AGACNP - Based on Frances Guide
Review Materials Exam-Graded A
What is the best way to advocate for gay and lesbian population?
a. participate in a high state or national level
b. join a non-profit advocacy group
c. consider lobbying the government
d. start at your facility - ANSWER-d. start at your facility
Answers are worded differently. "decrease bias in healthcare" "create in-servises in
healthcare" "obtain funding to increase access"
Which of the following is most important to evaluate statistical significance when
reviewing the literature?
a. consider the sample size
b. make sure the confidence interval is tight
c. see if the p-value is less than the alpha-coefficient
d. determine the error rate - ANSWER-a. consider the sample size
When closing a practice, the NP is required to do all of the following except
a. give the patient adequate time to find another provder
b. keep all of the patient's records for a minimum of five years
c. send a certified letter with a return receipt requested
d. provide names of other providers for future care - ANSWER-c. send a certified letter
with a return receipt requested
Which of the following components of an evidenced based research process is the most
important for NP to participate in?
a. specifying methods of data collection
b. formulating the hypothesis
c. carefully reviewing the literature
d. formulating the research problem - ANSWER-d. formulating the research problem
Can you tell the patient's wife, for her protection, that her husband has HIV? -
ANSWER-No, not without his permission
An 80 year old male patient with dementia requires long-term care placement. To which
funding agency does the patient apply after "spending down" to qualify? - ANSWER-
Medicaid
,Your patient is worried about insurance coverage and asks you for advice on Medicaid.
You instruct the patient that Medicaid: - ANSWER-Pays after insurance and 3rd party
payers have paid
You are giving a dinner presentation to a group. The pharmaceutical rep calls you the
night before and wants you to say that their drug is the only one that workds. What
ethical principles does this challenge? - ANSWER-Veracity and fidelity
Health literacy - ANSWER-Average american: 8th grade level
Quality assurance - ANSWER-A process for evaluating the care of patients using
established standards of care to ensure quality
CPI - ANSWER-Measures structure, processes, and outcomes
A root cause analysis of a crisis situation in the ICU identified a lack of clinician-family
communication as the basis for the resulting adverse outcome. As part of the
performance improvement plan, the NP is asked to develop evidence-based policies to
establish clinician-family communication standards in the unit. These policies should
include: - ANSWER-Guidelines for having discussions with family members that are
geared toward establishing treatment goals
Which clinical scenario does the NP evaluate for a quality improvement process
change? - ANSWER-An increased incidence of postoperative sternal wound infections
Goals set forth in healthy people 2020 by the US department of Health and Human
services include: - ANSWER-elimination of health disparities (and increased QOL/LOL)
Based on the individual's culture, ethnicity, and personal choices, the NP can optimize
the therapeutic partnership with the patient by: - ANSWER-Tailoring his or her
communication style to the patient's preference
A 70 year old patient with a history of DM, HTN, OAs, and a new diagnosis of CAD, is
being discharged. The adult-gerontology acute care NP teaches the patient that the first
point of contact for health care needs is the: - ANSWER-PCP
The NP is asked to provide evidence to the hospital administration about the safety of
NP placing central lines. Which resource provides the strongest level of evidence? -
ANSWER-A systematic review (meta analysis)
What legislation allowed NPs to be recognized Medicare providers in all geographical
areas with their own provider number? - ANSWER-Balanced Budget act
True/false: restraining an unwilling patient is grounds for malpractice? - ANSWER-
False, if they are a danger you can restrain
,Patient presents to the clinic for routine f/u and passes out. You revive the patient and
admit overnight. Which of the following would qualify as incident to billing? - ANSWER-
Temperature and weight recording
The NP program initiated, primarily, because of what issue in healthcare at the time? -
ANSWER-Pediatric physician shortage
Elderly patient takes a turn for the worse. The husband is crying when you enter the
room and begins telling you what end-of-life care he prefers. What do you do? -
ANSWER-Ask him to speak candidly with you
Patient calls to complain about bills and states he has Medicare, which should cover all
costs. You explain: - ANSWER-Since you are healthy, exams are not covered
Doc calls from another center asking if you can tell him what kind of orders he should
give for maintenance of patient... - ANSWER-No, HIPPA
Patient in ER not doing well, primary MD calls: - ANSWER-Give him info
