ANCC AGPCNP Non-Clinical Practice
Questions with Correct Answers
[Most Recent]
Q: What is the hierarchy of evidence from strongest to weakest?
A: The standard hierarchy is:
1. Meta-analysis
2. Systematic Review
3. Randomized Controlled Trial (RCT)
4. Experiment / Quasi-Experimental
5. Cohort Study
6. Case Reports/Series
7. Expert Opinions/Editorials
Q: What is the difference between "incidence" and "prevalence"?
A:
• Incidence: The rate of new cases of a disease in a population at
risk during a specific time period. It conveys information about the
risk of contracting the disease .
• Prevalence: The total number of existing cases (both new and
old) of a disease in a population at a given point in time. It
measures how widespread the disease is .
Q: How do "sensitivity" and "specificity" define a diagnostic test's
accuracy?
A:
• Sensitivity: The ability of a test to correctly identify those with the
disease (true positive rate). A highly sensitive test is good for ruling
out a disease when negative (SnNout). Example: The leukocyte
esterase test on a dipstick is very sensitive for bacteriuria .
, • Specificity: The ability of a test to correctly identify
those without the disease (true negative rate). A highly specific
test is good for ruling in a disease when positive (SpPin). Example:
The nitrate test on a dipstick is very specific for bacteriuria .
Q: What are the four main ethical principles in healthcare?
A:
• Autonomy: The patient's right to make their own informed
decisions about their healthcare .
• Beneficence: The obligation to act in the patient's best interest
and to promote good .
• Nonmaleficence: The obligation to do no harm and to prevent
harm. This is often discussed in the context of weighing the risks
and benefits of a treatment .
• Justice: The fair and equitable distribution of healthcare resources
and treatment .
Q: What is the difference between "licensure" and "certification"?
A:
• Licensure: A legal requirement to practice as an NP, granted by a
state governmental entity (like the State Board of Nursing) .
• Certification: A voluntary process where a non-governmental
agency validates an individual nurse's qualifications for practice in
a specific area. Many states require certification as a condition for
licensure .
Q: What is the difference between a "claims-based" and an
"occurrence-based" malpractice policy?
A:
• Occurrence-Based Policy: Covers the NP for any incident that
occurred during the policy period, regardless of when the claim
, is filed. This includes "tail coverage" and is generally more
expensive .
• Claims-Based Policy: Only covers the NP if the policy is active at
the time the claim is filed, even if the incident occurred in the
past. When the policy is terminated, "tail coverage" is needed to
cover future claims .
Q: What is the "Statute of Limitations"?
A: The legally defined time limit (often 2-3 years in most states) after an
incident within which a lawsuit or legal action can be filed .
Q: What is "Incident to" billing, and why is it significant for an NP?
A: A billing method for Medicare where services rendered by an NP are
billed under the supervising physician's National Provider Identifier (NPI).
This allows the practice to receive 100% of the physician fee schedule
instead of the standard 85% reimbursement for NPs. For this to apply,
the physician must have performed the initial visit and remain actively
involved in the patient's care plan .
Q: What is the standard Medicare reimbursement rate for an NP's
services when not billing "Incident to"?
A: Medicare reimburses NPs at 85% of the physician fee schedule rate
for services provided in collaboration with a physician .
Q: What do the acronyms ICD-10 and CPT refer to?
A:
• ICD-10 (International Classification of Diseases): The standard
diagnostic coding system used to report the patient's diagnosis or
condition .
• CPT (Current Procedural Terminology): A medical code set
(owned by the AMA) used to report medical, surgical, and
diagnostic procedures and services for billing and accreditation
purposes .
, Q: What is the "Balanced Budget Act" and how did it affect NPs?
A: This act broadened Medicare coverage for NP and CNS services,
making it easier for NPs to be directly reimbursed by Medicare Part B
and other health plans .
Q: What does HIPAA protect, and what are some key requirements?
A: The Health Insurance Portability and Accountability Act (HIPAA)
protects the privacy of a patient's Protected Health Information (PHI).
Key requirements include:
• Providers must give patients a copy of their HIPAA policy .
• Patients have the right to access and request corrections to their
medical records .
• Health information cannot be used or shared without written
patient permission .
Q: What is the HITECH Act?
A: The Health Information Technology for Economic and Clinical Health
Act (2009) was enacted to promote the adoption and "meaningful use"
of Electronic Health Records (EHRs). It also strengthened the privacy and
security protections of HIPAA, requiring PHI to be encrypted .
Q: What is the "Plan-Do-Study-Act" (PDSA) cycle?
A: A systematic framework used in quality improvement (QI) projects to
test and implement changes in clinical practice.
• Plan: Identify a problem and develop a plan for improvement.
• Do: Implement the plan on a small scale.
• Study: Analyze the outcomes and data collected.
• Act: Refine the intervention and scale it up if effective, or restart
the cycle if not.
Q: What is a "Sentinel Event" and what is the required response?
A: A sentinel event is an unexpected occurrence involving death or
serious physical or psychological injury, or the risk thereof (e.g., wrong-
site surgery, medication error resulting in patient death). The Joint
Questions with Correct Answers
[Most Recent]
Q: What is the hierarchy of evidence from strongest to weakest?
