# Advanced Practice Nursing: An Integrative
Approach (Hamric, Hanson, Tracy, & O'Grady, 6th
Edition) — Comprehensive Test Bank
**Course:** Master of Science in Nursing (MSN) —
Advanced Practice Nursing
**Textbook:** *Advanced Practice Nursing: An
Integrative Approach*, 6th Edition
**Authors:** Ann B. Hamric, Charlene M. Hanson,
Mary Fran Tracy, & Eileen T. O'Grady
**Publisher:** Elsevier (2019)
**Relevant Certification Exam:** APRN certification
exams (ANCC, AANP, AACN, NCC, AANP) and MSN
program comprehensive exams
**Document Edition:** 6th Edition ONLY —
standalone document
---
## PART 1 of 5: Foundations and Core Competencies of Advanced Practice Nursing — Questions 1–70
---
### Chapter 1: Advanced Practice Nursing: The Nurse-Patient Relationship and Core Competencies —
Questions 1–10
,**Q1.** An MSN student is reviewing the historical development of advanced practice nursing.
Which event is credited with establishing the first clinical nurse specialist (CNS) graduate program in
the United States?
A. The passage of Medicare and Medicaid legislation
B. The establishment of the first CNS program at the University of California, San Francisco
C. The founding of the American Nurses Association
D. The creation of the National League for Nursing
**Correct Answer: B**
**Rationale:** The first CNS graduate program was established at the University of California,
San Francisco in 1965, following the recommendations of the 1965 ANA position paper on nursing
education. Medicare/Medicaid (A) expanded access to care but did not create the CNS role. The ANA
(C) was founded in 1896. The NLN (D) was founded in 1952.
---
**Q2.** A nurse practitioner (NP) is working in a primary care clinic and is asked to define the scope
of practice. Which regulatory mechanism governs the NP's scope of practice?
A. Federal Medicare regulations
B. State nurse practice acts
C. The Joint Commission standards
D. National certification board policies
**Correct Answer: B**
**Rationale:** The scope of practice for NPs is governed primarily by state nurse practice acts,
which vary significantly across states (full practice, reduced, or restricted authority). Federal
Medicare regulations (A) determine reimbursement, not scope of practice. The Joint Commission (C)
accredits facilities. National certification boards (D) set certification standards but do not define legal
scope.
,---
**Q3.** An APRN is reviewing the four recognized APRN roles. Which role is described as providing
direct care in a specific specialty area, often hospital-based, with a focus on improving outcomes for
a defined patient population?
A. Nurse practitioner (NP)
B. Clinical nurse specialist (CNS)
C. Certified registered nurse anesthetist (CRNA)
D. Certified nurse-midwife (CNM)
**Correct Answer: B**
**Rationale:** The CNS provides direct care in a specific specialty area, often within a hospital
or health care system, with a focus on improving outcomes for a defined patient population. The NP
(A) provides primary or acute care across varied settings. The CRNA (C) provides anesthesia services.
The CNM (D) provides women's health and maternity care.
---
**Q4.** An APRN is reviewing the Consensus Model for APRN Regulation. Which statement
accurately describes the purpose of this model?
A. It established a uniform national licensure system for all nurses.
B. It provided a framework for standardizing APRN education, accreditation, certification, and
licensure.
C. It eliminated state-specific regulations for APRNs.
D. It limited APRN practice to hospital settings.
**Correct Answer: B**
, **Rationale:** The Consensus Model for APRN Regulation (2008) provided a framework for
standardizing APRN education, accreditation, certification, and licensure across the four APRN roles.
It did not establish a uniform national licensure system (A), eliminate state regulations (C), or limit
practice settings (D).
---
**Q5.** An APRN is reviewing the core competencies of advanced practice nursing. Which
competency is described as the "central competency" from which all other competencies flow?
A. Direct clinical practice
B. Consultation
C. Research
D. Ethical decision-making
**Correct Answer: A**
**Rationale:** Direct clinical practice is identified as the central competency of advanced
practice nursing from which all other competencies are actualized. Consultation (B), research (C), and
ethical decision-making (D) are important competencies but are not the central competency.
---
**Q6.** An APRN is reviewing the eight core competencies of advanced practice nursing. Which
competency involves the APRN using advanced communication skills to influence patients, families,
and the health care team to promote optimal outcomes?
