N5350 Roles Final Study Guide 2026–2027 – Complete
Review, Practice Questions, Correct Answers & Exam Prep
1. What are the 4 settings for prescriptive authority? Describe the requirements in each setting for
physician supervision, # of NPs, chart review, and any other special requirements in that site. - correct
answers -1. Medically Underserved
2. Physician Primary Site
3. Physician Alternate Site
4. Facility Based Practice Site.
* General requirements per TBON rule 222.5: regular visits, chart review as determined by APRN &
physician, periodic face to face meeting of APRN & physician to discuss pt care & improvement.
1a) Medically Underserved - correct answers -*site must be official, physician must be reachable by
phone & must be provided with daily status report of any major problems outside of the protocol.
*must have protocols.
1b) Physician Primary Practice Site - correct answers -* Must have protocols.
*Sign drug orders only for pts whom the MD has/will establish a relationship.
*alternate MD may delegate.
*MD may delegate to no more than 7 APNS or PAs.
*Physician on-site visits should be 50% of the time according to BME.
1c) Facility Based Practice - correct answers -*Must be physically present in facility (hospital or long
term facility).
*Physician must give prior consent.
1
,*Delegation only at > one hospital or > 2 long term care facilities - now it is 7 FTEs.
*Long term care-only 4 APNs (APRNs) or 4 PAs or their FTE equivalent - now it is 7 FTE & approved by
Chief Physician of Facility.
*Protocol signed by the Chief Physician.
1d) Physician Alternate Site - correct answers -*No longer in effect.
2. The FOUR Approved Categories of APN in TX? - correct answers -*CRNA, NP, CNS, and CNM
3. NP requirements by BON for approval of license/ AP recognition each biennium. - correct answers -
*Current valid RN licensure.
*400 hours of current clinical practice.
*20 hours of CEs.
*8 hours of continuing education in pharmacotherapeutics.
*Current board certification.
*Separate application for dual roles.
4. New NP graduate requirements when applying for the board? - correct answers -*Must take and pass
national certification exam.
5. What is the NP's scope of practice based on? - correct answers -*Nurse practice acts define legal
scope of practice for licensed practitioners.
*Includes privileges for diagnosis, treatment, prescriptive authority and reimbursement.
2
,11. What are clinical privileges and how are they obtained? - correct answers -*autonomy to perform
expanded role functions based on the individuals licensure, educational preparation, clinical experience,
and credentials.
*Via contractual agreement with hospitals or long term care facilities.
12. Define Malpractice - correct answers -*Any professional misconduct, unreasonable lack of skill, or
infidelity in professional or fiduciary duties, or illegal or immoral conduct.
*Negligence is the failure of an individual to do something that a reasonable person would do, that
results in injury to another.
*The alleged failure on the part of a professional to render services with the degree of care, diligence,
and precaution that another member of the same profession in similar circumstances would render to
prevent injury to some one else.
13. FOUR Elements of Malpractice - correct answers -1. Duty: provide some level of care, had some
contact.
2. Dereliction: reasonable, ordinary care, skill and diligence as NP's in good standing in similar practice.
3. Damage: Must have an injury or no malpractice even if violated standard of care; cap "pain and
suffering" $250,000 to $500, 000.
4. Causation of Injury: For malpractice to have occurred, a breach of the standard of care must have
caused an injury to the patient.
15. National Practitioner Data Bank - correct answers -*Receives and discloses the reports on medical
malpractice.
Who is credited to be the first advanced practice nurse role? - correct answers -Nurse Anesthesia in
1800's- perhaps the oldest advanced nursing specialty, Sister Mary Bernard at St. Vincent's Hospital was
the first anesthetist
3
, Who is credited to be the founder of the first nurse practitioner role? - correct answers -Loretta Ford-
1965- Colorado
Who is (are) the oldest primary care providers in the history of advanced practice nurses? - correct
answers -Midwifes in 1700's- perhaps the oldest primary health care provider
Martha Bullard, 1785 is the oldest noted in publication
What are the roles of APRNs? How are they different from each other? - correct answers -To provide
health care to individuals, family, groups in a variety of health care settings (homes, hospitals,
institutions, offices, clinics, etc)
APRN includes NP, nurse midwife, nurse anesthetist, and clinical nurse specialist
What states are responsible for being the first to have advanced practice language in their nurse
practice act? - correct answers -Idaho (language read- "assess, diagnose, treat")
What is NONPF? What is their influence for APRNs? - correct answers -National Organization of Nurse
Practitioner Faculty
They have developed domains and competencies
Organized role competencies (policy, ethics, quality, leadership, etc)
How is the NP role different from PA role? - correct answers -•PA's work directly under a MD, NP's can
function independently
•NP's focus on multiple practice and nursing models
•PA's focus on medical tasks utilizing a medical framework
What are the key elements of OTA, Brown, Safriet and Mundinger - correct answers -• OTA
4
Review, Practice Questions, Correct Answers & Exam Prep
1. What are the 4 settings for prescriptive authority? Describe the requirements in each setting for
physician supervision, # of NPs, chart review, and any other special requirements in that site. - correct
answers -1. Medically Underserved
2. Physician Primary Site
3. Physician Alternate Site
4. Facility Based Practice Site.
* General requirements per TBON rule 222.5: regular visits, chart review as determined by APRN &
physician, periodic face to face meeting of APRN & physician to discuss pt care & improvement.
