Advanced Practice Nursing exam questions and answers latest 2026

Advanced Practice Nursing exam questions and answers latest 2026 2005 Donabedian Model - Correct Answer - usede to evaluate quality of APRN care - Three quality dimensions 1. structure 2. process 3. outcomes - structure is care delivery context and factors that dictate how providers and patients behave (setting in which care occurs) - process is action taken in the delivery of health care (what is actually done in giving and receiving care) - outcome is the effect of health care on patients and populations (effects of care on the health status of patients and populations) - model is core of all other outcome measurments and role impact models - variables can be studied independently or as a model for overall APRN practice - Nursing role effectiveness model is based on this concept Accountable Care Organizations (ACOs) - Correct Answer - organizations or structures that assume responsibilities for a defined population of patients across a continuum of care, held accountable through payments linked to value, reliable performance measurements demonstrate savings are achieved with imporvements in care - key feature under reform of ACA - desgined to support properly coordinated care within a network (ensure patient care is coordinated and get right care at the right time with goal of avoiding unnecessary duplication of services and preventing medical errors) - Successful ACOs share savings with Medicare Program - create a more integrated system that can coordinate better and improve quality and managing costs created by ACA - give APRN opportunity to demonstrate ability to diagnose, manage, and coordinate care for every type of patient population - shared savings program for ACOs 1. consumer assessment of health care providers and systems (CAHPS) 2. care coordination and patient safety 3. preventative health 4. at risk populations Advanced Practice Nurse Roles - Correct Answer 1. Nurse Practitioner 2. Clinical Nurse Specialist 3. Certified Registered Nurse Anesthetist 4. Certified Nurse Midwife APRN Practice Model - Correct Answer - Consensus model? - Hamric Integrative Model of Advanced Practice Nursing - conceptual definition of APN and define characteristics that include primary critera (graduate education, certification in specialty, focus on Clinical practice with patients) and a set of core competencies (direct clinical practice, collaboration, guidance and coaching, evidence based practice, ethical decision making, consultation, and leadership) - key components: primary critera, seven advanced competencies with direct care as the core, and environmental and contextual factors that must be managed for APN to florish - generic features of APN: 1. use of knowledge in practice 2. critical thinking and analytic skills 3. clinical judgement and decision making 4. professional leadership and clinical inquiry 5. coaching and mentoring 6. research skills 7. changing practice - three sphere of influence aka literature review on CNS practice to further support Hamric theory - first sphere (management of complex or vulnerable populations) three Characteristics of expert direct care, coordination of care and collaboration identified as essential & Second sphere: (educationing and supporting interdisciplinary staff) education, consultation and collaboration are important &third sphere (influence) facilitating innovation and change Benner's Seven Domains of Expert Nursing Practice - Correct Answer - from novice to expert - based on expert practice of clinical nurses - domains are a combination of roles, functions, and competencies - domains not completely differentiated so there is overlap - domains: 1. helping role 2. administering and monitoring therapeutic interventions and regiments 3. effective management of rapidly changing situations 4. diagnostic and monitoring function 5. teaching and coaching funtion 6. monitoring and ensuring quality of health care practices 7. organizational and work role copetencies - is a conceptual model of practice Bundle Payments and health care expenditures - Correct Answer - Also known as bundle payments - Reimburstment of health care providers on the basis of expected cost for clinically defined episodes of care - "middle" ground between fee-for-service and capitation - healthcare delivery system takes on financial risk of patient - Forces system to enhance quality and coordination of care - Incentivizes system to deliver care that truly meets the Triple Aim Caplan's Principles - Correct Answer - broad definition of consultation where any professional activity is carried out by a specialist - indirect service model that involves a process of interaction between two professional consultant and consulted where consultee ask for consultant help in a current work problem that is believed to be within area of specialized competence - client must be lay person who is focus of consultation, consultant is not responsible for implementing interventions, consultee continues to have professional responsibilities for any corrective action, consultee is free to accept or reject suggestions - four major types: 1. Client centered case consultation (traditional, generalist asks a specialist for expert opinion on particular case) 2. Consultee centered case consultation (focused on consultee difficulty in handeling the situation and goal is education for consultee and focus on task and knowledge development & is still about improve patient care) 3. Program centered administrative consultation (focus on work problem that requires planning and administration and expert opinion to provide care & goal is to provide expert consultation around a program administrative question) 4. Consultee centered adminstrative consultation (focus on consultee difficulty with programming/organizational objectives rather than particular patient & goal is to help consultee develop and implement adaptic behaviors to work within administrative boundaries) Certified Nurse Midwife - Correct Answer - history from start of time - isolated communities rely on midwives - "granny midwives" - Fontier Nursing Service (FNS) in 1925 & was decentralized network of nurse run clinics in rural mountains of kentucky - earliest school was the School of the Association for the Promotion and Standardization of Midwifery in 1932 - combination of two disciplines nursing and midwifery - issues with insurance coverage in 1980s because of complex delivery outcomes - 1990s higher demand and expansion in scope of practice - hospitals tried to limit profession and 1980s CNMs work under civilian health and medical program of the uniformed Services for military and were first to recieve reimbursements - 1984 recognized by all states in laws and regulations - can get certification or master degree - no evidence to support doctoral degree and DNP not required Certified Registered Nurse Anesthetist - Correct Answer - history in civil war - typically anesthesia given only when a physician was unavailable - Dr Mayo first to recognize and formally train CRNA in 1889 -Alice Macaw mother of anesthesia (hired by mayo) - early challenges but practice has grown - 1931 Lakeside hospital establishes National Association of Nurse Anesthetists - LA medical association dues Nelson in 1934 for practicing without a license & nelson won but in response Chalmers-Frances filed another suit and judgement was the result only to have CA Supreme Court rule in favor of Nelson again and the practice of nurse anesthisa was legal/in scope as long as it was done under guidance of supervision of physician - reimburstment not clear cut - mandatory certification - master level education - after 2022 must have a doctoral degree CHIP - Correct Answer - Children's Health Insurance Program - Health coverage to uninsured children whose families earn too much to qualify for Mediciad but too little to afford private coverage Clinical Decision Making - Correct Answer Contextual, continuous, and evolving process where data is gathered, interpreted and evaluated in order to select an evidence based choice of action Clinical Nurse Specialist - Correct Answer - evolved out of increasingly complexity of nursing care - roots in psychiatric nursing