v
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Chapterv 1 v.vAdvancedvPracticevNursing:vDoingvWhatvHasvtovBevDone-Radicals,vRenegades,vandRebelsv MULTIPLEvCHOICE
- Thevnursevmanagervofvavpediatricvclinicvcouldvconfirmvthatvthevnewvnursevrecognizedvthevpurposeofv vt hevHEADSSvAdolescentvRiskvProfilevwhenvthevnewvnursevrespondsvthatvitvisvusedvtovassessvforvneedsvr elatedvto a. anticipatoryvguidance. b. low-riskvadolescents. c. physicalvdevelopment. d. sexualvdevelopment. ANS:vA ThevHEADSSvAdolescentvRiskvProfilevisvavpsychosocialvassessmentvscreeningvtoolvwhichvassesseshomev ,veducation,vactivities,vdrugs,vsex,vandvsuicidevforvthevpurposevofvidentifyingvhighriskvadolescentsvandvthevn eedvforvanticipatoryvguidance.vItvisvusedvtovidentifyvhigh- risk,vnotvlowrisk,vadolescents.vPhysicalvdevelopmentvisvassessedvwithvanthropometricvdata.vSexualvdevelop mentvisvas sessedvusingvphysicalvexamination. REF:v 6 vOBJ:vNCLEXvClientvNeedsvCategory:vHealthvPromotionvandvMaintenance
- Thevnursevpreparingvavteachingvplanvforvavpreschoolervknowsvthat,vaccordingvtovPiaget,vtheexv pectedvstagevofvdevelopmentvforvavpreschoolervis a. concretevoperational.
b. formalvoperational. c. preoperational. d. sensorimotor. ANS:vC Thevexpectedvstagevofvdevelopmentvforvavpreschoolerv(3vtov 4 vyearsvold)visvpreoperational.vConcreteoperatv ionalvdescribesvthevthinkingvofvavschool-agevchildv(7vtov 11 vyearsvold).vFormalvoperational describesvthevthinkingvofvanvindividualvaftervaboutv 11 vyearsvofvage.vSensorimotorvdescribesvtheearliestv (^) v patternvofvthinkingvfromvbirthvtov 2 vyearsvold. REF:v 5 vOBJ:vNCLEXvClientvNeedsvCategory:vHealthvPromotionvandvMaintenance
- Thevschoolvnursevtalkingvwithvavhighvschoolvclassvaboutvthevdifferencevbetweenvgrowthvanddev velopmentvwouldvbestvdescribevgrowthvas a. processesvbyvwhichvearlyvcellsvspecialize. b. psychosocialvandvcognitivevchanges. c. qualitativevchangesvassociatedvwithvaging. d. quantitativevchangesvinvsizevorvweight. ANS:vD Growthvisvavquantitativevchangevinvwhichvanvincreasevinvcellvnumbervandvsizevresultsvinvanvincreaseinv vov erallvsizevorvweightvofvthevbodyvorvanyvofvitsvparts.vThevprocessesvbyvwhichvearlyvcellsvspecializevarevref erredvtovas differentiation.v Psychosocialvandvcognitivevchangesvarevreferredvtovasv development.v Qualita tivevchangesvassociatedvwithvagingvarevreferredvtovasv maturation. REF:v 2 vOBJ:vNCLEXvClientvNeedsvCategory:vHealthvPromotionvandvMaintenance
- ThevmostvappropriatevresponsevofvthevnursevwhenvavmothervasksvwhatvthevDenvervIIvdoesvisvthatvit a. canvdiagnosevdevelopmentalvdisabilities. b. identifiesvavneedvforvphysicalvtherapy. c. isvavdevelopmentalvscreeningvtool. d. providesvavframeworkvforvhealthvteaching.