NP working on ESRD research project. A colleague renal specialist asks for patient info
on your patients: - ANSWER-HIPAA breach
Who enforces HIPAA? - ANSWER-Office of Civil Rights/Dept Health and Human
Services
Who isn't covered by HIPAA? - ANSWER-Law enforcment/municipal offices,
CPS/Schools, employers/workman's comp, life insurance
Insurance company calling to verify some patient appointments? - ANSWER-Answer by
picking out that there is already a medical release signed by the patient and give the
requested information to them
Benchmarking - ANSWER-How institution compares with similar organizations
Managed care - ANSWER-Know what this is and how it has improved costs, something
about putting caps on payments
Peer review - ANSWER-Timely, not anonymous, and NP knows how peer review will
impact yearly evaluation
Sensitivity vs specificity - ANSWER-Sensitivity: true positives, specificity: true negatives
There was a question where a patient had a multinodular goiter and wanted to know
why the NP was not going to do periodic US and fine needle biopsy in monitoring for
some kind of cancer or complication. The answer I picked was that these tests were not
very specific to detect the cancer
, Reliability - ANSWER-When implementing a new study, tested over and over, the
consistency of a measurement or the degree to which an instrument measures the
same way over time
Validity of results in an article - ANSWER-P-value, probability of falsely rejecting the null
hypothesis, want it to be <0.05
Statistical significance - ANSWER-Look at sample size and and low p value
Privileging - ANSWER-May be granted in full or part by the hospital, credentialing
committee is made of physicians
Who determines scope of practice? - ANSWER-State practice acts but institutional
bylaws may further restrict practice (facility limited scope of practice)
Informed consent - ANSWER-A state indicating patient has received adequate
instruction/information regarding aspects of care to make a prudent, personal choice
regarding such, includes risks and benefits, competence: ability to communicate,
understand, reason, differentiate good and bad
Case management - ANSWER-Mobilize, mointor, and control resources that a patient
uses during course of an illness while balancing quality and cost, "move patients
through the system appropriately"
50-60 year old patient ith a new diagnosis of cancer. To appropriately plan for
discharge, what should the NP do?
a. consult CM
b. Consult SW
c. refer to Oncology
d. refer to Hospice - ANSWER-a. consult CM
Nondisclosure - ANSWER-Not disclosing patient PHI without permission
Negligence - ANSWER-Failure of individual to do what any reasonable person would
do, resulting in injury to the patient
When serving as a nurse researcher, the NP is guided by which ethical principle to
ensure that research participants are protected from harm or exploitation? - ANSWER-
Nonmaleficence
Living will - ANSWER-Health care proxy/POA
NP sees a patient for HF and performs an H&P. What % is expected to be paid? -
ANSWER-Medicare pays 80% of the total bill, pt pays 20%, NP is reimbursed 85% of
what the MD is reimbursed for physician services, and for procedure 80% of that 85%
Review Materials Exam-Graded A
What is the best way to advocate for gay and lesbian population?
a. participate in a high state or national level
b. join a non-profit advocacy group
c. consider lobbying the government
d. start at your facility - ANSWER-d. start at your facility
Answers are worded differently. "decrease bias in healthcare" "create in-servises in
healthcare" "obtain funding to increase access"
Which of the following is most important to evaluate statistical significance when
reviewing the literature?
a. consider the sample size
b. make sure the confidence interval is tight
c. see if the p-value is less than the alpha-coefficient
d. determine the error rate - ANSWER-a. consider the sample size
When closing a practice, the NP is required to do all of the following except
a. give the patient adequate time to find another provder
b. keep all of the patient's records for a minimum of five years
c. send a certified letter with a return receipt requested
d. provide names of other providers for future care - ANSWER-c. send a certified letter
with a return receipt requested
Which of the following components of an evidenced based research process is the most
important for NP to participate in?
a. specifying methods of data collection
b. formulating the hypothesis
c. carefully reviewing the literature
d. formulating the research problem - ANSWER-d. formulating the research problem
Can you tell the patient's wife, for her protection, that her husband has HIV? -
ANSWER-No, not without his permission
An 80 year old male patient with dementia requires long-term care placement. To which
funding agency does the patient apply after "spending down" to qualify? - ANSWER-
Medicaid
,Your patient is worried about insurance coverage and asks you for advice on Medicaid.
