ANCC AGACNP
FRANCES GUIDE REVIEW
500+ Practice Qs w/ Ans
board-exam preparation
Main Features:
• Focused ANCC AGACNP board-exam review
• Extensive collection of practice questions
• Helpful for identifying knowledge gaps
• Covers high-yield acute care concepts
• Supports structured study and final revision
,1. You want to get more funding for your hospital's Rapid Response Team. How should
you present this issue to the committee?
a. Stress importance of the team (look up evidence about how team affects outcomes)
b. Describe how to improve and expand the team
>>> a. stress importance of team
2. What is the best way for the AGACNP to get involved in policy making?
a. attend legislative days at the state capitol
b. join a hospital committee
c. write your local congressman
d. review literature and give more in-services
>>> b. join a hospital committee
3. What is the best way for the AGACNP to demonstrate and advocate for full scope of
practice?
a. join a hospital committee
b. petition the government
c. bill for independent services
d. start your own practice
>>> c. bill for independent services
4. Which of the following is considered a high acuity role for the AGACNP?
a. primary care clinic
b. cardiology office
c. community health department
d. minute clinic
>>> b. cardiology office
5. 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
>>> d. start at your facility Answers are worded differently. "decrease bias in healthcare"
"create in-servises in healthcare" "obtain funding to increase access"
6. 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 alphacoefficient
d. determine the error rate
>>> a. consider the sample size
7. 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
>>> c. send a certified letter with a return receipt requested
8. 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
>>> d. formulating the research problem
9. A former pt of an NP is writing blog posts, sending emails, and distributing false,
accusatory statements about the NP's practice. Which of the following forms of
defamation is this?
, a. libel
b. slander
>>> a. libel
10. Can you tell the patient's wife, for her protection, that her husband has HIV?
>>> No, not without his permission
11. How can the ANCP prepare to get involved in future mass casualty event?
>>> Pre enroll in disaster volunteer program
12. 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?
>>> Medicaid
13. Your patient is worried about insurance coverage and asks you for advice on
Medicaid. You instruct the patient that Medicaid:
>>> Pays after insurance and 3rd party payers have paid
14. 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?
>>> Veracity and fidelity
15. Health literacy
>>> Average american: 8th grade level
16. Quality assurance
>>> A process for evaluating the care of patients using established standards of care to
ensure quality
17. CPI
>>> Measures structure, processes, and outcomes
18. 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:
, >>> Guidelines for having discussions with family members that are geared toward
establishing treatment goals
19. Which clinical scenario does the NP evaluate for a quality improvement process
change?
>>> An increased incidence of postoperative sternal wound infections
20. Goals set forth in healthy people 2020 by the US department of Health and Human
services include:
>>> elimination of health disparities (and increased QOL/LOL)
21. Based on the individual's culture, ethnicity, and personal choices, the NP can
optimize the therapeutic partnership with the patient by:
>>> Tailoring his or her communication style to the patient's preference
22. 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:
>>> PCP
23. 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?
>>> A systematic review (meta analysis)
24. What legislation allowed NPs to be recognized Medicare providers in all geographical
areas with their own provider number?
>>> Balanced Budget act
25. True/false: restraining an unwilling patient is grounds for malpractice?
>>> False, if they are a danger you can restrain
26. 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?
>>> Temperature and weight recording
27. The NP program initiated, primarily, because of what issue in healthcare at the time?
>>> Pediatric physician shortage
28. 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?
, >>> Ask him to speak candidly with you
29. Patient calls to complain about bills and states he has Medicare, which should cover
all costs. You explain:
>>> Since you are healthy, exams are not covered
30. Doc calls from another center asking if you can tell him what kind of orders he should
give for maintenance of patient...
