Comprehensive ANCC AGACNP
Adult Gerontology Acute Care Nurse
Practitioner Board EXAM Guide
questions with verified accurate
solution (detailed & elaborated)
(2026/2027)
Scope of Practice - ANSBased on legal allowances in each state, individual state nurse
practice acts providing guidelines for nursing practice
Key elements of the NP role include - ANSintegration 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... - ANSAmerican Nurses Association
which measure quality of practice, service, or education
State Practice Acts - ANSAuthorize Boards of Nursing in each state to establish statutory
authority for licensure of RNs
State Practice Acts - authority includes: - ANSuse of title, authorization for scope of practice
including prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as - ANScertification
Prescriptive authority - ANSAbility and extent of NPs ability to prescribe meds
DEA has ruled that nurses in advanced practice may obtain.. - ANSregistration numbers, state
practice acts dictate level of prescriptive authority allowed
Credentials encompass... - ANSrequired education, licensure and certification to practice as
an NP
Credentials establish... - ANSminimal levels of acceptable performance
Credentialing is necessary to: - ANSensure that safe healthcare is provided by qualified
individuals; comply with federal and state laws r/t APN
Credentials also... - ANSacknowledges the scope of practice of NP, mandates accountability,
enforces professional standards for practice
Licensure - ANSestablishes that a person is qualified to perform in a particular professional
role
Licensure is granted as defined by rules and regulations set forth by - ANSa governmental
regulatory body (ie. state board of nursing)
Certification - ANSPerson has met certain standards that signify mastery of specialized
knowledge
Certification is granted by nongovernmental agencies such as - ANSANCC, AANP
Admitting privileges to hospitals (non physican) were granted - ANS1983 by JC
Credentialing and privileging - ANSprocess which an NP is granted permission to practice in
an inpt setting
Credentialing with hospital privileges is granted by a - ANSHospital Credentialing
Committee
Pt Medical Abandoment - ANSWhen 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: - ANSWhether NP accepted pt
assignment, whether NP provided reasonable notice before termination, whether reasonable
arrangements could have been made
,Comprehensive ANCC AGACNP
Adult Gerontology Acute Care Nurse
Practitioner Board EXAM Guide
questions with verified accurate
solution (detailed & elaborated)
(2026/2027)
Following do not constitute pt abandonment - ANSNP 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 addtl hrs
beyond posted work schedule when proper notification has been given..latter phrase can be
controversial
Risk Mgmt - ANSSystematic 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 - ANSincident reports
Policies regarding incident reports should address: - ANSppl authorized to complete report;
ppl responsible for review of a report, immediate actions needed to minimize the effects of
the event; ppl responsible for follow up; plan for monitoring aftermath; security/storage of
completed report
Risk mgmt - Satisfaction surveys - ANSImportant 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: - ANSppl notified after receiving complaint; ppl
responsible for responding; ppl responsible for monitoring follow up
Action taking initiatives: - ANSPrevention, correction (corrective steps must be monitored
and audited), documentation, education, departmental coordination
Medical Futility - ANSInterventions 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: - ANSQuantitative 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) - ANSstate that pt is able to make
personal decisions about their care
competence implies that ability to: - ANSunderstand, reason, differentiate good and bad, and
communicate
informed consent - ANSpt has received adequate instruction or info regarding aspects of care
to make prudent, personal choice regarding such tx
Informed consent includes: - ANSdiscussing benefits and risk
consent is assumed if... - ANSpt's condition is life threatening
Danforth Amendment 1991 - ANSpts 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 - ANSstudy of moral conduct and behavior protecting the rights of an individual
1st priority is the - ANSmost salvagable pts. Most critically injured cared for last.
