NURS 6531 FINAL EXAM: ADVANCED
PRACTICE NURSING ROLES
1. When a Nurse Practitioner (NP) provides care under ‘incident-to’ billing guidelines, what is
the required level of physician supervision?
A. The physician must be present in the same office suite and immediately available.
B. The physician must be physically present in the same room as the NP and patient.
C. The physician must be reachable by telephone at all times.
D. The physician must review and sign the NP’s chart within 24 hours.
Answer: A
Conceptual Explanation: For ‘incident-to’ billing at 100% of the physician fee schedule,
Medicare requires the physician to be physically present in the office suite and immediately
available to provide assistance, though not necessarily in the room.
2. Under the Consensus Model for APRN Regulation, which of the following are the four
recognized APRN roles?
A. NP, Nurse Educator, CNS, and CNM
B. NP, CNS, Case Manager, and CRNA
,C. NP, CNS, CRNA, and CNM
D. NP, Nurse Administrator, CRNA, and CNS
Answer: C
Conceptual Explanation: The LACE Consensus Model recognizes four distinct roles:
Certified Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered
Nurse Anesthetist (CRNA), and Certified Nurse-Midwife (CNM).
3. A Nurse Practitioner is switching from a ‘claims-made’ malpractice insurance policy to a
new provider. What must the NP purchase to ensure coverage for potential incidents that
occurred during the ‘claims-made’ period but have not yet been filed?
A. Tail coverage
B. Occurrence coverage
C. Gap liability insurance
D. Retroactive indemnity
Answer: A
Conceptual Explanation: Tail coverage (Extended Reporting Period) is necessary for
claims-made policies to cover any claims filed after the policy is terminated for events that
happened while the policy was active.
, 4. Which of the following elements is NOT required to establish a prima facie case of
negligence in a malpractice suit against an NP?
A. A duty to the patient existed.
B. A breach of the standard of care occurred.
C. The NP intended to cause harm to the patient.
D. Proximate cause linked the breach to the injury.
Answer: C
Conceptual Explanation: Malpractice is based on negligence, not intent. The four elements
are duty, breach of duty, causation (proximate cause), and damages/injury.
5. Medicare Part B reimbursement for services provided by a Nurse Practitioner who bills
under their own NPI number is typically what percentage of the Physician Fee Schedule?
A. 100%
B. 85%
C. 95%
D. 75%
Answer: B
Conceptual Explanation: When billing under their own National Provider Identifier (NPI),
NPs are reimbursed at 85% of the physician rate according to Medicare Part B rules.
PRACTICE NURSING ROLES
1. When a Nurse Practitioner (NP) provides care under ‘incident-to’ billing guidelines, what is
the required level of physician supervision?
A. The physician must be present in the same office suite and immediately available.
B. The physician must be physically present in the same room as the NP and patient.
C. The physician must be reachable by telephone at all times.
D. The physician must review and sign the NP’s chart within 24 hours.
Answer: A
Conceptual Explanation: For ‘incident-to’ billing at 100% of the physician fee schedule,
Medicare requires the physician to be physically present in the office suite and immediately
available to provide assistance, though not necessarily in the room.
2. Under the Consensus Model for APRN Regulation, which of the following are the four
recognized APRN roles?
A. NP, Nurse Educator, CNS, and CNM
B. NP, CNS, Case Manager, and CRNA
,C. NP, CNS, CRNA, and CNM
D. NP, Nurse Administrator, CRNA, and CNS
Answer: C
Conceptual Explanation: The LACE Consensus Model recognizes four distinct roles:
Certified Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered
Nurse Anesthetist (CRNA), and Certified Nurse-Midwife (CNM).
3. A Nurse Practitioner is switching from a ‘claims-made’ malpractice insurance policy to a
new provider. What must the NP purchase to ensure coverage for potential incidents that
occurred during the ‘claims-made’ period but have not yet been filed?
A. Tail coverage
B. Occurrence coverage
C. Gap liability insurance
D. Retroactive indemnity
Answer: A
Conceptual Explanation: Tail coverage (Extended Reporting Period) is necessary for
claims-made policies to cover any claims filed after the policy is terminated for events that
happened while the policy was active.
, 4. Which of the following elements is NOT required to establish a prima facie case of
negligence in a malpractice suit against an NP?
A. A duty to the patient existed.
B. A breach of the standard of care occurred.
C. The NP intended to cause harm to the patient.
D. Proximate cause linked the breach to the injury.
Answer: C
Conceptual Explanation: Malpractice is based on negligence, not intent. The four elements
are duty, breach of duty, causation (proximate cause), and damages/injury.
5. Medicare Part B reimbursement for services provided by a Nurse Practitioner who bills
under their own NPI number is typically what percentage of the Physician Fee Schedule?
A. 100%
B. 85%
C. 95%
D. 75%
Answer: B
Conceptual Explanation: When billing under their own National Provider Identifier (NPI),
NPs are reimbursed at 85% of the physician rate according to Medicare Part B rules.
