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ANCC AGACNP - FRANCES GUIDE REVIEW
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ANCC AGACNP - FRANCES GUIDE REVIEW
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ANCC AGACNP- FRANCES
GUIDE REVIEW
You want to get more funding for your hospital's Rapid Response Team. How should
you present this issue to the committee?
a. Stress importance of the team (look up evidence about how team affects outcomes)
b. Describe how to improve and expand the team - Answers -a. stress importance of
team
What is the best way for the AGACNP to get involved in policy making?
a. attend legislative days at the state capitol
b. join a hospital committee
c. write your local congressman
d. review literature and give more in-services - Answers -b. join a hospital committee
What is the best way for the AGACNP to demonstrate and advocate for full scope of
practice?
a. join a hospital committee
b. petition the government
c. bill for independent services
d. start your own practice - Answers -c. bill for independent services
Which of the following is considered a high acuity role for the AGACNP?
a. primary care clinic
b. cardiology office
c. community health department
d. minute clinic - Answers -b. cardiology office
Patient in ER not doing well, primary MD calls: - Answers -Give him info
,NP working on ESRD research project. A colleague renal specialist asks for patient info
on your patients: - Answers -HIPAA breach
Who enforces HIPAA? - Answers -Office of Civil Rights/Dept Health and Human
Services
Who isn't covered by HIPAA? - Answers -Law enforcment/municipal offices,
CPS/Schools, employers/workman's comp, life insurance
Insurance company calling to verify some patient appointments? - Answers -Answer by
picking out that there is already a medical release signed by the patient and give the
requested information to them
Benchmarking - Answers -How institution compares with similar organizations
Managed care - Answers -Know what this is and how it has improved costs, something
about putting caps on payments
Peer review - Answers -Timely, not anonymous, and NP knows how peer review will
impact yearly evaluation
Sensitivity vs specificity - Answers -Sensitivity: true positives, specificity: true negatives
There was a question where a patient had a multinodular goiter and wanted to know
why the NP was not going to do periodic US and fine needle biopsy in monitoring for
some kind of cancer or complication. The answer I picked was that these tests were not
very specific to detect the cancer
Reliability - Answers -When implementing a new study, tested over and over, the
consistency of a measurement or the degree to which an instrument measures the
same way over time
Validity of results in an article - Answers -P-value, probability of falsely rejecting the null
hypothesis, want it to be <0.05
Statistical significance - Answers -Look at sample size and p value
Privileging - Answers -May be granted in full or part by the hospital, credentialing
committee is made of physicians
Who determines scope of practice? - Answers -State practice acts but institutional
bylaws may further restrict practice (facility limited scope of practice)
Informed consent - Answers -A state indicating patient has received adequate
instruction/information regarding aspects of care to make a prudent, personal choice
,regarding such, includes risks and benefits, competence: ability to communicate,
understand, reason, differentiate good and bad
Case management - Answers -Mobilize, mointor, and control resources that a patient
uses during course of an illness while balancing quality and cost, "move patients
through the system appropriately"
50-60 year old patient ith a new diagnosis of cancer. To appropriately plan for
discharge, what should the NP do?
a. consult CM
b. Consult SW
c. refer to Oncology
d. refer to Hospice - Answers -a. consult CM
Nondisclosure - Answers -Not disclosing patient PHI without permission
Negligence - Answers -Failure of individual to do what any reasonable person would do,
resulting in injury to the patient
When serving as a nurse researcher, the NP is guided by which ethical principle to
ensure that research participants are protected from harm or exploitation? - Answers -
Nonmaleficence
Living will - Answers -Health care proxy/POA
NP sees a patient for HF and performs an H&P. What % is expected to be paid? -
Answers -Medicare pays 80% of the total bill, pt pays 20%, NP is reimbursed 85% of
what the MD is reimbursed for physician services, and for procedure 80% of that 85%
Focus of palliative care - Answers -Basic improvement in QOL of anyone with an illness
at any stage
Hospice - Answers -<6m to live
Scope of practice: integration of care across the acute illness continuum with:
a. collaboration
b. coordination of care
c. research based clinical practice - Answers -a. collaboration
Collaboration - Answers -True partnership in which all players have the desire power,
share common goals, and recognize/accept separate areas of responsibility/activity
Patient is getting d/c'd and need wound care, pulmonary, and follow up. NP's role is to: -
Answers -Coordinate services
, Government is moving towards being cost effective. What is the best way? - Answers -
Allow NP to treat a wider variety of patients
Protected health information: discussion between the NP and consultant on case -
Answers -Considered clinical relevance
How should the ACNP stay up to date with current information? - Answers -Evidence
based guidelines
Which medicare is Hospice covered under? - Answers -Medicare A
A patient presents to the Er with c/o CP and SOB. The NP misinterprets the EKG and
admits the patient fro further monitoring without consulting cardio. Later in the shift, the
patient decompensates and goes into cardiac arrest. The patient was resuscitated but
sustained permanent brain damage. What grounds of malpractice is the NP
accountable for? - Answers -Lack of skill
Healthcare exchange - Answers -Health insurance marketplaces, organizations in each
state through which people can purchase health insurance
You notice there have been less favorable outcomes and satisfaction surveys in
patients treated for sickle cell anemia. How do you approach this problem?
a. ask the patients treated how care can be improved
b. look back at prior treatment given to see how outcomes can be improved
c. form a standardized tx plan for all patients that can be used by all healthcare staff
d. form individualized tx plans that can be used by all healthcare staff - Answers -c. form
a standardized tx plan for all patients that can be used by all healthcare staff
You have transferred a patient to the SNF. The MD in charge at that facility calls for info
about the patient's medical care, what do you do?
a. direct him to look it up in the EMR
b. refuse to share protected health information
c. instruct him to call the department head
d. share the information he requests - Answers -d. share the information he requests
Your patient has refused human blood products based on religious beliefs. He is now
rapidly destabilizing. What do you do?
a. administer PRBCs as needed
b. call the ethics committee
c. continue to research alternative treatments
d. ask the family to give permission now that he's unconscious - Answers -c. continue to
research alternative treatments
What is the best way to make sure a patient will follow up as instructed?
a. instruct the patient to schedule the appointment
b. ask the patient the best time they can go to an appointment
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