Exam (elaborations)
AGACNP Certification Exam
- Module
- Accounting 405
- Institution
- Accounting 405
AGACNP Certification Exam
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AGACNP Exam ReviewScope of Practice - ANS-Based on legal allowances in each state, individual state nurse
practice acts providing guidelines for nursing practice
Key elements of the NP role include - ANS-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... - ANS-American Nurses
Association which measure quality of practice, service, or education
State Practice Acts - ANS-Authorize Boards of Nursing in each state to establish
statutory authority for licensure of RNs
State Practice Acts - authority includes: - ANS-use of title, authorization for scope of
practice including prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as - ANS-certification
Prescriptive authority - ANS-Ability and extent of NPs ability to prescribe meds
DEA has ruled that nurses in advanced practice may obtain.. - ANS-registration
numbers, state practice acts dictate level of prescriptive authority allowed
Credentials encompass... - ANS-required education, licensure and certification to
practice as an NP
Credentials establish... - ANS-minimal levels of acceptable performance
Credentialing is necessary to: - ANS-ensure that safe healthcare is provided by qualified
individuals; comply with federal and state laws r/t APN
Credentials also... - ANS-acknowledges the scope of practice of NP, mandates
accountability, enforces professional standards for practice
Licensure - ANS-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 - ANS-a
governmental regulatory body (ie. state board of nursing)
Certification - ANS-Person has met certain standards that signify mastery of specialized
knowledge
Certification is granted by nongovernmental agencies such as - ANS-ANCC, AANP
Admitting privileges to hospitals (non physican) were granted - ANS-1983 by JC
Credentialing and privileging - ANS-process which an NP is granted permission to
practice in an inpt setting
Credentialing with hospital privileges is granted by a - ANS-Hospital Credentialing
Committee
Pt Medical Abandoment - ANS-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: - ANS-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 - ANS-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 - ANS-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 - ANS-incident reports
Policies regarding incident reports should address: - ANS-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 - ANS-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: - ANS-ppl notified after receiving complaint;
ppl responsible for responding; ppl responsible for monitoring follow up
Action taking initiatives: - ANS-Prevention, correction (corrective steps must be
monitored and audited), documentation, education, departmental coordination
Medical Futility - ANS-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: - ANS-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) - ANS-state that pt is able to
make personal decisions about their care
competence implies that ability to: - ANS-understand, reason, differentiate good and
bad, and communicate
informed consent - ANS-pt has received adequate instruction or info regarding aspects
of care to make prudent, personal choice regarding such tx
Informed consent includes: - ANS-discussing benefits and risk
consent is assumed if... - ANS-pt's condition is life threatening
Danforth Amendment 1991 - ANS-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 - ANS-study of moral conduct and behavior protecting the rights of an individual
1st priority is the - ANS-most salvagable pts. Most critically injured cared for last.
, Key ethical principles are: - ANS-nonmaleficence, utilitarianism, beneficence, justice,
fidelity, veracity, autonomy
Nonmaleficence - ANS-duty to do no harm
Utilitarianism - ANS-the right act is the one that produces the greatest good for the
greatest number
Beneficence - ANS-duty to prevent harm and promote good
Justice - ANS-duty to be fair
Fidelity - ANS-duty to be faithful
Veracity - ANS-duty to be truthful (tends to be in conflict with fidelity)
Autonomy - ANS-duty to respect an individual's thoughts and actions (tend to be in
conflict with beneficence)
Dismissing/discharging a pt or closing practice - ANS-NP cannot withdraw from caring
for a pt without notification
Examples of reasons for discharging a pt from practice: - ANS-abuse, refusal to pay,
persistent non-adherence to care
Steps for discharging a pt from practice: - ANS-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 - ANS-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... - ANS-1960s as a result of physician shortages in
the area of peds
First NP program was peds, begun in... - ANS-1964 by Dr. Loretta Ford and Dr. Henry
Silver at CU Health Sciences mainly focusing on ambulatory and outpt care
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