>>> No, HIPPA
31. Patient in ER not doing well, primary MD calls:
>>> Give him info
32. NP working on ESRD research project. A colleague renal specialist asks for patient
info on your patients:
>>> HIPAA breach
33. Who enforces HIPAA?
>>> Office of Civil Rights/Dept Health and Human Services
34. Who isn't covered by HIPAA?
>>> Law enforcment/municipal offices, CPS/Schools, employers/workman's comp, life
insurance
35. Insurance company calling to verify some patient appointments?
>>> Answer by picking out that there is already a medical release signed by the patient and
give the requested information to them
36. Benchmarking
>>> How institution compares with similar organizations
37. Managed care
>>> Know what this is and how it has improved costs, something about putting caps on
payments
38. Peer review
>>> Timely, not anonymous, and NP knows how peer review will impact yearly evaluation
39. Sensitivity vs specificity
, >>> 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
40. Reliability
>>> 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
41. Validity of results in an article
>>> P-value, probability of falsely rejecting the null hypothesis, want it to be <0.05
42. Statistical significance
>>> Look at sample size and p value
43. Privileging
>>> May be granted in full or part by the hospital, credentialing committee is made of
physicians
44. Who determines scope of practice?
>>> State practice acts but institutional bylaws may further restrict practice (facility limited
scope of practice)
45. Informed consent
>>> 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
46. Case management
>>> 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"
47. 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
, >>> a. consult CM
48. Nondisclosure
>>> Not disclosing patient PHI without permission
49. Negligence
>>> Failure of individual to do what any reasonable person would do, resulting in injury to
the patient
50. 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?
>>> Nonmaleficence
51. Living will
>>> Health care proxy/POA
52. NP sees a patient for HF and performs an H&P. What % is expected to be paid?
>>> 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%
53. Focus of palliative care
>>> Basic improvement in QOL of anyone with an illness at any stage
54. Hospice
>>> <6m to live
55. Scope of practice: integration of care across the acute illness continuum with:
a. collaboration
b. coordination of care
c. research based clinical practice
>>> a. collaboration
56. Collaboration
>>> True partnership in which all players have the desire power, share common goals, and
recognize/accept separate areas of responsibility/activity
57. Patient is getting d/c'd and need wound care, pulmonary, and follow up. NP's role is
to:
, >>> Coordinate services
58. Government is moving towards being cost effective. What is the best way?
>>> Allow NP to treat a wider variety of patients
59. Protected health information: discussion between the NP and consultant on case
>>> Considered clinical relevance
60. How should the ACNP stay up to date with current information?
>>> Evidence based guidelines
61. Which medicare is Hospice covered under?
>>> Medicare A
62. A patient presents to the Er with c/o CP and SOB. The NP misinterprets the EKG and
admits the patient fro further monitoring without consulting cardio. Later in the shift, the
patient decompensates and goes into cardiac arrest. The patient was resuscitated but
sustained permanent brain damage. What grounds of malpractice is the NP accountable
for?
>>> Lack of skill
63. Healthcare exchange
>>> Health insurance marketplaces, organizations in each state through which people can
purchase health insurance
64. You notice there have been less favorable outcomes and satisfaction surveys in
patients treated for sickle cell anemia. How do you approach this problem?
a. ask the patients treated how care can be improved
b. look back at prior treatment given to see how outcomes can be improved
c. form a standardized tx plan for all patients that can be used by all healthcare staff
d. form individualized tx plans that can be used by all healthcare staff
>>> c. form a standardized tx plan for all patients that can be used by all healthcare staff
65. You have transferred a patient to the SNF. The MD in charge at that facility calls for
info about the patient's medical care, what do you do?
a. direct him to look it up in the EMR
b. refuse to share protected health information
, c. instruct him to call the department head
d. share the information he requests
>>> d. share the information he requests
66. Your patient has refused human blood products based on religious beliefs. He is now
rapidly destabilizing. What do you do?
a. administer PRBCs as needed
b. call the ethics committee
c. continue to research alternative treatments
d. ask the family to give permission now that he's unconscious
>>> c. continue to research alternative treatments
67. What is the best way to make sure a patient will follow up as instructed?
a. instruct the patient to schedule the appointment
b. ask the patient the best time they can go to an appointment
c. have the office manager to schedule the appointment
d. schedule the appointment for the patient
>>> d. schedule the appointment for the patient
68. Your patient is brain dead on the ventilator. The family wants all possible treatment
measures done to preserves life, but states that the patient would not want to be on a
ventilator. What should you do?
