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HAMRIC AND HANSON'S ADVANCED PRACTICE
NURSING 7TH EDITION
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VERIFIED ANSWERS | DOWNLOAD IMMEDIATELY AFTER THE ORDER
,Table of Contents
Chapter 01 History and Evolution of Advanced Practice Nursing 1
Chapter 02 Conceptualizations of Advanced Practice Nursing 5
Chapter 03 A Definition of Advanced Practice Nursing 9
Chapter 04 Role Development of the Advanced Practice Nurse 13
Chapter 05 International Development of Advanced Practice Nursing 19
Chapter 06 Direct Clinical Practice 22
Chapter 07 Guidance and Coaching 30
Chapter 08 Evidence-Based Practice 35
Chapter 09 Leadership 40
Chapter 10 Collaboration 44
Chapter 11 Ethical Practice 51
Chapter 12 The Clinical Nurse Specialist 57
Chapter 13 The Primary Care Nurse Practitioner 61
Chapter 14 The Acute Care Nurse Practitioner 65
Chapter 15 The Certified Nurse-Midwife 69
Chapter 16 The Certified Registered Nurse Anesthetist 74
Chapter 17 Maximizing APRN Power and Influencing Policy 78
Chapter 18 Marketing Yourself as an APRN Contracting and Negotiation 82
Chapter 19 Reimbursement and Payment for APRN Services 88
Chapter 20 Understanding Regulatory, Legal, and Credentialing Requirements 94
Chapter 21 APRN Outcomes and Performance Improvement Research 97
Chapter 22 Future Technologies Influencing APRN Practice 100
Chapter 23 Using Healthcare Information Technology to Evaluate and Improve
Performance and Patient Outcomes 104
,Chapter 01: History and Evolution of Advanced Practice Nursing
Tracy & O’Grady: Hamric & Hanson’s Advanced Practice Nursing, 7th Edition
MULTIPLE CHOICE
1. Which of the following is the best explanation for the creation of the Doctorate of Nursing
Practice (DNP) degree?
a. To validate APRN’s for financial reimbursement
b. To address increasing curriculum requirements of master’s degree programs
c. To compete against master’s degree programs
d. To ensure standardized curriculum ensuring independent practice
ANSWER: B
Although all answers are influenced by the DNP core competencies, the DNP program
creation in 2004 by the American Association of Colleges of Nursing (AACN) was
designed to address curriculum requirements of master’s degree programs.
2. Which of the following was the first recognized area of advanced practice nursing?
a. Clinical Nurse Specialist
b. Certified Registered Nurse Anesthetist
c. Family Nurse practitioner
d. Pediatric Nurse practitioner
ANSWER: B
In 1931, the National Association of Nurse Anesthetists (NANA), renamed in 1939 to the
American Association of Nurse Anesthetists (AANA) was the first recognized group
promoting advanced nursing practice. Agatha Hodgins founded the AANM at Lakeside
Hospital in Cleveland, Ohio.
3. Which factor is broadly perceived to solidify and standardize the role of the APNs over the
last 25 years?
a. Societal forces
b. Lack of access to health care providers
c. Payment for services
d. Standardized curriculum development
ANSWER: D
As the evolution of Advanced Practice Nursing advances specific specialties and needs are
identified. Through the evolution of organization and standardization these roles have
solidified the APN’s role in today’s health care environment.
4. During the formation of early APN roles in anesthesia, which of the following increased
demand for access to health care?
a. War
b. Poverty
c. Rural access to care
d. Availability of training
ANSWER: A
, Earliest demand for nursing-provided anesthesia spiked during periods of war when
numbers of physicians were inadequate. The earliest records date back to the American
Civil War with the administration of chloroform. During World War I in 1917 more than
1000 nurses, some trained anesthetists, traveled into battle. Other factors such as need for
rural health care came later in the validation and need for APNs.
5. In 1889, Dr. William Worrall Mayo built and opened St. Mary’s hospital in Rochester, NY.
He is known for some of the earliest recruitment and specialized training of nurses in which
of the following roles?
a. Obstetrics
b. Anesthesia
c. Family NURSING
d. Pediatrics
e. Research and statistics
ANSWER: B
In 1889, Dr. William Worrall Mayo began formally training and recognizing NURSE
anesthetists. This has been regarded as the earliest training in NURSE-provided anesthesia.