Functionvisvonevofvthevconceptsvmostvsignificantlyvimpactedvbyvdevelopment.vOthersvincludevsensoryperce ptual,vcognition,vmobility,vreproduction,vandvsexuality.vKnowledgevofvthesevconceptsvcanvhelpvth evnursevanticipatevareasvthatvneedvtovbevaddressed.vCulturevisvavconceptvthatvisvconsideredvtovsignificantl yvaffectvdevelopment;vthevdifferencevisvthevconceptsvthatvaffectvdevelopmentvarevthosevthatvrepresentvm ajorvinfluencingvfactorsv(causes),vhencevdeterminationvofvdevelopmentvandvwouldvbethev vfocusvofvpreve ntivevinterventions.vEnvironmentvisvconsideredvtovsignificantlyvaffectvdevelopment.vNutritionvisvconsid eredvtovsignificantlyvaffectvdevelopment. REF:v 1 vOBJ:vNCLEXvClientvNeedsvCategory:vHealthvPromotionvandvMaintenance
- Avmothervcomplainsvtovthevnursevatvthevpediatricvclinicvthatvherv 4 - yearoldvchildvalwaysvtalksvtoherv vtoysvandvmakesvupvstories.vThevmothervwantsvhervchildvtovhavevavpsychol ogicvevaluation.vThenursesv vbestvinitialvresponsevisvto a. refervthevchildvtovavpsychologist. b. explainvthatvplayingvmakevbelievevwithvdollsvandvpeoplevisvnormalvatvthisvage. c. completevavdevelopmentalvscreening. d. separatevthevchildvfromvthevmothervtovgetvmorevinformation. ANS:vB Byvthevendvofvthevfourthvyear,vitvisvexpectedvthatvavchildvwillvengagevinvfantasy,vsovthisvisvnormalvatvthisva ge.vAvreferralvtovavpsychologistvwouldvbevprematurevbasedvonlyvonvthevcomplaintvofvthevmother.vCompl etingvavdevelopmentalvscreeningvwouldvbevveryvappropriatevbutvnotvthevinitialvresponse.vThevnursevwou ldvcertainlyvwantvtovgetvmorevinformation,vbutvseparatingvthevchildvfromvthemotherv visvnotvnecessaryvatvth isvtime. REF:v 5 vOBJ:vNCLEXvClientvNeedsvCategory:vHealthvPromotionvandvMaintenance
- Av 17 - yearoldvgirlvisvhospitalizedvforvappendicitis,vandvhervmothervasksvthevnursevwhyvshevisvsoneedyv vandvacting^ vlikevavchild.vThevbestvresponsevofvthevnursevisvthatvinvthevhospital,vadolescents a. havevseparationvanxiety. b. rebelvagainstvrules. c. regressvbecausevofvstress. d. wantvtovknowveverything.
ANS:vC Regressionvtovanvearliervstagevofvdevelopmentvisvavcommonvresponsevtovstress.vSeparationvanxietyvismov stvcommonvinvinfantsvandvtoddlers.vRebellionvagainstvhospitalvrulesvisvusuallyvnotvanvissuevifvthevadoles centvunderstandsvthevrulesvandvwouldvnotvcreatevchildlikevbehaviors.vAnvadolescentvmayvwanttov vknowv everythingvwithvtheirvlogicalvthinkingvandvdeductivevreasoning,vbutvthatvwouldvnotvexplainvwhyvtheyvw ouldvactvlikevavchild. Chapterv2.vEmergingvRolesvofvthevAdvancedvPracticevNurse
ANS:v D Allvofvthevanswersvmayvcontributevtovethicalvdilemmasvbutvfailurevofvavclinicianvtovspeakvupvaboutav vre alvorvpotentialvethicalvproblemvisvcommonlyvidentified.vErosionvofvopenvandvhonestvcommunicationvi svtypicallyvthevfirstvthemevencounteredvinvmanyvethicalvdilemmas.
- Av 76 - yearoldvpatientvisvadmittedvtovthevhospitalvaftervsufferingvavspinalvcompressionvfracture.vThevpatie ntvisvu nablevtovambulatevadequatelyvonvhisvorvhervownvandvrequiresvassistancevforvbasicneeds.v vYourvassess mentvisvthatvthevpatientvwillvrecovervtheirvstrengthvwithinv 2 vweeks.vThevbillingdepartmentv vatvthevfaci lityvnotifiesvyouvthatvthevpatientvmayvnotvstayvinvthevhospitalvforvmorevthan2v vdays.vThevpatientvdoesvn otvwishvtovbevtransferredvtovavnursingvfacilityvandvwishesvtovremainvinvthevhospitalvforvthevremainin gv 12 vdaysvtovgainvstrength.vWhichvofvthevfollowingvbestvdefines thisvscenario? a. Interprofessionalvconflict b. Communicationvproblems c. Legalvissues d. Multiplevcommitments ANS:v A Thisvethicalvscenariovplaysvoutvroutinelyvinvmedicalvcarevasvanvelementvofvinterprofessionalvconflict.Thv evclinicianvwishesvtovrespectvpatientvautonomyvbutvmustvunderstandvandvexpressvthevbestvinterestsofv (^) vthe vpatientvtovavmultidisciplinaryvteam.
