AGACNP Exam Review
Scope of Practice - Answer Based on legal allowances in each state, individual state
nurse practice acts providing guidelines for nursing practice
Key elements of the NP role include - Answer 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... - Answer American Nurses
Association which measure quality of practice, service, or education
State Practice Acts - Answer Authorize Boards of Nursing in each state to establish
statutory authority for licensure of RNs
State Practice Acts - authority includes: - Answer use of title, authorization for scope of
practice including prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as - Answer certification
Prescriptive authority - Answer Ability and extent of NPs ability to prescribe meds
DEA has ruled that nurses in advanced practice may obtain.. - Answer registration
numbers, state practice acts dictate level of prescriptive authority allowed
Credentials encompass... - Answer required education, licensure and certification to
practice as an NP
Credentials establish... - Answer minimal levels of acceptable performance
Credentialing is necessary to: - Answer ensure that safe healthcare is provided by
qualified individuals; comply with federal and state laws r/t APN
Credentials also... - Answer acknowledges the scope of practice of NP, mandates
accountability, enforces professional standards for practice
Licensure - Answer 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 - Answer a
governmental regulatory body (ie. state board of nursing)
Certification - Answer Person has met certain standards that signify mastery of
specialized knowledge
Certification is granted by nongovernmental agencies such as - Answer ANCC, AANP
Admitting privileges to hospitals (non physican) were granted - Answer 1983 by JC
,AGACNP Exam Review
Credentialing and privileging - Answer process which an NP is granted permission to
practice in an inpt setting
Credentialing with hospital privileges is granted by a - Answer Hospital Credentialing
Committee
Pt Medical Abandoment - Answer 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: - Answer 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 - Answer 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 - Answer 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 - Answer incident reports
Policies regarding incident reports should address: - Answer 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 - Answer 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: - Answer ppl notified after receiving
complaint; ppl responsible for responding; ppl responsible for monitoring follow up
Action taking initiatives: - Answer Prevention, correction (corrective steps must be
monitored and audited), documentation, education, departmental coordination
Medical Futility - Answer Interventions that are unlikely to produce significant benefit for
pt - "Does the intervention have any reasonable prospect of helping this pt?"
,AGACNP Exam Review
Two kind of medical futility: - Answer Quantitative futility: likelihood that intervention will
benefit pt is extremely poor
Qualitative futility: quality of benefit an intervention will produce is extremely poor
Informed consent - competence (decisional capability) - Answer state that pt is able to
make personal decisions about their care
competence implies that ability to: - Answer understand, reason, differentiate good and
bad, and communicate
informed consent - Answer pt has received adequate instruction or info regarding
aspects of care to make prudent, personal choice regarding such tx
Informed consent includes: - Answer discussing benefits and risk
consent is assumed if... - Answer pt's condition is life threatening
Danforth Amendment 1991 - Answer pts are informed at time of admission to federally
funded institution (such as hospital, nursing home, hospice, HMO, etc) that they have
the right to refuse care as long as the pt has decisional capability (competence)
Ethics - Answer study of moral conduct and behavior protecting the rights of an
individual
1st priority is the - Answer most salvagable pts. Most critically injured cared for last.
Key ethical principles are: - Answer nonmaleficence, utilitarianism, beneficence, justice,
fidelity, veracity, autonomy
Nonmaleficence - Answer duty to do no harm
Utilitarianism - Answer the right act is the one that produces the greatest good for the
greatest number
Beneficence - Answer duty to prevent harm and promote good
Justice - Answer duty to be fair
Fidelity - Answer duty to be faithful
Veracity - Answer duty to be truthful (tends to be in conflict with fidelity)
Autonomy - Answer duty to respect an individual's thoughts and actions (tend to be in
conflict with beneficence)
, AGACNP Exam Review
Dismissing/discharging a pt or closing practice - Answer NP cannot withdraw from
caring for a pt without notification
Examples of reasons for discharging a pt from practice: - Answer abuse, refusal to pay,
persistent non-adherence to care
Steps for discharging a pt from practice: - Answer send a certified letter with return
receipt (copy for chart), provide general healthcare coverage for 1st 15-30 days post
termination deadline, obtain release of info to provide copies of all needed records for
next care provider
Obligations in closing practice d/t relocation, retirement - Answer give pt adequate time
to find another provider, keep all files for min 5 years, provide timely notification and
names of other providers and resources for future care
Role of NP developed in the early... - Answer 1960s as a result of physician shortages
in the area of peds
First NP program was peds, begun in... - Answer 1964 by Dr. Loretta Ford and Dr.
