AGACNP Exam Review Questions and Answers 2023
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
,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
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
,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