- AnvAPRNvisvscheduledvtovcompletevhisvorvhervshiftvatv 7 vp.m.vonvavparticularvday.vAvnewvpatientarriv vesv 5 vminutesvpriorvtovthevtimevthevAPRNvisvexpectedvtovleave.vHevorvshevisvaskedvbyvavsupervisorvt ovstayvbeyondvtheirvscheduledvtimevtovassessvthevpatientvandvprovidevcare.vWhichvofvthevfollowingv bestvdefinesvthisvscenario? a. Interprofessionalvconflict b. Multiplevcommitments c. Communicationvproblems d. Legalvissuesv ANS:v B APRNsvoftenvfailvtovpracticevselfcarevandvitvisvavsignificantvthreatvtovethicalvpractice.vMultiplecomm itmentsv vincludingvobligationsvtov multiplevpartiesvinvolvingvthevpatient,vemployer,vandvlegalsystemv vmayvcreatevavscenariovforvethicalvi ssuesvinvnursingvpractice.vSocietalvissuesvincludingvcostcontainmentv vpressuresvinvhealthvsystemsvare vlikelyvpartiallyvresponsiblevforvdevelopmentvofvthisvscenario.
- AnvAPRNvworksvinvavprimaryvcarevclinic.vThevAPRNvwishesvtovtreatvavpatient’svdiseasevwithvavspe cificvmedicationvthatvisvfarvsuperiorvtovothervtreatments.vThevAPRNvhasvnevervencounteredvissuesv prescribingvthisvtherapyvasvfirstlinevtreatmentvinvthevpast.vThevAPRNvisvinformedvbyvthisparticular v vpatient’svinsurancevthatvtheyvre quirevproofvthatvthevAPRNvhasvtriedvavfarvlessveffectivetherapyv vforv^1 vmonthvpriorvtovpayingvforvthev medication.vWhichvofvthevfollowingvbestvdescribesvthevforcesvatvworkvinvthisvscenario? a. Communicationvproblems b. Legalvissues c. Interprofessionalvconflict d. Societalvissues ANS:v D Societalvissuesvincludingvcostvcontainmentvpressuresvinvhealthvsystemsvarevlikelyvresponsiblevforvdevel opmentvofvthisvscenario.vInterprofessionalvconflictsvwouldvbestvbevinvolvedvinvthisvscenariovifthisv visvapp liedvinvavmultidisciplinaryvteamvscenario.
- Whichvofvthevfollowingvarevdefinedvasvthevfourvelementsvofvcorevcompetencyvdevelopmentvinethv icalvdecisionvmakingvforvAPRNs? a. Knowledgevdevelopment,vknowledgevapplication,vcreatingvanvethicalvenvironment,pv romotingvsocialvjustice b. Knowledgevdevelopment,veducatingvothers,vcreatingvanvethicalvenvironment,vpromotingsv ocialvjustice c. Knowledgevdevelopment,vknowledgevapplication,veffectivevcommunication,vpromotingsv ocialvjustice d. Knowledgevdevelopment,vknowledgevapplication,vcreatingvanvethicalvenvironment,uv nderstandingvlegalvbarriers ANS:v A Thev corev competencyv ofv ethicalv decisionv makingv forv APRNsv isv bestv organizedv intov fourv keyelemenv ts:vknowledgevdevelopment,vknowledgevapplication,vcreatingvanvethicalvenvironment,vandvpromotingvsocia lvjustice.