A. Collaboration
B. Guidance and coaching
C. Leadership
D. Consultation
**Correct Answer: B**
Approach (Hamric, Hanson, Tracy, & O'Grady, 6th
Edition) — Comprehensive Test Bank
**Course:** Master of Science in Nursing (MSN) —
Advanced Practice Nursing
**Textbook:** *Advanced Practice Nursing: An
Integrative Approach*, 6th Edition
**Authors:** Ann B. Hamric, Charlene M. Hanson,
Mary Fran Tracy, & Eileen T. O'Grady
**Publisher:** Elsevier (2019)
**Relevant Certification Exam:** APRN certification
exams (ANCC, AANP, AACN, NCC, AANP) and MSN
program comprehensive exams
**Document Edition:** 6th Edition ONLY —
standalone document
---
## PART 1 of 5: Foundations and Core Competencies of Advanced Practice Nursing — Questions 1–70
---
### Chapter 1: Advanced Practice Nursing: The Nurse-Patient Relationship and Core Competencies —
Questions 1–10
,**Q1.** An MSN student is reviewing the historical development of advanced practice nursing.
Which event is credited with establishing the first clinical nurse specialist (CNS) graduate program in
the United States?
A. The passage of Medicare and Medicaid legislation
B. The establishment of the first CNS program at the University of California, San Francisco
C. The founding of the American Nurses Association
D. The creation of the National League for Nursing
**Correct Answer: B**
**Rationale:** The first CNS graduate program was established at the University of California,
San Francisco in 1965, following the recommendations of the 1965 ANA position paper on nursing
education. Medicare/Medicaid (A) expanded access to care but did not create the CNS role. The ANA
(C) was founded in 1896. The NLN (D) was founded in 1952.
---
**Q2.** A nurse practitioner (NP) is working in a primary care clinic and is asked to define the scope
of practice. Which regulatory mechanism governs the NP's scope of practice?
A. Federal Medicare regulations
B. State nurse practice acts
C. The Joint Commission standards
D. National certification board policies
**Correct Answer: B**
**Rationale:** The scope of practice for NPs is governed primarily by state nurse practice acts,
which vary significantly across states (full practice, reduced, or restricted authority). Federal
Medicare regulations (A) determine reimbursement, not scope of practice. The Joint Commission (C)
accredits facilities. National certification boards (D) set certification standards but do not define legal
scope.
,---
**Q3.** An APRN is reviewing the four recognized APRN roles. Which role is described as providing
direct care in a specific specialty area, often hospital-based, with a focus on improving outcomes for
a defined patient population?
A. Nurse practitioner (NP)
B. Clinical nurse specialist (CNS)
C. Certified registered nurse anesthetist (CRNA)
D. Certified nurse-midwife (CNM)
**Correct Answer: B**
**Rationale:** The CNS provides direct care in a specific specialty area, often within a hospital
or health care system, with a focus on improving outcomes for a defined patient population. The NP
(A) provides primary or acute care across varied settings. The CRNA (C) provides anesthesia services.
The CNM (D) provides women's health and maternity care.
---
**Q4.** An APRN is reviewing the Consensus Model for APRN Regulation. Which statement
accurately describes the purpose of this model?
A. It established a uniform national licensure system for all nurses.
B. It provided a framework for standardizing APRN education, accreditation, certification, and
licensure.
C. It eliminated state-specific regulations for APRNs.
D. It limited APRN practice to hospital settings.
**Correct Answer: B**
, **Rationale:** The Consensus Model for APRN Regulation (2008) provided a framework for
standardizing APRN education, accreditation, certification, and licensure across the four APRN roles.
It did not establish a uniform national licensure system (A), eliminate state regulations (C), or limit
practice settings (D).
---
**Q5.** An APRN is reviewing the core competencies of advanced practice nursing. Which
competency is described as the "central competency" from which all other competencies flow?
A. Direct clinical practice
B. Consultation
C. Research
D. Ethical decision-making
**Correct Answer: A**
**Rationale:** Direct clinical practice is identified as the central competency of advanced
practice nursing from which all other competencies are actualized. Consultation (B), research (C), and
ethical decision-making (D) are important competencies but are not the central competency.
---
**Q6.** An APRN is reviewing the eight core competencies of advanced practice nursing. Which
competency involves the APRN using advanced communication skills to influence patients, families,
and the health care team to promote optimal outcomes?
A. Collaboration
B. Guidance and coaching
C. Leadership
D. Consultation
**Correct Answer: B**
