ANCC Domain 1-5 questions
1. A newly graduated nurse practitioner (NP) wants to open a private psychiatric practice in her hometown. She wants to find out
about the laws that cover her responsibility and the legal liability that this practice will encounter for her as an independent
psychiatric nurse practitioner. Her best source of information is:
A. The State Statues on Nursing or Advanced Nursing Practice
B. Her city statutes
C. Local Psychiatric Nurse Practitioners in practice
D. The American Academy of Nurse practitioners: A. The State Statues on Nursing or Advanced
Nursing Practice
2. Which of the following best depicts the Psychiatric-Mental Health Nurse Practitioner in a grassroots mental health advocacy
role?
A. Attending a town hall meeting to seek timely police response to rising domestic violence crisis
calls.
B. Working on the campaign of an individual running for the state senate.
C. Assisting with depression screening at a health fair in a local shopping mall
D. Meeting states legislators during RN lobbying day organized by the state
nurses' association: A. Attending a town hall meeting to seek timely police response to rising domestic violence crisis calls.
3. During a medication follow-up appointment at student mental health clinic, a 20 y/o college sophomore with depression and
history of binge drinking disclosed that she has been struggling with recurrent intrusive thoughts of overdose. She recently broke
up with her boyfriend when she learned that he was sleeping with her closest girlfriend. She admits taking a handful of her
sertraline prescribed by the Psychiatric-mental Health Nurse Practitioner last weekend and was frustrated that it only made her
sleep for a day. She's angry and ambivalent about the future, unwilling to make any promise not to harm herself, and has made
veiled threats to "pay back both of them for cheating" (referring to her ex-boyfriend and girlfriend). What is the most appropriate
intervention at this juncture?
A. Counsel the student that she would regret hurting herself and can move beyond this broken relationship
B. Ask the student to promise that she wont harm herself or anyone else and schedule next day counseling
C. Negotiate with the student to touch base daily by phone between counseling visits to avoid hospitalization
D. Ask the student if she will agree to voluntary admission and arrange invol-
untary admission is necessary: D. Ask the student if she will agree to voluntary admission and arrange involuntary
admission is necessary
4. Per the Health Insurance Portability and Accountability Act (HIPAA), a nurse practitioner (NP) who is in an independent, single
practitioner practice is considered a "Covered Entity" because:
A. Writers information and generates protected health information
, ANCC Domain 1-5 questions
B. The NP transmits protected health information in electronic forms
C. May accidentally release protected health information
D. Maintains charts with patient information that contains protected health
information: B. The NP transmits protected health information in electronic forms
5. The Nurse Practitioner (NP) attends a local meeting where allocation of resources for healthcare will be discussed. One of the
stakeholders has a pamphlet that describes the types of healthcare providers available to help persons in need of health care. The
NP notices that Nurse Practitioners are labeled as "Paraprofessionals". In the meeting, the NP askes the organization responsible
for the pamphlet why they have identified the Nurse Practitioners as paraprofessionals when a Nurse Practitioner is by law
working as 85-90% of the same capacity as a Medical Doctor. The NP goes on to explain what a Nurse Practitioner does in various
areas of practice. This is an example of:
A. Promoting nurse practitioners in the community
B. Public education on the NP scope and standards of practice
C. Correcting misinformation that deliberately misleads the public
D. Advocating for the role and value of the Nurse Practitioner.: D. Advocating for the role and value of the
Nurse Practitioner.
6. Your patient wants to communicate with you through email. You have a secure email account that is encrypted and will protect
health information as required by the Health Insurance Portability and Accountability Act (HIPAA).
Your patient does not have an encrypted email account. You reply is:
A. I do not like to communicate through email I would prefer to talk to you in person or over the telephone only
B. I can encrypt our email communications to be sure that your protected health information (PHI) is unavailable to others and
protect you
C. I have no problems with you communicating with me through my personal email
D. In order to communicate back and forth, you will have to find a way to
encrypt you're protected health information (PHI): D. In order to communicate back and forth, you will have to find
a way to encrypt you're protected health information (PHI)
7. As an individual advanced practitioner, you cannot afford to have a standalone Electronic Health Record (HER) system to keep
all of your patient's health information on a computer based system. How could you problem-solve this dilemma?
A. Process your notes and patient records in a secure electronic system with a template for patient
information and interactions, supporting quick access within your network
B. Process your notes and patient records on a laptop that you are able to transport between your office and home office. You
always have the records available if needed
C. Process your notes manually and keep them in a locked file. The records are available for copy and distribution at any time.
