Mary Fran Tracy; Susanne J. Phillips Eileen O'Grady
TEST BANK
Hamric and Hanson’s Advanced Practice Nursing: An
Integrative Approach
7th Edition
9780323777117 Stuvia.com - The Marketplace to Buy and Sell your Study Material
Table of Contents
Chapter 01 History and Evolution of Advanced Practice Nursing 1
Chapter 02 Conceptualizations of Advanced Practice Nursing 5
Chapter 03 A Definition of Advanced Practice Nursing 9
Chapter 04 Role Development of the Advanced Practice Nurse 13
Chapter 05 International Development of Advanced Practice Nursing 19
Chapter 06 Direct Clinical Practice 22
Chapter 07 Guidance and Coaching 30
Chapter 08 Evidence-Based Practice 35
Chapter 09 Leadership 40
Chapter 10 Collaboration 44
Chapter 11 Ethical Practice 51
Chapter 12 The Clinical Nurse Specialist 57
Chapter 13 The Primary Care Nurse Practitioner 61
Chapter 14 The Acute Care Nurse Practitioner 65
Chapter 15 The Certified Nurse-Midwife 69
Chapter 16 The Certified Registered Nurse Anesthetist 74
Chapter 17 Maximizing APRN Power and Influencing Policy 78
Chapter 18 Marketing Yourself as an APRN Contracting and Negotiation 82
Chapter 19 Reimbursement and Payment for APRN Services 88
Chapter 20 Understanding Regulatory, Legal, and Credentialing Requirements 94
Chapter 21 APRN Outcomes and Performance Improvement Research 97
Chapter 22 Future Technologies Influencing APRN Practice 100
Chapter 23 Using Healthcare Information Technology to Evaluate and Improve Performance and Patient Outcomes 104Stuvia.com - The Marketplace to Buy and Sell your Study Material
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WWW.TBSM.WSChapter 01: History and Evolution of Advanced Pract ice Nursing Tracy & O’Grady: Hamric & Hanson’s Advanced Practic e Nursing, 7th Edition MULTIPLE CHOICE 1. Which of the following is the best explanation f or the creation of the Doctorate of Nursing Practice (DNP) degree? a. To validate APRN’s for financial reimbursement b. To address increasing curriculum requirements of ma ster’s degree programs c. To compete against master’s degree programs d. To ensure standardized curriculum ensuring independ ent practice ANS: B Although all answers are influenced by the DNP core competencies, the DNP program creation in 2004 by the American Association of Coll eges of Nursing (AACN) was designed to address curriculum requirements of mast er’s degree programs. 2. Which of the following was the first recognized area of advanced practice nursing? a. Clinical Nurse Specialist b. Certified Registered Nurse Anesthetist c. Family Nurse practitioner d. Pediatric Nurse practitioner ANS: B In 1931, the National Association of Nurse Anesthetis ts (NANA), renamed in 1939 to the American Association of Nurse Anesthetists (AANA) wa s the first recognized group promoting advanced nursing practice. Agatha Hodgins founded the AANM at Lakeside Hospital in Cleveland, Ohio. 3. Which factor is broadly perceived to solidify and standardize the role of the APNs over the last 25 years? a. Societal forces b. Lack of access to health care providers c. Payment for services d. Standardized curriculum development ANS: D As the evolution of Advanced Practice Nursing advanc es specific specialties and needs are identified. Through the evolution of organization a nd standardization these roles have solidified the APN’s role in today’s health care en vironment. 4. During the formation of early APN roles in anes thesia, which of the following increased demand for access to health care? a. War b. Poverty c. Rural access to care d. Availability of training ANS: A ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Hamric and Hanson’s Advanced Practice Nursing: An Integrative Approach, 7th Edition (Tracy, 2023)
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WWW.TBSM.WSEarliest demand for nursing-provided anesthesia spi ked during periods of war when numbers of physicians were inadequate. The earliest records date back to the American Civil War with the administration of chloroform. Du ring World War I in 1917 more than 1000 nurses, some trained anesthetists, traveled in to battle. Other factors such as need for rural health care came later in the validation and need for APNs. 5. In 1889, Dr. William Worrall Mayo built and open ed St. Mary’s hospital in Rochester, NY. He is known for some of the earliest recruitment an d specialized training of nurses in which of the following roles? a. Obstetrics b. Anesthesia c. Family nursing d. Pediatrics e. Research and statistics ANS: B In 1889, Dr. William Worrall Mayo began formally tra ining and recognizing nurse anesthetists. This has been regarded as the earliest training in nurse-provided anesthesia. 