6. In 1893, Lillian Wald established the Henry Street Settlement (HSS) House for
WHICHprimary purpose?
a. Access to health care of rural areas
b. Provide the disadvantaged access to care
c. Establish guidelines for advanced NURSING roles
d. Create inner-city NURSING awareness
ANSWE
R: B
The HHS was established to provide NURSING services to immigrants and low-income
PATIENTs and their families in Manhattan. As resistance to NURSE-provided care grew,
standingorders were drafted from a group of Lower East Side physicians thereby
circumventing then-existing legal ramifications.
7. The Frontier NURSING Service (FNS) founded in Kentucky in 1925 by Mary
Breckenridgeinitially provided Appalachia with WHICH type of advanced NURSING
care?
a. Surgical services
b. Pediatric care
c. Anesthesia
d. Midwifery
ANSWER: D
The original FNS provided midwifery in addition to other NURSING services to
Appalachianresidents. Later working from standard orders developed from their medical
advisory committee NURSES treated PATIENTs, made diagnoses, and dispensed
medications.
8. WHICH organization founded in 1941 under Mary Breckenridge’s leadership merged
withthe American College of NURSE-Midwives (ACNM) in 1969
a. Association for National NURSE-Midwifery (ANNM)
b. American Association of NURSE-Midwives (AANM)
c. American NURSES Association (ANA)
d. Council of NURSING Midwifery (ANM)
, ANSWER: B
The American College of NURSE-Midwives (ACNM) formed under the leadership of
Mary Breckenridge in 1941 to provide NURSE-midwife development and collaboration for
midwifedevelopment. In 1955, the American College of NURSE-Midwives was formed
and the two organizations merged in 1969 after the death of Mary Breckenridge.
9. In a landmark ruling by the Supreme Court as a result of Chalmers-Frances v. Nelson, 1936,
what legal precedent was established?
a. NURSE anesthesia was allowed under the NURSE practice act
b. NURSE anesthesia was legal, if under guidance of a supervising physician
c. NURSE anesthesia scope of practice included anesthesia
d. Only trained NURSING professionals could administer anesthesia independently
ANSWER: B
The landmark decision from the Chalmers-Frances v. Nelson case set national precedent for
the advanced NURSING practice role. It proved to be the basis for other cases over the
following few decades and established that trained NURSES could legally provide
anesthesia care under supervision of a physician.
10. The first known establishment of the NURSE practitioner role occurred in 1965 at
theUniversity of Colorado. In WHICH area of training did this role specialize?
a. Geriatrics
b. Pediatrics
c. Midwifery
d. Anesthesia
ANSWE
R: B
The establishment of the first pediatric NURSE practitioner program was in 1965 at the
University of Colorado. Loretta Ford, RN and Henry Silver, MD provided a 4-month course
to certified registered NURSES to provide education on managing childhood health
problems.
11. What has the AANA as of 2025 as the standard for entry into NURSE anesthesia practice?
a. Master’s degree
b. Bachelors of NURSING and master’s degree
c. Doctorate degree
d. No specification
ANSWER: C
In 2007 the AANA affirmed support that the doctor of NURSE anesthesia practice be the
entryof NURSE anesthesia by 2025. Students entering anesthesia programs during or after
2022 must graduate with a doctoral degree.
12. WHICH state became the first to recognize diagnosis and treatment as part of the scope
ofpractice of specialty NURSES?
a. Oklahoma
b. South Dakota
c. Maryland
d. Idaho
ANSWE
R: D
, Idaho Governor Cecil Andrus signed HB 46 and HB 207 into law on February 11, 1971.
This amended the states’ NURSE practice act making it the first state to officially
recognizediagnosis and treatment of specialty NURSES. The recognition of the ability to
diagnose andtreat overcame an initial hurdle toward independent NURSING practice.
13. The American NURSING Association (ANA) defines WHICH requirement for the
designation ofa clinical NURSE specialist in any specialty?
a. 1000 hours relevant supervised training
b. Masters or doctoral degree
c. Specialty training certificate
d. Two or more years of clinically relevant experience
e. Successful completion of certification examination
ANSWER: B
In 1980, the ANA specifically outlined criteria for the acknowledgment of clinical NURSE
specialist training programs. At that time they required graduate level training to become an
expert in a relevant specialty area of NURSING. Additionally, they must meet any
requirementsset forth by the specific professional society.
