Adult-Gerontology Acute Care Nurse Practitioner Exam –
AGACNP Certification – Comprehensive Practice Questions
and Exam Preparation Material
Scope of Practice - Correct Answer -Based on legal allowances in each state,
individual state nurse practice acts providing guidelines for nursing practice
Key elements of the NP role include - Correct Answer -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... - Correct Answer -American
Nurses Association which measure quality of practice, service, or education
State Practice Acts - Correct Answer -Authorize Boards of Nursing in each state to
establish statutory authority for licensure of RNs
State Practice Acts - authority includes: - Correct Answer -use of title, authorization
for scope of practice including prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as - Correct Answer -certification
Prescriptive authority - Correct Answer -Ability and extent of NPs ability to prescribe
meds
DEA has ruled that nurses in advanced practice may obtain... - Correct Answer -
registration numbers, state practice acts dictate level of prescriptive authority allowed
Credentials encompass... - Correct Answer -required education, licensure and
certification to practice as an NP
Credentials establish... - Correct Answer -minimal levels of acceptable performance
Credentialing is necessary to: - Correct Answer -ensure that safe healthcare is
provided by qualified individuals; comply with federal and state laws r/t APN
Credentials also... - Correct Answer -acknowledges the scope of practice of NP,
mandates accountability, enforces professional standards for practice
Licensure - Correct Answer -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 - Correct
Answer -a governmental regulatory body (i.e. state board of nursing)
Certification - Correct Answer -Person has met certain standards that signify mastery
of specialized knowledge
,Certification is granted by nongovernmental agencies such as - Correct Answer -
ANCC, AANP
Admitting privileges to hospitals (non physician) were granted - Correct Answer -
1983 by JC
Credentialing and privileging - Correct Answer -process which an NP is granted
permission to practice in an input setting
Credentialing with hospital privileges is granted by a - Correct Answer -Hospital
Credentialing Committee
Pt Medical Abandonment - Correct Answer -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: - Correct Answer -
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 - Correct Answer -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. - Correct Answer -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. - Correct Answer -incident
reports
Policies regarding incident reports should address: - Correct Answer -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 - Correct Answer -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: - Correct Answer -pal notified after
receiving complaint; pal responsible for responding; pal responsible for monitoring
follow up
,Action taking initiatives: - Correct Answer -Prevention, correction (corrective steps
must be monitored and audited), documentation, education, departmental
coordination
Medical Futility - Correct Answer -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: - Correct Answer -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) - Correct Answer -state that
pt. is able to make personal decisions about their care
Competence implies that ability to: - Correct Answer -understand, reason,
differentiate good and bad, and communicate
Informed consent - Correct Answer -pt. has received adequate instruction or info
regarding aspects of care to make prudent, personal choice regarding such TX
Informed consent includes: - Correct Answer -discussing benefits and risk
Consent is assumed if... - Correct Answer -pt.’s condition is life threatening
Danforth Amendment 1991 - Correct Answer -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 - Correct Answer -study of moral conduct and behavior protecting the rights of
an individual
1st priority is the - Correct Answer -most salvageable pts. Most critically injured
cared for last.
Key ethical principles are: - Correct Answer -no maleficence, utilitarianism,
beneficence, justice, fidelity, veracity, autonomy
No maleficence - Correct Answer -duty to do no harm
Utilitarianism - Correct Answer -the right act is the one that produces the greatest
good for the greatest number
Beneficence - Correct Answer -duty to prevent harm and promote good
Justice - Correct Answer -duty to be fair
Fidelity - Correct Answer -duty to be faithful
, Veracity - Correct Answer -duty to be truthful (tends to be in conflict with fidelity)
Autonomy - Correct Answer -duty to respect an individual's thoughts and actions
(tend to be in conflict with beneficence)
Dismissing/discharging a pt. or closing practice - Correct Answer -NP cannot
withdraw from caring for a pt. without notification
Examples of reasons for discharging a pt. from practice: - Correct Answer -abuse,
refusal to pay, persistent non-adherence to care
Steps for discharging a pt. from practice: - Correct Answer -send a certified letter
with return receipt (copy for chart), provide general healthcare coverage for 1st 15-
30 days post termination deadline, obtain release of info to provide copies of all
needed records for next care provider
Obligations in closing practice d/t relocation, retirement - Correct Answer -give pt.
