AGACNP EXAM |LATEST UPLOADS
2026
Scope of Practice Based on legal allowances in each state, individual state nurse practice acts
providing guidelines for nursing practice
Key elements of the NP role include integration of care across the acute illness continuum with
collaboration and coordination of care; research based clinical practices, clinical leadership,
family assessment, and discharge planning
Standards of Advanced Practice are delineated by... American Nurses Association which
measure quality of practice, service, or education
State Practice Acts Authorize Boards of Nursing in each state to establish statutory authority for
licensure of RNs
State Practice Acts - authority includes: use of title, authorization for scope of practice
including prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as certification
Prescriptive authority Ability and extent of NPs ability to prescribe meds
DEA has ruled that nurses in advanced practice may obtain. registration numbers, state
practice acts dictate level of prescriptive authority allowed
Credentials encompass... required education, licensure and certification to practice as an NP
,Credentials establish... minimal levels of acceptable performance
Credentialing is necessary to: ensure that safe healthcare is provided by qualified individuals;
comply with federal and state laws r/t APN
Credentials also... acknowledges the scope of practice of NP, mandates accountability, enforces
professional standards for practice
Licensure establishes that a person is qualified to perform in a particular professional role
Licensure is granted as defined by rules and regulations set forth by a governmental regulatory
body (i.e. state board of nursing)
Certification Person has met certain standards that signify mastery of specialized knowledge
Certification is granted by nongovernmental agencies such as ANCC, AANP
Admitting privileges to hospitals (non physician) were granted 1983 by JC
Credentialing and privileging process which an NP is granted permission to practice in an input
setting
Credentialing with hospital privileges is granted by a Hospital Credentialing Committee
Pt Medical Abandonment When caregiver-pt. relationship is terminated w/o making reasonable
arrangements w an appropriate person so that care can be continued
,Determination of pt. abandonment depends on factors such as: Whether NP accepted pt.
assignment, whether NP provided reasonable notice before termination, whether reasonable
arrangements could have been made
Following do not constitute pt. abandonment NP refuses to accept responsibility for pt.
assignment when NP has given reasonable notice to proper authority that NP lacks competence
to carry out assignment; NP refuses assignment of a double shift or addle hrs. beyond posted
work schedule when proper notification has been given. Latter phrase can be controversial
Risk Mgmt. Systematic effort to reduce risk begins w formal written risk mgmt. plan that
includes: organizations goals, delineation of program's scope, components, methods;
delegating responsibility for implementation and enforcement; demonstrating commitment by
the board; confidentiality and immunity from retaliation for those who report sensitive info
Most common method of documentation for risk mgmt. incident reports
Policies regarding incident reports should address: pal authorized to complete report; pal
responsible for review of a report, immediate actions needed to minimize the effects of the
event; pal responsible for follow up; plan for monitoring aftermath; security/storage of
completed report
Risk mgmt. - Satisfaction Surveys Important for identifying problems before they develop into
incidents or claims; for pts and employees
Risk mgmt. - Complaints: Risk mgmt. plan should delineate tracking, analyzing, and managing
complaints by clearly identifying: pal notified after receiving complaint; pal responsible for
responding; pal responsible for monitoring follow up
Action taking initiatives: Prevention, correction (corrective steps must be monitored and
audited), documentation, education, departmental coordination
, Medical Futility Interventions that are unlikely to produce significant benefit for pt. - "Does the
intervention have any reasonable prospect of helping this pt.?"
Two kind of medical futility: Quantitative futility: likelihood that intervention will benefit pt. is
extremely poor
Qualitative futility: quality of benefit an intervention will produce is extremely poor
Informed consent - competence (decisional capability) state that pt. is able to make personal
decisions about their care
competence implies that ability to: understand, reason, differentiate good and bad, and
communicate
informed consent pt. has received adequate instruction or info regarding aspects of care to
make prudent, personal choice regarding such TX
Informed consent includes: discussing benefits and risk
consent is assumed if... pt.’s condition is life threatening
Danforth Amendment 1991 pts are informed at time of admission to federally funded
institution (such as hospital, nursing home, hospice, HMO, etc.) that they have the right to
refuse care as long as the pt. has decisional capability (competence)
Ethics study of moral conduct and behavior protecting the rights of an individual
1st priority is the most salvageable pts. Most critically injured cared for last.