,Chapter 02: Conceptualizations of Advanced Practice NURSING
Tracy & O’Grady: Hamric & Hanson’s Advanced Practice NURSING, 7th Edition
MULTIPLE CHOICE
1. WHICH of the following is the primary mission of the National Organization of
NURSEPractitioner Faculties (NONPF)?
a. Provide leadership in promoting quality NP education
b. Provide financial assistance to NP students
c. NP Faculty training program assistance
d. Lobbying legislature on behalf of NPs
ANSWER: A
The NONPF’s primary mission is to provide leadership in promoting quality NP education.
The organization has published domains and core competencies for primary care and these
serve as a framework for NP education and practice.
2. The 2019 updated model of competencies that are encompassed around three spheres of
impact known as PATIENT direct care, NURSES and NURSING practice, and
organizations and systems is known as?
a. Shuler’s Model of NP Practice
b. Fenton’s and Brykczynski’s Expert Practice
c. Calkin’s model of Advanced NURSING Practice
d. NACNS Model of clinical NURSE specialist competencies
ANSWE
R: D
The NACNS’s initial 2008 statement was revised in 2004 and again in 2019 to specifically
differentiate CNS practice from that of others APRNs. The statement outlined competencies
that align to each of the three spheres of impact including PATIENT direct care, NURSES
and NURSING practice, and organizations and systems.
3. Building upon Benner’s seven domains of expert NURSING practice, WHICH conceptual
modeladds an additional domain “The consulting role of the NURSE”?
a. NACNS Clinical NURSE Specialists Model
b. Shuler’s Model of NP Practice
c. Fenton’s and Brykczynski’s Expert Practice
d. Strong Memorial Hospital’s Model of Advanced NURSING Practice
e. Calkin’s model of Advanced NURSING Practice
ANSWER: C
Fenton’s and Brykczynski’s Expert Practice Domains of the CNS and NP expanded on
Benner’s seven domains adding consultation provided by CNS’s to other NURSES
and management of health and illness in ambulatory care settings.
4. WHICH model of conceptual practice was the first to explicitly distinguish the
experiencelevel of advanced practitioners?
a. NACNS Clinical NURSE Specialists Model
b. Shuler’s Model of NP Practice
c. Fenton’s and Brykczynski’s Expert Practice
, d. Strong Memorial Hospital’s Model of Advanced NURSING Practice
e. Calkin’s Model of Advanced NURSING Practice
ANSWER: E
Calkin’s model of Advanced NURSING Practice was the first to explicitly
distinguish experience levels of advanced practitioners for NURSE administrators
to differentiateadvanced practice NURSING from other levels of clinical practice.
5. The circular and continuous threads of direct comprehensive PATIENT care, support of
systems, education, research, and publication and professional leadership make up the five
domains of WHICH advanced NURSING conceptual model?
a. Strong Memorial Hospital’s Model of Advanced NURSING Practice
b. NACNS Clinical NURSE Specialists Model
c. Shuler’s Model of NP Practice
d. Fenton’s and Brykczynski’s Expert Practice
e. Calkin’s model of Advanced NURSING Practice
ANSWER: A
Direct and indirect activities across five domains including: direct comprehensive
PATIENT care, support of systems, education, research, and publication and professional
leadership make up the Strong Memorial Hospital’s Model of Advanced Practice
NURSING.
6. Texas Children’s Hospital Transformational Advanced Professional Practice (TAPP) APRN
Model added what unifying conceptual strand to Strong Memorial Hospital’s Model of
Advanced Practice NURSING?
a. Professional Ethics
b. Quality and Safety
c. Culture
d. Education
ANSWER: A
The TAPP model added two additional domains: quality and safety, and credentialing and
regulatory practice, to the Strong model. Specifically, professional ethics was added as a
unifying conceptual strand alongside collaboration, scholarship, and empowerment.
7. Poghosyan, Boyd, and Clarke (2016) proposed a comprehensive conceptual model including
three factors: scope of practice regulations, institutional policies, and practice environments.
What was their primary purpose?
a. To enhance PATIENT education provided by the APRN
b. To maximize NP Contributions to primary care
c. To provide educational practice guidelines to enhance NP education
d. To discourage role ambiguity among CNS providers
ANSWER: B
The 2016 model provided a comprehensive review of literature and described potential
factors that affect NP care and PATIENT outcomes. This included scope of practice
regulationsthat often cause barriers for NP provided primary care.
