,
,
, Advanced Practice Nursing: Essential Knowledge for the Profession 5rd Edition Denisco Test Ba
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
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 theUniversity
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.
, Advanced Practice Nursing: Essential Knowledge for the Profession 5rd Edition Denisco Test Ba
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 a clinical nurse specialist in any specialty?
a. Specialty training certificate
b. Successful completion of certification examination
c. Masters or doctoral degree
d. 1000 hours relevant supervised training
e. Two or more years of clinically relevant experience
ANS: C
In 1980, the ANA specifically outlined criteria for the acknowledgment of clinical
nurse specialist training programs. At that time they required graduate level training
to become an expert in a relevant specialty area of nursing. Additionally, they must
meet any requirements set forth by the specific professional society.
Chapter2 The Nurse Practitioner: Historical Perspective on the Art and Science of
NursePractitionering
1. Which of the following is the primary mission of the National Organization of Nurse
Practitioner Faculties (NONPF)?
a. Provide leadership in promoting quality NP education
b. NP Faculty training program assistance
c. Provide financial assistance to NP students
d. Lobbying legislature on behalf of NPs
, Advanced Practice Nursing: Essential Knowledge for the Profession 5rd Edition Denisco Test Ba
ANS: A
The NONPF’s primary mission is to provide leadership in promoting quality NP education. The
organization has published domains and core competencies for primary care and these serve as a
framework for NP education and practice.
2. A model of competencies that are encompassed around three spheres of influence known as
patient, nurses and nursing practice, and organization and influence is known as?
a. NACNS Model of clinical nurse specialist competencies
b. Fenton’s and Brykczynski’s Expert Practice
c. Calkin’s model of Advanced Nursing Practice
d. Shuler’s Model of NP Practice
ANS: A
The NACNS’s initial 2008 statement was revised in 2004. The statement outlined competencies
that aligned to each of the three spheres of influence: patient, nurses and nursing practice, and
organization and influence.
3. Building upon Benner’s seven domains of expert nursing practice, which conceptual model
adds an additional domain “The consulting role of the nurse”?
a. Calkin’s model of Advanced Nursing Practice
b. Fenton’s and Brykczynski’s Expert Practice
c. Strong Memorial Hospital’s Model of Advanced Nursing Practice
d. Shuler’s Model of NP Practice
e. NACNS Clinical Nurse Specialists Model
ANS: B
Fenton’s and Brykczynski’s Expert Practice Domains of the CNS and NP expanded on Benner’s
seven domains adding consultation provided by CNS’s to other nurses and management of health
and illness in ambulatory care settings.
4. Which model of conceptual practice was the first to explicitly distinguish the experience level
of advanced practitioners?
a. Calkin’s model of Advanced Nursing Practice
b. Shuler’s Model of NP Practice
c. NACNS Clinical Nurse Specialists Model
d. Strong Memorial Hospital’s Model of Advanced Nursing Practice
e. Fenton’s and Brykczynski’s Expert Practice
ANS: A
, Advanced Practice Nursing: Essential Knowledge for the Profession 5rd Edition Denisco Test Ba
Calkins model of Advanced Nursing Practice was the first to explicitly distinguish experience
levels of advanced practitioners for nurse administrators to differentiate advanced practice nursing
from other levels of clinical practice.
5. The circular and continuous threads of direct comprehensive patient care, support of systems,
education, research, and publication and professional leadership make up the five domains of
which advanced nursing conceptual model?
a. Strong Memorial Hospital’s Model of Advanced Nursing Practice
b. Calkin’s model of Advanced Nursing Practice
c. NACNS Clinical Nurse Specialists Model
d. Fenton’s and Brykczynski’s Expert Practice
e. Shuler’s Model of NP Practice
ANS: A
Direct and indirect activities across five domains including: direct comprehensive patient care,
support of systems, education, research, and publication and professional leadership make up the
Strong Memorial Hospital’s Model of Advanced Practice Nursing.
6. Texas Children’s Hospital Transformational Advanced Professional Practice (TAPP) APRN
Model added what unifying conceptual strand?
a. Ethics
b. Culture
c. Informatics
d. Education
ANS: A
The TAPP model added two additional domains: quality and safety, and credentialing and
regulatory practice, to the Strong model. It additionally added professional ethics as a unifying
conceptual strand.