, ANCC Domain 1-5 questions
D. Process your patient records manually, in your current fashion. You are
keeping a full record according to HIPAA.: A. Process your notes and patient records in a secure
electronic system with a template for patient information and interactions, supporting quick access within your network
8. The nurse practitioner (NP) sees an opportunity to help her patient who duffers from anxiety and hypertension by utilizing a
medication that can treat both issues. She talks to her patient about using Atenolol 25mg ½ tab po Q HS to manage his
hypertension and his chronic anxiety. To promote both the patient's continued health and collaboration, the NP:
A. Faxes a copy of her care notes to the Primary Care Provider (PCP) to inform the PCP of her plan of care
B. Telephones the Primary Care Provider's office and leaves a message about the change in medication
C. Tells the patient to let his Primary Care Provider know about the change in medication
D. Telephones the patient's Primary Care Provider to discuss the use of the Atenolol before
starting the medication: D. Telephones the patient's Primary Care Provider to discuss the use of the Atenolol before
starting the medication
9. A frail 76 y/o woman with Alzheimer's type dementia in a skilled nursing facility has been increasingly agitated, combative, and
has struck out at other patients in the dining room and at staff attempting to care for her. What would be the most appropriate
initial intervention by the consulting Psychiatric-Mental Health Nurse Practitioner who receives a call from the nursing staff
requesting medication and restraint orders?
A. Order close observation by staff in quiet area secluded from other patients until you can
evaluate in person
B. Order soft wrist and vest restraints until you can evaluate in person
C. Order short-acting benzodiazepine and close observation until you can evaluate in person
D. Order low-dose atypical antipsychotic and soft vest restraint until you can
evaluate in person: A. Order close observation by staff in quiet area secluded from other patients until you can evaluate in person
10. You frequently use your iPhone/smart phone to connect with your office, the pharmacy and patients. These multifunction
devices assist you in your practice. What needs to happen to the protected/private health information on your phone after you
conclude a healthcare interaction?
A. You document an abbreviated note of the phone conversation
B. You document that you had a telephone interaction only
C. You document it briefly, only if it is important
D. You document it fully in the patient record as a patient interaction: D. You document it fully in the patient
record as a patient interaction
11. A Psychiatric-Mental Nurse Practitioner practices in a state requiring a collaborating psychiatrist. The Psychiatric-Mental
Health Nurse Practitioner review all new and complex cases with the psychiatrist on a monthly basis. A young adult patient with
, ANCC Domain 1-5 questions
recurrent depression has been under the care of the Psychiatric-Mental Health Nurse Practitioner for 3 months when she commits
suicide. The family sues for wrongful death. Who is legally responsible for this patient's care in a court of law?
A. Equal responsibility of Psychiatric-Mental Health Nurse Practitioner and psychiatrist
B. Psychiatrist
C. Primary responsibility of Psychiatric-Mental health Nurse Practitioner and secondary responsibility of psychiatrist
D. Psychiatric-Mental Health Nurse Practitioner: D. Psychiatric-Mental Health Nurse Practitioner
12. The Nurse Practitioner (NP) is seeing a patient for both psychiatric and chemical dependency illnesses. The patient wants the
NP to send medical records to his General Practitioner. The NP tells the patient that because of Federal Law 42 CFR he must:
A. Sign two separate releases of information due to the special protected nature of chemical
dependency information
B. Sign once combined release that does not mention his chemical dependency illness due to its special protected nature
C. Sign two separate releases due to the special protected nature of psychiatric information
D. Sign one combined release that designated that he is being treated for both
chemical dependency and psychiatric illnesses: A. Sign two separate releases of information due to the special protected nature of
chemical dependency information
13. You see a patient for a routine medication visit. At the end of the session, the patient asks questions and the session ends up
50 minutes in length. You normally charge for the 30-minute appointment, but instead you charge for the 1-hour appointment.
The 1-hour appointment included a full body assessment that you did not perform. This is violation is known as:
A. Up-coding
B. Over-coding
C. Down-coding
D. Super-coding: A. Up-coding
14. The nurse practitioner (NP) is on an airplane and the flight attendant asks if there is a medical professional on the flight. The
NP agrees to help. The NP is presented with a young woman who is suffering from a severe panic attack. The woman is nauseated
and lying on the floor of the plane. The woman has trouble communicating much more than she is upset, afraid and her husband
is a few airplane stops away at an air force base where she is headed. The woman's pulse is 89 and regular, her respirations are 18
and regular. The woman occasionally pants and vomits some pale brown liquid. You provide information to the flight medical
doctor on call. At the destination, the flight attendant offers to give you some Alprazolam 0.5mg to give to the patient.
You:
A. Give her the alprazolam to help her calm down until you get to the destina-tion. Then, she can go to the hospital.
B. Give her the alprazolam so that she calm down and go on to her next flightC. Do not give the medication. Ask her is she
would like to take the medication. If she agrees, allow the flight attendant to give it to her.
