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AGACNP Exam Review Questions and answers | With complete solution 2024/25 RATED A+
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AGACNP Exam Review Questions and answers | With complete solution 2024/25 RATED A+
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AGACNP Exam Review Questions andanswers | With complete solution
2024/25 RATED A+
Scope of Practice - Based on legal allowances in each state, individual state nurse
practice acts providing guidelines for nursing practice
Key elements of the NP role include - integration of care across the acute illness
continuum with collaboration and coordination of care; research based clinical practices,
clinical leadership, family assessment, and discharge planning
Standards of Advanced Practice are delineated by... - American Nurses Association
which measure quality of practice, service, or education
State Practice Acts - Authorize Boards of Nursing in each state to establish statutory
authority for licensure of RNs
State Practice Acts - authority includes: - use of title, authorization for scope of
practice including prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as - certification
Prescriptive authority - Ability and extent of NPs ability to prescribe meds
DEA has ruled that nurses in advanced practice may obtain.. - registration numbers,
state practice acts dictate level of prescriptive authority allowed
Credentials encompass... - required education, licensure and certification to practice
as an NP
Credentials establish... - minimal levels of acceptable performance
Credentialing is necessary to: - ensure that safe healthcare is provided by qualified
individuals; comply with federal and state laws r/t APN
Credentials also... - acknowledges the scope of practice of NP, mandates
accountability, enforces professional standards for practice
Licensure - establishes that a person is qualified to perform in a particular
professional role
Licensure is granted as defined by rules and regulations set forth by - a governmental
regulatory body (ie. state board of nursing)
, Certification - Person has met certain standards that signify mastery of specialized
knowledge
Certification is granted by nongovernmental agencies such as - ANCC, AANP
Admitting privileges to hospitals (non physican) were granted - 1983 by JC
Credentialing and privileging - process which an NP is granted permission to practice
in an inpt setting
Credentialing with hospital privileges is granted by a - Hospital Credentialing
Committee
Pt Medical Abandoment - When caregiver-pt relationship is terminated w/o making
reasonable arrangements w an appropriate person so that care can be continued
Determination of pt abandonment depends on factors such as: - Whether NP
accepted pt assignment, whether NP provided reasonable notice before termination,
whether reasonable arrangements could have been made
Following do not constitute pt abandonment - NP refuses to accept responsibility for
pt assignment when NP has given reasonable notice to proper authority that NP lacks
competence to carry out assignment; NP refuses assignment of a double shift or addtl
hrs beyond posted work schedule when proper notification has been given..latter phrase
can be controversial
Risk Mgmt - Systematic effort to reduce risk begins w formal written risk mgmt plan
that includes: organizations goals, delineation of program's scope, components,
methods; delegating responsibility for implementation and enforcement; demonstrating
commitment by the board; confidentiality and immunity from retaliation for those who
report sensitive info
Most common method of documentation for risk mgmt - incident reports
Policies regarding incident reports should address: - ppl authorized to complete
report; ppl responsible for review of a report, immediate actions needed to minimize the
effects of the event; ppl responsible for follow up; plan for monitoring aftermath;
security/storage of completed report
Risk mgmt - Satisfaction surveys - Important for identifying problems before they
develop into incidents or claims; for pts and employees
Risk mgmt - Complaints: Risk mgmt plan should delineate tracking, analyzing, and
managing complaints by clearly identifying: - ppl notified after receiving complaint; ppl
responsible for responding; ppl responsible for monitoring follow up
, Action taking initiatives: - Prevention, correction (corrective steps must be monitored
and audited), documentation, education, departmental coordination
Medical Futility - Interventions that are unlikely to produce significant benefit for pt -
"Does the intervention have any reasonable prospect of helping this pt?"
Two kind of medical futility: - Quantitative futility: likelihood that intervention will benefit
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pt is extremely poor
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Qualitative futility: quality of benefit an intervention will produce is extremely poor
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Informed consent - competence (decisional capability) - state that pt is able to make
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personal decisions about their care
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competence implies that ability to: - understand, reason, differentiate good and bad, and
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communicate
II
informed consent - pt has received adequate instruction or info regarding aspects of
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care to make prudent, personal choice regarding such tx
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II IIInformed consent includes: - discussing benefits and risk II II II II II II II II II
II IIconsent is assumed if... - pt's condition is life threatening
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Danforth Amendment 1991 - pts are informed at time of admission to federally funded
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institution (such as hospital, nursing home, hospice, HMO, etc) that they have the right to
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refuse care as long as the pt has decisional capability (competence)
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II IIEthics - study of moral conduct and behavior protecting the rights of an individual
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II II1st priority is the - most salvagable pts. Most critically injured cared for last.
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Key ethical principles are: - nonmaleficence, utilitarianism, beneficence, justice, fidelity,
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veracity, autonomy
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II IINonmaleficence - duty to do no harm II II II II II II II II
Utilitarianism - the right act is the one that produces the greatest good for the greatest
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number
II
II IIBeneficence - duty to prevent harm and promote good II II II II II II II II II II
II IIJustice - duty to be fair II II II II II II II
II IIFidelity - duty to be faithful II II II II II II II
, II IIVeracity - duty to be truthful (tends to be in conflict with fidelity)
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Autonomy - duty to respect an individual's thoughts and actions (tend to be in conflict
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with beneficence)
II II
Dismissing/discharging a pt or closing practice - NP cannot withdraw from caring for a pt
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without notification
II II
Examples of reasons for discharging a pt from practice: - abuse, refusal to pay,
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persistent non-adherence to care
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Steps for discharging a pt from practice: - send a certified letter with return receipt (copy
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for chart), provide general healthcare coverage for 1st 15-30 days post termination
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deadline, obtain release of info to provide copies of all needed records for next care
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provider
II
Obligations in closing practice d/t relocation, retirement - give pt adequate time to find
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another provider, keep all files for min 5 years, provide timely notification and names of
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other providers and resources for future care
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Role of NP developed in the early... - 1960s as a result of physician shortages in the
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area of peds
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First NP program was peds, begun in... - 1964 by Dr. Loretta Ford and Dr. Henry Silver
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at CU Health Sciences mainly focusing on ambulatory and outpt care
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Historical service of NPs in primary care resulted in part from the... - availability of
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federal funding for preventive and primary care NP education
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Movement of NPs expanded to the... - inpt setting as a result of managed care, hospital
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restructuring, and decreases in medical residency programs
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II II4 distinct roles for NPs: - clinician, consultant/collaborator, educator, researcher
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Crisis/Acute Grief Communication - Acknowledge feelings
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Offer self II
Crisis Intervention - Boundaries
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Security if necessary, NOT police II II II II
Establish trust/rapport II
II IIAdvance Directive - Written statement of patient's intent regarding medical treatment
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The Patient Self-Determination Act of 1990 - All patients in a hospital setting are
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required to be advised of their right to execute an advance directive
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