Chapter 9. Participation of the Advanced
Practice Nurse in Health Plans and Quality
Initiatives
1. Which of the following is best classified as role strain?
a. A difficult disagreement with a physician
b. An APN’s feelings of poor self-esteem after failing two examinations
c. Maintaining family responsibilities while in school
d. Starting a first job as an NP
ANS: B
Role strain is defined as the subjective feeling of frustration, tension, or anxiety in
response to role stress. Examples of role strain typically include subjective feelings of
decreased self-esteem when performance is below the expectations of self or others. A
difficult disagreement with a physician is an example of role conflict. Starting a first
job as an NP is an example of role transition. Maintaining family responsibilities
while in school is an example of role stress.
2. Which of the following is an example of role conflict?
a. Difficult work-life balance
b. A difficult disagreement with a physician
c. Starting a first job as an NP
d. Maintaining family responsibilities while in school
ANS: B
Role conflict occurs when role expectations are perceived to be mutually exclusive or
contradictory. Role conflict does not have to be with superiors but can occur between
, APRNs and nurses, other APRNs, or physicians. Starting a first job as an NP is an
example of role transition. Maintaining family responsibilities while in school is an
example of role stress.
3. The four-stage process to NP role development first identified by Anderson, Leonard, and
Yates (1974) and validated by Roberts et al. (1997) included which four components?
a. Finding a niche, coping with pressures, feeling competent, internalizing the role
b. Complete dependence, developing competence, independence, interdependence
c. Novice, developing competence, competent, advanced
d. Developing competence, partial independence, complete independence,
interdependence
e. Dependence, independence, interdependence, role model
ANS: B
Complete dependence, developing competence, independence, and interdependence
are the four- stage process of NP development outlined by Anderson, Leonard, and
Yates in 1974 and validated by Roberts et al. (1997).
4. A trained nurse enters the first semester of an NP training program. He or she is required
to learn new and more advanced techniques beginning with conducting an advanced
physical examination. The overwhelming feeling and stress of learning additional skills is
most likely classified by the studies of Anderson, Leonard, and Yates in 1974 as:
a. Independence
b. Developing competence
c. Interdependence
d. Complete dependence
ANS: D
The initial learning of skills and additional techniques experienced by NPs in the
beginning of their training has been described as complete dependence.
Practice Nurse in Health Plans and Quality
Initiatives
1. Which of the following is best classified as role strain?
a. A difficult disagreement with a physician
b. An APN’s feelings of poor self-esteem after failing two examinations
c. Maintaining family responsibilities while in school
d. Starting a first job as an NP
ANS: B
Role strain is defined as the subjective feeling of frustration, tension, or anxiety in
response to role stress. Examples of role strain typically include subjective feelings of
decreased self-esteem when performance is below the expectations of self or others. A
difficult disagreement with a physician is an example of role conflict. Starting a first
job as an NP is an example of role transition. Maintaining family responsibilities
while in school is an example of role stress.
2. Which of the following is an example of role conflict?
a. Difficult work-life balance
b. A difficult disagreement with a physician
c. Starting a first job as an NP
d. Maintaining family responsibilities while in school
ANS: B
Role conflict occurs when role expectations are perceived to be mutually exclusive or
contradictory. Role conflict does not have to be with superiors but can occur between
, APRNs and nurses, other APRNs, or physicians. Starting a first job as an NP is an
example of role transition. Maintaining family responsibilities while in school is an
example of role stress.
3. The four-stage process to NP role development first identified by Anderson, Leonard, and
Yates (1974) and validated by Roberts et al. (1997) included which four components?
a. Finding a niche, coping with pressures, feeling competent, internalizing the role
b. Complete dependence, developing competence, independence, interdependence
c. Novice, developing competence, competent, advanced
d. Developing competence, partial independence, complete independence,
interdependence
e. Dependence, independence, interdependence, role model
ANS: B
Complete dependence, developing competence, independence, and interdependence
are the four- stage process of NP development outlined by Anderson, Leonard, and
Yates in 1974 and validated by Roberts et al. (1997).
4. A trained nurse enters the first semester of an NP training program. He or she is required
to learn new and more advanced techniques beginning with conducting an advanced
physical examination. The overwhelming feeling and stress of learning additional skills is
most likely classified by the studies of Anderson, Leonard, and Yates in 1974 as:
a. Independence
b. Developing competence
c. Interdependence
d. Complete dependence
ANS: D
The initial learning of skills and additional techniques experienced by NPs in the
beginning of their training has been described as complete dependence.
