ANCC AGACNP
FRANCES GUIDE REVIEW
500+ Practice Qs w/ Ans
board-exam preparation
Main Features:
• Focused ANCC AGACNP board-exam review
• Extensive collection of practice questions
• Helpful for identifying knowledge gaps
• Covers high-yield acute care concepts
• Supports structured study and final revision
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, AGACNP - FRANCES GUIDE REVIEW MATERIALS
1. You want to get more funding for your hospital's Rapid Response Team. How should you present
this issue to the committee?
A. Stress importance of the team (look up evidence about how team affects outcomes)
B. Describe how to improve and expand the team
Answer: a. stress importance of team
2. What is the best way for the AGACNP to get involved in policy making?
A. attend legislative days at the state capitol
B. join a hospital committee
C. write your local congressman
D. review literature and give more in-services
Answer: b. join a hospital committee
3. What is the best way for the AGACNP to demonstrate and advocate for full scope of practice?
A. join a hospital committee
B. petition the government
C. bill for independent services
D. start your own practice
Answer: c. bill for independent services
4. Which of the following is considered a high acuity role for the AGACNP?
A. primary care clinic
B. cardiology office
C. community health department
D. minute clinic
Answer: b. cardiology office
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5. What is the best way to advocate for gay and lesbian population?
A. participate in a high state or national level
B. join a non-profit advocacy group
C. consider lobbying the government
D. start at your facility
Answer: d. start at your facility
Note: Answers are worded differently. "decrease bias in healthcare"
"create in-servises in healthcare" "obtain funding to increase access"
6. Which of the following is most important to evaluate statistical significance when reviewing the
literature?
A. consider the sample size
B. make sure the confidence interval is tight
C. see if the p-value is less than the alphacoefficient
D. determine the error rate
Answer: a. consider the sample size
7. When closing a practice, the NP is required to do all of the following except
A. give the patient adequate time to find another provder
B. keep all of the patient's records for a minimum of five years
C. send a certified letter with a return receipt requested
D. provide names of other providers for future care
Answer: c. send a certified letter with a return receipt requested
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8. Which of the following components of an evidenced based research process is the most important
for NP to participate in?
A. specifying methods of data collection
B. formulating the hypothesis
C. carefully reviewing the literature
D. formulating the research problem
Answer: d. formulating the research problem
9. A former pt of an NP is writing blog posts, sending emails, and distributing false, accusatory
statements about the NP's practice. Which of the following forms of defamation is this?
A. libel
B. slander
Answer: a. libel
10. Can you tell the patient's wife, for her protection, that her husband has HIV?
Answer: No, not without his permission
11. How can the ANCP prepare to get involved in future mass casualty event?
Answer: Pre enroll in disaster volunteer program
12. An 80 year old male patient with dementia requires long-term care placement. To which funding
agency does the patient apply after "spending down" to qualify?
Answer: Medicaid
13. Your patient is worried about insurance coverage and asks you for advice on Medicaid. You
instruct the patient that Medicaid:
Answer: Pays after insurance and 3rd party payers have paid
14. You are giving a dinner presentation to a group. The pharmaceutical rep calls you the night before
and wants you to say that their drug is the only one that workds. What ethical principles does this
challenge?
Answer: Veracity and fidelity
15. Health literacy
Answer: Average american: 8th grade level
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16. Quality assurance
Answer: A process for evaluating the care of patients using established standards of care to ensure
quality
17. CPI
Answer: Measures structure, processes, and outcomes
18. A root cause analysis of a crisis situation in the ICU identified a lack of clinician-family
communication as the basis for the resulting adverse outcome. As part of the performance
improvement plan, the NP is asked to develop evidence-based policies to establish clinician-family
communication standards in the unit. These policies should include:
Answer: Guidelines for having discussions with family members that are geared toward
establishing treatment goals
19. Which clinical scenario does the NP evaluate for a quality improvement process change?
Answer: An increased incidence of postoperative sternal wound infections
20. Goals set forth in healthy people 2020 by the US department of Health and Human services
include:
Answer: elimination of health disparities (and increased QOL/LOL)
21. Based on the individual's culture, ethnicity, and personal choices, the NP can optimize the
therapeutic partnership with the patient by:
Answer: Tailoring his or her communication style to the patient's preference
22. A 70 year old patient with a history of DM, HTN, OAs, and a new diagnosis of CAD, is being
discharged. The adult-gerontology acute care NP teaches the patient that the first point of contact for
health care needs is the:
Answer: PCP
23. The NP is asked to provide evidence to the hospital administration about the safety of NP placing
central lines. Which resource provides the strongest level of evidence?
Answer: A systematic review (meta analysis)
24. What legislation allowed NPs to be recognized Medicare providers in all geographical areas with
their own provider number?
Answer: Balanced Budget act
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25. True/false: restraining an unwilling patient is grounds for malpractice?
Answer: False, if they are a danger you can restrain
26. Patient presents to the clinic for routine f/u and passes out. You revive the patient and admit
overnight. Which of the following would qualify as incident to billing?
Answer: Temperature and weight recording
27. The NP program initiated, primarily, because of what issue in healthcare at the time?
Answer: Pediatric physician shortage
28. Elderly patient takes a turn for the worse. The husband is crying when you enter the room and
begins telling you what end-of-life care he prefers. What do you do?
