Tracy: Hamric & Hanson's Advanced Practice Nursing, th
6 Edition
Chapter 1: Highlights from the History of Advanced Practice Nursing in the United
States
Multiple Choice
1. In which year did the American Association of College of Nursing (AACN) introduced the
Doctorate of Nursing Practice (DNP)?
a. 2006
b. 2004
c. 2000
d. 2002
ANS: B
The AACN introduced the DNP degree in 2004 to prepare advanced practice nurses (APRNs) to
meet challenges and standardize practice beyond master’s degree programs.
2. Which of the following is the best explanation for the creation of the Doctorate of Nursing
Practice (DNP) degree?
a. To compete against master’s degree programs
b. To ensure standardized curriculum ensuring independent practice
c. To validate APRN’s for financial reimbursement
d. To address increasing curriculum requirements of master’s degree programs
ANS: D
Although all answers are influenced by the DNP core competencies, the DNP program creation in
2004 by the AACN was designed to address curriculum requirements of master’s degree
programs.
3. Which of the following was the first recognized area of advanced practice nursing?
a. Clinical Nurse Specialist
b. Family nurse practitioner
c. Pediatric nurse practitioner
d. Certified Registered Nurse Anesthetist
ANS: D
In 1931, the National Association of Nurse Anesthetists (NANA), renamed in 1939 to the
American Association of Nurse Anesthetists (AANA) was the first recognized group promoting
advanced nursing practice. Agatha Hodgins founded the AANM at Lakeside Hospital in
Cleveland, Ohio.
4. Which factor is broadly perceived to solidify and standardize the role of the APNs over the last
25 years?
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, a. Lack of access to health care providers
b. Standardized curriculum development
c. Payment for services
d. Societal forces
ANS: B
As the evolution of Advanced Practice Nursing advances specific specialties and needs are
identified. Through the evolution of organization and standardization these roles have solidified
the APN’s role in today’s health care environment.
5. During the formation of early APN roles in anesthesia, which of the following increased
demand for access to health care?
a. Poverty
b. War
c. Rural access to care
d. Availability of training
ANS: B
Earliest demand for nursing-provided anesthesia spiked during periods of war when numbers of
physicians were inadequate. The earliest records date back to the American Civil War with the
administration of chloroform. During World War I in 1917 more than 1000 nurses, some trained
anesthetists, traveled into battle. Other factors such as need for rural health care came later in the
validation and need for APNs.
6. In 1889, Dr. William Worrall Mayo built and opened St. Mary’s hospital in Rochester, NY. He
is known for some of the earliest recruitment and specialized training of nurses in which of
the following roles?
a. Pediatrics
b. Anesthesia
c. Obstetrics
d. Research and statistics
e. Family nursing
ANS: B
In 1889, Dr. William Worrall Mayo began formally training and recognizing nurse anesthetists.
This has been regarded as the earliest training in nurse-provided anesthesia.
7. In 1893, Lillian Wald established the Henry Street Settlement (HSS) House for which purpose?
a. Access to health care of rural areas
b. Create inner-city nursing awareness
c. Provide the disadvantaged access to care
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, d. Establish guidelines for advanced nursing roles
ANS: C
The HHS was established to provide nursing services to immigrants and low-income patients and
their families in Manhattan. As resistance to nurse-provided care grew, standing orders were
drafted from a group of Lower East Side physicians thereby circumventing then-existing legal
ramifications.
8. The Frontier Nursing Service (FNS) founded in Kentucky in 1925 by Mary Breckenridge
initially provided Appalachia with nursing resources and which type of advanced nursing
care?
a. Pediatric care
b. Anesthesia
c. Midwifery
d. Surgical services
ANS: C
The original FNS provided nursing services and obstetric services to Appalachian residents. Later
working from standard orders developed from their medical advisory committee nurses treated
patients, made diagnoses, and dispensed medications.
9. Which organization founded in 1941 under Mary Breckenridge’s leadership merged with the
American College of Nurse-Midwives (ACNM) in 1969?
a. American Association of Nurse-Midwives (AANM)
b. American Nurses Association (ANA)
c. Association for National Nurse-Midwifery (ANNM)
d. Council of Nursing Midwifery (ANM)
ANS: A
The American College of Nurse-Midwives (ACNM) formed under the leadership of Mary
Breckenridge in 1941 to provide nurse-midwife development and collaboration for midwife
development. In 1955, the American College of Nurse-Midwives was formed and the two
organizations merged in 1969 after the death of Mary Breckenridge.