,Comprehensive ANCC AGACNP
Adult Gerontology Acute Care Nurse
Practitioner Board EXAM Guide
questions with verified accurate
solution (detailed & elaborated)
(2026/2027)
Key ethical principles are: - ANSnonmaleficence, utilitarianism, beneficence, justice, fidelity,
veracity, autonomy
Nonmaleficence - ANSduty to do no harm
Utilitarianism - ANSthe right act is the one that produces the greatest good for the greatest
number
Beneficence - ANSduty to prevent harm and promote good
Justice - ANSduty to be fair
Fidelity - ANSduty to be faithful
Veracity - ANSduty to be truthful (tends to be in conflict with fidelity)
Autonomy - ANSduty to respect an individual's thoughts and actions (tend to be in conflict
with beneficence)
Dismissing/discharging a pt or closing practice - ANSNP cannot withdraw from caring for a
pt without notification
Examples of reasons for discharging a pt from practice: - ANSabuse, refusal to pay, persistent
non-adherence to care
Steps for discharging a pt from practice: - ANSsend 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 - ANSgive pt adequate time to find
another provider, keep all files for min 5 years, provide timely notification and names of
other providers and resources for future care
Role of NP developed in the early... - ANS1960s as a result of physician shortages in the area
of peds
First NP program was peds, begun in... - ANS1964 by Dr. Loretta Ford and Dr. Henry Silver
at CU Health Sciences mainly focusing on ambulatory and outpt care
Historical service of NPs in primary care resulted in part from the... - ANSavailability of
federal funding for preventive and primary care NP education
Movement of NPs expanded to the... - ANSinpt setting as a result of managed care, hospital
restructuring, and decreases in medical residency programs
4 distinct roles for NPs: - ANSclinician, consultant/collaborator, educator, researcher
Crisis/Acute Grief Communication - ANSAcknowledge feelings
Offer self
Crisis Intervention - ANSBoundaries
Security if necessary, NOT police
Establish trust/rapport
Advance Directive - ANSWritten statement of patient's intent regarding medical treatment
The Patient Self-Determination Act of 1990 - ANSAll patients in a hospital setting are
required to be advised of their right to execute an advance directive
, Comprehensive ANCC AGACNP
Adult Gerontology Acute Care Nurse
Practitioner Board EXAM Guide
questions with verified accurate
solution (detailed & elaborated)
(2026/2027)
Living Will - ANSCompilation of statements that specify which life-prolonging measures
one does and does not want if they become incapacitated
Durable Power of Attourney - ANSIndividual designated in the living will that is authorized
to make medical decisions in the event patient is incapacitated
Title I of HIPPA - ANSProtects health insurance coverage for workers and their families in
the event they change or lose their jobs
COBRA
COBRA - ANSprotects health insurance coverage for workers and their families in the event
worker loses or changes jobs
Who enforces HIPPA - ANSOffice for Civil Rights
Patient Safety Rule - ANSProtects patient information to analyze patient safety events and
improve
True or False: A patient has the right to see their medical record - ANSTrue
The Privacy Rule: Patient's Rights - ANSSee/have their medical record
Corrections added to medical record
Patient Safety and Quality Improvement Act (PSQIA) - ANSVoluntary reporting system
improve patient safety outcomes through anonymous reporting by providers of patient safety
outcomes and events
Duty to Warn - ANSPatient's condition may endanger others overrides confidentiality
Patient is diagnosed with HIV. Duty to Warn applies how? - ANSCan notify providers not
family
Invasion of Privacy - ANSDamaging one's reputation as a result of sharing patient
information without their permission
When can invasion of privacy charge not be made - ANSin good faith
accurate information
receiver has valid reason to obtain information
Initiating any change in heathcare - ANSBegin at most local level and expand outward
What comes first when treating a patient with a medical and psychosocial condition -
ANSMedical condition
strongest method to evaluate teaching - ANSreturned demonstration
when to transfer to teritary care facility - ANSseriously ill or injured patients that cannot be
cared for at your institution
stabilize and ship
Patient reluctant to undergo procedure. you should? - ANSFully educate patient and tell them
why
Primary care screening exams that are not emergent - ANSdo not delay hospital discharge