8. WHICH model of practice intended to impact the NP domain at four levels:
theoretical,clinical, educational, and research in 1993?
a. Shuler’s Model of NP Practice
, b. Strong Memorial Hospital’s Model of Advanced NURSING Practice
c. Calkin’s model of Advanced NURSING Practice
d. Hamric’s model
ANSWER: A
Shuler’s Model of NP Practice model is holistic and wellness oriented and was designed to
impact the NP domain at four levels: theoretical, clinical, educational, and research. It is
designed to elaborate the NP’s expanded knowledge and skills into medicine including a
template for conducting a visit.
9. WHICH model highlighted some of the earliest efforts to address APRN practice among
allroles by outlining primary criteria among a central competency with highlighted core
competencies in addition to managing environmental elements?
a. Strong Memorial Hospital’s Model of Advanced NURSING Practice
b. Calkin’s model of Advanced NURSING Practice
c. Donabedian Model
d. Hamric’s model
ANSWER: D
Many models highlight core competencies among specific APRN roles, Hamric’s model
outlines primary criteria for a central competency (direct clinical practice) that further
outlines core competencies. Additionally, Hamric’s model highlights critical environmental
elements that affect APRNs such as regulatory and credentialing requirements, health
policy, business aspects among others.
10. WHICH of the following is one of the eight published essentials included in the Essentials
ofDoctoral Education for AdvancWedWW
N. urTsiB
ngSM
Pr.acWtiSce developed by the AACN in 2006?
a. Scientific underpinnings of practice
b. Informatics and health care technologies
c. Liberal education for general NURSING practice
d. Algorithms for advanced PATIENT care
ANSWER: A
The AACN publishes their national consensus to provide the core elements for NURSING
curriculum creation. Currently published are Baccalaureate Essentials, Master’s Essentials,
DNP Essentials, and Clinical Resources Essentials. Although they are similar in their core
approach to education, listed first in DNP essentials is the scientific underpinnings of
practice.
11. WHICH model of conceptualization identifies that health care needs are not met in a
systemdominated by medical language as a basis for reimbursement?
a. Dunphy and Winland-Brown’s Circle of Caring model
b. Donabedian Model
c. Calkin’s model of Advanced NURSING Practice
d. Shuler’s Model of NP Practice
ANSWER: A
, Dunphy and Winland-Brown’s transformative model (Dunphy, Winland-Brown, Porter,
Thomas, and Gallagher, 2011; Fig. 2.12) proposed a circle of caring to encourage medical
collaboration and enhance the NURSING presence in the health care system. Their model
incorporates both strengths of medicine and NURSING with process of assessment,
planning,intervention, and evaluation, with a feedback loop.
12. Without additional application of conceptual models WHICH model would be best chosen
tomodel the skill level of beginning NURSES, experienced NURSES, or advanced
NURSE practitioners with the appropriate level of PATIENT care?
a. Strong Memorial Hospital’s Model of Advanced NURSING Practice
b. Dunphy and Winland-Brown’s Circle of Caring model
c. Donabedian Model
d. Calkin’s Model of Advanced NURSING Practice
ANSWER: D
Calkin’s Model of Advanced NURSING Practice outlines skills and knowledge of
beginning NURSES, experienced NURSES, and advance practice NURSES as they relate
the PATIENT responses for health care problems. The model was developed to assist
NURSE administrators match theskill level of advanced practice NURSE from other levels
of clinical practice in personnel policies.
13. The 2005 Donabedian model has been used to evaluate the quality of APRN care using
WHICH conceptual outline?
a. Assessment, diagnosis, planning, intervention, and evaluation
b. Diagnosis and outcomes
c. Structure, process, and outcomes
d. Diagnosis, morbidity, and mWoWrW
ta.
litTyBSM.WS
ANSWER: D
The Donabedian model encompasses structure (health care systems and facilities), process
(diagnosis, treatment & education), and outcomes.
MULTIPLE RESPONSE
1. WHICH of the following are the functions of a conceptualization of advanced
practiceNURSING? (Select all that apply.)
a. Articulate professional role identity and function
b. Identify specific procedures to provide
c. Basis for furthermore development of knowledge
d. Deliver holistic and collaborative care
e. Provide guidelines on billing
ANSWER: A, C, D
Conceptual models allow for articulation of professional role identity, provide a basis for
furthermore development of knowledge and assist in clinical practice for the delivery of
holistic, comprehensive, and collaborative care. Models may assist but in general do not
provide assistance with clinical decision making or billing.
