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ADVANCED PRACTICE NURSING QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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ADVANCED PRACTICE NURSING QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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ADVANCED PRACTICE NURSINGQUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
Bundle Payments and health care expenditures - ANSWER - Also known as bundle payments
- Reimburstment of health care providers on the basis of expected cost for clinically defined episodes of
care
- "middle" ground between fee-for-service and capitation
- healthcare delivery system takes on financial risk of patient
- Forces system to enhance quality and coordination of care
- Incentivizes system to deliver care that truly meets the Triple Aim
CHIP - ANSWER - Children's Health Insurance Program
- Health coverage to uninsured children whose families earn too much to qualify for Mediciad but too
little to afford private coverage
Role Strain - ANSWER Subjective feelings of frustration, tension, or anxiety expierenced in response to
role stress & can be feelings of decreased self-esteem when performance is below expectations
Role Conflict - ANSWER Role expectations are percieved to be mutually exclusive or contraditctory
Medicare Part D Billing - ANSWER - Prescription drug coverage
- Must join a drug place to receive coverage under part D
- Coverage is attempt to lower prescription costs
- Payment is monthly fee that varies by plan & is addition to Part B premium or inbedded in Part C
premium
Role Stress - ANSWER A situation of increased role performance demand (ex: returning to school while
maintaining work and family responsibilities or the expectation of increased workload
Medicare Part B Billing - ANSWER - Covers medical expenses such as physician and outpatient care
,- Direct reimbursement can only occur when submitting claim through part B
- Covers physician and nonphysical provider services, outpatient hospital services, home health care not
covered by part A (PT/OT) and other services such as diagnostic testing, durable medical equipment and
ambulance costs
- Enrollment in part B is voluntary to those receiving Part A
- Payment into system via monthly premiums that are established yearly based on system expenses
through deductibles & coinsurance programs
Advanced Practice Nurse Roles - ANSWER 1. Nurse Practitioner
2. Clinical Nurse Specialist
3. Certified Registered Nurse Anesthetist
4. Certified Nurse Midwife
Nurse Practition - ANSWER - provide care through diagnosis and treatment as well as addressing disease
prevention and health management
- 1893 Lillian Wald & Henry Street Settlement (HSS) House
- HHS nurses obtained standing orders for emergency medications and treatments
- nurses considered "good enough" to care for the poor whereas physicians seen as only careing for
those who could pay
- FNS/FSA nurse practice centered around the practice autonomy in the requirement that the patients be
poor, marginalized and have little access to physician provided medical care
- NP role formally described in 1960s and was implemented in outpatient pediatric clinics in response to
a shortage of primary care physicians
- Loretta Ford in 1965 established first Pediatric NP program (PNP) & was designed to prepare
professional nurses to provide comprehensive well-child care and manage common childhood health
problems
- 1970 continue to enhance visibility in health system, and expand role while demonstrating cost
effective quality care
- role expanded/included because nurse role was essential to providing equal access to health care for all
Americans
- conflict surrounds role between other RN and NP and NP and physicians
- issues surrounding prescriptive treatment & idaho in 1971 was first state to recognize diagnosis and
treatment as part of practice
, - Support DNP but does not require educational programs to be at the doctoral level
Clinical Nurse Specialist - ANSWER - evolved out of increasingly complexity of nursing care
- roots in psychiatric nursing
- psych specialists date back to 1880 & richards is credited with founding specialty of psych nursing
specialists
- Rutgers University first educational program for CNS but was for psychiatric nursing
- coronary care nurse specialists established in 1962 & CCU nurses blurred invisible boundary separating
nursing and medicine
- 1960s noted to be when clincal nurse specialist took on modern day form
- three social forces drove specialization 1. increase in specialty related information 2. new tech
advances 3. response to public need and interests
- crtical care and oncology specialty grew in 1970s
- ANA recognized CNS role 1970s defining the CNS as an expert practitioner and change agent
- master degree required
- role has postive effect on improving nursing care and patient outcomes
- view shift from direct patient care to education and organizations (seen as too valuable)
- education complex due to number of specialties involved
- can prescribe without physician supervision in 20 states now
- 1997 Balanced Budget Act identified CNS eligible for Medicare reimburstment
Certified Registered Nurse Anesthetist - ANSWER - history in civil war
- typically anesthesia given only when a physician was unavailable
- Dr Mayo first to recognize and formally train CRNA in 1889
-Alice Macaw mother of anesthesia (hired by mayo)
- early challenges but practice has grown
- 1931 Lakeside hospital establishes National Association of Nurse Anesthetists
- LA medical association dues Nelson in 1934 for practicing without a license & nelson won but in
response Chalmers-Frances filed another suit and judgement was the result only to have CA Supreme
Court rule in favor of Nelson again and the practice of nurse anesthisa was legal/in scope as long as it
was done under guidance of supervision of physician
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