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Table of Contents
Chapter 01 History and Evolution of Advanced Practice Nursing 1
Chapter 02 Conceptualizations of Advanced Practice Nursing 5
Chapter 03 A Definition of Advanced Practice Nursing 9
Chapter 04 Role Development of the Advanced Practice Nurse 13
Chapter 05 International Development of Advanced Practice Nursing 19
Chapter 06 Direct Clinical Practice 22
Chapter 07 Guidance and Coaching 30
Chapter 08 Evidence-Based Practice 35
Chapter 09 Leadership 40
Chapter 10 Collaboration 44
Chapter 11 Ethical Practice 51
Chapter 12 The Clinical Nurse Specialist 57
Chapter 13 The Primary Care Nurse Practitioner 61
Chapter 14 The Acute Care Nurse Practitioner 65
Chapter 15 The Certified Nurse-Midwife 69
Chapter 16 The Certified Registered Nurse Anesthetist 74
Chapter 17 Maximizing APRN Power and Influencing Policy 78
Chapter 18 Marketing Yourself as an APRN Contracting and Negotiation 82
Chapter 19 Reimbursement and Payment for APRN Services 88
Chapter 20 Understanding Regulatory, Legal, and Credentialing Requirements 94
Chapter 21 APRN Outcomes and Performance Improvement Research 97
Chapter 22 Future Technologies Influencing APRN Practice 100
Chapter 23 Using Healthcare Information Technology to Evaluate and Improve
Performance and Patient Outcomes 104
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Chapter 01: History and Evolution of Advanced Practice Nursing
Tracy & O’Grady: Hamric & Hanson’s Advanced Practice Nursing, 7th Edition
1.
The development of the Doctor of Nursing Practice (DNP) degree in 2004 primarily addressed which key
issue in nursing education?
A. Competition with other healthcare doctorates
B. Expansion of master’s curriculum requirements
C. Standardization of doctoral nursing research
D. Reimbursement for APRN services
Answer: B
Rationale: The DNP was created by the AACN to address the increasing curriculum requirements that were
overcrowding master’s programs. It was not intended for reimbursement or competition, but for educational
reform.
2.
Which of the following was the first recognized area of advanced practice nursing?
A. Clinical Nurse Specialist
B. Certified Registered Nurse Anesthetist (CRNA)
C. Family Nurse Practitioner
D. Pediatric Nurse Practitioner
Answer: B
Rationale: Nurse anesthesia, pioneered in the late 1800s and formally organized in 1931 as the NANA, was
the first APN specialty, predating others by decades.
3.
The legal validation of nurse anesthesia practice under physician supervision was established in which
landmark case?
A. Brown v. Board of Nursing (1928)
B. Chalmers-Frances v. Nelson (1936)
C. Nelson v. American Nurses Association (1942)
D. Mayo v. Ohio Health Board (1930)
Answer: B
Rationale: Chalmers-Frances v. Nelson (1936) confirmed that trained nurses could legally administer
anesthesia under physician supervision—crucial in legitimizing early APRN roles.
4.
Which historical event most significantly increased the demand for nurse anesthetists?
A. The Great Depression
B. Civil War and World War I
C. Polio Epidemic
D. 1918 Influenza Pandemic
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Answer: B
Rationale: Wartime shortages of physicians led nurses to deliver anesthesia on the battlefield, advancing
nurse anesthetist training and professional acceptance.
5.
The establishment of the Henry Street Settlement in 1893 primarily aimed to:
A. Advance nursing education standards
B. Provide urban healthcare to immigrants and the poor
C. Create rural access to midwifery services
D. Regulate early nurse licensure
Answer: B
Rationale: Lillian Wald’s Henry Street Settlement in New York City was foundational for public health
nursing and social justice—key APN precursors.
6.
Mary Breckenridge’s Frontier Nursing Service (FNS), founded in 1925, pioneered which APN role?
A. Nurse Educator
B. Nurse Midwife
C. Clinical Nurse Specialist
D. Nurse Anesthetist
Answer: B
Rationale: The FNS established nurse-midwifery in the U.S., focusing on maternal and child health in rural
Appalachia.
7.
Which factor most contributed to standardizing APN roles in the late 20th century?
A. Federal reimbursement for NP services
B. Development of standardized curricula
C. AMA opposition
D. Post–World War II nursing shortage
Answer: B
Rationale: Consistent educational standards and competency frameworks unified and legitimized APN roles
across states.
8.
Who established the first formal training for nurse anesthetists at St. Mary’s Hospital in 1889?