refer to PCP
most powerful data collected from patient - ANSsubjective or data you observed as the np
Adult Gerontology Acute Care Nurse
Practitioner Board EXAM Guide
questions with verified accurate
solution (detailed & elaborated)
(2026/2027)
Scope of Practice - ANSBased on legal allowances in each state, individual state nurse
practice acts providing guidelines for nursing practice
Key elements of the NP role include - ANSintegration 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... - ANSAmerican Nurses Association
which measure quality of practice, service, or education
State Practice Acts - ANSAuthorize Boards of Nursing in each state to establish statutory
authority for licensure of RNs
State Practice Acts - authority includes: - ANSuse of title, authorization for scope of practice
including prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as - ANScertification
Prescriptive authority - ANSAbility and extent of NPs ability to prescribe meds
DEA has ruled that nurses in advanced practice may obtain.. - ANSregistration numbers, state
practice acts dictate level of prescriptive authority allowed
Credentials encompass... - ANSrequired education, licensure and certification to practice as
an NP
Credentials establish... - ANSminimal levels of acceptable performance
Credentialing is necessary to: - ANSensure that safe healthcare is provided by qualified
individuals; comply with federal and state laws r/t APN
Credentials also... - ANSacknowledges the scope of practice of NP, mandates accountability,
enforces professional standards for practice
Licensure - ANSestablishes that a person is qualified to perform in a particular professional
role
Licensure is granted as defined by rules and regulations set forth by - ANSa governmental
regulatory body (ie. state board of nursing)
Certification - ANSPerson has met certain standards that signify mastery of specialized
knowledge
Certification is granted by nongovernmental agencies such as - ANSANCC, AANP
Admitting privileges to hospitals (non physican) were granted - ANS1983 by JC
Credentialing and privileging - ANSprocess which an NP is granted permission to practice in
an inpt setting
Credentialing with hospital privileges is granted by a - ANSHospital Credentialing
Committee
Pt Medical Abandoment - ANSWhen 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: - ANSWhether NP accepted pt
assignment, whether NP provided reasonable notice before termination, whether reasonable
arrangements could have been made
,Comprehensive ANCC AGACNP
Adult Gerontology Acute Care Nurse
Practitioner Board EXAM Guide
questions with verified accurate
solution (detailed & elaborated)
(2026/2027)
Following do not constitute pt abandonment - ANSNP 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 addtl hrs
beyond posted work schedule when proper notification has been given..latter phrase can be
controversial
Risk Mgmt - ANSSystematic 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 - ANSincident reports
Policies regarding incident reports should address: - ANSppl authorized to complete report;
ppl responsible for review of a report, immediate actions needed to minimize the effects of
the event; ppl responsible for follow up; plan for monitoring aftermath; security/storage of
completed report
Risk mgmt - Satisfaction surveys - ANSImportant 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: - ANSppl notified after receiving complaint; ppl
responsible for responding; ppl responsible for monitoring follow up
Action taking initiatives: - ANSPrevention, correction (corrective steps must be monitored
and audited), documentation, education, departmental coordination
Medical Futility - ANSInterventions 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: - ANSQuantitative 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) - ANSstate that pt is able to make
personal decisions about their care
competence implies that ability to: - ANSunderstand, reason, differentiate good and bad, and
communicate
informed consent - ANSpt has received adequate instruction or info regarding aspects of care
to make prudent, personal choice regarding such tx
Informed consent includes: - ANSdiscussing benefits and risk
consent is assumed if... - ANSpt's condition is life threatening
Danforth Amendment 1991 - ANSpts 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 - ANSstudy of moral conduct and behavior protecting the rights of an individual
1st priority is the - ANSmost salvagable pts. Most critically injured cared for last.