D. Do not give the medication. Instead, wait until the plane lands and a full
1. A newly graduated nurse practitioner (NP) wants to open a private psychiatric practice in her hometown. She wants to find out
about the laws that cover her responsibility and the legal liability that this practice will encounter for her as an independent
psychiatric nurse practitioner. Her best source of information is:
A. The State Statues on Nursing or Advanced Nursing Practice
B. Her city statutes
C. Local Psychiatric Nurse Practitioners in practice
D. The American Academy of Nurse practitioners: A. The State Statues on Nursing or Advanced
Nursing Practice
2. Which of the following best depicts the Psychiatric-Mental Health Nurse Practitioner in a grassroots mental health advocacy
role?
A. Attending a town hall meeting to seek timely police response to rising domestic violence crisis
calls.
B. Working on the campaign of an individual running for the state senate.
C. Assisting with depression screening at a health fair in a local shopping mall
D. Meeting states legislators during RN lobbying day organized by the state
nurses' association: A. Attending a town hall meeting to seek timely police response to rising domestic violence crisis calls.
3. During a medication follow-up appointment at student mental health clinic, a 20 y/o college sophomore with depression and
history of binge drinking disclosed that she has been struggling with recurrent intrusive thoughts of overdose. She recently broke
up with her boyfriend when she learned that he was sleeping with her closest girlfriend. She admits taking a handful of her
sertraline prescribed by the Psychiatric-mental Health Nurse Practitioner last weekend and was frustrated that it only made her
sleep for a day. She's angry and ambivalent about the future, unwilling to make any promise not to harm herself, and has made
veiled threats to "pay back both of them for cheating" (referring to her ex-boyfriend and girlfriend). What is the most appropriate
intervention at this juncture?
A. Counsel the student that she would regret hurting herself and can move beyond this broken relationship
B. Ask the student to promise that she wont harm herself or anyone else and schedule next day counseling
C. Negotiate with the student to touch base daily by phone between counseling visits to avoid hospitalization
D. Ask the student if she will agree to voluntary admission and arrange invol-
untary admission is necessary: D. Ask the student if she will agree to voluntary admission and arrange involuntary
admission is necessary
4. Per the Health Insurance Portability and Accountability Act (HIPAA), a nurse practitioner (NP) who is in an independent, single
practitioner practice is considered a "Covered Entity" because:
A. Writers information and generates protected health information
, ANCC Domain 1-5 questions
B. The NP transmits protected health information in electronic forms
C. May accidentally release protected health information
D. Maintains charts with patient information that contains protected health
information: B. The NP transmits protected health information in electronic forms
5. The Nurse Practitioner (NP) attends a local meeting where allocation of resources for healthcare will be discussed. One of the
stakeholders has a pamphlet that describes the types of healthcare providers available to help persons in need of health care. The
NP notices that Nurse Practitioners are labeled as "Paraprofessionals". In the meeting, the NP askes the organization responsible
for the pamphlet why they have identified the Nurse Practitioners as paraprofessionals when a Nurse Practitioner is by law
working as 85-90% of the same capacity as a Medical Doctor. The NP goes on to explain what a Nurse Practitioner does in various
areas of practice. This is an example of:
A. Promoting nurse practitioners in the community
B. Public education on the NP scope and standards of practice
C. Correcting misinformation that deliberately misleads the public
D. Advocating for the role and value of the Nurse Practitioner.: D. Advocating for the role and value of the
Nurse Practitioner.
6. Your patient wants to communicate with you through email. You have a secure email account that is encrypted and will protect
health information as required by the Health Insurance Portability and Accountability Act (HIPAA).
Your patient does not have an encrypted email account. You reply is:
A. I do not like to communicate through email I would prefer to talk to you in person or over the telephone only
B. I can encrypt our email communications to be sure that your protected health information (PHI) is unavailable to others and
protect you
C. I have no problems with you communicating with me through my personal email
D. In order to communicate back and forth, you will have to find a way to
encrypt you're protected health information (PHI): D. In order to communicate back and forth, you will have to find
a way to encrypt you're protected health information (PHI)
7. As an individual advanced practitioner, you cannot afford to have a standalone Electronic Health Record (HER) system to keep
all of your patient's health information on a computer based system. How could you problem-solve this dilemma?
A. Process your notes and patient records in a secure electronic system with a template for patient
information and interactions, supporting quick access within your network
B. Process your notes and patient records on a laptop that you are able to transport between your office and home office. You
always have the records available if needed
C. Process your notes manually and keep them in a locked file. The records are available for copy and distribution at any time.