- Whichvofvthevfollowingvexamplesvbestvdescribesvthevknowledgevdevelopmentvelementvofvcorevco mpetencyvdevelopmentvforvethicalvdecisionvmaking? a. Analyzingvthevpolicymakingvprocess b. Usingvself-reflectionvduringvpatientvcasevreviews c. Applyingvethicalvdecision-makingvmodelvtovavclinicalvproblem d. Mentoringvothersvtovdevelopvethicalvpractice ANS:v B Thevusevofvknowledgevdevelopmentvisvavkeyvelementvofvcorevcompetencyvdevelopmentvforvethicalvdeci sionvmaking.vItvinvolvesvgainingvknowledgevofvethicalvtheoriesvandvdevelopingvthevabilityvtovdistinguis
ANS:v A Creatingv anv ethicalv environmentv mayv includev thev usev ofv preventativev ethicsv andv awarenessv ofenvirov nmentalvbarriersvtovethicalvpractice.
- Applicationvofvexistingvrulesvandvdoctrinevasvavguidevforvethicalvdecisionvmakingvisvbestdev scribedvasvwhichvethicalvapproach? a. Narrativevethics b. Care-basedvethics c. Casuistry d. Principle-basedvethics e. Virtue-basedvethics ANS:v D Invprinciplebasedvethicalvdecisionvmaking,vthevprinciplesvorvrulesvinvcontentionvarevbalancedvandinterpret edv vwithvth evcontextualvelementsvofvthevsituation.vHowever,vthevfinalvdecisionvandvmoralvjustificationvforvactionsva revbasedvonvprinciples.
- Whichvethicalvapproachvusesvcomparisonsvofvprecedent-settingvcasesvandvcurrentvscenarios? a. Principle-basedvethics b. Casuistry c. Care-basedvethics d. Narrativevethics e. Virtue-basedvethics ANS:v B Casuistryvisvanvethicalvapproachvwhichvusesvcomparisonsvofvprecedentsettingvcasesvandvcurrentscenarios. v
- Whichvapproachvemphasizesvthevparticularsvofvavcasevorvstoryvasvavvehiclevforvdiscerningvthemev aningvandvvaluesvembeddedvinvthevethicalvdecisionvmaking? a. Principle-basedvethics b. Casuistry c. Virtue-basedvethics d. Care-basedvethics e. Narrativevethics ANS:v E Narrativevethicsvemphasizesvthevparticularsvofvavcasevorvstoryvasvavvehiclevforvdiscerningvthemev aningvandvvaluesvembeddedvinvthevethicalvdecisionvmaking.
- Whichvethicalvapproachvseesvindividualsvasvinterdependentvrathervthanvindependentvandfov cusesvonvpartiesvinvavrelationship? a. Principle-basedvethics b. Care-basedvethics c. Narrativevethics d. Casuistry e. Virtue-basedvethics ANS:v B Carebasedvethicsvemphasizesvcreatingvandvsustainingvresponsivevconnectionsvwithvothers,vimportan cevofv contactvandvsubjectivityvinvdiscerningvethicalvaction,vandvseesvindividualsvasinterdependentv vrathervth anvindependentvandvfocusesvonvpartiesvinvavrelationship. MultiplevChoice
- AsvdefinedvbyvKilpatrickvetval.v(2016),vwhichvofvthevfollowingvisvavhallmarkvofvthevrolevofvtheCNv S? a. Adaptingvtovchangingvneedsvofvpatients,vnurses,vandvhealthvcarevsystems b. Advancedvknowledgevandvskills c. Lackvofveducationalvrequirements d. Abilityvtovindependentlyvpractice ANS:v A AvhallmarkvofvthevrolevisvthevabilityvofvthevCNSvtovadaptvtovchangingvneedsvofvpatients,vnurses,vandvhealth v carev systemsv (Kilpatrick,v Tchouaket,v Carter,v Bryant- Lukosius,v &v DiCenso,v 2016).v Thisversatilityv (^) vallowsvforvavCNSvtovtransitionvbetweenvpositionsvasvavpri maryvcaregivervorveducatorvdependingvonvthevenvironment.
