NURS 5350 Module 7 Quiz V3 | NURS 5350
Role of the Nurse in Advanced Practice |
Actual Q&A with Rationale (NURS5350
Module 7 Quiz) | The University of Texas
at Arlington
1. Which component of the LACE model is defined as the formal recognition of the
knowledge, skills, and experience demonstrated by the achievement of standards identified
by the profession?
A. Licensure
B. Accreditation
C. Certification
D. Education
Answer: C
Rationale: Certification is the process by which a non-governmental agency validates an
individual nurse’s qualifications and knowledge for a specific practice area. It is a critical
component of the LACE model, which also includes Licensure, Accreditation, and Education
to ensure regulatory uniformity. This validation provides the public and employers with
evidence that the APRN has met established national standards for specialty practice.
,2. According to the APRN Consensus Model, which of the following is considered one of the
four recognized APRN roles?
A. Nurse Educator
B. Nurse Administrator
C. Certified Registered Nurse Anesthetist
D. Forensic Nurse Consultant
Answer: C
Rationale: The APRN Consensus Model recognizes four distinct roles: Certified Nurse-
Midwife (CNM), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist
(CRNA), and Certified Nurse Practitioner (CNP). These roles are defined by their specific
focus on direct patient care at an advanced level. This model was developed to provide a
uniform framework for the regulation and practice of all APRNs across different states.
3. What percentage of the physician fee schedule is typically reimbursed to an APRN by
Medicare for the same service?
A. 100%
B. 75%
C. 85%
D. 90%
Answer: C
,Rationale: Currently, Medicare Part B reimburses Nurse Practitioners and Clinical Nurse
Specialists at 85% of the Physician Fee Schedule for services rendered. This
reimbursement rate is a significant policy issue often discussed in professional advocacy
regarding pay equity for advanced practice providers. Understanding these financial
structures is essential for the APN involved in practice management or billing oversight.
4. Which type of professional liability insurance covers an APRN only for incidents that occur
and are reported while the policy is active?
A. Occurrence Policy
B. Claims-Made Policy
C. Umbrella Policy
D. Tail Coverage
Answer: B
Rationale: A Claims-Made policy provides coverage only if the claim is made while the
policy is in effect. If the policy is cancelled and a claim is filed later for an incident that
happened during the coverage period, it will not be covered unless ‘tail’ coverage is
purchased. This differs from an Occurrence policy, which covers any incident that
happened while the policy was active, regardless of when the claim is filed.
5. What is the primary purpose of the National Provider Identifier (NPI) number for the
APRN?
A. To track continuing education credits
, B. To authorize the prescription of controlled substances
C. To grant hospital admitting privileges
D. To provide a unique identification for billing and administrative transactions
Answer: D
Rationale: The NPI is a unique 10-digit identification number mandated by HIPAA for
healthcare providers to use in standard administrative and financial transactions. It is
required for all providers who are ‘covered entities’ under HIPAA, including APRNs who
bill for services. This identifier stays with the provider for their entire career, regardless of
location or practice changes.
6. When an APRN bills for services that are provided in a physician’s office but are physically
performed by the NP, and meet specific criteria for 100% reimbursement, this is known as:
A. Direct Billing
B. Global Billing
C. Split/Shared Billing
D. Incident-To Billing
Answer: D
Rationale: Incident-to billing refers to services provided by a non-physician practitioner
that are billed under a physician’s NPI to receive 100% of the fee schedule. Specific
requirements must be met, including the physician being in the office suite and the service
Role of the Nurse in Advanced Practice |
Actual Q&A with Rationale (NURS5350
Module 7 Quiz) | The University of Texas
at Arlington
1. Which component of the LACE model is defined as the formal recognition of the
knowledge, skills, and experience demonstrated by the achievement of standards identified
by the profession?
A. Licensure
B. Accreditation
C. Certification
D. Education
Answer: C
Rationale: Certification is the process by which a non-governmental agency validates an
individual nurse’s qualifications and knowledge for a specific practice area. It is a critical
component of the LACE model, which also includes Licensure, Accreditation, and Education
to ensure regulatory uniformity. This validation provides the public and employers with
evidence that the APRN has met established national standards for specialty practice.
,2. According to the APRN Consensus Model, which of the following is considered one of the
four recognized APRN roles?
A. Nurse Educator
B. Nurse Administrator
C. Certified Registered Nurse Anesthetist
D. Forensic Nurse Consultant
Answer: C
Rationale: The APRN Consensus Model recognizes four distinct roles: Certified Nurse-
Midwife (CNM), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist
(CRNA), and Certified Nurse Practitioner (CNP). These roles are defined by their specific
focus on direct patient care at an advanced level. This model was developed to provide a
uniform framework for the regulation and practice of all APRNs across different states.
3. What percentage of the physician fee schedule is typically reimbursed to an APRN by
Medicare for the same service?
A. 100%
B. 75%
C. 85%
D. 90%
Answer: C
,Rationale: Currently, Medicare Part B reimburses Nurse Practitioners and Clinical Nurse
Specialists at 85% of the Physician Fee Schedule for services rendered. This
reimbursement rate is a significant policy issue often discussed in professional advocacy
regarding pay equity for advanced practice providers. Understanding these financial
structures is essential for the APN involved in practice management or billing oversight.
4. Which type of professional liability insurance covers an APRN only for incidents that occur
and are reported while the policy is active?
A. Occurrence Policy
B. Claims-Made Policy
C. Umbrella Policy
D. Tail Coverage
Answer: B
Rationale: A Claims-Made policy provides coverage only if the claim is made while the
policy is in effect. If the policy is cancelled and a claim is filed later for an incident that
happened during the coverage period, it will not be covered unless ‘tail’ coverage is
purchased. This differs from an Occurrence policy, which covers any incident that
happened while the policy was active, regardless of when the claim is filed.
5. What is the primary purpose of the National Provider Identifier (NPI) number for the
APRN?
A. To track continuing education credits
, B. To authorize the prescription of controlled substances
C. To grant hospital admitting privileges
D. To provide a unique identification for billing and administrative transactions
Answer: D
Rationale: The NPI is a unique 10-digit identification number mandated by HIPAA for
healthcare providers to use in standard administrative and financial transactions. It is
required for all providers who are ‘covered entities’ under HIPAA, including APRNs who
bill for services. This identifier stays with the provider for their entire career, regardless of
location or practice changes.
6. When an APRN bills for services that are provided in a physician’s office but are physically
performed by the NP, and meet specific criteria for 100% reimbursement, this is known as:
A. Direct Billing
B. Global Billing
C. Split/Shared Billing
D. Incident-To Billing
Answer: D
Rationale: Incident-to billing refers to services provided by a non-physician practitioner
that are billed under a physician’s NPI to receive 100% of the fee schedule. Specific
requirements must be met, including the physician being in the office suite and the service