A: The standard hierarchy is:
1. Meta-analysis
2. Systematic Review
3. Randomized Controlled Trial (RCT)
4. Experiment / Quasi-Experimental
5. Cohort Study
6. Case Reports/Series
7. Expert Opinions/Editorials
Q: What is the difference between "incidence" and "prevalence"?
A:
• Incidence: The rate of new cases of a disease in a population at
risk during a specific time period. It conveys information about the
risk of contracting the disease .
• Prevalence: The total number of existing cases (both new and
old) of a disease in a population at a given point in time. It
measures how widespread the disease is .
Q: How do "sensitivity" and "specificity" define a diagnostic test's
accuracy?
A:
• Sensitivity: The ability of a test to correctly identify those with the
disease (true positive rate). A highly sensitive test is good for ruling
out a disease when negative (SnNout). Example: The leukocyte
esterase test on a dipstick is very sensitive for bacteriuria .
, • Specificity: The ability of a test to correctly identify
those without the disease (true negative rate). A highly specific
test is good for ruling in a disease when positive (SpPin). Example:
The nitrate test on a dipstick is very specific for bacteriuria .
Q: What are the four main ethical principles in healthcare?
A:
• Autonomy: The patient's right to make their own informed
decisions about their healthcare .
• Beneficence: The obligation to act in the patient's best interest
and to promote good .
• Nonmaleficence: The obligation to do no harm and to prevent
harm. This is often discussed in the context of weighing the risks
and benefits of a treatment .
• Justice: The fair and equitable distribution of healthcare resources
and treatment .
Q: What is the difference between "licensure" and "certification"?
A:
• Licensure: A legal requirement to practice as an NP, granted by a
state governmental entity (like the State Board of Nursing) .
• Certification: A voluntary process where a non-governmental
agency validates an individual nurse's qualifications for practice in
a specific area. Many states require certification as a condition for
licensure .
Q: What is the difference between a "claims-based" and an
"occurrence-based" malpractice policy?
A:
• Occurrence-Based Policy: Covers the NP for any incident that
occurred during the policy period, regardless of when the claim
, is filed. This includes "tail coverage" and is generally more
expensive .
• Claims-Based Policy: Only covers the NP if the policy is active at
the time the claim is filed, even if the incident occurred in the
past. When the policy is terminated, "tail coverage" is needed to
cover future claims .
Q: What is the "Statute of Limitations"?
A: The legally defined time limit (often 2-3 years in most states) after an
incident within which a lawsuit or legal action can be filed .
Q: What is "Incident to" billing, and why is it significant for an NP?
A: A billing method for Medicare where services rendered by an NP are
billed under the supervising physician's National Provider Identifier (NPI).
This allows the practice to receive 100% of the physician fee schedule
instead of the standard 85% reimbursement for NPs. For this to apply,
the physician must have performed the initial visit and remain actively
involved in the patient's care plan .
Q: What is the standard Medicare reimbursement rate for an NP's
services when not billing "Incident to"?
A: Medicare reimburses NPs at 85% of the physician fee schedule rate
for services provided in collaboration with a physician .
Q: What do the acronyms ICD-10 and CPT refer to?
A:
• ICD-10 (International Classification of Diseases): The standard
diagnostic coding system used to report the patient's diagnosis or
condition .
• CPT (Current Procedural Terminology): A medical code set
(owned by the AMA) used to report medical, surgical, and
diagnostic procedures and services for billing and accreditation
purposes .
, Q: What is the "Balanced Budget Act" and how did it affect NPs?
A: This act broadened Medicare coverage for NP and CNS services,
making it easier for NPs to be directly reimbursed by Medicare Part B
and other health plans .
Q: What does HIPAA protect, and what are some key requirements?
A: The Health Insurance Portability and Accountability Act (HIPAA)
protects the privacy of a patient's Protected Health Information (PHI).
Key requirements include:
• Providers must give patients a copy of their HIPAA policy .
• Patients have the right to access and request corrections to their
medical records .
• Health information cannot be used or shared without written
patient permission .
Q: What is the HITECH Act?
A: The Health Information Technology for Economic and Clinical Health
Act (2009) was enacted to promote the adoption and "meaningful use"
of Electronic Health Records (EHRs). It also strengthened the privacy and
security protections of HIPAA, requiring PHI to be encrypted .
Q: What is the "Plan-Do-Study-Act" (PDSA) cycle?
A: A systematic framework used in quality improvement (QI) projects to
test and implement changes in clinical practice.
• Plan: Identify a problem and develop a plan for improvement.
• Do: Implement the plan on a small scale.
• Study: Analyze the outcomes and data collected.
• Act: Refine the intervention and scale it up if effective, or restart
the cycle if not.
Q: What is a "Sentinel Event" and what is the required response?
A: A sentinel event is an unexpected occurrence involving death or
serious physical or psychological injury, or the risk thereof (e.g., wrong-
site surgery, medication error resulting in patient death). The Joint
