N5350 ROLES FINAL CERTIFICATION TEST
PAPER 2026 COMPLETE SOLUTIONS GRADED
A PLUS
◉ 1a) Medically Underserved
Answer: *site must be official, physician must be reachable by phone
& must be provided with daily status report of any major problems
outside of the protocol.
*must have protocols.
◉ 1b) Physician Primary Practice Site
Answer: * Must have protocols.
*Sign drug orders only for pts whom the MD has/will establish a
relationship.
*alternate MD may delegate.
*MD may delegate to no more than 7 APNS or PAs.
*Physician on-site visits should be 50% of the time according to
BME.
◉ 1c) Facility Based Practice
Answer: *Must be physically present in facility (hospital or long term
facility).
,*Physician must give prior consent.
*Delegation only at > one hospital or > 2 long term care facilities -
now it is 7 FTEs.
*Long term care-only 4 APNs (APRNs) or 4 PAs or their FTE
equivalent - now it is 7 FTE & approved by Chief Physician of Facility.
*Protocol signed by the Chief Physician.
◉ 1d) Physician Alternate Site
Answer: *No longer in effect.
◉ 2. The FOUR Approved Categories of APN in TX?
Answer: *CRNA, NP, CNS, and CNM
◉ 3. NP requirements by BON for approval of license/ AP
recognition each biennium.
Answer: *Current valid RN licensure.
*400 hours of current clinical practice.
*20 hours of CEs.
*8 hours of continuing education in pharmacotherapeutics.
*Current board certification.
*Separate application for dual roles.
,◉ 4. New NP graduate requirements when applying for the board?
Answer: *Must take and pass national certification exam.
◉ 5. What is the NP's scope of practice based on?
Answer: *Nurse practice acts define legal scope of practice for
licensed practitioners.
*Includes privileges for diagnosis, treatment, prescriptive authority
and reimbursement.
◉ 11. What are clinical privileges and how are they obtained?
Answer: *autonomy to perform expanded role functions based on
the individuals licensure, educational preparation, clinical
experience, and credentials.
*Via contractual agreement with hospitals or long term care
facilities.
◉ 12. Define Malpractice
Answer: *Any professional misconduct, unreasonable lack of skill, or
infidelity in professional or fiduciary duties, or illegal or immoral
conduct.
*Negligence is the failure of an individual to do something that a
reasonable person would do, that results in injury to another.
*The alleged failure on the part of a professional to render services
with the degree of care, diligence, and precaution that another
, member of the same profession in similar circumstances would
render to prevent injury to some one else.
◉ 13. FOUR Elements of Malpractice
Answer: 1. Duty: provide some level of care, had some contact.
2. Dereliction: reasonable, ordinary care, skill and diligence as NP's
in good standing in similar practice.
3. Damage: Must have an injury or no malpractice even if violated
standard of care; cap "pain and suffering" $250,000 to $500, 000.
4. Causation of Injury: For malpractice to have occurred, a breach of
the standard of care must have caused an injury to the patient.
◉ 15. National Practitioner Data Bank
Answer: *Receives and discloses the reports on medical malpractice.
◉ Who is credited to be the first advanced practice nurse role?
Answer: Nurse Anesthesia in 1800's- perhaps the oldest advanced
nursing specialty, Sister Mary Bernard at St. Vincent's Hospital was
the first anesthetist
◉ Who is credited to be the founder of the first nurse practitioner
role?
Answer: Loretta Ford-1965- Colorado
PAPER 2026 COMPLETE SOLUTIONS GRADED
A PLUS
◉ 1a) Medically Underserved
Answer: *site must be official, physician must be reachable by phone
& must be provided with daily status report of any major problems
outside of the protocol.
*must have protocols.
◉ 1b) Physician Primary Practice Site
Answer: * Must have protocols.
*Sign drug orders only for pts whom the MD has/will establish a
relationship.
*alternate MD may delegate.
*MD may delegate to no more than 7 APNS or PAs.
*Physician on-site visits should be 50% of the time according to
BME.
◉ 1c) Facility Based Practice
Answer: *Must be physically present in facility (hospital or long term
facility).
,*Physician must give prior consent.
*Delegation only at > one hospital or > 2 long term care facilities -
now it is 7 FTEs.
*Long term care-only 4 APNs (APRNs) or 4 PAs or their FTE
equivalent - now it is 7 FTE & approved by Chief Physician of Facility.
*Protocol signed by the Chief Physician.
◉ 1d) Physician Alternate Site
Answer: *No longer in effect.
◉ 2. The FOUR Approved Categories of APN in TX?
Answer: *CRNA, NP, CNS, and CNM
◉ 3. NP requirements by BON for approval of license/ AP
recognition each biennium.
Answer: *Current valid RN licensure.
*400 hours of current clinical practice.
*20 hours of CEs.
*8 hours of continuing education in pharmacotherapeutics.
*Current board certification.
*Separate application for dual roles.
,◉ 4. New NP graduate requirements when applying for the board?
Answer: *Must take and pass national certification exam.
◉ 5. What is the NP's scope of practice based on?
Answer: *Nurse practice acts define legal scope of practice for
licensed practitioners.
*Includes privileges for diagnosis, treatment, prescriptive authority
and reimbursement.
◉ 11. What are clinical privileges and how are they obtained?
Answer: *autonomy to perform expanded role functions based on
the individuals licensure, educational preparation, clinical
experience, and credentials.
*Via contractual agreement with hospitals or long term care
facilities.
◉ 12. Define Malpractice
Answer: *Any professional misconduct, unreasonable lack of skill, or
infidelity in professional or fiduciary duties, or illegal or immoral
conduct.
*Negligence is the failure of an individual to do something that a
reasonable person would do, that results in injury to another.
*The alleged failure on the part of a professional to render services
with the degree of care, diligence, and precaution that another
, member of the same profession in similar circumstances would
render to prevent injury to some one else.
◉ 13. FOUR Elements of Malpractice
Answer: 1. Duty: provide some level of care, had some contact.
2. Dereliction: reasonable, ordinary care, skill and diligence as NP's
in good standing in similar practice.
3. Damage: Must have an injury or no malpractice even if violated
standard of care; cap "pain and suffering" $250,000 to $500, 000.
4. Causation of Injury: For malpractice to have occurred, a breach of
the standard of care must have caused an injury to the patient.
◉ 15. National Practitioner Data Bank
Answer: *Receives and discloses the reports on medical malpractice.
◉ Who is credited to be the first advanced practice nurse role?
Answer: Nurse Anesthesia in 1800's- perhaps the oldest advanced
nursing specialty, Sister Mary Bernard at St. Vincent's Hospital was
the first anesthetist
◉ Who is credited to be the founder of the first nurse practitioner
role?
Answer: Loretta Ford-1965- Colorado