6. In 1893, Lillian Wald established the Henry Str eet Settlement (HSS) House for which primary purpose? a. Access to health care of rural areas b. Provide the disadvantaged access to care c. Establish guidelines for advanced nursing roles d. Create inner -city nursing awareness ANS: B The HHS was established to provide nursing services to immigrants and low-income patients and their families in Manhattan. As resist ance to nurse-provided care grew, standing orders were drafted from a group of Lower East Side physicians thereby circumventing then-existing legal ramifications. 7. The Frontier Nursing Service (FNS) founded in Ke ntucky in 1925 by Mary Breckenridge initially provided Appalachia with which type of adv anced nursing care? a. Surgical services b. Pediatric care c. Anesthesia d. Midwifery ANS: D The original FNS provided midwifery in addition to o ther nursing services to Appalachian residents. Later working from standard orders devel oped from their medical advisory committee nurses treated patients, made diagnoses, a nd dispensed medications. 8. Which organization founded in 1941 under Mary B reckenridge’s leadership merged with the American College of Nurse-Midwives (ACNM) in 19 69 a. Association for National Nurse -Midwifery (ANNM) b. American Association of Nurse -Midwives (AANM) c. American Nurs es Association (ANA) d. Council of Nursing Midwifery (ANM) ______________________________________________________________________________________________
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WWW.TBSM.WSANS: B The American College of Nurse-Midwives (ACNM) formed under the leadership of Mary Breckenridge in 1941 to provide nurse-midwife develo pment and collaboration for midwife development. In 1955, the American College of Nurse- Midwives was formed and the two organizations merged in 1969 after the death of Mar y Breckenridge. 9. In a landmark ruling by the Supreme Court as a r esult of Chalmers-Frances v. Nelson, 1936 , what legal precedent was established? a. Nurse anesthesia was allowed under the nurse practic e act b. Nurse anesthesia was legal, if under guidance of a supervising physician c. Nurse anesthesia scope of practice included anesthes ia d. Only trained nursing professionals could administer anesthesia independently ANS: B The landmark decision from the Chalmers-Frances v. Nelson case set national precedent for the advanced nursing practice role. It proved to be th e basis for other cases over the following few decades and established that trained nurses could legally provide anesthesia care under supervision of a physician. 10. The first known establishment of the nurse prac titioner role occurred in 1965 at the University of Colorado. In which area of training d id this role specialize? a. Geriatrics b. Pediatrics c. Midwifery d. Anesthesia ANS: B The establishment of the first pediatric nurse practi tioner program was in 1965 at the University of Colorado. Loretta Ford, RN and Henry Silver, MD provided a 4-month course to certified registered nurses to provide education on managing childhood health problems. 11. What has the AANA as of 2025 as the standard f or entry into nurse anesthesia practice? a. Master’s degree b. Bachelors of nursing and master’s degree c. Doctorate degree d. No specification ANS: C In 2007 the AANA affirmed support that the doctor o f nurse anesthesia practice be the entry of nurse anesthesia by 2025. Students entering anest hesia programs during or after 2022 must graduate with a doctoral degree. 12. Which state became the first to recognize diagn osis and treatment as part of the scope of practice of specialty nurses? a. Oklahoma b. South Dakota c. Maryland d. Idaho ANS: D ______________________________________________________________________________________________
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WWW.TBSM.WSIdaho Governor Cecil Andrus signed HB 46 and HB 207 into law on February 11, 1971. This amended the states’ nurse practice act making i t the first state to officially recognize diagnosis and treatment of specialty nurses. The re cognition of the ability to diagnose and treat overcame an initial hurdle toward independent nursing practice. 13. The American Nursing Association (ANA) defines which requirement for the designation of a clinical nurse specialist in any specialty? a. 1000 hours relevant supervised training b. Masters or doctoral degree c. Specialty training certificate d. Two or more years of clinically relevant experience e. Successful completion of certification examination ANS: B In 1980, the ANA specifically outlined criteria for the acknowledgment of clinical nurse specialist training programs. At that time they requ ired graduate level training to become an expert in a relevant specialty area of nursing. Add itionally, they must meet any requirements set forth by the specific professional society. ______________________________________________________________________________________________