A. Lillian Wald
B. Agatha Hodgins
C. Dr. William Worrall Mayo
D. Mary Breckenridge
Answer: C
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Table of Contents
Chapter 01 History and Evolution of Advanced Practice Nursing 1
Chapter 02 Conceptualizations of Advanced Practice Nursing 5
Chapter 03 A Definition of Advanced Practice Nursing 9
Chapter 04 Role Development of the Advanced Practice Nurse 13
Chapter 05 International Development of Advanced Practice Nursing 19
Chapter 06 Direct Clinical Practice 22
Chapter 07 Guidance and Coaching 30
Chapter 08 Evidence-Based Practice 35
Chapter 09 Leadership 40
Chapter 10 Collaboration 44
Chapter 11 Ethical Practice 51
Chapter 12 The Clinical Nurse Specialist 57
Chapter 13 The Primary Care Nurse Practitioner 61
Chapter 14 The Acute Care Nurse Practitioner 65
Chapter 15 The Certified Nurse-Midwife 69
Chapter 16 The Certified Registered Nurse Anesthetist 74
Chapter 17 Maximizing APRN Power and Influencing Policy 78
Chapter 18 Marketing Yourself as an APRN Contracting and Negotiation 82
Chapter 19 Reimbursement and Payment for APRN Services 88
Chapter 20 Understanding Regulatory, Legal, and Credentialing Requirements 94
Chapter 21 APRN Outcomes and Performance Improvement Research 97
Chapter 22 Future Technologies Influencing APRN Practice 100
Chapter 23 Using Healthcare Information Technology to Evaluate and Improve
Performance and Patient Outcomes 104
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Chapter 01: History and Evolution of Advanced Practice Nursing
Tracy & O’Grady: Hamric & Hanson’s Advanced Practice Nursing, 7th Edition
1.
The development of the Doctor of Nursing Practice (DNP) degree in 2004 primarily addressed which key
issue in nursing education?
A. Competition with other healthcare doctorates
B. Expansion of master’s curriculum requirements
C. Standardization of doctoral nursing research
D. Reimbursement for APRN services
Answer: B
Rationale: The DNP was created by the AACN to address the increasing curriculum requirements that were
overcrowding master’s programs. It was not intended for reimbursement or competition, but for educational
reform.
2.
Which of the following was the first recognized area of advanced practice nursing?
A. Clinical Nurse Specialist
B. Certified Registered Nurse Anesthetist (CRNA)
C. Family Nurse Practitioner
D. Pediatric Nurse Practitioner
Answer: B
Rationale: Nurse anesthesia, pioneered in the late 1800s and formally organized in 1931 as the NANA, was
the first APN specialty, predating others by decades.
3.
The legal validation of nurse anesthesia practice under physician supervision was established in which
landmark case?
A. Brown v. Board of Nursing (1928)
B. Chalmers-Frances v. Nelson (1936)
C. Nelson v. American Nurses Association (1942)
D. Mayo v. Ohio Health Board (1930)
Answer: B
Rationale: Chalmers-Frances v. Nelson (1936) confirmed that trained nurses could legally administer
anesthesia under physician supervision—crucial in legitimizing early APRN roles.
4.
Which historical event most significantly increased the demand for nurse anesthetists?
A. The Great Depression
B. Civil War and World War I
C. Polio Epidemic
D. 1918 Influenza Pandemic
1|Page
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Answer: B
Rationale: Wartime shortages of physicians led nurses to deliver anesthesia on the battlefield, advancing
nurse anesthetist training and professional acceptance.
5.
The establishment of the Henry Street Settlement in 1893 primarily aimed to:
A. Advance nursing education standards
B. Provide urban healthcare to immigrants and the poor
C. Create rural access to midwifery services
D. Regulate early nurse licensure
Answer: B
Rationale: Lillian Wald’s Henry Street Settlement in New York City was foundational for public health
nursing and social justice—key APN precursors.
6.
Mary Breckenridge’s Frontier Nursing Service (FNS), founded in 1925, pioneered which APN role?
A. Nurse Educator
B. Nurse Midwife
C. Clinical Nurse Specialist
D. Nurse Anesthetist
Answer: B
Rationale: The FNS established nurse-midwifery in the U.S., focusing on maternal and child health in rural
Appalachia.
7.
Which factor most contributed to standardizing APN roles in the late 20th century?
A. Federal reimbursement for NP services
B. Development of standardized curricula
C. AMA opposition
D. Post–World War II nursing shortage
Answer: B
Rationale: Consistent educational standards and competency frameworks unified and legitimized APN roles
across states.
8.
Who established the first formal training for nurse anesthetists at St. Mary’s Hospital in 1889?
A. Lillian Wald
B. Agatha Hodgins
C. Dr. William Worrall Mayo
D. Mary Breckenridge
Answer: C
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