, ANCC Domain 1-5 questions
D. Process your patient records manually, in your current fashion. You are
keeping a full record according to HIPAA.: A. Process your notes and patient records in a secure
electronic system with a template for patient information and interactions, supporting quick access within your network
8. The nurse practitioner (NP) sees an opportunity to help her patient who duffers from anxiety and hypertension by utilizing a
medication that can treat both issues. She talks to her patient about using Atenolol 25mg ½ tab po Q HS to manage his
hypertension and his chronic anxiety. To promote both the patient's continued health and collaboration, the NP:
A. Faxes a copy of her care notes to the Primary Care Provider (PCP) to inform the PCP of her plan of care
B. Telephones the Primary Care Provider's office and leaves a message about the change in medication
C. Tells the patient to let his Primary Care Provider know about the change in medication
D. Telephones the patient's Primary Care Provider to discuss the use of the Atenolol before
starting the medication: D. Telephones the patient's Primary Care Provider to discuss the use of the Atenolol before
starting the medication
9. A frail 76 y/o woman with Alzheimer's type dementia in a skilled nursing facility has been increasingly agitated, combative, and
has struck out at other patients in the dining room and at staff attempting to care for her. What would be the most appropriate
initial intervention by the consulting Psychiatric-Mental Health Nurse Practitioner who receives a call from the nursing staff
requesting medication and restraint orders?
A. Order close observation by staff in quiet area secluded from other patients until you can
evaluate in person
B. Order soft wrist and vest restraints until you can evaluate in person
C. Order short-acting benzodiazepine and close observation until you can evaluate in person
D. Order low-dose atypical antipsychotic and soft vest restraint until you can
evaluate in person: A. Order close observation by staff in quiet area secluded from other patients until you can evaluate in person
10. You frequently use your iPhone/smart phone to connect with your office, the pharmacy and patients. These multifunction
devices assist you in your practice. What needs to happen to the protected/private health information on your phone after you
conclude a healthcare interaction?
A. You document an abbreviated note of the phone conversation
B. You document that you had a telephone interaction only
C. You document it briefly, only if it is important
D. You document it fully in the patient record as a patient interaction: D. You document it fully in the patient
record as a patient interaction
11. A Psychiatric-Mental Nurse Practitioner practices in a state requiring a collaborating psychiatrist. The Psychiatric-Mental
Health Nurse Practitioner review all new and complex cases with the psychiatrist on a monthly basis. A young adult patient with
, ANCC Domain 1-5 questions
recurrent depression has been under the care of the Psychiatric-Mental Health Nurse Practitioner for 3 months when she commits
suicide. The family sues for wrongful death. Who is legally responsible for this patient's care in a court of law?
A. Equal responsibility of Psychiatric-Mental Health Nurse Practitioner and psychiatrist
B. Psychiatrist
C. Primary responsibility of Psychiatric-Mental health Nurse Practitioner and secondary responsibility of psychiatrist
D. Psychiatric-Mental Health Nurse Practitioner: D. Psychiatric-Mental Health Nurse Practitioner
12. The Nurse Practitioner (NP) is seeing a patient for both psychiatric and chemical dependency illnesses. The patient wants the
NP to send medical records to his General Practitioner. The NP tells the patient that because of Federal Law 42 CFR he must:
A. Sign two separate releases of information due to the special protected nature of chemical
dependency information
B. Sign once combined release that does not mention his chemical dependency illness due to its special protected nature
C. Sign two separate releases due to the special protected nature of psychiatric information
D. Sign one combined release that designated that he is being treated for both
chemical dependency and psychiatric illnesses: A. Sign two separate releases of information due to the special protected nature of
chemical dependency information
13. You see a patient for a routine medication visit. At the end of the session, the patient asks questions and the session ends up
50 minutes in length. You normally charge for the 30-minute appointment, but instead you charge for the 1-hour appointment.
The 1-hour appointment included a full body assessment that you did not perform. This is violation is known as:
A. Up-coding
B. Over-coding
C. Down-coding
D. Super-coding: A. Up-coding
14. The nurse practitioner (NP) is on an airplane and the flight attendant asks if there is a medical professional on the flight. The
NP agrees to help. The NP is presented with a young woman who is suffering from a severe panic attack. The woman is nauseated
and lying on the floor of the plane. The woman has trouble communicating much more than she is upset, afraid and her husband
is a few airplane stops away at an air force base where she is headed. The woman's pulse is 89 and regular, her respirations are 18
and regular. The woman occasionally pants and vomits some pale brown liquid. You provide information to the flight medical
doctor on call. At the destination, the flight attendant offers to give you some Alprazolam 0.5mg to give to the patient.
You:
A. Give her the alprazolam to help her calm down until you get to the destina-tion. Then, she can go to the hospital.
B. Give her the alprazolam so that she calm down and go on to her next flightC. Do not give the medication. Ask her is she
would like to take the medication. If she agrees, allow the flight attendant to give it to her.
D. Do not give the medication. Instead, wait until the plane lands and a full