- WhichvofvthevfollowingvhasvcomplicatedvclarifyingvthevworkvandvcorevcompetencyvofvallCv NSs? a. Varyingveducational,vcompetency,vandvpracticevstandards b. BureauvofvLaborvStatistics’vfailurevtovcapturevdata c. Lackvofvinterest d. Advancementvofvthevnursevpractitionervrole ANS:v A Varyingveducational,vcompetency,vandvpracticevstandardsv havevcomplicatedvclarifyingvthevworkanv dvcorevcompetenciesvofvallvCNSs,vregardlessvofvspecialty.vThevfailurevofvthevBureauvofvLaborvStatis ticsvtovtrackvCNSvprovidersvonlyvcreatesvbarriersvwhenvitvcomesvtovcountingvthevnumbervofCNSsv vinv^ thevUnitedvStates.
- WhichvofvthevfollowingvisvavcentralvcompetencyvforvCNSsvaccordingvtovthevHamricvmodel?
ANS:v B ThevNationalvAssociationvofvClinicalvNursevSpecialists’vCorevCompetenciesvincludevatvthevhighestlevev lvsevenvcompetencies:vdirectvcare,vconsultation,vsystemsvleadership,vcollaboration,vcoaching,vresearch, vandvethicalvdecisionvmaking,vmoralvagency,vandvadvocacy.
- EachvofvthevfollowingvisvspecificallyvdescribedvinvthevNACNS’svthreevspheresvofvinfluencevforthev vCNSvrolevexcept: a. Nurses/nursingvpractice b. Organization/system c. Leadership d. Patient ANS:v C ThevNACNSvhasvdefinedvthevCNSvrolevasvoperatingvbetweenvthevthreevspheresvofvinfluence:vthevpatient ,vthevorganization/system,vandvthevnurse/nursingvpractice.vThevCNSvshouldvemployvHamric’ssevenv vco mpetenciesvacrossvthevthreevspheresvofvinfluence.
- Accordingvtovav 2016 vruling,vhowvhasvthevDepartmentvofvVeteransvAffairsvalleviatedvstatebasedv vpracticevregulationsvatvVAvfacilities? a. AllowsvCNSvtovworkvatvfullvpracticevauthority b. AllowsvCNSvtovpracticevaccordingvtovtheirvhomevstate’svregulation c. Providesvimmediatevlicensures d. Providesvmalpracticevinsurancevfreevofvcharge ANS:v A Inv2016,vthevDepartmentvofvVeteransvAffairsvalleviatedvstatebasedvpracticevregulationsvbyvallowingCNSv vtovworkvatvfullvpracticevauthorityvinsidevVAvfacilitiesvandvno tvwithinvavstate’svscopevofvpractice.
- WhichvofvthevfollowingvisvmajorvregulatoryvbarriervforvmanyvCNSvspecialtiesvinvrelationvtovtheCov nsensusvModel? a. Poorvreimbursementvforvservices b. Lackvofvspecialtyvcertificationvexaminations c. Lackvofveducation d. PoorvCNSvinvolvementvinvadvocacy ANS:v B AvlackvofvspecialtyvcertificationvexaminationsvinvsomevareasvisvavmajorvregulatoryvbarriervforvmanyCNSv vspecialtiesvinvrelationvtovthevConsensusvModel.
- Withvregardvtovprescriptivevauthority,vhowvdidvOregonvmanagevCNSsvwhosevoriginaledv ucationvcurriculumvdidvnotvincludevprescriptionvofvpharmacologicvagents? a. Takevavspecializedvstate-specificvexaminationvregardingvprescriptivevauthority b. Permanentvexclusionvfromvprescriptivevauthority c. Anvadvancedvpharmacologyvcoursevandvcompletev 150 vsupervisedvhours d. 2080 vhoursvinvolvedvinvavcollaborativevagreement ANS:v C Oregon’svregulationvforvinclusionsvofvCNSsvwhosevoriginalveducationvcurriculumvdidvnotvincludevpre scriptionv ofv pharmacologicv agentsv includesv thev completionv ofv anv advancedv pharmacologycoursv evandvavminimumvofv 150 vhoursvofvsupervisedvpharmacologicvmanagement.vMinnesotavrequiresv 2080 v hoursvofvpracticevwithinvavcollaborativevagreementvwithvavlicensedvCNP,vCNS,vorvphysicianv experien cedv withv similarv patients.v Wisconsinvrequiresv advancedv practicev nursevprescribersvtovpassvanvexam inationvonvWisconsin’svstatutesvandvrulesvofvpractice.