1a) Medically Underserved - correct answers -*site must be official, physician must be reachable by
phone & must be provided with daily status report of any major problems outside of the protocol.
*must have protocols.
1b) Physician Primary Practice Site - correct answers -* Must have protocols.
*Sign drug orders only for pts whom the MD has/will establish a relationship.
*alternate MD may delegate.
*MD may delegate to no more than 7 APNS or PAs.
*Physician on-site visits should be 50% of the time according to BME.
1c) Facility Based Practice - correct answers -*Must be physically present in facility (hospital or long
term facility).
*Physician must give prior consent.
1
,*Delegation only at > one hospital or > 2 long term care facilities - now it is 7 FTEs.
*Long term care-only 4 APNs (APRNs) or 4 PAs or their FTE equivalent - now it is 7 FTE & approved by
Chief Physician of Facility.
*Protocol signed by the Chief Physician.
1d) Physician Alternate Site - correct answers -*No longer in effect.
2. The FOUR Approved Categories of APN in TX? - correct answers -*CRNA, NP, CNS, and CNM
3. NP requirements by BON for approval of license/ AP recognition each biennium. - correct answers -
*Current valid RN licensure.
*400 hours of current clinical practice.
*20 hours of CEs.
*8 hours of continuing education in pharmacotherapeutics.
*Current board certification.
*Separate application for dual roles.
4. New NP graduate requirements when applying for the board? - correct answers -*Must take and pass
national certification exam.
5. What is the NP's scope of practice based on? - correct answers -*Nurse practice acts define legal
scope of practice for licensed practitioners.
*Includes privileges for diagnosis, treatment, prescriptive authority and reimbursement.
2
,11. What are clinical privileges and how are they obtained? - correct answers -*autonomy to perform
expanded role functions based on the individuals licensure, educational preparation, clinical experience,
and credentials.
*Via contractual agreement with hospitals or long term care facilities.
12. Define Malpractice - correct answers -*Any professional misconduct, unreasonable lack of skill, or
infidelity in professional or fiduciary duties, or illegal or immoral conduct.
*Negligence is the failure of an individual to do something that a reasonable person would do, that
results in injury to another.
*The alleged failure on the part of a professional to render services with the degree of care, diligence,
and precaution that another member of the same profession in similar circumstances would render to
prevent injury to some one else.
13. FOUR Elements of Malpractice - correct answers -1. Duty: provide some level of care, had some
contact.
2. Dereliction: reasonable, ordinary care, skill and diligence as NP's in good standing in similar practice.
3. Damage: Must have an injury or no malpractice even if violated standard of care; cap "pain and
suffering" $250,000 to $500, 000.
4. Causation of Injury: For malpractice to have occurred, a breach of the standard of care must have
caused an injury to the patient.
15. National Practitioner Data Bank - correct answers -*Receives and discloses the reports on medical
malpractice.
Who is credited to be the first advanced practice nurse role? - correct answers -Nurse Anesthesia in
1800's- perhaps the oldest advanced nursing specialty, Sister Mary Bernard at St. Vincent's Hospital was
the first anesthetist
3
, Who is credited to be the founder of the first nurse practitioner role? - correct answers -Loretta Ford-
1965- Colorado
Who is (are) the oldest primary care providers in the history of advanced practice nurses? - correct
answers -Midwifes in 1700's- perhaps the oldest primary health care provider
Martha Bullard, 1785 is the oldest noted in publication
What are the roles of APRNs? How are they different from each other? - correct answers -To provide
health care to individuals, family, groups in a variety of health care settings (homes, hospitals,
institutions, offices, clinics, etc)
APRN includes NP, nurse midwife, nurse anesthetist, and clinical nurse specialist
What states are responsible for being the first to have advanced practice language in their nurse
practice act? - correct answers -Idaho (language read- "assess, diagnose, treat")
What is NONPF? What is their influence for APRNs? - correct answers -National Organization of Nurse
Practitioner Faculty
They have developed domains and competencies
Organized role competencies (policy, ethics, quality, leadership, etc)
How is the NP role different from PA role? - correct answers -•PA's work directly under a MD, NP's can
function independently
•NP's focus on multiple practice and nursing models
•PA's focus on medical tasks utilizing a medical framework
What are the key elements of OTA, Brown, Safriet and Mundinger - correct answers -• OTA
4
