NUR 6111: Adv Nursing Practice I | WPU | Spring 2026
NUR 6111: ADVANCED NURSING PRACTICE I
COMPREHENSIVE EXAM | SPRING 2026 UPDATE
Advanced Practice Role Transition & Scope of Practice
Comprehensive Health Assessment & Diagnostic Reasoning
Foundational Pathophysiology & Pharmacology Principles
Evidence-Based Practice, QI, & 2026 Updates
William Paterson University | Graduate Nursing (APRN)
2026 | 2027 Academic Standards
Specification Detail
Total Questions 40
Points per Question 2.5
Total Points 100
Cognitive Mix 30% Recall / 50% Application / 20% Analysis
Question Style 75% Scenario-Based / 25% Direct
Format Multiple Choice (A-D), One Correct
Sections 4 (10 questions each)
Institution William Paterson University
Page 1
, NUR 6111: Adv Nursing Practice I | WPU | Spring 2026
PART 1: EXAM QUESTIONS
Section 1: Advanced Practice Role, Scope, Ethics, & Interprofessional
Collaboration
Q1: A newly graduated FNP in New Jersey is establishing an independent practice. Under current 2026 New
Jersey state regulations, which statement most accurately describes NP practice authority?
A. NPs in New Jersey have full independent practice authority without any physician collaboration requirement
B. NPs in New Jersey may practice independently after completing a supervised practice period, but must
maintain a collaborative agreement with a physician for prescriptive authority for controlled substances as
mandated by state law [CORRECT]
C. NPs in New Jersey require direct physician supervision for all patient encounters and cannot write any
prescriptions
D. NPs in New Jersey have full practice authority identical to physicians in all specialties without any
restrictions
Correct Answer: B
Rationale: New Jersey is a reduced practice authority state: NPs must have a collaborative agreement with a physician,
particularly for prescriptive authority of controlled substances (CDS). While NPs can evaluate, diagnose, and treat
independently after meeting supervision requirements, the collaborative agreement for CDS prescribing remains. Option
A describes full practice authority states (e.g., Arizona, Colorado). Option C is overly restrictive. Option D is incorrect
as NP scope is defined by their certification and collaborative requirements.
Q2: An NP encounters a patient who refuses a recommended biopsy after full explanation of risks, benefits, and
alternatives. The patient demonstrates decisional capacity. Which ethical principle and legal obligation guide
the NP's response?
A. Beneficence requires the NP to override the refusal because the biopsy is medically necessary
B. Paternalism justifies proceeding with the biopsy against the patient's wishes for their own good
C. Respect for autonomy requires the NP to honor the competent patient's informed refusal, while documenting
the discussion, risks of refusal, and the patient's decision-making capacity [CORRECT]
D. Justice requires equal treatment, so the NP should force compliance since other patients would undergo the
biopsy
Correct Answer: C
Rationale: Respect for autonomy is the foundational ethical principle: a patient with decisional capacity has the right to
refuse treatment even if it leads to harm. The NP must ensure informed refusal (understanding risks, benefits,
alternatives) and document capacity assessment and discussion. Option A conflates beneficence with overriding
autonomy. Option B is paternalism, which is ethically inappropriate with a competent patient. Option D misapplies
justice, which refers to fair distribution of resources, not forced compliance.
Q3: During the RN-to-APRN role transition, which conceptual change most distinguishes the advanced
practice role from the bedside RN role?
A. Moving from a dependent role executing physician orders to an independent clinical decision-maker who
formulates differential diagnoses, orders and interprets diagnostic tests, and develops comprehensive
management plans [CORRECT]
B. Transitioning from direct patient care to exclusively administrative and managerial responsibilities
C. Shifting from evidence-based practice to intuition-based clinical reasoning
D. Changing from interprofessional collaboration to autonomous practice without any team interaction
Correct Answer: A
Rationale: The RN-to-APRN transition involves moving from a dependent, protocol-driven role to an independent
diagnostic and prescriptive authority role. APRNs formulate differential diagnoses, independently order and interpret
tests, and manage treatment plans. Option B incorrectly suggests leaving clinical care. Option C reverses the evidence
trajectory (APRNs use more EBP, not less). Option D misrepresents the collaborative nature of APRN practice.
Page 2
, NUR 6111: Adv Nursing Practice I | WPU | Spring 2026
Q4: An NP working in an interprofessional primary care team includes a physician, pharmacist, social worker,
and medical assistant. Which interprofessional collaboration principle is most essential for optimal patient
outcomes?
A. Hierarchical communication where the physician directs all team decisions and other members follow orders
B. Shared decision-making with mutual respect, clear role delineation, effective communication using SBAR or
similar structured frameworks, and recognition that each discipline contributes unique expertise to
patient-centered care [CORRECT]
C. Parallel practice where each provider independently manages their aspect of care without communication
D. Conflict avoidance by deferring all disagreements to the most senior team member
Correct Answer: B
Rationale: Effective interprofessional collaboration requires mutual respect, shared decision-making, clear
communication (SBAR, huddles), and valuing each discipline's expertise. The IPEC competencies emphasize these core
principles. Option A describes hierarchical practice, not collaboration. Option C describes siloed/parallel practice.