adequate time to find another provider, keep all files for min 5 years, and provide
timely notification and names of other providers and resources for future care
Role of NP developed in the early... - Correct Answer -1960s as a result of physician
shortages in the area of pads
First NP program was pads, begun in... - Correct Answer -1964 by Dr. Loretta Ford
and Dr. Henry Silver at CU Health Sciences mainly focusing on ambulatory and
output care
Historical service of NPs in primary care resulted in part from the... - Correct Answer
-availability of federal funding for preventive and primary care NP education
Movement of NPs expanded to the... - Correct Answer -input setting as a result of
managed care, hospital restructuring, and decreases in medical residency programs
4 distinct roles for NPs: - Correct Answer -clinician, consultant/collaborator, educator,
researcher
Crisis/Acute Grief Communication - Correct Answer -Acknowledge feelings
Offer self
Crisis Intervention - Correct Answer -Boundaries
Security if necessary, NOT police
Establish trust/rapport
Advance Directive - Correct Answer -Written statement of patient's intent regarding
medical treatment
The Patient Self-Determination Act of 1990 - Correct Answer -All patients in a
hospital setting are required to be advised of their right to execute an advance
directive
AGACNP Certification – Comprehensive Practice Questions
and Exam Preparation Material
Scope of Practice - Correct Answer -Based on legal allowances in each state,
individual state nurse practice acts providing guidelines for nursing practice
Key elements of the NP role include - Correct Answer -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... - Correct Answer -American
Nurses Association which measure quality of practice, service, or education
State Practice Acts - Correct Answer -Authorize Boards of Nursing in each state to
establish statutory authority for licensure of RNs
State Practice Acts - authority includes: - Correct Answer -use of title, authorization
for scope of practice including prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as - Correct Answer -certification
Prescriptive authority - Correct Answer -Ability and extent of NPs ability to prescribe
meds
DEA has ruled that nurses in advanced practice may obtain... - Correct Answer -
registration numbers, state practice acts dictate level of prescriptive authority allowed
Credentials encompass... - Correct Answer -required education, licensure and
certification to practice as an NP
Credentials establish... - Correct Answer -minimal levels of acceptable performance
Credentialing is necessary to: - Correct Answer -ensure that safe healthcare is
provided by qualified individuals; comply with federal and state laws r/t APN
Credentials also... - Correct Answer -acknowledges the scope of practice of NP,
mandates accountability, enforces professional standards for practice
Licensure - Correct Answer -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 - Correct
Answer -a governmental regulatory body (i.e. state board of nursing)
Certification - Correct Answer -Person has met certain standards that signify mastery
of specialized knowledge
,Certification is granted by nongovernmental agencies such as - Correct Answer -
ANCC, AANP
Admitting privileges to hospitals (non physician) were granted - Correct Answer -
1983 by JC
Credentialing and privileging - Correct Answer -process which an NP is granted
permission to practice in an input setting
Credentialing with hospital privileges is granted by a - Correct Answer -Hospital
Credentialing Committee
Pt Medical Abandonment - Correct Answer -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: - Correct Answer -
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 - Correct Answer -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. - Correct Answer -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. - Correct Answer -incident
reports
Policies regarding incident reports should address: - Correct Answer -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 - Correct Answer -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: - Correct Answer -pal notified after
receiving complaint; pal responsible for responding; pal responsible for monitoring
follow up
,Action taking initiatives: - Correct Answer -Prevention, correction (corrective steps
must be monitored and audited), documentation, education, departmental
coordination
Medical Futility - Correct Answer -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: - Correct Answer -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) - Correct Answer -state that
pt. is able to make personal decisions about their care
Competence implies that ability to: - Correct Answer -understand, reason,
differentiate good and bad, and communicate
Informed consent - Correct Answer -pt. has received adequate instruction or info
regarding aspects of care to make prudent, personal choice regarding such TX
Informed consent includes: - Correct Answer -discussing benefits and risk
Consent is assumed if... - Correct Answer -pt.’s condition is life threatening
Danforth Amendment 1991 - Correct Answer -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 - Correct Answer -study of moral conduct and behavior protecting the rights of
an individual
1st priority is the - Correct Answer -most salvageable pts. Most critically injured
cared for last.
Key ethical principles are: - Correct Answer -no maleficence, utilitarianism,
beneficence, justice, fidelity, veracity, autonomy
No maleficence - Correct Answer -duty to do no harm
Utilitarianism - Correct Answer -the right act is the one that produces the greatest
good for the greatest number
Beneficence - Correct Answer -duty to prevent harm and promote good
Justice - Correct Answer -duty to be fair
Fidelity - Correct Answer -duty to be faithful
, Veracity - Correct Answer -duty to be truthful (tends to be in conflict with fidelity)
Autonomy - Correct Answer -duty to respect an individual's thoughts and actions
(tend to be in conflict with beneficence)
Dismissing/discharging a pt. or closing practice - Correct Answer -NP cannot
withdraw from caring for a pt. without notification
Examples of reasons for discharging a pt. from practice: - Correct Answer -abuse,
refusal to pay, persistent non-adherence to care
Steps for discharging a pt. from practice: - Correct Answer -send a certified letter
with return receipt (copy for chart), provide general healthcare coverage for 1st 15-
30 days post termination deadline, obtain release of info to provide copies of all
needed records for next care provider
Obligations in closing practice d/t relocation, retirement - Correct Answer -give pt.
adequate time to find another provider, keep all files for min 5 years, and provide
timely notification and names of other providers and resources for future care
Role of NP developed in the early... - Correct Answer -1960s as a result of physician
shortages in the area of pads
First NP program was pads, begun in... - Correct Answer -1964 by Dr. Loretta Ford
and Dr. Henry Silver at CU Health Sciences mainly focusing on ambulatory and
output care
Historical service of NPs in primary care resulted in part from the... - Correct Answer
-availability of federal funding for preventive and primary care NP education
Movement of NPs expanded to the... - Correct Answer -input setting as a result of
managed care, hospital restructuring, and decreases in medical residency programs
4 distinct roles for NPs: - Correct Answer -clinician, consultant/collaborator, educator,
researcher
Crisis/Acute Grief Communication - Correct Answer -Acknowledge feelings
Offer self
Crisis Intervention - Correct Answer -Boundaries
Security if necessary, NOT police
Establish trust/rapport
Advance Directive - Correct Answer -Written statement of patient's intent regarding
medical treatment
The Patient Self-Determination Act of 1990 - Correct Answer -All patients in a
hospital setting are required to be advised of their right to execute an advance
directive