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WWW.TBSM.WSChapter 02: Conceptualizations of Advanced Practice Nursing Tracy & O’Grady: Hamric & Hanson’s Advanced Practic e Nursing, 7th Edition MULTIPLE CHOICE 1. Which of the following is the primary mission of the National Organization of Nurse Practitioner Faculties (NONPF)? a. Provide leadership in promoting quality NP education b. Provide financial assistance to NP students c. NP Faculty training program assistance d. Lobbying legislature on behalf of NPs ANS: A The NONPF’s primary mission is to provide leadership i n promoting quality NP education. The organization has published domains and core comp etencies for primary care and these serve as a framework for NP education and practice. 2. The 2019 updated model of competencies that are encompassed around three spheres of impact known as patient direct care, nurses and nurs ing practice, and organizations and systems is known as? a. Shuler’s Model of NP Practice b. Fenton’s and Brykczynski’s Expert Practice c. Calkin’s model of Advanced Nursing Practice d. NACNS Model of clinical nurse specialist competenci es ANS: D The NACNS’s initial 2008 statement was revised in 20 04 and again in 2019 to specifically differentiate CNS practice from that of others APRNs . The statement outlined competencies that align to each of the three spheres of impact i ncluding patient direct care, nurses and nursing practice, and organizations and systems. 3. Building upon Benner’s seven domains of expert nursing practice, which conceptual model adds an additional domain “The consulting role of t he nurse”? a. NACNS Clinical Nurse Specialists Model b. Shuler’s Model of NP Practice c. Fenton’s and Brykczynski’s Expert Practice d. Strong Memorial Hospital’s Model of Advanced Nursing Practice e. Calkin’s model of Advanced Nursing Practice ANS: C Fenton’s and Brykczynski’s Expert Practice Domains of the CNS and NP expanded on Benner’s seven domains adding consultation provided b y CNS’s to other nurses and management of health and illness in ambulatory care settings. 4. Which model of conceptual practice was the first to explicitly distinguish the experience level of advanced practitioners? a. NACNS Clinical Nurse Specialists Model b. Shuler’s Model of NP Practice c. Fenton’s and Brykczynski’s Expert Practice ______________________________________________________________________________________________
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WWW.TBSM.WSd. Strong Memorial Hospital’ s Model of Advanced Nursing Practice e. Calkin’s Model of Advanced Nursing Practice ANS: E Calkin’s model of Advanced Nursing Practice was the first to explicitly distinguish experience levels of advanced practitioners for nurs e administrators to differentiate advanced practice nursing from other levels of clini cal practice. 5. The circular and continuous threads of direct c omprehensive patient care, support of systems, education, research, and publication and pr ofessional leadership make up the five domains of which advanced nursing conceptual model? a. Strong Memorial Hospital’s Model of Advanced Nursing Practice b. NACNS Clinical Nurse Specialists Model c. Shuler’ s Model of NP Practice d. Fenton’s and Brykczynski’s Expert Practice e. Calkin’s model of Advanced Nursing Practice ANS: A Direct and indirect activities across five domains including: direct comprehensive patient care, support of systems, education, research, and publication and professional leadership make up the Strong Memorial Hospital’s Model of Adv anced Practice Nursing. 6. Texas Children’s Hospital Transformational Adva nced Professional Practice (TAPP) APRN Model added what unifying conceptual strand to Stro ng Memorial Hospital’s Model of Advanced Practice Nursing? a. Professional Ethics b. Quality and Safety c. Culture d. Education ANS: A The TAPP model added two additional domains: qualit y and safety, and credentialing and regulatory practice, to the Strong model. Specifical ly, professional ethics was added as a unifying conceptual strand alongside collaboration, scholarship, and empowerment. 7. Poghosyan, Boyd, and Clarke (2016) proposed a co mprehensive conceptual model including three factors: scope of practice regulations, instit utional policies, and practice environments. What was their primary purpose? a. To enhance patient education provided by the APRN b. To maximize NP Contributions to primary care c. To provide educational practice guidelines to enhance NP education d. To discourage role ambiguity among CNS providers ANS: B The 2016 model provided a comprehensive review of li terature and described potential factors that affect NP care and patient outcomes. Thi s included scope of practice regulations that often cause barriers for NP provided primary care. 8. Which model of practice intended to impact the N P domain at four levels: theoretical, clinical, educational, and research in 1993? a. Shuler’s Model of NP Practice ______________________________________________________________________________________________
