AGACNP Exam Practice Questions and Answers Latest 2024/2025 (Graded)

AGACNP Exam Practice Questions and Answers Latest 2024/2025 (Graded) 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 Practice Questions and Answers Latest 2024/2025 (Graded) 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?" 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) 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 Durable Power of Attourney - ANSWER Individual designated in the living will that is authorized to make medical decisions in the event patient is incapacitated Title I of HIPPA - ANSWER Protects health insurance coverage for workers and their families in the event they change or lose their jobs COBRA COBRA - ANSWER protects health insurance coverage for workers and their families in the event worker loses or changes jobs Who enforces HIPPA - ANSWER Office for Civil Rights Patient Safety Rule - ANSWER Protects patient information to analyze patient safety events and improve True or False: A patient has the right to see their medical record - ANSWER True The Privacy Rule: Patient's Rights - ANSWER See/have their medical record Corrections added to medical record Patient Safety and Quality Improvement Act (PSQIA) - ANSWER Voluntary reporting system improve patient safety outcomes through anonymous reporting by providers of patient safety outcomes and events Duty to Warn - ANSWER Patient's condition may endanger others overrides confidentiality Patient is diagnosed with HIV. Duty to Warn applies how? - ANSWER Can notify providers not family Invasion of Privacy - ANSWER Damaging one's reputation as a result of sharing patient information without their permission When can invasion of privacy charge not be made - ANSWER in good faith accurate information receiver has valid reason to obtain information Initiating any change in heathcare - ANSWER Begin at most local level and expand outward What comes first when treating a patient with a medical and psychosocial condition - ANSWER Medical condition strongest method to evaluate teaching - ANSWER returned demonstration when to transfer to teritary care facility - ANSWER seriously ill or injured patients that cannot be cared for at your institution stabilize and ship Patient reluctant to undergo procedure. you should? - ANSWER Fully educate patient and tell them why Primary care screening exams that are not emergent - ANSWER do not delay hospital discharge refer to PCP most powerful data collected from patient - ANSWER subjective or data you observed as the np RN calls you as the night shift NP and states patient is decompensating. You would? - ANSWER Call primary MD when patient status changes Code goes bad and all involved are talking badly about it on the unit. You should? - ANSWER Hold a one time debriefing with everyone invovled What is a response that would suggest admitting a patient to a SNF would be the best action? - ANSWER Needing assistance with ADLs Goals of Healthy People 2020 - ANSWER increase the quality and years of healthy life eliminate health disparities among americans Healthy People 2020 purpose - ANSWER used to understand health status of the nation and plan prevention programs NP must notify department of health with what dx - ANSWER Gonorrhea Chlamydia Syphillis HIV TB NPs must report to state - ANSWER Criminal acts and injury from dangerous weapon (GSW) Gonorrhea Chlamydia Syphillis HIV TB Animal bites Suspected/actual child abuse Domestic violence Physical Therapy - ANSWER Strength training coordination Occupational Therapy - ANSWER ADLs Medicare - ANSWER Third party payers sets the standard for reimbursement and cutting costs 65 yo. Disabled Medicaid - ANSWER Third party payers Poverty Medicare A - ANSWER Covers inpatient hospitalizations SNF home health hospice 65 yo. Medicare B - ANSWER Covers physician services outpatient hospital services labs/diagnostic procedures medical equipment Pay premium NPs 85% physician scheduled fee Medicare B pays how much of bill - ANSWER Medicare pays 80% and patient pays 20% Medicare D - ANSWER Limited prescription drug coverage Monthly premium required Co-pay on each prescription required Incident-to-Billing - ANSWER Services billed under MD provider number to get the full physician fee Under MD direct supervision Does direct supervision require MD to be physically in the room with NP to be eligible for incident-to-billing - ANSWER no same office suite and easily accesible does incident-to-billing apply to the inpatient hospital setting - ANSWER No. NP must bill under their NPI in the hospital setting Root Cause Analysis - ANSWER Tool for identifying prevention strategies to ensure safety Culture of safety and not culture of blame Root Cause Analysis involves - ANSWER Interdisciplinary experts those who are most familiar with the situation continually asking why at each level of cause and effect Identifying changes Impartial process Debriefing after an event is an example of - ANSWER root cause analysis Sentinel Events - ANSWER Unexpected occurrences involving death or serious physical injury or psychological injury or risk thereof immediate investigation and response Sentinel Event and medical error - ANSWER not synonymous not all sentinel events occur because of an error not all medical errors result in a sentinel event