You instruct the patient that Medicaid: - ANSWER-Pays after insurance and 3rd party
payers have paid
You are giving a dinner presentation to a group. The pharmaceutical rep calls you the
night before and wants you to say that their drug is the only one that workds. What
ethical principles does this challenge? - ANSWER-Veracity and fidelity
Health literacy - ANSWER-Average american: 8th grade level
Quality assurance - ANSWER-A process for evaluating the care of patients using
established standards of care to ensure quality
CPI - ANSWER-Measures structure, processes, and outcomes
A root cause analysis of a crisis situation in the ICU identified a lack of clinician-family
communication as the basis for the resulting adverse outcome. As part of the
performance improvement plan, the NP is asked to develop evidence-based policies to
establish clinician-family communication standards in the unit. These policies should
include: - ANSWER-Guidelines for having discussions with family members that are
geared toward establishing treatment goals
Which clinical scenario does the NP evaluate for a quality improvement process
change? - ANSWER-An increased incidence of postoperative sternal wound infections
Goals set forth in healthy people 2020 by the US department of Health and Human
services include: - ANSWER-elimination of health disparities (and increased QOL/LOL)
Based on the individual's culture, ethnicity, and personal choices, the NP can optimize
the therapeutic partnership with the patient by: - ANSWER-Tailoring his or her
communication style to the patient's preference
A 70 year old patient with a history of DM, HTN, OAs, and a new diagnosis of CAD, is
being discharged. The adult-gerontology acute care NP teaches the patient that the first
point of contact for health care needs is the: - ANSWER-PCP
The NP is asked to provide evidence to the hospital administration about the safety of
NP placing central lines. Which resource provides the strongest level of evidence? -
ANSWER-A systematic review (meta analysis)
What legislation allowed NPs to be recognized Medicare providers in all geographical
areas with their own provider number? - ANSWER-Balanced Budget act
True/false: restraining an unwilling patient is grounds for malpractice? - ANSWER-
False, if they are a danger you can restrain
,Patient presents to the clinic for routine f/u and passes out. You revive the patient and
admit overnight. Which of the following would qualify as incident to billing? - ANSWER-
Temperature and weight recording
The NP program initiated, primarily, because of what issue in healthcare at the time? -
ANSWER-Pediatric physician shortage
Elderly patient takes a turn for the worse. The husband is crying when you enter the
room and begins telling you what end-of-life care he prefers. What do you do? -
ANSWER-Ask him to speak candidly with you
Patient calls to complain about bills and states he has Medicare, which should cover all
costs. You explain: - ANSWER-Since you are healthy, exams are not covered
Doc calls from another center asking if you can tell him what kind of orders he should
give for maintenance of patient... - ANSWER-No, HIPPA
Patient in ER not doing well, primary MD calls: - ANSWER-Give him info
NP working on ESRD research project. A colleague renal specialist asks for patient info
on your patients: - ANSWER-HIPAA breach
Who enforces HIPAA? - ANSWER-Office of Civil Rights/Dept Health and Human
Services
Who isn't covered by HIPAA? - ANSWER-Law enforcment/municipal offices,
CPS/Schools, employers/workman's comp, life insurance
Insurance company calling to verify some patient appointments? - ANSWER-Answer by
picking out that there is already a medical release signed by the patient and give the
requested information to them
Benchmarking - ANSWER-How institution compares with similar organizations
Managed care - ANSWER-Know what this is and how it has improved costs, something
about putting caps on payments
Peer review - ANSWER-Timely, not anonymous, and NP knows how peer review will
impact yearly evaluation
Sensitivity vs specificity - ANSWER-Sensitivity: true positives, specificity: true negatives
There was a question where a patient had a multinodular goiter and wanted to know
why the NP was not going to do periodic US and fine needle biopsy in monitoring for
some kind of cancer or complication. The answer I picked was that these tests were not
very specific to detect the cancer
, Reliability - ANSWER-When implementing a new study, tested over and over, the
consistency of a measurement or the degree to which an instrument measures the
same way over time
Validity of results in an article - ANSWER-P-value, probability of falsely rejecting the null
hypothesis, want it to be <0.05
Statistical significance - ANSWER-Look at sample size and and low p value
Privileging - ANSWER-May be granted in full or part by the hospital, credentialing
committee is made of physicians
Who determines scope of practice? - ANSWER-State practice acts but institutional
bylaws may further restrict practice (facility limited scope of practice)
Informed consent - ANSWER-A state indicating patient has received adequate
instruction/information regarding aspects of care to make a prudent, personal choice
regarding such, includes risks and benefits, competence: ability to communicate,
understand, reason, differentiate good and bad
Case management - ANSWER-Mobilize, mointor, and control resources that a patient
uses during course of an illness while balancing quality and cost, "move patients
through the system appropriately"
50-60 year old patient ith a new diagnosis of cancer. To appropriately plan for
discharge, what should the NP do?
a. consult CM
b. Consult SW
c. refer to Oncology
d. refer to Hospice - ANSWER-a. consult CM
Nondisclosure - ANSWER-Not disclosing patient PHI without permission
Negligence - ANSWER-Failure of individual to do what any reasonable person would
do, resulting in injury to the patient
When serving as a nurse researcher, the NP is guided by which ethical principle to
ensure that research participants are protected from harm or exploitation? - ANSWER-
Nonmaleficence
Living will - ANSWER-Health care proxy/POA
NP sees a patient for HF and performs an H&P. What % is expected to be paid? -
ANSWER-Medicare pays 80% of the total bill, pt pays 20%, NP is reimbursed 85% of
what the MD is reimbursed for physician services, and for procedure 80% of that 85%