- Statesvhaveveachvindependentlyvcreatedvregulationvregardingvadvancedvpractice.vWithvregardvtopr v escriptivevauthority,vwhatvrequirementvhasvWisconsinvimplementedvregardingvauthorizationvofvC NSsvasvadvancedvpracticevnursevprescribers? a. 2080 vhoursvinvolvedvinvavcollaborativevagreement b. Anvadvancedvpharmacologyvcoursevandvcompletev 150 vsupervisedvhours c. Permanentvexclusionvfromvprescriptivevauthority d. Takevavspecializedvstate-specificvexaminationvregardingvprescriptivevauthority ANS:v D WisconsinvrequiresvadvancedvpracticevnursevprescribersvtovpassvanvexaminationvonvWisconsin’svstatut esvandvrulesvofvpractice.vOregon’svregulationvforvinclusionsvofvCNSsvwhosevoriginalveducationcurriculuv mvdidvnotvincludevprescriptionvofvpharmacologicvagentsvincludesvthevcompletionvofvanvadvancedvphar macologyvcoursevandvavminimumvofv 150 vhoursvofvsupervisedvpharmacologicvmanagement.vMinnesotav requiresv 2080 vhoursvofvpracticevwithinvavcollaborativevagreementvwithvavlicensedvCNP,vCNS,vorvphysic ianvexperiencedvwithvsimilarvpatients.
- WhichvfactorvledvtovavdecreasevofvCNSsventeringvCNSvprogramsvinv1990s? a. RepurposingvCNSsvintovqualityvmanagersvandveducatorvroles b. Increasedvjobvpositions c. IncreasevinvfacilityvfundingvforvNPvprograms d. Lackvofvemphasisvonvprimaryvcare ANS:v A SeveralvforcesvledvtovthevinitialvdeclinevinvthevnumbervofvstudentsventeringvCNSvprograms.vFiscalvrestrai ntsvofvhealthvcarevfacilities,vrepurposingvCNSsvintovothervroles,v increasedv emphasisv invprimaryv care,v a ndv rapidv growthvofv NPv programsv havev previouslyv andv continuev tov contributevtodecreasedv vnumbers vofvstudentsventeringvCNSvprograms.
TestvBankvMulti plevChoice
- Thevfederalvgovernment’svcriterionvtovestablishvhealthvprofessionalvshortagevareasv(HPSAs)visbav sedvonvwhichvofvthevfollowingvstatistics? a. Averagevfamilyvincomevlessvthanvtwo-thirdsvofvnationalvpovertyvlevel b. Anvareavinvwhichvtherevarevlessvthanv 500 vindividualsvforveveryvprimaryvcarevphysicianv(PCMD) c. Averagevfamilyvincomevlessvthanvhalfvofvnationalvpovertyvlevel d. Anvareavinvwhichvtherevarevmorevthanv 4500 vindividualsvforveveryvprimaryvcarevphysicianv(P CMD) e. Anvareavinvwhichvtherevarevmorevthanv 3500 vindividualsvforveveryvprimaryvcarevphysicianv(P CMD) ANS:v E Thevfederalvgovernmentvestablishesvhealthvprofessionalvshortagevareasv(HPSAs)vthatvarevprimarilyvbas edvonvthevcriterionvthatvanvareavhasvmorevthanv 3500 vindividualsvforveveryvprimaryvcarevphysicianv(PCM D).
- WhatvisvavdownfallvofvthevHPSA’svcalculation? a. Isvonlyvrecalculatedveveryv 10 vyears b. DoesvnotvincludevothervPCPvdesignationsv(PAs,vNPs) c. Doesvnotvadjustvforvinflation d. HasvavlowervweightedvaveragevforvNPvversusvMDvproviders ANS:v B Thevhealthvprofessionalvshortagevareasv(HPSAs)varevcurrentlyvonlyvcalculatedvbasedvonvprimaryvcar evphysiciansv(PCMDs)vandvdovnotvtakevintovaccountvothervprimaryvcarevprovidersvsuchvasvPAsandv vN Ps.