,Comprehensive ANCC AGACNP
Adult Gerontology Acute Care Nurse
Practitioner Board EXAM Guide
questions with verified accurate
solution (detailed & elaborated)
(2026/2027)
Key ethical principles are: - ANSnonmaleficence, utilitarianism, beneficence, justice, fidelity,
veracity, autonomy
Nonmaleficence - ANSduty to do no harm
Utilitarianism - ANSthe right act is the one that produces the greatest good for the greatest
number
Beneficence - ANSduty to prevent harm and promote good
Justice - ANSduty to be fair
Fidelity - ANSduty to be faithful
Veracity - ANSduty to be truthful (tends to be in conflict with fidelity)
Autonomy - ANSduty to respect an individual's thoughts and actions (tend to be in conflict
with beneficence)
Dismissing/discharging a pt or closing practice - ANSNP cannot withdraw from caring for a
pt without notification
Examples of reasons for discharging a pt from practice: - ANSabuse, refusal to pay, persistent
non-adherence to care
Steps for discharging a pt from practice: - ANSsend 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 - ANSgive pt adequate time to find
another provider, keep all files for min 5 years, provide timely notification and names of
other providers and resources for future care
Role of NP developed in the early... - ANS1960s as a result of physician shortages in the area
of peds
First NP program was peds, begun in... - ANS1964 by Dr. Loretta Ford and Dr. Henry Silver
at CU Health Sciences mainly focusing on ambulatory and outpt care
Historical service of NPs in primary care resulted in part from the... - ANSavailability of
federal funding for preventive and primary care NP education
Movement of NPs expanded to the... - ANSinpt setting as a result of managed care, hospital
restructuring, and decreases in medical residency programs
4 distinct roles for NPs: - ANSclinician, consultant/collaborator, educator, researcher
Crisis/Acute Grief Communication - ANSAcknowledge feelings
Offer self
Crisis Intervention - ANSBoundaries
Security if necessary, NOT police
Establish trust/rapport
Advance Directive - ANSWritten statement of patient's intent regarding medical treatment
The Patient Self-Determination Act of 1990 - ANSAll patients in a hospital setting are
required to be advised of their right to execute an advance directive
, Comprehensive ANCC AGACNP
Adult Gerontology Acute Care Nurse
Practitioner Board EXAM Guide
questions with verified accurate
solution (detailed & elaborated)
(2026/2027)
Living Will - ANSCompilation of statements that specify which life-prolonging measures
one does and does not want if they become incapacitated
Durable Power of Attourney - ANSIndividual designated in the living will that is authorized
to make medical decisions in the event patient is incapacitated
Title I of HIPPA - ANSProtects health insurance coverage for workers and their families in
the event they change or lose their jobs
COBRA
COBRA - ANSprotects health insurance coverage for workers and their families in the event
worker loses or changes jobs
Who enforces HIPPA - ANSOffice for Civil Rights
Patient Safety Rule - ANSProtects patient information to analyze patient safety events and
improve
True or False: A patient has the right to see their medical record - ANSTrue
The Privacy Rule: Patient's Rights - ANSSee/have their medical record
Corrections added to medical record
Patient Safety and Quality Improvement Act (PSQIA) - ANSVoluntary reporting system
improve patient safety outcomes through anonymous reporting by providers of patient safety
outcomes and events
Duty to Warn - ANSPatient's condition may endanger others overrides confidentiality
Patient is diagnosed with HIV. Duty to Warn applies how? - ANSCan notify providers not
family
Invasion of Privacy - ANSDamaging one's reputation as a result of sharing patient
information without their permission
When can invasion of privacy charge not be made - ANSin good faith
accurate information
receiver has valid reason to obtain information
Initiating any change in heathcare - ANSBegin at most local level and expand outward
What comes first when treating a patient with a medical and psychosocial condition -
ANSMedical condition
strongest method to evaluate teaching - ANSreturned demonstration
when to transfer to teritary care facility - ANSseriously ill or injured patients that cannot be
cared for at your institution
stabilize and ship
Patient reluctant to undergo procedure. you should? - ANSFully educate patient and tell them
why
Primary care screening exams that are not emergent - ANSdo not delay hospital discharge
refer to PCP
most powerful data collected from patient - ANSsubjective or data you observed as the np