7. Poghosyan, Boyd, and Clarke (2016) proposed a comprehensive conceptual model including
three factors: scope of practice regulations, institutional policies, and practice environments.
What was their primary purpose?
a. To discourage role ambiguity among CNS providers
b. To enhance patient education provided by the APRN
c. To maximize NP Contributions to primary care
d. To provide educational practice guidelines to enhance NP education
ANS: C
, Advanced Practice Nursing: Essential Knowledge for the Profession 5rd Edition Denisco Test Ba
The 2016 model provided a comprehensive review of literature and described potential factors that
affect NP care and patient outcomes. This included scope of practice regulations that often cause
barriers for NP provided primary care.
8. Which model of practice intended to impact the NP domain at four levels: theoretical, clinical,
educational, and research in 1993?
a. Hamric’s model
b. Calkin’s model of Advanced Nursing Practice
c. Strong Memorial Hospital’s Model of Advanced Nursing Practice
d. Shuler’s Model of NP Practice
ANS: D
Shuler’s Model of NP Practice is a holistic and wellness oriented model that was designed to
impact the NP domain at four levels: theoretical, clinical, educational, and research. It is designed
to elaborate the NP’s expanded knowledge and skills into medicine including a template for
conducting a visit.
9. Which model for APRN practice addresses all four APRN roles: CNS, CRNA, CNM, and NP?
a. Calkin’s model of Advanced Nursing Practice
b. Hamric’s model
c. Strong Memorial Hospital’s Model of Advanced Nursing Practice
d. Donabedian Model
ANS: B
Many models highlight core competencies among specific APRN roles, while others emphasize
competencies for hiring managers. At the time of this writing, only the Hamric’s model
encompasses all four APRN roles.
10. Which of the following is one of the eight published essentials included in the Essentials of
Doctoral Education for Advanced Nursing Practice developed by the AACN in 2006?
a. Algorithms for advanced patient care
b. Informatics and health care technologies
c. Scientific underpinnings of practice
d. Liberal education for general nursing practice
ANS: C
The AACN publishes their national consensus to provide the core elements for nursing curriculum
creation. Currently published are Baccalaureate Essentials, Master’s Essentials, DNP Essentials,
and Clinical Resources Essentials. Although they are similar in their core approach to education,
listed first in DNP essentials is the scientific underpinnings of practice.
, Advanced Practice Nursing: Essential Knowledge for the Profession 5rd Edition Denisco Test Ba
11. Which model of conceptualization identifies that health care needs are not met in a system
dominated by medical language as a basis for reimbursement?
a. Donabedian Model
b. Dunphy and Winland-Brown’s Circle of Caring model
c. Shuler’s Model of NP Practice
d. Calkin’s model of Advanced Nursing Practice
ANS: B
Dunphy and Winland-Brown’s transformative model (Dunphy, Winland-Brown, Porter, Thomas,
and Gallagher, 2011; Fig. 2.12) proposed a circle of caring to encourage medical collaboration and
enhance the nursing presence in the health care system. Their model incorporates both strengths
of medicine and nursing with process of assessment, planning, intervention, and evaluation, with
a feedback loop.
12. Without additional application of conceptual models which model would be best chosen to
model the skill level of beginning nurses, experienced nurses, or advanced nurse practitioners
with the appropriate level of patient care?
a. Dunphy and Winland-Brown’s Circle of Caring model
b. Strong Memorial Hospital’s Model of Advanced Nursing Practice
c. Donabedian Model
d. Calkin’s model of Advanced Nursing Practice
ANS: D
Calkin’s model of Advanced Nursing Practice outlines skills and knowledge of beginning nurses,
experienced nurses, and advance practice nurses as they relate the patient responses for health care
problems.
13. The 2005 Donabedian model has been used to evaluate the quality of APRN care using which
conceptual outline?
a. Assessment, diagnosis, planning, intervention, and evaluation
b. Structure, process, and outcome
c. Diagnosis and outcome
d. Diagnosis, morbidity, and mortality
ANS: D
The Donabedian model encompasses structure (health care systems and facilities), process
(diagnosis, treatment, education), and outcomes.