HAMRIC AND HANSON'S ADVANCED PRACTICE
NURSING 7TH EDITION
PRINTED PDF | ORIGINAL DIRECTLY FROM THE PUBLISHER | 100%
VERIFIED ANSWERS | DOWNLOAD IMMEDIATELY AFTER THE ORDER
,Table of Contents
Chapter 01 History and Evolution of Advanced Practice Nursing 1
Chapter 02 Conceptualizations of Advanced Practice Nursing 5
Chapter 03 A Definition of Advanced Practice Nursing 9
Chapter 04 Role Development of the Advanced Practice Nurse 13
Chapter 05 International Development of Advanced Practice Nursing 19
Chapter 06 Direct Clinical Practice 22
Chapter 07 Guidance and Coaching 30
Chapter 08 Evidence-Based Practice 35
Chapter 09 Leadership 40
Chapter 10 Collaboration 44
Chapter 11 Ethical Practice 51
Chapter 12 The Clinical Nurse Specialist 57
Chapter 13 The Primary Care Nurse Practitioner 61
Chapter 14 The Acute Care Nurse Practitioner 65
Chapter 15 The Certified Nurse-Midwife 69
Chapter 16 The Certified Registered Nurse Anesthetist 74
Chapter 17 Maximizing APRN Power and Influencing Policy 78
Chapter 18 Marketing Yourself as an APRN Contracting and Negotiation 82
Chapter 19 Reimbursement and Payment for APRN Services 88
Chapter 20 Understanding Regulatory, Legal, and Credentialing Requirements 94
Chapter 21 APRN Outcomes and Performance Improvement Research 97
Chapter 22 Future Technologies Influencing APRN Practice 100
Chapter 23 Using Healthcare Information Technology to Evaluate and Improve
Performance and Patient Outcomes 104
,Chapter 01: History and Evolution of Advanced Practice Nursing
Tracy & O’Grady: Hamric & Hanson’s Advanced Practice Nursing, 7th Edition
MULTIPLE CHOICE
1. Which of the following is the best explanation for the creation of the Doctorate of Nursing
Practice (DNP) degree?
a. To validate APRN’s for financial reimbursement
b. To address increasing curriculum requirements of master’s degree programs
c. To compete against master’s degree programs
d. To ensure standardized curriculum ensuring independent practice
ANSWER: B
Although all answers are influenced by the DNP core competencies, the DNP program
creation in 2004 by the American Association of Colleges of Nursing (AACN) was
designed to address curriculum requirements of master’s degree programs.
2. Which of the following was the first recognized area of advanced practice nursing?
a. Clinical Nurse Specialist
b. Certified Registered Nurse Anesthetist
c. Family Nurse practitioner
d. Pediatric Nurse practitioner
ANSWER: B
In 1931, the National Association of Nurse Anesthetists (NANA), renamed in 1939 to the
American Association of Nurse Anesthetists (AANA) was the first recognized group
promoting advanced nursing practice. Agatha Hodgins founded the AANM at Lakeside
Hospital in Cleveland, Ohio.
3. Which factor is broadly perceived to solidify and standardize the role of the APNs over the
last 25 years?
a. Societal forces
b. Lack of access to health care providers
c. Payment for services
d. Standardized curriculum development
ANSWER: D
As the evolution of Advanced Practice Nursing advances specific specialties and needs are
identified. Through the evolution of organization and standardization these roles have
solidified the APN’s role in today’s health care environment.
4. During the formation of early APN roles in anesthesia, which of the following increased
demand for access to health care?
a. War
b. Poverty
c. Rural access to care
d. Availability of training
ANSWER: A
, Earliest demand for nursing-provided anesthesia spiked during periods of war when
numbers of physicians were inadequate. The earliest records date back to the American
Civil War with the administration of chloroform. During World War I in 1917 more than
1000 nurses, some trained anesthetists, traveled into battle. Other factors such as need for
rural health care came later in the validation and need for APNs.
5. In 1889, Dr. William Worrall Mayo built and opened St. Mary’s hospital in Rochester, NY.
He is known for some of the earliest recruitment and specialized training of nurses in which
of the following roles?
a. Obstetrics
b. Anesthesia
c. Family NURSING
d. Pediatrics
e. Research and statistics
ANSWER: B
In 1889, Dr. William Worrall Mayo began formally training and recognizing NURSE
anesthetists. This has been regarded as the earliest training in NURSE-provided anesthesia.