10. In a landmark ruling by the Supreme Court as a result of Chalmers-Frances v. Nelson, 1936,
what legal precedent was established?
a. Nurse anesthesia was allowed under the nurse practice act
b. Nurse anesthesia scope of practice included anesthesia
c. Nurse anesthesia was legal, if under guidance of a supervising physician d.
Only trained nursing professionals could administer anesthesia independently
ANS: C
The landmark decision from the Chalmers-Frances v. Nelson case set national precedent for the
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, advanced nursing practice role. It proved to be the basis for other cases over the following few
decades and established that trained nurses could legally provide anesthesia care under
supervision of a physician.
11. The first known establishment of the nurse practitioner role occurred in 1965 at the
University of Colorado. In which area of training did this role specialize?
a. Pediatrics
b. Geriatrics
c. Midwifery
d. Anesthesia
ANS: A
The establishment of the first pediatric nurse practitioner program was in 1965 at the University
of Colorado. Loretta Ford, RN and Henry Silver, MD provided a 4-month course to certified
registered nurses to provide education on managing childhood health problems.
12. The DNP program curriculum outlined which of the following clinical requirements in an
effort to standardize training?
a. 1000 supervised clinical hours and 200 unsupervised clinical hours
b. 1000 supervised clinical hours
c. 900 supervised clinical hours
d. 800 supervised clinical hours and 200 unsupervised clinical hours
ANS: B
In 2004, the AACN outlined the DNP curriculum in an effort to standardize and relieve
challenges of master’s degree programs. This includes a standardized curriculum requiring 1000
supervised clinical hours.
13. Which state became the first to recognize diagnosis and treatment as part of the scope of
practice of specialty nurses?
a. Idaho
b. Oklahoma
c. South Dakota
d. Maryland
ANS: A
Idaho Governor Cecil Andrus signed HB 46 and HB 207 into law on February 11, 1971. This
amended the states’ nurse practice act making it the first state to officially recognize diagnosis
and treatment of specialty nurses. The recognition of the ability to diagnose and treat overcame
an initial hurdle toward independent nursing practice.
14. The American Nursing Association (ANA) defines which requirement for the designation of
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6 Edition
Chapter 1: Highlights from the History of Advanced Practice Nursing in the United
States
Multiple Choice
1. In which year did the American Association of College of Nursing (AACN) introduced the
Doctorate of Nursing Practice (DNP)?
a. 2006
b. 2004
c. 2000
d. 2002
ANS: B
The AACN introduced the DNP degree in 2004 to prepare advanced practice nurses (APRNs) to
meet challenges and standardize practice beyond master’s degree programs.
2. Which of the following is the best explanation for the creation of the Doctorate of Nursing
Practice (DNP) degree?
a. To compete against master’s degree programs
b. To ensure standardized curriculum ensuring independent practice
c. To validate APRN’s for financial reimbursement
d. To address increasing curriculum requirements of master’s degree programs
ANS: D
Although all answers are influenced by the DNP core competencies, the DNP program creation in
2004 by the AACN was designed to address curriculum requirements of master’s degree
programs.
3. Which of the following was the first recognized area of advanced practice nursing?
a. Clinical Nurse Specialist
b. Family nurse practitioner
c. Pediatric nurse practitioner
d. Certified Registered Nurse Anesthetist
ANS: D
In 1931, the National Association of Nurse Anesthetists (NANA), renamed in 1939 to the
American Association of Nurse Anesthetists (AANA) was the first recognized group promoting
advanced nursing practice. Agatha Hodgins founded the AANM at Lakeside Hospital in
Cleveland, Ohio.
4. Which factor is broadly perceived to solidify and standardize the role of the APNs over the last
25 years?
SuccessShelf2 © 2025 SuccessShelf2. For Personal Use Only. All rights reserved.
Downloaded by: Plusbay | Want to earn $1.236
Distribution of this document is illegal extra per year?
, a. Lack of access to health care providers
b. Standardized curriculum development
c. Payment for services
d. Societal forces
ANS: B
As the evolution of Advanced Practice Nursing advances specific specialties and needs are
identified. Through the evolution of organization and standardization these roles have solidified
the APN’s role in today’s health care environment.
5. During the formation of early APN roles in anesthesia, which of the following increased
demand for access to health care?
a. Poverty
b. War
c. Rural access to care
d. Availability of training
ANS: B
Earliest demand for nursing-provided anesthesia spiked during periods of war when numbers of
physicians were inadequate. The earliest records date back to the American Civil War with the
administration of chloroform. During World War I in 1917 more than 1000 nurses, some trained
anesthetists, traveled into battle. Other factors such as need for rural health care came later in the
validation and need for APNs.