- Somevcommunityvhealthvcentersvcanvapplyvforvavspecialvdesignationvifvtheyvarevanventityvthatvserv esvavpopulationvthatvisvmedicallyvunderservedvorvavspeciallyvmedicallyvunderservedvpopulationv c omprisedv ofv migratoryv andv seasonalv agriculturalv workers,v thev homeless,v andresidentsv (^) vofvpu blicvhousing.vWhatvisvthisvdesignation? a. Federallyvqualifiedvhealthvcenterv(FQHC) b. Patient-centeredvmedicalvhomev(PCMH) c. School-basedvhealthvcenterv(SBHC) d. Nurse-ledvhealthvcenterv(NLHC) ANS:v A
ThevHRSAvBureauvofvPrimaryvCarevenablesvthesevsafetyvnetvorganizationsvtovreceivevavvarietyvofvenha ncedv federalv supportv byv applyingv forv designationv asv av federallyv qualifiedv healthv center(v FQHC).
- Whichvofvthevfollowingvisvnotvavcommonvcharacteristicvofvavschool-basedvhealthvcenterv(SBHC)? a. Novparentalvrequirementvforvconsentvforvtreatment b. Closevintegrationvwithvthevschool c. Comprisedvofvavmultidisciplinaryvteam d. Locatedvinvschoolsvorvonvschoolvgrounds ANS:v A NearlyvallvSBHCsvrequirevparentalvconsentvforvfullvtreatmentvofvadolescents,vexceptvinvstatesvwherevsuc hv adolescentsv canv consentv forv certainv treatmentsv likevcontraception,v pregnancy,v drugv abuse,vand/o rvsexuallyvtransmittedvinfections.
- Avnursevpractitionervprovidesvcarevatvavveteran’svclinicvmanagedvbyvthevDepartmentvofvVeteransvA f fairs.v Thev statev inv whichv hev orv shev practicesv prohibitsv manyv procedures.v Whichv ofv thefollov wingvisvmostvaccuratevregardingvthevcarevthevNPvprovides? a. AdditionalvlicensurevisvrequiredvtovpracticevinvVAvsystemsvbyvthevstate b. NPvmustvbevsupervisedvforvallvskills c. StatevpracticevregulationsvoverridevVAvregulations d. FullvpracticevauthorityvisvallowedvinsidevthevVAvsystem ANS:v D Inv2016,vThevDepartmentvofvVeteransvAffairsvgrantedvfullvpracticevauthorityvtovNPs,vCNSs,vandvCNMs .vThisvallowsvthesevprovidersvtovworkvatvfullvpracticevauthorityvinsidevVAvfacilitiesvandvnotconfinedv vwit hinvavstate’svscopevofvpractice.
- Medicalv carev providedv byv primaryv carev providersv (PCMD,v PCNP)v asv partv ofv thev patientcenteredv vmedicalvhomev(PCMH)vmodelvencompassesvthevfullvspectrumvofvprimaryvcarevincludingv standardsvofvaccessibility,vcontinuity,vcomprehensiveness,vintegratedvcare,vandvinterprofessionalv c are.vThisvmodelvwasvfirstvdefinedvforvwhatvpopulationvgroup? a. Geriatrics b. Gynecology c. Pediatrics d. Mentalvhealth ANS:v C Thevpatient- centeredvmedicalvhomev(PCMH)vmodelvwasvfirstvdevelopedvforvthevpediatricvmedicalcommunityv vforvde velopmentvofvchildrenvwithvcomplexvmedicalvconditions.
a. Pediatrics b. Acutevcare c. Psychiatric/mentalvhealth d. Primaryvcare e. TertiaryvCare ANS:v D Aboutv89.2%vofvNPsvarevcertifiedvinvanvareavofvprimaryvcarevasvofv 2017 vincludingvAdult,vAdultGerontolo gy,v vFamily,vGerontology,vPediatric-PrimaryvCare,vandvWomen’svHealth.
- AccordingvtovthevAmericanvAssociationvofvNursevPractitioners:v 2017 vNPvFactvSheetvandvthevA ANPvNationalvNursevPractitionersvDatabase,vapproximatelyvhowvmanyvNPsvarevlicensedv inthev (^) v UnitedvStates? a. 1,26, b. 2,34, c. 3,18, d. 3,81, e. 4,08, ANS: B Asvofv2017,vtherevarevmorevthanv2,34,000vNPsvlicensedvtovpracticevinvthevUnitedvStates.