6. In 1893, Lillian Wald established the Henry Street Settlement (HSS) House for
WHICHprimary purpose?
a. Access to health care of rural areas
b. Provide the disadvantaged access to care
c. Establish guidelines for advanced NURSING roles
d. Create inner-city NURSING awareness
ANSWE
R: B
The HHS was established to provide NURSING services to immigrants and low-income
PATIENTs and their families in Manhattan. As resistance to NURSE-provided care grew,
standingorders were drafted from a group of Lower East Side physicians thereby
circumventing then-existing legal ramifications.
7. The Frontier NURSING Service (FNS) founded in Kentucky in 1925 by Mary
Breckenridgeinitially provided Appalachia with WHICH type of advanced NURSING
care?
a. Surgical services
b. Pediatric care
c. Anesthesia
d. Midwifery
ANSWER: D
The original FNS provided midwifery in addition to other NURSING services to
Appalachianresidents. Later working from standard orders developed from their medical
advisory committee NURSES treated PATIENTs, made diagnoses, and dispensed
medications.
8. WHICH organization founded in 1941 under Mary Breckenridge’s leadership merged
withthe American College of NURSE-Midwives (ACNM) in 1969
a. Association for National NURSE-Midwifery (ANNM)
b. American Association of NURSE-Midwives (AANM)
c. American NURSES Association (ANA)
d. Council of NURSING Midwifery (ANM)
, ANSWER: B
The American College of NURSE-Midwives (ACNM) formed under the leadership of
Mary Breckenridge in 1941 to provide NURSE-midwife development and collaboration for
midwifedevelopment. In 1955, the American College of NURSE-Midwives was formed
and the two organizations merged in 1969 after the death of Mary Breckenridge.
9. In a landmark ruling by the Supreme Court as a result of Chalmers-Frances v. Nelson, 1936,
what legal precedent was established?
a. NURSE anesthesia was allowed under the NURSE practice act
b. NURSE anesthesia was legal, if under guidance of a supervising physician
c. NURSE anesthesia scope of practice included anesthesia
d. Only trained NURSING professionals could administer anesthesia independently
ANSWER: B
The landmark decision from the Chalmers-Frances v. Nelson case set national precedent for
the advanced NURSING practice role. It proved to be the basis for other cases over the
following few decades and established that trained NURSES could legally provide
anesthesia care under supervision of a physician.
10. The first known establishment of the NURSE practitioner role occurred in 1965 at
theUniversity of Colorado. In WHICH area of training did this role specialize?
a. Geriatrics
b. Pediatrics
c. Midwifery
d. Anesthesia
ANSWE
R: B
The establishment of the first pediatric NURSE practitioner program was in 1965 at the
University of Colorado. Loretta Ford, RN and Henry Silver, MD provided a 4-month course
to certified registered NURSES to provide education on managing childhood health
problems.
11. What has the AANA as of 2025 as the standard for entry into NURSE anesthesia practice?
a. Master’s degree
b. Bachelors of NURSING and master’s degree
c. Doctorate degree
d. No specification
ANSWER: C
In 2007 the AANA affirmed support that the doctor of NURSE anesthesia practice be the
entryof NURSE anesthesia by 2025. Students entering anesthesia programs during or after
2022 must graduate with a doctoral degree.
12. WHICH state became the first to recognize diagnosis and treatment as part of the scope
ofpractice of specialty NURSES?
a. Oklahoma
b. South Dakota
c. Maryland
d. Idaho
ANSWE
R: D
, Idaho Governor Cecil Andrus signed HB 46 and HB 207 into law on February 11, 1971.
This amended the states’ NURSE practice act making it the first state to officially
recognizediagnosis and treatment of specialty NURSES. The recognition of the ability to
diagnose andtreat overcame an initial hurdle toward independent NURSING practice.
13. The American NURSING Association (ANA) defines WHICH requirement for the
designation ofa clinical NURSE specialist in any specialty?
a. 1000 hours relevant supervised training
b. Masters or doctoral degree
c. Specialty training certificate
d. Two or more years of clinically relevant experience
e. Successful completion of certification examination
ANSWER: B
In 1980, the ANA specifically outlined criteria for the acknowledgment of clinical NURSE
specialist training programs. At that time they required graduate level training to become an
expert in a relevant specialty area of NURSING. Additionally, they must meet any
requirementsset forth by the specific professional society.
