AGACNP Exam Review Questions with Complete Solutions, A+

Scope of Practice - cORRECT sOLUTION Based on legal allowances in each state, individual state nurse practice acts providing guidelines for nursing practice Key elements of the NP role include - cORRECT sOLUTION 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... - cORRECT sOLUTION American Nurses Association which measure quality of practice, service, or education State Practice Acts - cORRECT sOLUTION Authorize Boards of Nursing in each state to establish statutory authority for licensure of RNs State Practice Acts - authority includes: - cORRECT sOLUTION use of title, authorization for scope of practice including prescriptive authority, and disciplinary grounds States vary in practice requirements, such as - cORRECT sOLUTION certification Prescriptive authority - cORRECT sOLUTION Ability and extent of NPs ability to prescribe meds DEA has ruled that nurses in advanced practice may obtain.. - cORRECT sOLUTION registration numbers, state practice acts dictate level of prescriptive authority allowed Credentials encompass... - cORRECT sOLUTION required education, licensure and certification to practice as an NP Credentials establish... - cORRECT sOLUTION minimal levels of acceptable performance Credentialing is necessary to: - cORRECT sOLUTION ensure that safe healthcare is provided by qualified individuals; comply with federal and state laws r/t APN Credentials also... - cORRECT sOLUTION acknowledges the scope of practice of NP, mandates accountability, enforces professional standards for practice Licensure - cORRECT sOLUTION 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 - cORRECT sOLUTION a governmental regulatory body (ie. state board of nursing) Certification - cORRECT sOLUTION Person has met certain standards that signify mastery of specialized knowledge Certification is granted by nongovernmental agencies such as - cORRECT sOLUTION ANCC, AANP Admitting privileges to hospitals (non physican) were granted - cORRECT sOLUTION 1983 by JC Credentialing and privileging - cORRECT sOLUTION process which an NP is granted permission to practice in an inpt setting Credentialing with hospital privileges is granted by a - cORRECT sOLUTION Hospital Credentialing Committee Pt Medical Abandoment - cORRECT sOLUTION 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: - cORRECT sOLUTION 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 - cORRECT sOLUTION 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 - cORRECT sOLUTION 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 - cORRECT sOLUTION incident reports Policies regarding incident reports should address: - cORRECT sOLUTION 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 - cORRECT sOLUTION 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: - cORRECT sOLUTION ppl notified after receiving complaint; ppl responsible for responding; ppl responsible for monitoring follow up Action taking initiatives: - cORRECT sOLUTION Prevention, correction (corrective steps must be monitored and audited), documentation, education, departmental coordination Medical Futility - cORRECT sOLUTION 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: - cORRECT sOLUTION 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) - cORRECT sOLUTION state that pt is able to make personal decisions about their care competence implies that ability to: - cORRECT sOLUTION understand, reason, differentiate good and bad, and communicate informed consent - cORRECT sOLUTION pt has received adequate instruction or info regarding aspects of care to make prudent, personal choice regarding such tx Informed consent includes: - cORRECT sOLUTION discussing benefits and risk consent is assumed if... - cORRECT sOLUTION pt's condition is life threatening Danforth Amendment 1991 - cORRECT sOLUTION 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 - cORRECT sOLUTION study of moral conduct and behavior protecting the rights of an individual