- WhichvofvthevfollowingvhasvshownvpromisingvoutcomesvforvNPsvinvachievementvofvco mpetence,vconfidence,vandvmasteryvasvwellvasvincreasedvlevelsvofvNPvsatisfaction? a. NPvPostgraduatevResidencyvPrograms b. WorkvinvUnderservedvpopulationvareas c. IncreasedvNPvPay d. Decreasedvmalpracticevclaims e. AdvancementvofvNPvcarevpractices ANS:v A NPvPostgraduatevResidencyvProgramsvstillvneedvadditionalvresearchvonvoutcomes,vpolicyvconsiderat ions,vandvacademicvarrangements.vEarlyvstudiesvhavevsuggestedvthatvNPsvwhovcompleteav vresidencyv programvacquirevhighervachievementvofvcompetence,vconfidence,vandvmasteryvasvwellasv vincreasedvle velsvofvNPvsatisfaction.
- ThevTriplevAimvInitiativevwasvlaunchedvinv 2007 vbyvthevInstitutevforvHealthcarevImprovementv(HI T)vwhichvfocusedvonvthreevdimensionsvofvhealthvcare:vexperiencevofvcare,vpervcapitavcost,vandvpop ulationvhealth.vWhichvfourthvaimvwasvproposedvinv 2014 vbyvBodenheimervandvSinskyvinav (^) vcallvtovre designvthevinitiative? a. Improvedvclinicianvexperience
b. Prevention c. Increasedvreimbursements d. Decreasedvadversevevents ANS:v A BodenheimervandvSinskyvproposedvavfourthvaimv“improvedvclinicianvexperience”vwhichvbringsvtolightv v thevfactsvthatvthev“joy”vhasvgonevoutvofvpracticingvmedicine.vOthervstudiesvhavevshownvthatvpatientvoutc omesvsuffervifvprovidersvfeelvoverwhelmed,voverworked,vorvpowerless.
- ThevAmericanvAcademyvofvPediatricsvquestionedvwhichvofvthevfollowingvnegativevoutcomesofv v CommunityvCarevClinicsv(CCCs)?v(Selectvallvthatvapply.) a. UnevenvEHRvinteroperabilityvwithvcommunityvprimaryvcarevproviders b. Lackvofvlongitudinalvrelationshipsvwithvproviders c. Incentivesvtovoverprescribe d. Increasedvpatientvsatisfaction e. Decreasedvwaitvtimesv ANS:vA,vB,vC Inv2014,vthevAmericanvAcademyvofvPediatricsvhadvquestionsvregardingvCCCsvandvtheirvpossiblevincent ivesvtovoverprescribe,vlackvofvlongitudinalvrelationshipsvwithvproviders,vandvunevenvEHRvinteroperabil ityvwithvcommunityvprimaryvcarevprovidersvthatvmayvnegativelyvimpactvthevhealthvcaresystem.v Chapterv4.vEducationalvPreparationvofvAdvancedvPracticevNurses:vLookingvtovthevFuture
- Whichvofvthevfollowingvisvthevmostvessentialvcomponentvtovleadvclinicalvstaffvandvprogramsveff ectivelyvasvanvadvancedvpracticevregisteredvnurse? a. Clinicalvcredibility b. Appropriateveducation c. Yearsvofvexperience d. Age ANS:v A AllvofvthevoptionsvmayvattributevtoveffectivelyvleadingvclinicalvstaffvandvprogramsvasvanvAPRN.vDirec tvcarevisvthevcentralvcompetencyvofvadvancedvpracticevnursingvandvexcellencevinvdirectvcarevrequiresvc linicalvcredibilityvtovleadvothervclinicalvstaff.vYearsvofvexperiencevorvagevmayvorvmayvnotbev (^) vrelatedvtov directvcare.vAppropriateveducationvisvimportantvforvclinicalvleadership,vbutvclinicalvcredibilityvrequir esvexperiencevcombinedvwithvdirectvcare.
- Anvadvancedvpracticevregisteredvnursevinvanvoutpatientvclinicvhasvavphonevconferencevwithvacarv diologistvregardingvavpatient’svcondition.vThisvisvanvexamplevof:
