QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
LevelHofHEvidenceHHierarchy:H-HANSWERH1.HMeta-analysis
2.HSystemicHreview
3.HRandomizedHControlledHTrialH(RCT)
4.HExperiment
5.HCohortHStudy
6.HCaseHReports/Series
7.HExpertHOpinions/Editorials
TypesHofHResearchH-HANSWERH•HMeta-analysis
•HSystemicHreview
•HRandomizedHControlledHTrialH(RCT)
•HExperimentH(ClassicHResearch)H
•HCross-Section
•HLongitudinalHDesignH
•HCaseHStudyH(Report/Hseries)
•HFieldHstudyHorHNaturalisticHstudyH
•HSurveyHstudyH
•HCohortHresearch
StatuteHofHLimitations:H-
HANSWERH•HTheHtimeHlimitHwhenHaHlawsuitHcanHbeHfiledHorHactionHagainstHaHnursingHlicenseeHforHallegedHv
iolationHcanHoccur.HMostHstatesHareH2-3Hyears.H
•HAHperiodHofHlimitationHforHtheHbringingHofHcertainHkindsHofHlegalHaction.
,StandardsHofHPracticeH-
HANSWERH•HAuthoritativeHstatementsHofHtheHdutiesHthatHallHregisteredHnurses,HregardlessHofHrole,Hpopulat
ion,HorHspecialtyHareHexpectedHtoHperform
•HItHisHdevelopedHbyHprofessionalHsocietiesH(ANA)HandHspecialtyHorganizationsH(AANP)
EmancipatedHMinorH-HANSWERH•HCanHsignHownHlegalHdocuments
•HLegallyHmarriedHorHdivorceH
•HActiveHdutyHinHtheHarmedHforces
•HTheseHareHpeopleHunderHtheHageHofH18Hy/oHbutHdoHnotHrequireHanHadultHforHconsent.
•HLegalHcourtHdocument
HITECHH-HANSWERH•HHeathHInformationHTechnologyHorHEconomicHandHClinicalHHealthHAct
•HPromotesHadoptionHandHmeaningfulHuseHofHhealthHinformationHtechnology
•HACTHapprovedHinH2009HforHtheHuseHofHelectronicHhealthHinformation.
•HProtectionHofHPHIHenactedHinH2009.HPHIHmustHbeHencryptedHpriorHtoHsending.
•HPatientsHmustHbeHinformedHifHtheirHPHIHhasHbeenHdisclosedHinappropriatelyHevenHifHtheHdisclosureHwasH
accidental.
•HProvidersHwillHbeHofferedHfinancialHincentivesHforHdemonstratingHmeaningfulHuseHofHEHRHuntilH2015Hthe
nHpenalties.
•HHITECH-
HsignedHbyHPresidentHObamaHtoHtransitionHtoHelectronicHhealthHrecords.HNoHmoreHpaperHcharting.HTheH20
09HHealthHInformationHTechnologyHforHEconomicHandHClinicalHHealthH(HITECH)HActHwasHsignedHintoHlawHw
ithHtheHexplicitHintentionHofHacceleratingHtheHadoptionHandHpromotingHtheH"meaningfulHuseH(MU)"HofHele
ctronicHhealthHrecordsH(EHRs)HbyHUSHphysicians.
PatientHinHEOLH(endHofHlife)HstageHaskHofHhospice:H-
HANSWERH•HTheHpatientHisHalreadyHendHstageHsoHbeneficenceHisHnotHcorrectHunlessHyouHareHeducatingHabo
utHsmokingHcessationHorHvaccination.HThisHisHtoHpromoteHgood.HUtilitarianismHisHtheHgreaterHgoodHforHaHp
opulationHofHpatients.HJusticeHisHtoHbeHfair.HWhichHleavesHusHtoHautonomy.HThisHisHallowingHtheHpatientHtoH
makeHhisHownHchoiceHafterHgivingHhimHallHtheHinformationHtoHmakeHaHgoodHinformedHdecision.H
•HAFTTH(adultHfailureHtoHthrive).HThisHisHaHsecondaryHdiagnosisHforHhospiceHeligibility.HSoHwhenHyouHconsul
tHhospiceHforHweightHlossHandHnotHeatingHwithHnoHotherHmajorHdiagnoses,HthisHisHnotHaHgoodHreferral.HHos
piceHisHnoHlongerHableHtoHuseHthisHasHaHprimaryHdiagnosis.
,PrescriptiveHAuthorityH-
HANSWERH•HTheHmajorityHofHstatesHrequireHNPsHtoHhaveHaHcollaborativeHagreementHwithHaHphysicianHinHor
derHtoHprescribe.
•HAllHstatesHnowHallowHNPsHtoHprescribeHcertainHcontrolledHdrugs,HbutHwithHlimitations
DEAH-HANSWERH•HDrugHEnforcementHAdministration
•HNPHmustHobtainHprescriptiveHauthorityHbeforeHgettingHaHDEAHnumberHtoHprescribedHcontrolledHsubstanc
es.
•HAllowsHadvancedHpracticeHnursesHtoHobtainHregistrationHnumbersHforHprescribingHcontrolledHmedication
•HThoughHDEAHisHfederal,HprescriptiveHauthorityHisHmanagedHbyHtheHstateHboard
CertificationH-
HANSWERH•HGenerallyHaH"voluntary"HprocessHandHisHdoneHthroughHaHnongovernmentalHentityHsuchHasHpro
fessionalHnursingHassociationHorHspecialtyHorganization.
•HManyHstatesHmandateHcertificationHasHaHconditionHtoHobtainHlicensure
LicensureH-HANSWERH•HLegalHrequirementHtoHpracticeHasHanHNP
•HObtainedHthroughHaHgovernmentalHentity,HtheHSBON
•HMustHmeetHminimalHeducationalHandHclinicalHrequirementsHinHorderHtoHbecomeHlicensed
IncidenceH-HANSWERH•HConveysHinformationHaboutHtheHriskHofHcontractingHaHdisease
•HMeasureHofHdiseaseHthatHallowsHusHtoHdetermineHaHperson'sHprobabilityHofHbeingHdiagnosedHwithHaHdise
aseHduringHaHgivenHperiodHofHtime.
•HRateHofHnewHcasesHofHtheHdisease
PrevalenceH-HANSWERH•HHowHwidespreadHtheHdiseaseHis
•HMeasureHofHdiseaseHthatHallowsHusHtoHdetermineHaHperson'sHlikelihoodHofHhavingHaHdisease,HnumberHofH
aliveHcasesHwithHtheHdisease
WhatHareHtheH4HethicalHprinciples?H(andHdefine)H-HANSWERH•HBeneficenceH(promotingHwell-
beingHforHpt.HandHsociety)
•HNonmaleficenceH-H"aboveHall,HdoHnoHharm"
, •HAutonomyH(personHactsHintentionallyHafterHbeingHgivenHinformedHconsent)
•HJusticeH(equitableHdistributionHofHsocialHbenefits)
BeneficenceH-
HANSWERH•HToHdoHgood.HTheHobligationHtoHhelpHtheHpatient;HtoHremoveHharm,HpreventHharm,HandHpromo
teHgood
•HActingHinHtheHpatient'sHbestHinterest
•HCompassionateHpatientHcare
•HTheHcoreHprincipleHinHpatientHadvocacy.
•HEncourageHaHpatientHtoHstopHdrinkingHandHenrollHinHAAHprogram.
•HEducationHonHaHnewHprescriptionHaboutHhowHtoHtakeHtheHmedication,HhealthHpromotion,Heducation,Hsm
okingHcessation
NonmaleficenceH-HANSWERH•HObligationHtoHdoHnoHharm;HprotectingHaHpatientHfromHharm
•HYourHpatientHhasHasthma.HSheHbrownHbagsHherHmedicationHonHthisHvisitHandHyouHnoticeHaHbeta-
blocker.HYouHeducateHherHthatHsheHisHnotHaHgoodHcandidateHforHtheseHdrugs
•HExample:HDiscussingHrisksHvs.HbenefitsHofHaHtreatment;HworkingHwithinHSOPH(standardHoperatingHproced
ures).
UtilitarianismH-
HANSWERH•HTheHoutcomeHofHtheHactionHisHwhatHmattersHwithHutilitarianism.HItHalsoHmeansHtoHuseHaHresou
rceHforHtheHbenefitHofHmostH(e.g.,HtaxHmoney).HItHmayHresembleHjustice,HbutHitHisHnotHtheHsameHconceptH
•HTheHWomen,HInfants,HandHChildrenHfoodH(WIC)HprogramHisHonlyHforHpregnantHwomenHandHchildren.
•HOutcomeHofHtheHactionHisHwhatHmatterHwithHutilitarianism.H
•HItHalsoHmeansHtoHuseHaHresourceHforHtheHbenefitHofHmost.H
•HItHmayHresembleHjustice,HbutHitHisHnotHtheHsameHconcept.
•HExample:HWICHprogramHisHonlyHforHpregnantHwomenHandHchildren.HItHisHnotHopenHtoHadultsHandHelderlyH
males.HTheHreasonHmaybeHthatHitHwouldHcostHsocietyHmoreHifHwomenH(andHtheirHfetuses),Hinfants,HandHchi
ldrenHareHharmedHbyHinadequateHfoodHintakeH(affectsHtheHbrainHgrowth).
•HObligationHtoHactHinHaHwayHthatHisHusefulHtoHorHbenefitsHtheHmajority
JusticeH-HANSWERH•HTheHqualityHofHbeingHfairHandHactingHwithHaHlackHofHbias