a. consult neurology to come interview the family
b. document the situation carefully in the chart
c. call a clergy member to offer support
d. call the ethics committee
>>> d. call the ethics committee
69. A patient visits your clinic for sinusitis. She requests a PAP smear since she has not
had one in "years". You:
a. refer her to a gynecologist
b. schedule her to come back next week for the PAP at another appt
FRANCES GUIDE REVIEW
500+ Practice Qs w/ Ans
board-exam preparation
Main Features:
• Focused ANCC AGACNP board-exam review
• Extensive collection of practice questions
• Helpful for identifying knowledge gaps
• Covers high-yield acute care concepts
• Supports structured study and final revision
,1. You want to get more funding for your hospital's Rapid Response Team. How should
you present this issue to the committee?
a. Stress importance of the team (look up evidence about how team affects outcomes)
b. Describe how to improve and expand the team
>>> a. stress importance of team
2. What is the best way for the AGACNP to get involved in policy making?
a. attend legislative days at the state capitol
b. join a hospital committee
c. write your local congressman
d. review literature and give more in-services
>>> b. join a hospital committee
3. What is the best way for the AGACNP to demonstrate and advocate for full scope of
practice?
a. join a hospital committee
b. petition the government
c. bill for independent services
d. start your own practice
>>> c. bill for independent services
4. Which of the following is considered a high acuity role for the AGACNP?
a. primary care clinic
b. cardiology office
c. community health department
d. minute clinic
>>> b. cardiology office
5. 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
>>> d. start at your facility Answers are worded differently. "decrease bias in healthcare"
"create in-servises in healthcare" "obtain funding to increase access"
6. 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 alphacoefficient
d. determine the error rate
>>> a. consider the sample size
7. 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
>>> c. send a certified letter with a return receipt requested
8. 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
>>> d. formulating the research problem
9. A former pt of an NP is writing blog posts, sending emails, and distributing false,
accusatory statements about the NP's practice. Which of the following forms of
defamation is this?
, a. libel
b. slander
>>> a. libel
10. Can you tell the patient's wife, for her protection, that her husband has HIV?
>>> No, not without his permission
11. How can the ANCP prepare to get involved in future mass casualty event?
>>> Pre enroll in disaster volunteer program
12. 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?
>>> Medicaid
13. Your patient is worried about insurance coverage and asks you for advice on
Medicaid. You instruct the patient that Medicaid:
>>> Pays after insurance and 3rd party payers have paid
14. 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?
>>> Veracity and fidelity
15. Health literacy
>>> Average american: 8th grade level
16. Quality assurance
>>> A process for evaluating the care of patients using established standards of care to
ensure quality
17. CPI
>>> Measures structure, processes, and outcomes
18. 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:
, >>> Guidelines for having discussions with family members that are geared toward
establishing treatment goals
19. Which clinical scenario does the NP evaluate for a quality improvement process
change?
>>> An increased incidence of postoperative sternal wound infections
20. Goals set forth in healthy people 2020 by the US department of Health and Human
services include:
>>> elimination of health disparities (and increased QOL/LOL)
21. Based on the individual's culture, ethnicity, and personal choices, the NP can
optimize the therapeutic partnership with the patient by:
>>> Tailoring his or her communication style to the patient's preference
22. 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:
>>> PCP
23. 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?
>>> A systematic review (meta analysis)
24. What legislation allowed NPs to be recognized Medicare providers in all geographical
areas with their own provider number?
>>> Balanced Budget act
25. True/false: restraining an unwilling patient is grounds for malpractice?
>>> False, if they are a danger you can restrain
26. 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?
>>> Temperature and weight recording
27. The NP program initiated, primarily, because of what issue in healthcare at the time?
>>> Pediatric physician shortage
28. 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?
, >>> Ask him to speak candidly with you
29. Patient calls to complain about bills and states he has Medicare, which should cover
all costs. You explain:
>>> Since you are healthy, exams are not covered
30. Doc calls from another center asking if you can tell him what kind of orders he should
give for maintenance of patient...