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WWW.TBSM.WSb. Strong Memorial Hospital’s Model of Advanced Nursing Practice c. Calkin’s model of Advanced Nursing Practice d. Hamric’s model ANS: A Shuler’s Model of NP Practice model is holistic and wellness oriented and was designed to impact the NP domain at four levels: theoretical, cl inical, educational, and research. It is designed to elaborate the NP’s expanded knowledge a nd skills into medicine including a template for conducting a visit. 9. Which model highlighted some of the earliest ef forts to address APRN practice among all roles by outlining primary criteria among a central c ompetency with highlighted core competencies in addition to managing environmental elements? a. Strong Memorial Hos pital’s Model of Advanced Nursing Practice b. Calkin’s model of Advanced Nursing Practice c. Donabedian Model d. Hamric’s model ANS: D Many models highlight core competencies among speci fic APRN roles, Hamric’s model outlines primary criteria for a central competency ( direct clinical practice) that further outlines core competencies. Additionally, Hamric’s model highlights critical environmental elements that affect APRNs such as regulatory and c redentialing requirements, health policy, business aspects among others. 10. Which of the following is one of the eight publ ished essentials included in the Essentials of Doctoral Education for Advanced Nursing Practice dev eloped by the AACN in 2006? a. Scientific underpinnings of practice b. Informatics and health care technologies c. Liberal education for general nursing practice d. Algorithms for advanced patient care ANS: A The AACN publishes their national consensus to provid e the core elements for nursing curriculum creation. Currently published are Baccala ureate Essentials, Master’s Essentials, DNP Essentials, and Clinical Resources Essentials. Although they are similar in their core approach to education, listed first in DNP essentia ls is the scientific underpinnings of practice. 11. Which model of conceptualization identifies th at health care needs are not met in a system dominated by medical language as a basis for reimburs ement? a. Dunphy and Winland -Brown’s Circle of Caring model b. Donabedian Model c. Calkin’s model of Advanced Nursing Practice d. Shuler’s Model of NP Practice ANS: A ______________________________________________________________________________________________
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WWW.TBSM.WSDunphy and Winland-Brown’s transformative model (Du nphy, Winland-Brown, Porter, Thomas, and Gallagher, 2011; Fig. 2.12) proposed a c ircle of caring to encourage medical collaboration and enhance the nursing presence in th e health care system. Their model incorporates both strengths of medicine and nursing with process of assessment, planning, intervention, and evaluation, with a feedback loop. 12. Without additional application of conceptual m odels which model would be best chosen to model the skill level of beginning nurses, experienc ed nurses, or advanced nurse practitioners with the appropriate level of patient care? a. Strong Memorial Hospital’s Model of Advanced Nursing Practice b. Dunphy and Winland -Brown’s Circle of Caring model c. Donabedian Model d. Calkin’s Model of Advanced Nursing Practice ANS: D Calkin’s Model of Advanced Nursing Practice outlines skills and knowledge of beginning nurses, experienced nurses, and advance practice nur ses as they relate the patient responses for health care problems. The model was developed to assist nurse administrators match the skill level of advanced practice nurse from other le vels of clinical practice in personnel policies. 13. The 2005 Donabedian model has been used to eval uate the quality of APRN care using which conceptual outline? a. Assessment, diagnosis, planning, intervention, a nd evaluation b. Diagnosis and outcomes c. Structure, process, and outcomes d. Diagnosis, morbidity, and mortality ANS: D The Donabedian model encompasses structure (health care systems and facilities), process (diagnosis, treatment & education), and outcomes. MULTIPLE RESPONSE 1. Which of the following are the functions of a c onceptualization of advanced practice nursing? (Select all that apply.) a. Articulate professional role identity and function b. Identify specific procedures to provide c. Basis for furthermore development o f knowledge d. Deliver holistic and collaborative care e. Provide guidelines on billing ANS: A, C, D Conceptual models allow for articulation of professi onal role identity, provide a basis for furthermore development of knowledge and assist in clinical practice for the delivery of holistic, comprehensive, and collaborative care. Mo dels may assist but in general do not provide assistance with clinical decision making or billing. ______________________________________________________________________________________________
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