Henry Silver at CU Health Sciences mainly focusing on ambulatory and outpt care
Historical service of NPs in primary care resulted in part from the... - Answer availability
of federal funding for preventive and primary care NP education
Movement of NPs expanded to the... - Answer inpt setting as a result of managed care,
hospital restructuring, and decreases in medical residency programs
4 distinct roles for NPs: - Answer clinician, consultant/collaborator, educator, researcher
Crisis/Acute Grief Communication - Answer Acknowledge feelings
Offer self
Crisis Intervention - Answer Boundaries
Security if necessary, NOT police
Establish trust/rapport
Advance Directive - Answer Written statement of patient's intent regarding medical
treatment
The Patient Self-Determination Act of 1990 - Answer All patients in a hospital setting are
required to be advised of their right to execute an advance directive
Living Will - Answer Compilation of statements that specify which life-prolonging
measures one does and does not want if they become incapacitated
Scope of Practice - Answer Based on legal allowances in each state, individual state
nurse practice acts providing guidelines for nursing practice
Key elements of the NP role include - Answer 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... - Answer American Nurses
Association which measure quality of practice, service, or education
State Practice Acts - Answer Authorize Boards of Nursing in each state to establish
statutory authority for licensure of RNs
State Practice Acts - authority includes: - Answer use of title, authorization for scope of
practice including prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as - Answer certification
Prescriptive authority - Answer Ability and extent of NPs ability to prescribe meds
DEA has ruled that nurses in advanced practice may obtain.. - Answer registration
numbers, state practice acts dictate level of prescriptive authority allowed
Credentials encompass... - Answer required education, licensure and certification to
practice as an NP
Credentials establish... - Answer minimal levels of acceptable performance
Credentialing is necessary to: - Answer ensure that safe healthcare is provided by
qualified individuals; comply with federal and state laws r/t APN
Credentials also... - Answer acknowledges the scope of practice of NP, mandates
accountability, enforces professional standards for practice
Licensure - Answer 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 - Answer a
governmental regulatory body (ie. state board of nursing)
Certification - Answer Person has met certain standards that signify mastery of
specialized knowledge
Certification is granted by nongovernmental agencies such as - Answer ANCC, AANP
Admitting privileges to hospitals (non physican) were granted - Answer 1983 by JC
,AGACNP Exam Review
Credentialing and privileging - Answer process which an NP is granted permission to
practice in an inpt setting
Credentialing with hospital privileges is granted by a - Answer Hospital Credentialing
Committee
Pt Medical Abandoment - Answer 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: - Answer 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 - Answer 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 - Answer 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 - Answer incident reports
Policies regarding incident reports should address: - Answer 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 - Answer 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: - Answer ppl notified after receiving
complaint; ppl responsible for responding; ppl responsible for monitoring follow up
Action taking initiatives: - Answer Prevention, correction (corrective steps must be
monitored and audited), documentation, education, departmental coordination
Medical Futility - Answer Interventions that are unlikely to produce significant benefit for
pt - "Does the intervention have any reasonable prospect of helping this pt?"
,AGACNP Exam Review
Two kind of medical futility: - Answer Quantitative futility: likelihood that intervention will
benefit pt is extremely poor
Qualitative futility: quality of benefit an intervention will produce is extremely poor
Informed consent - competence (decisional capability) - Answer state that pt is able to
make personal decisions about their care
competence implies that ability to: - Answer understand, reason, differentiate good and
bad, and communicate
informed consent - Answer pt has received adequate instruction or info regarding
aspects of care to make prudent, personal choice regarding such tx
Informed consent includes: - Answer discussing benefits and risk
consent is assumed if... - Answer pt's condition is life threatening
Danforth Amendment 1991 - Answer pts are informed at time of admission to federally
funded institution (such as hospital, nursing home, hospice, HMO, etc) that they have
the right to refuse care as long as the pt has decisional capability (competence)
Ethics - Answer study of moral conduct and behavior protecting the rights of an
individual
1st priority is the - Answer most salvagable pts. Most critically injured cared for last.
Key ethical principles are: - Answer nonmaleficence, utilitarianism, beneficence, justice,
fidelity, veracity, autonomy
Nonmaleficence - Answer duty to do no harm
Utilitarianism - Answer the right act is the one that produces the greatest good for the
greatest number
Beneficence - Answer duty to prevent harm and promote good
Justice - Answer duty to be fair
Fidelity - Answer duty to be faithful
Veracity - Answer duty to be truthful (tends to be in conflict with fidelity)
Autonomy - Answer duty to respect an individual's thoughts and actions (tend to be in
conflict with beneficence)
, AGACNP Exam Review
Dismissing/discharging a pt or closing practice - Answer NP cannot withdraw from
caring for a pt without notification
Examples of reasons for discharging a pt from practice: - Answer abuse, refusal to pay,
persistent non-adherence to care
Steps for discharging a pt from practice: - Answer send a certified letter with return
receipt (copy for chart), provide general healthcare coverage for 1st 15-30 days post
termination deadline, obtain release of info to provide copies of all needed records for
next care provider
Obligations in closing practice d/t relocation, retirement - Answer give pt adequate time
to find another provider, keep all files for min 5 years, provide timely notification and
names of other providers and resources for future care
Role of NP developed in the early... - Answer 1960s as a result of physician shortages
in the area of peds
First NP program was peds, begun in... - Answer 1964 by Dr. Loretta Ford and Dr.
Henry Silver at CU Health Sciences mainly focusing on ambulatory and outpt care
Historical service of NPs in primary care resulted in part from the... - Answer availability
of federal funding for preventive and primary care NP education
Movement of NPs expanded to the... - Answer inpt setting as a result of managed care,
hospital restructuring, and decreases in medical residency programs
4 distinct roles for NPs: - Answer clinician, consultant/collaborator, educator, researcher
Crisis/Acute Grief Communication - Answer Acknowledge feelings
Offer self
Crisis Intervention - Answer Boundaries
Security if necessary, NOT police
Establish trust/rapport
Advance Directive - Answer Written statement of patient's intent regarding medical
treatment
The Patient Self-Determination Act of 1990 - Answer All patients in a hospital setting are
required to be advised of their right to execute an advance directive
Living Will - Answer Compilation of statements that specify which life-prolonging
measures one does and does not want if they become incapacitated