Answer: Ask him to speak candidly with you
29. Patient calls to complain about bills and states he has Medicare, which should cover all costs. You
explain:
Answer: Since you are healthy, exams are not covered
30. Doc calls from another center asking if you can tell him what kind of orders he should give for
maintenance of patient...
Answer: No, HIPPA
31. Patient in ER not doing well, primary MD calls:
Answer: Give him info
32. NP working on ESRD research project. A colleague renal specialist asks for patient info on your
patients:
Answer: HIPAA breach
33. Who enforces HIPAA?
Answer: Office of Civil Rights/Dept Health and Human Services
34. Who isn't covered by HIPAA?
Answer: Law enforcment/municipal offices, CPS/Schools, employers/workman's comp, life
insurance
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35. Insurance company calling to verify some patient appointments?
Answer: Answer by picking out that there is already a medical release signed by the patient and
give the requested information to them
36. Benchmarking
Answer: How institution compares with similar organizations
37. Managed care
Answer: Know what this is and how it has improved costs, something about putting caps on
payments
38. Peer review
Answer: Timely, not anonymous, and NP knows how peer review will impact yearly evaluation
39. Sensitivity vs specificity
Answer: Sensitivity: true positives, specificity: true negatives
There was a question where a patient had a multinodular goiter and wanted to know why the NP
was not going to do periodic
US and fine needle biopsy in monitoring for some kind of cancer or complication. The answer I
picked was that these tests were not very specific to detect the cancer
40. Reliability
Answer: When implementing a new study, tested over and over, the consistency of a measurement
or the degree to which an instrument measures the same way over time
41. Validity of results in an article
Answer: P-value, probability of falsely rejecting the null hypothesis, want it to be <0.05
42. Statistical significance
Answer: Look at sample size and p value
43. Privileging
Answer: May be granted in full or part by the hospital, credentialing committee is made of
physicians
44. Who determines scope of practice?
Answer: State practice acts but institutional bylaws may further restrict practice (facility limited
scope of practice)
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45. Informed consent
Answer: A state indicating patient has received adequate instruction/information regarding aspects
of care to make a prudent, personal choice regarding such, includes risks and benefits, competence:
ability to communicate, understand, reason, differentiate good and bad
46. Case management
Answer: Mobilize, mointor, and control resources that a patient uses during course of an illness
while balancing quality and cost,
"move patients through the system appropriately"
47. 50-60 year old patient ith a new diagnosis of cancer. To appropriately plan for discharge, what
should the NP do?
A. consult CM
B. Consult SW
C. refer to Oncology
D. refer to Hospice
Answer: a. consult CM
48. Nondisclosure
Answer: Not disclosing patient PHI without permission
49. Negligence
Answer: Failure of individual to do what any reasonable person would do, resulting in injury to the
patient
50. When serving as a nurse researcher, the NP is guided by which ethical principle to ensure that
research participants are protected from harm or exploitation?
Answer: Nonmaleficence
51. Living will
Answer: Health care proxy/POA
52. NP sees a patient for HF and performs an H&P. What % is expected to be paid?
Answer: Medicare pays 80% of the total bill, pt pays 20%, NP is reimbursed 85% of what the MD is
reimbursed for physician services, and for procedure 80% of that 85%
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53. Focus of palliative care
Answer: Basic improvement in QOL of anyone with an illness at any stage
54. Hospice
Answer: <6m to live
55. Scope of practice: integration of care across the acute illness continuum with:
A. collaboration
B. coordination of care
C. research based clinical practice
Answer: a. collaboration
56. Collaboration
Answer: True partnership in which all players have the desire power, share common goals, and
recognize/accept separate areas of responsibility/activity
57. Patient is getting d/c'd and need wound care, pulmonary, and follow up. NP's role is to:
Answer: Coordinate services
58. Government is moving towards being cost effective. What is the best way?
Answer: Allow NP to treat a wider variety of patients
59. Protected health information: discussion between the NP and consultant on case
Answer: Considered clinical relevance
60. How should the ACNP stay up to date with current information?
Answer: Evidence based guidelines
61. Which medicare is Hospice covered under?
Answer: Medicare A
62. A patient presents to the Er with c/o CP and SOB. The NP misinterprets the EKG and admits the
patient fro further monitoring without consulting cardio. Later in the shift, the patient decompensates
and goes into cardiac arrest. The patient was resuscitated but sustained permanent brain damage.
What grounds of malpractice is the NP accountable for?
Answer: Lack of skill
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63. Healthcare exchange
Answer: Health insurance marketplaces, organizations in each state through which people can
purchase health insurance
64. You notice there have been less favorable outcomes and satisfaction surveys in patients treated
for sickle cell anemia. How do you approach this problem?
A. ask the patients treated how care can be improved
B. look back at prior treatment given to see how outcomes can be improved
C. form a standardized tx plan for all patients that can be used by all healthcare staff
D. form individualized tx plans that can be used by all healthcare staff
Answer: c. form a standardized tx plan for all patients that can be used by all healthcare staff
65. You have transferred a patient to the SNF. The MD in charge at that facility calls for info about the
patient's medical care, what do you do?
A. direct him to look it up in the EMR
B. refuse to share protected health information
C. instruct him to call the department head
D. share the information he requests
Answer: d. share the information he requests
66. Your patient has refused human blood products based on religious beliefs. He is now rapidly
destabilizing. What do you do?
A. administer PRBCs as needed
B. call the ethics committee
C. continue to research alternative treatments
D. ask the family to give permission now that he's unconscious
Answer: c. continue to research alternative treatments
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