NS 660 Advanced Clinical Decision-
Making Exam 2025-2026 Questions
with Correct Answers and Rationales
UNH
1. A nurse practitioner is evaluating a patient with poorly controlled
hypertension despite adherence to medication. The nurse decides to apply
Orem’s Self-Care Deficit Theory to assess the case. Which of the
following actions best reflects this theory?
A. Ordering a new antihypertensive medication.
B. Evaluating the patient’s ability to manage lifestyle modifications
independently.
C. Referring the patient to a cardiologist for advanced management.
D. Scheduling more frequent follow-up visits.
Correct Answer: B
Rationale: Orem's Self-Care Deficit Theory focuses on assessing and
addressing a patient's ability to perform self-care. Identifying if a patient
can manage lifestyle changes is central to this theory.
,2. The Affordable Care Act (ACA) significantly influenced the role of
advanced practice nurses. Which of the following best describes the
impact?
A. Restricted scope of practice to hospital settings only.
B. Reduced the number of nurse practitioners due to federal limitations.
C. Expanded access to care, enabling APRNs to serve as primary care
providers.
D. Removed all licensure barriers for APRNs across the U.S.
Correct Answer: C
Rationale: The ACA increased the need for primary care providers,
empowering APRNs to fill the gap and assume leadership roles in patient
care.
3. Which of the following is the most appropriate first step when
applying evidence-based practice in an advanced nursing role?
A. Conducting a literature review.
B. Evaluating the outcomes of previous interventions.
C. Developing a clinical guideline.
D. Formulating a clinical question using the PICOT format.
,Correct Answer: D
Rationale: The first step in evidence-based practice is to formulate a
well-structured clinical question, often using the PICOT format, to guide
research.
4. A nurse leader is implementing a change based on Lewin’s Change
Theory. Which of the following best represents the 'refreezing' stage?
A. Introducing a new electronic medical record system.
B. Reinforcing training and providing support post-implementation.
C. Communicating the need for the new system to staff.
D. Allowing staff to give feedback during the transition.
Correct Answer: B
Rationale: In Lewin’s Change Theory, 'refreezing' solidifies the change
into the system by reinforcing behaviors and providing ongoing support.
5. In developing a policy proposal to increase APRN autonomy in your
state, which of the following would be the most effective advocacy
strategy?
A. Posting opinions on social media.
B. Holding internal hospital meetings.
, C. Collaborating with state nursing associations and legislators.
D. Conducting private discussions with patients.
Correct Answer: C
Rationale: Policy advocacy is most effective through collaboration with
established organizations and lawmakers to influence legislation and
practice.
6. Which nursing theorist emphasized the importance of the nurse-client
relationship as central to nursing care?
A. Virginia Henderson
B. Hildegard Peplau
C. Dorothea Orem
D. Jean Watson
Correct Answer: B
Rationale: Peplau's theory is centered on the interpersonal relationship
between nurse and patient, emphasizing therapeutic communication.
7. A key characteristic of a DNP-prepared nurse is the ability to:
A. Conduct original research.
B. Focus solely on clinical tasks.
Making Exam 2025-2026 Questions
with Correct Answers and Rationales
UNH
1. A nurse practitioner is evaluating a patient with poorly controlled
hypertension despite adherence to medication. The nurse decides to apply
Orem’s Self-Care Deficit Theory to assess the case. Which of the
following actions best reflects this theory?
A. Ordering a new antihypertensive medication.
B. Evaluating the patient’s ability to manage lifestyle modifications
independently.
C. Referring the patient to a cardiologist for advanced management.
D. Scheduling more frequent follow-up visits.
Correct Answer: B
Rationale: Orem's Self-Care Deficit Theory focuses on assessing and
addressing a patient's ability to perform self-care. Identifying if a patient
can manage lifestyle changes is central to this theory.
,2. The Affordable Care Act (ACA) significantly influenced the role of
advanced practice nurses. Which of the following best describes the
impact?
A. Restricted scope of practice to hospital settings only.
B. Reduced the number of nurse practitioners due to federal limitations.
C. Expanded access to care, enabling APRNs to serve as primary care
providers.
D. Removed all licensure barriers for APRNs across the U.S.
Correct Answer: C
Rationale: The ACA increased the need for primary care providers,
empowering APRNs to fill the gap and assume leadership roles in patient
care.
3. Which of the following is the most appropriate first step when
applying evidence-based practice in an advanced nursing role?
A. Conducting a literature review.
B. Evaluating the outcomes of previous interventions.
C. Developing a clinical guideline.
D. Formulating a clinical question using the PICOT format.
,Correct Answer: D
Rationale: The first step in evidence-based practice is to formulate a
well-structured clinical question, often using the PICOT format, to guide
research.
4. A nurse leader is implementing a change based on Lewin’s Change
Theory. Which of the following best represents the 'refreezing' stage?
A. Introducing a new electronic medical record system.
B. Reinforcing training and providing support post-implementation.
C. Communicating the need for the new system to staff.
D. Allowing staff to give feedback during the transition.
Correct Answer: B
Rationale: In Lewin’s Change Theory, 'refreezing' solidifies the change
into the system by reinforcing behaviors and providing ongoing support.
5. In developing a policy proposal to increase APRN autonomy in your
state, which of the following would be the most effective advocacy
strategy?
A. Posting opinions on social media.
B. Holding internal hospital meetings.
, C. Collaborating with state nursing associations and legislators.
D. Conducting private discussions with patients.
Correct Answer: C
Rationale: Policy advocacy is most effective through collaboration with
established organizations and lawmakers to influence legislation and
practice.
6. Which nursing theorist emphasized the importance of the nurse-client
relationship as central to nursing care?
A. Virginia Henderson
B. Hildegard Peplau
C. Dorothea Orem
D. Jean Watson
Correct Answer: B
Rationale: Peplau's theory is centered on the interpersonal relationship
between nurse and patient, emphasizing therapeutic communication.
7. A key characteristic of a DNP-prepared nurse is the ability to:
A. Conduct original research.
B. Focus solely on clinical tasks.
