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, Chapter1:IntroductiontotheRoleofAdvanced PracticesNursing Multiple
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n Choice
1. In which yeardidtheAmericanAssociation ofCollegeofNursing(AACN)introduced the
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Doctorate of Nursing Practice (DNP)?
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a. 2006
b. 2004
c. 2000
d. 2002
ANS:B n
IntroducedtheDNPdegreein2004toprepareadvancedpracticenurses (APRNs)tomeet challenges and
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standardize practice beyond master’s degree programs.
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2. Whichofthe followingis thebest explanation forthe creation ofthe Doctorate ofNursing
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Practice (DNP) degree?
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a. Tocompeteagainst master’sdegree programs
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b. Toensurestandardized curriculum ensuringindependent practice
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c. TovalidateAPRN’sforfinancial reimbursement
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d. Toaddressincreasingcurriculumrequirements ofmaster’sdegreeprograms
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ANS: D n
Although all answers are influenced by the DNP core competencies, the DNP program creation in 2004
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bytheAACNwasdesignedtoaddresscurriculumrequirementsofmaster’sdegreeprograms.
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3. Whichofthefollowingwas thefirstrecognized areaofadvanced practice nursing?
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a. ClinicalNurseSpecialist n n
b. Familynursepractitioner n n
c. Pediatricnursepractitioner n n
d. CertifiedRegisteredNurseAnesthetist n n n
ANS: D
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In 1931, the National Association of Nurse Anesthetists (NANA), renamed in 1939 to the
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American Association of Nurse Anesthetists (AANA) was the first recognized group promoting
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advanced nursing practice. Agatha Hodgins founded the AANM at Lakeside Hospital in Cleveland,
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Ohio.
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4. Whichfactorisbroadlyperceivedtosolidifyandstandardizetheroleofthe APNsoverthelast 25
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years? n
a. Lackof access to health careproviders n n n n n n
b. Standardizedcurriculumdevelopment n n
c. Paymentforservices n n
d. Societalforces n
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, ANS: B n
As the evolution of Advanced Practice Nursing advances specific specialties and needs are identified.
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Through the evolution of organization and standardization these roles have solidified the APN’s role in
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today’s health care environment.
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5. Duringtheformation of earlyAPN roles inanesthesia, which ofthefollowingincreased
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demand for access to health care?
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a. Poverty
b. War
c. Ruralaccess tocare n n n
d. Availabilityoftraining n n
ANS: B n
Earliest demand for nursing-provided anesthesia spiked during periods of war when numbers of
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physicians were inadequate. The earliest records date back to the American Civil War with the
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administration of chloroform. During World War I in 1917 more than 1000 nurses, some trained
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anesthetists, traveled into battle. Other factors such as need for rural health care came later in the
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validation and need for APNs.
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6. In 1889, Dr. William Worrall Mayo built and opened St. Mary’s hospital in Rochester, NY. He is
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knownforsomeofthe earliest recruitment and specialized trainingofnurses in whichofthe following
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roles? n
a. Pediatrics
b. Anesthesia
c. Obstetrics
d. Research andstatistics n n
e. Familynursing n
ANS: B n
In 1889, Dr. William Worrall Mayo began formally training and recognizing nurse anesthetists. This has
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been regarded as the earliest training in nurse-provided anesthesia.
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7. In1893,LillianWaldestablishedtheHenryStreetSettlement(HSS)Houseforwhichpurpose?
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a. Access tohealth careofruralareas n n n n n n
b. Createinner-citynursing awareness n n n
c. Providethedisadvantaged access to care n n n n n
d. Establish guidelines foradvanced nursing roles n n n n n
ANS: C n
The HHS was established to provide nursing services to immigrants and low-income patients and their
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families in Manhattan. As resistance to nurse-provided care grew, standing orders were drafted from a
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group of Lower East Side physicians thereby circumventing then-existing legal ramifications.
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, 8. TheFrontier NursingService(FNS) founded in Kentuckyin 1925 byMaryBreckenridge
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initially provided Appalachia withnursingresources and whichtype ofadvanced nursing care?
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a. Pediatriccare n
b. Anesthesia
c. Midwifery
d. Surgical services n
ANS: C n
The original FNS provided nursing services and obstetric services to Appalachian residents. Later
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working from standard orders developed from their medical advisory committee nurses treated
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patients, made diagnoses, and dispensed medications.
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9. Whichorganization foundedin1941underMaryBreckenridge’s leadershipmerged withthe
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American College of Nurse-Midwives (ACNM) in 1969?
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a. American Associationof Nurse-Midwives(AANM) n n n n
b. AmericanNurses Association(ANA) n n n
c. AssociationforNational Nurse-Midwifery(ANNM) n n n n
d. Council ofNursingMidwifery(ANM) n n n n
ANS: A n
The American College of Nurse-Midwives (ACNM) formed under the leadership of Mary
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Breckenridgein 1941 to providenurse-midwifedevelopment and collaboration formidwife
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development. In 1955, the American College of Nurse-Midwives was formed and the two n n n n n n n n n n n n
organizations merged in 1969 after the death of Mary Breckenridge.
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10. In alandmarkrulingbytheSupremeCourtasa resultofChalmers-Frances v.Nelson,1936, what
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legal precedent was established?
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a. Nurseanesthesiawas allowed underthenursepractice act
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b. Nurseanesthesia scope ofpracticeincluded anesthesia
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c. Nurseanesthesiawas legal,ifunderguidanceof a supervising physician
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d. Onlytrained nursingprofessionals could administer anesthesia independently
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ANS: C n
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
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andestablishedthattrainednursescouldlegallyprovideanesthesiacareundersupervision of a physician.
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11. Thefirstknownestablishment ofthenursepractitioner roleoccurred in1965 at theUniversity of
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Colorado. In which area of training did this rolespecialize?
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a. Pediatrics
b. Geriatrics
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extra pr year? n n