Option D suppresses constructive debate that improves care quality.
Q5: A 75-year-old patient with mild cognitive impairment is asked to consent for a complex surgical procedure.
Which elements must be present for informed consent to be valid?
A. A signed consent form witnessed by any hospital staff member is sufficient
B. Disclosure of the nature of the procedure, risks, benefits, and alternatives; patient understanding of the
information; voluntary decision without coercion; and patient capacity to make the decision [CORRECT]
C. The physician's recommendation alone constitutes adequate informed consent if documented in the chart
D. Informed consent is unnecessary if the procedure is medically indicated and the family agrees
Correct Answer: B
Rationale: Valid informed consent requires four elements: (1) disclosure (nature, risks, benefits, alternatives), (2)
understanding (patient comprehends the information), (3) voluntariness (no coercion), and (4) capacity (ability to reason
and decide). With mild cognitive impairment, capacity assessment is crucial. Option A is legally insufficient (form alone
does not ensure understanding). Option C omits patient involvement. Option D violates autonomy; family consent
cannot replace patient consent when the patient has capacity.
Q6: An NP discovers that a colleague has been prescribing opioids inappropriately to multiple patients. Which
ethical and legal obligation applies?
A. Loyalty to colleagues supersedes reporting obligations; the NP should address it informally only
B. The NP has a professional and legal mandatory reporting obligation to the appropriate state board and/or
DEA, as patient safety and nonmaleficence take precedence over collegial loyalty [CORRECT]
C. The NP should wait until a patient files a formal complaint before taking any action
D. Reporting is optional because it could damage the NP's professional relationships
Correct Answer: B
Rationale: Mandatory reporting laws and the ethical duty of nonmaleficence require reporting impaired or unethical
colleagues to protect patients. Professional loyalty does not supersede patient safety. State nurse practice acts and DEA
regulations impose reporting obligations. Option A prioritizes collegial loyalty over patient safety. Option C delays
necessary action. Option D mischaracterizes reporting as optional rather than obligatory.
Q7: According to the 2026 AACN Essentials for doctoral education, which domain encompasses the advanced
practice nurse's role in health policy advocacy?
A. Domain 1: Knowledge for Nursing Practice
B. Domain 8: Informatics and Healthcare Technologies
C. Domain 7: Health Policy and Advocacy, which includes engaging in policy development, analyzing policy
impact on health equity, and advocating for legislative changes that expand APRN practice authority and
improve population health outcomes [CORRECT]
D. Domain 3: Population Health
Correct Answer: C
Page 3
NUR 6111: ADVANCED NURSING PRACTICE I
COMPREHENSIVE EXAM | SPRING 2026 UPDATE
Advanced Practice Role Transition & Scope of Practice
Comprehensive Health Assessment & Diagnostic Reasoning
Foundational Pathophysiology & Pharmacology Principles
Evidence-Based Practice, QI, & 2026 Updates
William Paterson University | Graduate Nursing (APRN)
2026 | 2027 Academic Standards
Specification Detail
Total Questions 40
Points per Question 2.5
Total Points 100
Cognitive Mix 30% Recall / 50% Application / 20% Analysis
Question Style 75% Scenario-Based / 25% Direct
Format Multiple Choice (A-D), One Correct
Sections 4 (10 questions each)
Institution William Paterson University
Page 1
, NUR 6111: Adv Nursing Practice I | WPU | Spring 2026
PART 1: EXAM QUESTIONS
Section 1: Advanced Practice Role, Scope, Ethics, & Interprofessional
Collaboration
Q1: A newly graduated FNP in New Jersey is establishing an independent practice. Under current 2026 New
Jersey state regulations, which statement most accurately describes NP practice authority?
A. NPs in New Jersey have full independent practice authority without any physician collaboration requirement
B. NPs in New Jersey may practice independently after completing a supervised practice period, but must
maintain a collaborative agreement with a physician for prescriptive authority for controlled substances as
mandated by state law [CORRECT]
C. NPs in New Jersey require direct physician supervision for all patient encounters and cannot write any
prescriptions
D. NPs in New Jersey have full practice authority identical to physicians in all specialties without any
restrictions
Correct Answer: B
Rationale: New Jersey is a reduced practice authority state: NPs must have a collaborative agreement with a physician,
particularly for prescriptive authority of controlled substances (CDS). While NPs can evaluate, diagnose, and treat
independently after meeting supervision requirements, the collaborative agreement for CDS prescribing remains. Option
A describes full practice authority states (e.g., Arizona, Colorado). Option C is overly restrictive. Option D is incorrect
as NP scope is defined by their certification and collaborative requirements.
Q2: An NP encounters a patient who refuses a recommended biopsy after full explanation of risks, benefits, and
alternatives. The patient demonstrates decisional capacity. Which ethical principle and legal obligation guide
the NP's response?