,Chapter 02: Conceptualizations of Advanced Practice NURSING
Tracy & O’Grady: Hamric & Hanson’s Advanced Practice NURSING, 7th Edition
MULTIPLE CHOICE
1. WHICH of the following is the primary mission of the National Organization of
NURSEPractitioner Faculties (NONPF)?
a. Provide leadership in promoting quality NP education
b. Provide financial assistance to NP students
c. NP Faculty training program assistance
d. Lobbying legislature on behalf of NPs
ANSWER: A
The NONPF’s primary mission is to provide leadership in promoting quality NP education.
The organization has published domains and core competencies for primary care and these
serve as a framework for NP education and practice.
2. The 2019 updated model of competencies that are encompassed around three spheres of
impact known as PATIENT direct care, NURSES and NURSING practice, and
organizations and systems is known as?
a. Shuler’s Model of NP Practice
b. Fenton’s and Brykczynski’s Expert Practice
c. Calkin’s model of Advanced NURSING Practice
d. NACNS Model of clinical NURSE specialist competencies
ANSWE
R: D
The NACNS’s initial 2008 statement was revised in 2004 and again in 2019 to specifically
differentiate CNS practice from that of others APRNs. The statement outlined competencies
that align to each of the three spheres of impact including PATIENT direct care, NURSES
and NURSING practice, and organizations and systems.
3. Building upon Benner’s seven domains of expert NURSING practice, WHICH conceptual
modeladds an additional domain “The consulting role of the NURSE”?
a. NACNS Clinical NURSE Specialists Model
b. Shuler’s Model of NP Practice
c. Fenton’s and Brykczynski’s Expert Practice
d. Strong Memorial Hospital’s Model of Advanced NURSING Practice
e. Calkin’s model of Advanced NURSING Practice
ANSWER: C
Fenton’s and Brykczynski’s Expert Practice Domains of the CNS and NP expanded on
Benner’s seven domains adding consultation provided by CNS’s to other NURSES
and management of health and illness in ambulatory care settings.
4. WHICH model of conceptual practice was the first to explicitly distinguish the
experiencelevel of advanced practitioners?
a. NACNS Clinical NURSE Specialists Model
b. Shuler’s Model of NP Practice
c. Fenton’s and Brykczynski’s Expert Practice
, d. Strong Memorial Hospital’s Model of Advanced NURSING Practice
e. Calkin’s Model of Advanced NURSING Practice
ANSWER: E
Calkin’s model of Advanced NURSING Practice was the first to explicitly
distinguish experience levels of advanced practitioners for NURSE administrators
to differentiateadvanced practice NURSING from other levels of clinical practice.
5. The circular and continuous threads of direct comprehensive PATIENT care, support of
systems, education, research, and publication and professional leadership make up the five
domains of WHICH advanced NURSING conceptual model?
a. Strong Memorial Hospital’s Model of Advanced NURSING Practice
b. NACNS Clinical NURSE Specialists Model
c. Shuler’s Model of NP Practice
d. Fenton’s and Brykczynski’s Expert Practice
e. Calkin’s model of Advanced NURSING Practice
ANSWER: A
Direct and indirect activities across five domains including: direct comprehensive
PATIENT care, support of systems, education, research, and publication and professional
leadership make up the Strong Memorial Hospital’s Model of Advanced Practice
NURSING.
6. Texas Children’s Hospital Transformational Advanced Professional Practice (TAPP) APRN
Model added what unifying conceptual strand to Strong Memorial Hospital’s Model of
Advanced Practice NURSING?
a. Professional Ethics
b. Quality and Safety
c. Culture
d. Education
ANSWER: A
The TAPP model added two additional domains: quality and safety, and credentialing and
regulatory practice, to the Strong model. Specifically, professional ethics was added as a
unifying conceptual strand alongside collaboration, scholarship, and empowerment.
7. Poghosyan, Boyd, and Clarke (2016) proposed a comprehensive conceptual model including
three factors: scope of practice regulations, institutional policies, and practice environments.
What was their primary purpose?
a. To enhance PATIENT education provided by the APRN
b. To maximize NP Contributions to primary care
c. To provide educational practice guidelines to enhance NP education
d. To discourage role ambiguity among CNS providers
ANSWER: B
The 2016 model provided a comprehensive review of literature and described potential
factors that affect NP care and PATIENT outcomes. This included scope of practice
regulationsthat often cause barriers for NP provided primary care.
