COMPREHENSIVE EXAM ASSESSMENT
NR 668 CEA
Final Exam
Actual Questions and Answers — 125 capstone-level
examination questions across nine advanced practice
competency domains, each with the verified correct
answer and an advanced-practice rationale.
Chamberlain University
Advanced Practice Nursing Education · Practicum Final
Examination Preparation
2 0 2 0 2 7 E D I TI O N · Q U E STI O N S 1 – 1 2 5 · A N SW E RS & RATI O N A L E S
,NR 668 CEA Final Exam (2026/2027) | Chamberlain Practicum | Actual Questions and Answers
Examination Contents
Section 1: Advanced Practice Role Transition and Professional Identity 2
Section 2: Clinical Judgment and Diagnostic Reasoning 8
Section 3: Comprehensive Primary Care Management Across the Lifespan 14
Section 4: Pharmacological and Non-Pharmacological Interventions 24
Section 5: Health Policy, Advocacy, and Systems-Based Practice 31
Section 6: Interprofessional Collaboration and Care Coordination 37
Section 7: Ethical, Legal, and Regulatory Issues in Advanced Practice 42
Section 8: Evidence-Based Practice, Research, and Quality Improvement 49
Section 9: Population Health, Cultural Competence, and Health Equity 55
Total questions: 125 | Format: multiple choice, four options (A-D), one correct answer per question | Correct answers
and rationales appear inline with each question. Sections begin at the page numbers listed above.
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,NR 668 CEA Final Exam (2026/2027) | Chamberlain Practicum | Actual Questions and Answers
SECTION 1 | QUESTIONS 1-12
Section 1: Advanced Practice Role Transition and Professional
Identity
APRN Roles, Scope of Practice, and Professional Organizations
Q1. Which regulatory framework established the LACE (Licensure, Accreditation, Certification, and
Education) model that standardizes Advanced Practice Registered Nurse (APRN) preparation, title
protection, and role delineation across the United States?
A. The APRN Consensus Model (2008) [CORRECT]
B. The Patient Protection and Affordable Care Act (2010)
C. The Institute of Medicine Future of Nursing report (2011)
D. The Nursing Community Coalition Consensus Document (2018)
Correct Answer: A
Rationale: The APRN Consensus Model (2008) is the definitive regulatory framework aligning Licensure,
Accreditation, Certification, and Education for the four APRN roles (CNM, CRNA, CNS, CNP) across six
population foci. The Affordable Care Act addresses healthcare coverage and delivery reform, not APRN
regulation. The IOM Future of Nursing report provided influential workforce recommendations but has no
regulatory authority, and the Nursing Community Coalition document is a position statement rather than a binding
regulatory model.
Q2. A newly certified family nurse practitioner accepts a position in a state that permits independent
evaluation, diagnosis, treatment, and prescribing under the exclusive licensing authority of the board of
nursing. According to the APRN practice environment categories, how should the NP characterize this state,
and what is the corresponding professional implication?
A. Reduced practice; the NP must maintain a formal collaborative agreement with a physician for
prescriptive authority to remain valid
B. Full practice; the NP may evaluate, diagnose, order and interpret tests, and initiate and
manage treatment, including prescribing, without physician oversight [CORRECT]
C. Restricted practice; the NP's career-long supervision, delegation, or team management by another
health discipline is required by state law
D. Transitional practice; the NP may practice independently only after completing a board-mandated
postgraduate mentorship period
Correct Answer: B
Rationale: Full practice states authorize APRNs to evaluate, diagnose, interpret diagnostic tests, and manage
treatment, including prescribing, under the exclusive authority of the board of nursing, which is exactly the
environment described. Reduced practice requires a career-long regulated collaborative agreement, and restricted
practice requires supervision or team management by another discipline, so neither matches the scenario. A
transitional practice category is not one of the three recognized APRN practice environment designations.
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, NR 668 CEA Final Exam (2026/2027) | Chamberlain Practicum | Actual Questions and Answers
Q3. During the first month of practice, a new nurse practitioner reports persistent self-doubt, fear of being
discovered as unprepared, and anxiety when making independent decisions despite excellent academic
preparation and board certification. What is the most appropriate first intervention by the NP?
A. Request a reduction in patient panel size until self-confidence develops over the first year of
practice
B. Return to a registered nurse position in the same organization until competence is firmly established
C. Recognize the experience as a normal stage of role transition and seek mentorship and
structured peer support [CORRECT]
D. Enroll immediately in a doctoral program to close perceived gaps in clinical knowledge before
practicing further
Correct Answer: C
Rationale: Self-doubt and fear of inadequacy during the first months of practice are hallmark features of
transition shock and imposter phenomenon, a well-documented normative experience in RN-to-APRN role
transition; the appropriate response is normalization plus structured mentorship and peer support. Reducing the
panel or returning to an RN role reinforces avoidance and delays role integration. A doctoral program is not
indicated because certification already validates entry-level competence, and more education does not address the
psychosocial work of role transition.
Q4. A nurse practitioner with two years of experience intuitively grasps clinical situations, smoothly shifts
between managing multiple patient problems, and adapts management plans fluidly as presentations evolve.
Using Benner's Novice to Expert framework, which stage does this NP most likely occupy?
A. Advanced beginner, because pattern recognition has replaced rule-based thinking
B. Competent, because two years of deliberate practice produces organizational mastery
C. Proficient, because intuition fully guides decision-making without any conscious analysis
D. Expert, because intuitive grasp of whole situations and fluid, adaptive performance
characterize this level [CORRECT]
Correct Answer: D
Rationale: Benner defines the expert stage by an intuitive grasp of whole clinical situations, fluid performance,
and the ability to adapt flexibly without deliberative rule application, which matches the description. Advanced
beginners still require contextual help and prioritize tasks by rules. Competent practitioners are deliberate,
organized planners who lack the speed and flexibility described, and proficient practitioners demonstrate holistic
perception but still rely on maxims and conscious analysis rather than fully intuitive performance.
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