A. Beneficence requires the NP to override the refusal because the biopsy is medically necessary
B. Paternalism justifies proceeding with the biopsy against the patient's wishes for their own good
C. Respect for autonomy requires the NP to honor the competent patient's informed refusal, while documenting
the discussion, risks of refusal, and the patient's decision-making capacity [CORRECT]
D. Justice requires equal treatment, so the NP should force compliance since other patients would undergo the
biopsy
Correct Answer: C
Rationale: Respect for autonomy is the foundational ethical principle: a patient with decisional capacity has the right to
refuse treatment even if it leads to harm. The NP must ensure informed refusal (understanding risks, benefits,
alternatives) and document capacity assessment and discussion. Option A conflates beneficence with overriding
autonomy. Option B is paternalism, which is ethically inappropriate with a competent patient. Option D misapplies
justice, which refers to fair distribution of resources, not forced compliance.
Q3: During the RN-to-APRN role transition, which conceptual change most distinguishes the advanced
practice role from the bedside RN role?
A. Moving from a dependent role executing physician orders to an independent clinical decision-maker who
formulates differential diagnoses, orders and interprets diagnostic tests, and develops comprehensive
management plans [CORRECT]
B. Transitioning from direct patient care to exclusively administrative and managerial responsibilities
C. Shifting from evidence-based practice to intuition-based clinical reasoning
D. Changing from interprofessional collaboration to autonomous practice without any team interaction
Correct Answer: A
Rationale: The RN-to-APRN transition involves moving from a dependent, protocol-driven role to an independent
diagnostic and prescriptive authority role. APRNs formulate differential diagnoses, independently order and interpret
tests, and manage treatment plans. Option B incorrectly suggests leaving clinical care. Option C reverses the evidence
trajectory (APRNs use more EBP, not less). Option D misrepresents the collaborative nature of APRN practice.
Page 2
, NUR 6111: Adv Nursing Practice I | WPU | Spring 2026
Q4: An NP working in an interprofessional primary care team includes a physician, pharmacist, social worker,
and medical assistant. Which interprofessional collaboration principle is most essential for optimal patient
outcomes?
A. Hierarchical communication where the physician directs all team decisions and other members follow orders
B. Shared decision-making with mutual respect, clear role delineation, effective communication using SBAR or
similar structured frameworks, and recognition that each discipline contributes unique expertise to
patient-centered care [CORRECT]
C. Parallel practice where each provider independently manages their aspect of care without communication
D. Conflict avoidance by deferring all disagreements to the most senior team member
Correct Answer: B
Rationale: Effective interprofessional collaboration requires mutual respect, shared decision-making, clear
communication (SBAR, huddles), and valuing each discipline's expertise. The IPEC competencies emphasize these core
principles. Option A describes hierarchical practice, not collaboration. Option C describes siloed/parallel practice.
Option D suppresses constructive debate that improves care quality.
Q5: A 75-year-old patient with mild cognitive impairment is asked to consent for a complex surgical procedure.
Which elements must be present for informed consent to be valid?
A. A signed consent form witnessed by any hospital staff member is sufficient
B. Disclosure of the nature of the procedure, risks, benefits, and alternatives; patient understanding of the
information; voluntary decision without coercion; and patient capacity to make the decision [CORRECT]
C. The physician's recommendation alone constitutes adequate informed consent if documented in the chart
D. Informed consent is unnecessary if the procedure is medically indicated and the family agrees
Correct Answer: B
Rationale: Valid informed consent requires four elements: (1) disclosure (nature, risks, benefits, alternatives), (2)
understanding (patient comprehends the information), (3) voluntariness (no coercion), and (4) capacity (ability to reason
and decide). With mild cognitive impairment, capacity assessment is crucial. Option A is legally insufficient (form alone
does not ensure understanding). Option C omits patient involvement. Option D violates autonomy; family consent
cannot replace patient consent when the patient has capacity.
Q6: An NP discovers that a colleague has been prescribing opioids inappropriately to multiple patients. Which
ethical and legal obligation applies?
A. Loyalty to colleagues supersedes reporting obligations; the NP should address it informally only
B. The NP has a professional and legal mandatory reporting obligation to the appropriate state board and/or
DEA, as patient safety and nonmaleficence take precedence over collegial loyalty [CORRECT]
C. The NP should wait until a patient files a formal complaint before taking any action
D. Reporting is optional because it could damage the NP's professional relationships
Correct Answer: B
Rationale: Mandatory reporting laws and the ethical duty of nonmaleficence require reporting impaired or unethical
colleagues to protect patients. Professional loyalty does not supersede patient safety. State nurse practice acts and DEA
regulations impose reporting obligations. Option A prioritizes collegial loyalty over patient safety. Option C delays
necessary action. Option D mischaracterizes reporting as optional rather than obligatory.
Q7: According to the 2026 AACN Essentials for doctoral education, which domain encompasses the advanced
practice nurse's role in health policy advocacy?
A. Domain 1: Knowledge for Nursing Practice
B. Domain 8: Informatics and Healthcare Technologies
C. Domain 7: Health Policy and Advocacy, which includes engaging in policy development, analyzing policy
impact on health equity, and advocating for legislative changes that expand APRN practice authority and
improve population health outcomes [CORRECT]
D. Domain 3: Population Health
Correct Answer: C
Page 3