6. In 1889, Dr. William Worrall Mayo built and opened St. Mary’s hospital in Rochester, NY. He
is known for some of the earliest recruitment and specialized training of nurses in which of
the following roles?
a. Pediatrics
b. Anesthesia
c. Obstetrics
d. Research and statistics
e. Family nursing
ANS: B
In 1889, Dr. William Worrall Mayo began formally training and recognizing nurse anesthetists.
This has been regarded as the earliest training in nurse-provided anesthesia.
7. In 1893, Lillian Wald established the Henry Street Settlement (HSS) House for which purpose?
a. Access to health care of rural areas
b. Create inner-city nursing awareness
c. Provide the disadvantaged access to care
SuccessShelf2 © 2025 SuccessShelf2. For Personal Use Only. All rights reserved.
Downloaded by: Plusbay | Want to earn $1.236
Distribution of this document is illegal extra per year?
, d. Establish guidelines for advanced nursing roles
ANS: C
The HHS was established to provide nursing services to immigrants and low-income patients and
their families in Manhattan. As resistance to nurse-provided care grew, standing orders were
drafted from a group of Lower East Side physicians thereby circumventing then-existing legal
ramifications.
8. The Frontier Nursing Service (FNS) founded in Kentucky in 1925 by Mary Breckenridge
initially provided Appalachia with nursing resources and which type of advanced nursing
care?
a. Pediatric care
b. Anesthesia
c. Midwifery
d. Surgical services
ANS: C
The original FNS provided nursing services and obstetric services to Appalachian residents. Later
working from standard orders developed from their medical advisory committee nurses treated
patients, made diagnoses, and dispensed medications.
9. Which organization founded in 1941 under Mary Breckenridge’s leadership merged with the
American College of Nurse-Midwives (ACNM) in 1969?
a. American Association of Nurse-Midwives (AANM)
b. American Nurses Association (ANA)
c. Association for National Nurse-Midwifery (ANNM)
d. Council of Nursing Midwifery (ANM)
ANS: A
The American College of Nurse-Midwives (ACNM) formed under the leadership of Mary
Breckenridge in 1941 to provide nurse-midwife development and collaboration for midwife
development. In 1955, the American College of Nurse-Midwives was formed and the two
organizations merged in 1969 after the death of Mary Breckenridge.
10. In a landmark ruling by the Supreme Court as a result of Chalmers-Frances v. Nelson, 1936,
what legal precedent was established?
a. Nurse anesthesia was allowed under the nurse practice act
b. Nurse anesthesia scope of practice included anesthesia
c. Nurse anesthesia was legal, if under guidance of a supervising physician d.
Only trained nursing professionals could administer anesthesia independently
ANS: C
The landmark decision from the Chalmers-Frances v. Nelson case set national precedent for the
SuccessShelf2 © 2025 SuccessShelf2. For Personal Use Only. All rights reserved.
Downloaded by: Plusbay | Want to earn $1.236
Distribution of this document is illegal extra per year?
, advanced nursing practice role. It proved to be the basis for other cases over the following few
decades and established that trained nurses could legally provide anesthesia care under
supervision of a physician.
11. The first known establishment of the nurse practitioner role occurred in 1965 at the
University of Colorado. In which area of training did this role specialize?
a. Pediatrics
b. Geriatrics
c. Midwifery
d. Anesthesia
ANS: A
The establishment of the first pediatric nurse practitioner program was in 1965 at the University
of Colorado. Loretta Ford, RN and Henry Silver, MD provided a 4-month course to certified
registered nurses to provide education on managing childhood health problems.
12. The DNP program curriculum outlined which of the following clinical requirements in an
effort to standardize training?
a. 1000 supervised clinical hours and 200 unsupervised clinical hours
b. 1000 supervised clinical hours
c. 900 supervised clinical hours
d. 800 supervised clinical hours and 200 unsupervised clinical hours
ANS: B
In 2004, the AACN outlined the DNP curriculum in an effort to standardize and relieve
challenges of master’s degree programs. This includes a standardized curriculum requiring 1000
supervised clinical hours.
13. Which state became the first to recognize diagnosis and treatment as part of the scope of
practice of specialty nurses?
a. Idaho
b. Oklahoma
c. South Dakota
d. Maryland
ANS: A
Idaho Governor Cecil Andrus signed HB 46 and HB 207 into law on February 11, 1971. This
amended the states’ nurse practice act making it the first state to officially recognize diagnosis
and treatment of specialty nurses. The recognition of the ability to diagnose and treat overcame
an initial hurdle toward independent nursing practice.
14. The American Nursing Association (ANA) defines which requirement for the designation of
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Distribution of this document is illegal extra per year?