Key ethical principles are: no maleficence, utilitarianism, beneficence, justice, fidelity, veracity,
autonomy
2026
Scope of Practice Based on legal allowances in each state, individual state nurse practice acts
providing guidelines for nursing practice
Key elements of the NP role include integration of care across the acute illness continuum with
collaboration and coordination of care; research based clinical practices, clinical leadership,
family assessment, and discharge planning
Standards of Advanced Practice are delineated by... American Nurses Association which
measure quality of practice, service, or education
State Practice Acts Authorize Boards of Nursing in each state to establish statutory authority for
licensure of RNs
State Practice Acts - authority includes: use of title, authorization for scope of practice
including prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as certification
Prescriptive authority Ability and extent of NPs ability to prescribe meds
DEA has ruled that nurses in advanced practice may obtain. registration numbers, state
practice acts dictate level of prescriptive authority allowed
Credentials encompass... required education, licensure and certification to practice as an NP
,Credentials establish... minimal levels of acceptable performance
Credentialing is necessary to: ensure that safe healthcare is provided by qualified individuals;
comply with federal and state laws r/t APN
Credentials also... acknowledges the scope of practice of NP, mandates accountability, enforces
professional standards for practice
Licensure establishes that a person is qualified to perform in a particular professional role
Licensure is granted as defined by rules and regulations set forth by a governmental regulatory
body (i.e. state board of nursing)
Certification Person has met certain standards that signify mastery of specialized knowledge
Certification is granted by nongovernmental agencies such as ANCC, AANP
Admitting privileges to hospitals (non physician) were granted 1983 by JC
Credentialing and privileging process which an NP is granted permission to practice in an input
setting
Credentialing with hospital privileges is granted by a Hospital Credentialing Committee
Pt Medical Abandonment When caregiver-pt. relationship is terminated w/o making reasonable
arrangements w an appropriate person so that care can be continued
,Determination of pt. abandonment depends on factors such as: Whether NP accepted pt.
assignment, whether NP provided reasonable notice before termination, whether reasonable
arrangements could have been made
Following do not constitute pt. abandonment NP refuses to accept responsibility for pt.
assignment when NP has given reasonable notice to proper authority that NP lacks competence
to carry out assignment; NP refuses assignment of a double shift or addle hrs. beyond posted
work schedule when proper notification has been given. Latter phrase can be controversial
Risk Mgmt. Systematic effort to reduce risk begins w formal written risk mgmt. plan that
includes: organizations goals, delineation of program's scope, components, methods;
delegating responsibility for implementation and enforcement; demonstrating commitment by
the board; confidentiality and immunity from retaliation for those who report sensitive info
Most common method of documentation for risk mgmt. incident reports
Policies regarding incident reports should address: pal authorized to complete report; pal
responsible for review of a report, immediate actions needed to minimize the effects of the
event; pal responsible for follow up; plan for monitoring aftermath; security/storage of
completed report
Risk mgmt. - Satisfaction Surveys Important for identifying problems before they develop into
incidents or claims; for pts and employees
Risk mgmt. - Complaints: Risk mgmt. plan should delineate tracking, analyzing, and managing
complaints by clearly identifying: pal notified after receiving complaint; pal responsible for
responding; pal responsible for monitoring follow up
Action taking initiatives: Prevention, correction (corrective steps must be monitored and
audited), documentation, education, departmental coordination
, Medical Futility Interventions that are unlikely to produce significant benefit for pt. - "Does the
intervention have any reasonable prospect of helping this pt.?"
Two kind of medical futility: Quantitative futility: likelihood that intervention will benefit pt. is
extremely poor
Qualitative futility: quality of benefit an intervention will produce is extremely poor
Informed consent - competence (decisional capability) state that pt. is able to make personal
decisions about their care
competence implies that ability to: understand, reason, differentiate good and bad, and
communicate
informed consent pt. has received adequate instruction or info regarding aspects of care to
make prudent, personal choice regarding such TX
Informed consent includes: discussing benefits and risk
consent is assumed if... pt.’s condition is life threatening
Danforth Amendment 1991 pts are informed at time of admission to federally funded
institution (such as hospital, nursing home, hospice, HMO, etc.) that they have the right to
refuse care as long as the pt. has decisional capability (competence)
Ethics study of moral conduct and behavior protecting the rights of an individual
1st priority is the most salvageable pts. Most critically injured cared for last.
Key ethical principles are: no maleficence, utilitarianism, beneficence, justice, fidelity, veracity,
autonomy