8. WHICH model of practice intended to impact the NP domain at four levels:
theoretical,clinical, educational, and research in 1993?
a. Shuler’s Model of NP Practice
, b. Strong Memorial Hospital’s Model of Advanced NURSING Practice
c. Calkin’s model of Advanced NURSING Practice
d. Hamric’s model
ANSWER: A
Shuler’s Model of NP Practice model is holistic and wellness oriented and was designed to
impact the NP domain at four levels: theoretical, clinical, educational, and research. It is
designed to elaborate the NP’s expanded knowledge and skills into medicine including a
template for conducting a visit.
9. WHICH model highlighted some of the earliest efforts to address APRN practice among
allroles by outlining primary criteria among a central competency with highlighted core
competencies in addition to managing environmental elements?
a. Strong Memorial Hospital’s Model of Advanced NURSING Practice
b. Calkin’s model of Advanced NURSING Practice
c. Donabedian Model
d. Hamric’s model
ANSWER: D
Many models highlight core competencies among specific APRN roles, Hamric’s model
outlines primary criteria for a central competency (direct clinical practice) that further
outlines core competencies. Additionally, Hamric’s model highlights critical environmental
elements that affect APRNs such as regulatory and credentialing requirements, health
policy, business aspects among others.
10. WHICH of the following is one of the eight published essentials included in the Essentials
ofDoctoral Education for AdvancWedWW
N. urTsiB
ngSM
Pr.acWtiSce developed by the AACN in 2006?
a. Scientific underpinnings of practice
b. Informatics and health care technologies
c. Liberal education for general NURSING practice
d. Algorithms for advanced PATIENT care
ANSWER: A
The AACN publishes their national consensus to provide the core elements for NURSING
curriculum creation. Currently published are Baccalaureate Essentials, Master’s Essentials,
DNP Essentials, and Clinical Resources Essentials. Although they are similar in their core
approach to education, listed first in DNP essentials is the scientific underpinnings of
practice.
11. WHICH model of conceptualization identifies that health care needs are not met in a
systemdominated by medical language as a basis for reimbursement?
a. Dunphy and Winland-Brown’s Circle of Caring model
b. Donabedian Model
c. Calkin’s model of Advanced NURSING Practice
d. Shuler’s Model of NP Practice
ANSWER: A
, Dunphy and Winland-Brown’s transformative model (Dunphy, Winland-Brown, Porter,
Thomas, and Gallagher, 2011; Fig. 2.12) proposed a circle of caring to encourage medical
collaboration and enhance the NURSING presence in the health care system. Their model
incorporates both strengths of medicine and NURSING with process of assessment,
planning,intervention, and evaluation, with a feedback loop.
12. Without additional application of conceptual models WHICH model would be best chosen
tomodel the skill level of beginning NURSES, experienced NURSES, or advanced
NURSE practitioners with the appropriate level of PATIENT care?
a. Strong Memorial Hospital’s Model of Advanced NURSING Practice
b. Dunphy and Winland-Brown’s Circle of Caring model
c. Donabedian Model
d. Calkin’s Model of Advanced NURSING Practice
ANSWER: D
Calkin’s Model of Advanced NURSING Practice outlines skills and knowledge of
beginning NURSES, experienced NURSES, and advance practice NURSES as they relate
the PATIENT responses for health care problems. The model was developed to assist
NURSE administrators match theskill level of advanced practice NURSE from other levels
of clinical practice in personnel policies.
13. The 2005 Donabedian model has been used to evaluate the quality of APRN care using
WHICH conceptual outline?
a. Assessment, diagnosis, planning, intervention, and evaluation
b. Diagnosis and outcomes
c. Structure, process, and outcomes
d. Diagnosis, morbidity, and mWoWrW
ta.
litTyBSM.WS
ANSWER: D
The Donabedian model encompasses structure (health care systems and facilities), process
(diagnosis, treatment & education), and outcomes.
MULTIPLE RESPONSE
1. WHICH of the following are the functions of a conceptualization of advanced
practiceNURSING? (Select all that apply.)
a. Articulate professional role identity and function
b. Identify specific procedures to provide
c. Basis for furthermore development of knowledge
d. Deliver holistic and collaborative care
e. Provide guidelines on billing
ANSWER: A, C, D
Conceptual models allow for articulation of professional role identity, provide a basis for
furthermore development of knowledge and assist in clinical practice for the delivery of
holistic, comprehensive, and collaborative care. Models may assist but in general do not
provide assistance with clinical decision making or billing.