>>> No, HIPPA
31. Patient in ER not doing well, primary MD calls:
>>> Give him info
32. NP working on ESRD research project. A colleague renal specialist asks for patient
info on your patients:
>>> HIPAA breach
33. Who enforces HIPAA?
>>> Office of Civil Rights/Dept Health and Human Services
34. Who isn't covered by HIPAA?
>>> Law enforcment/municipal offices, CPS/Schools, employers/workman's comp, life
insurance
35. Insurance company calling to verify some patient appointments?
>>> Answer by picking out that there is already a medical release signed by the patient and
give the requested information to them
36. Benchmarking
>>> How institution compares with similar organizations
37. Managed care
>>> Know what this is and how it has improved costs, something about putting caps on
payments
38. Peer review
>>> Timely, not anonymous, and NP knows how peer review will impact yearly evaluation
39. Sensitivity vs specificity
, >>> 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
40. Reliability
>>> 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
41. Validity of results in an article
>>> P-value, probability of falsely rejecting the null hypothesis, want it to be <0.05
42. Statistical significance
>>> Look at sample size and p value
43. Privileging
>>> May be granted in full or part by the hospital, credentialing committee is made of
physicians
44. Who determines scope of practice?
>>> State practice acts but institutional bylaws may further restrict practice (facility limited
scope of practice)
45. Informed consent
>>> 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
46. Case management
>>> 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"
47. 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
, >>> a. consult CM
48. Nondisclosure
>>> Not disclosing patient PHI without permission
49. Negligence
>>> Failure of individual to do what any reasonable person would do, resulting in injury to
the patient
50. 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?
>>> Nonmaleficence
51. Living will
>>> Health care proxy/POA
52. NP sees a patient for HF and performs an H&P. What % is expected to be paid?
>>> 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%
53. Focus of palliative care
>>> Basic improvement in QOL of anyone with an illness at any stage
54. Hospice
>>> <6m to live
55. Scope of practice: integration of care across the acute illness continuum with:
a. collaboration
b. coordination of care
c. research based clinical practice
>>> a. collaboration
56. Collaboration
>>> True partnership in which all players have the desire power, share common goals, and
recognize/accept separate areas of responsibility/activity
57. Patient is getting d/c'd and need wound care, pulmonary, and follow up. NP's role is
to:
, >>> Coordinate services
58. Government is moving towards being cost effective. What is the best way?
>>> Allow NP to treat a wider variety of patients
59. Protected health information: discussion between the NP and consultant on case
>>> Considered clinical relevance
60. How should the ACNP stay up to date with current information?
>>> Evidence based guidelines
61. Which medicare is Hospice covered under?
>>> Medicare A
62. A patient presents to the Er with c/o CP and SOB. The NP misinterprets the EKG and
admits the patient fro further monitoring without consulting cardio. Later in the shift, the
patient decompensates and goes into cardiac arrest. The patient was resuscitated but
sustained permanent brain damage. What grounds of malpractice is the NP accountable
for?
>>> Lack of skill
63. Healthcare exchange
>>> Health insurance marketplaces, organizations in each state through which people can
purchase health insurance
64. You notice there have been less favorable outcomes and satisfaction surveys in
patients treated for sickle cell anemia. How do you approach this problem?
a. ask the patients treated how care can be improved
b. look back at prior treatment given to see how outcomes can be improved
c. form a standardized tx plan for all patients that can be used by all healthcare staff
d. form individualized tx plans that can be used by all healthcare staff
>>> c. form a standardized tx plan for all patients that can be used by all healthcare staff
65. You have transferred a patient to the SNF. The MD in charge at that facility calls for
info about the patient's medical care, what do you do?
a. direct him to look it up in the EMR
b. refuse to share protected health information
, c. instruct him to call the department head
d. share the information he requests
>>> d. share the information he requests
66. Your patient has refused human blood products based on religious beliefs. He is now
rapidly destabilizing. What do you do?
a. administer PRBCs as needed
b. call the ethics committee
c. continue to research alternative treatments
d. ask the family to give permission now that he's unconscious
>>> c. continue to research alternative treatments
67. What is the best way to make sure a patient will follow up as instructed?
a. instruct the patient to schedule the appointment
b. ask the patient the best time they can go to an appointment
c. have the office manager to schedule the appointment
d. schedule the appointment for the patient
>>> d. schedule the appointment for the patient
68. Your patient is brain dead on the ventilator. The family wants all possible treatment
measures done to preserves life, but states that the patient would not want to be on a
ventilator. What should you do?
a. consult neurology to come interview the family
b. document the situation carefully in the chart
c. call a clergy member to offer support
d. call the ethics committee
>>> d. call the ethics committee
69. A patient visits your clinic for sinusitis. She requests a PAP smear since she has not
had one in "years". You:
a. refer her to a gynecologist
b. schedule her to come back next week for the PAP at another appt
