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Hamric & Hanson’s Advanced Practice Nursing, 7th Edition by Tracy & O’Grady
Chapter 1-23
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
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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
ANS: 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.
mathematics.Calculation and Accuracy: Mathematical exams test a student’s ability to perform accurate calculations and apply mathematical principles in the correct sequence to reach
a solution.Understanding of Concepts: Beyond solving problems, mathematics exams test students’ conceptual understanding of core topics, such as algebra, geometry, calculus, or
statistics.3.4. Preparing for Mathematics ExamsMathematics requires
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
ANS: 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
ANS: 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
ANS: A
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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.
mathematics.Calculation and Accuracy: Mathematical exams test a student’s ability to perform accurate calculations and apply mathematical principles in the correct sequence to reach
a solution.Understanding of Concepts: Beyond solving problems, mathematics exams test students’ conceptual understanding of core topics, such as algebra, geometry, calculus, or
statistics.3.4. Preparing for Mathematics ExamsMathematics requires
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
ANS: 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 which
primary 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
ANS: B F4C VDF JN
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, standing
orders 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 Breckenridge
initially provided Appalachia with which type of advanced nursing care?
a. Surgical services
b. Pediatric care
c. Anesthesia
d. Midwifery
ANS: D
The original FNS provided midwifery in addition to other nursing services to Appalachian
residents. 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 with
the 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)
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ANS: 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 midwife
development. 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
ANS: 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.
mathematics.Calculation and Accuracy: Mathematical exams test a student’s ability to perform accurate calculations and apply mathematical principles in the correct sequence to reach
a solution.Understanding of Concepts: Beyond solving problems, mathematics exams test students’ conceptual understanding of core topics, such as algebra, geometry, calculus, or
statistics.3.4. Preparing for Mathematics ExamsMathematics requires
10. The first known establishment of the nurse practitioner role occurred in 1965 at the
University of Colorado. In which area of training did this role specialize?
a. Geriatrics
b. Pediatrics
c. Midwifery
d. Anesthesia
ANS: 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
ANS: C
In 2007 the AANA affirmed support that the doctor of nurse anesthesia practice be the entry
of 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 of
practice of specialty nurses?
a. Oklahoma
b. South Dakota
c. Maryland
d. Idaho
ANS: D
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Hamric & Hanson’s Advanced Practice Nursing, 7th Edition by Tracy & O’Grady
Chapter 1-23
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
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MaterialStuvia.com- The Marketplace to Buy and Sell your Study Material
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
ANS: 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.
mathematics.Calculation and Accuracy: Mathematical exams test a student’s ability to perform accurate calculations and apply mathematical principles in the correct sequence to reach
a solution.Understanding of Concepts: Beyond solving problems, mathematics exams test students’ conceptual understanding of core topics, such as algebra, geometry, calculus, or
statistics.3.4. Preparing for Mathematics ExamsMathematics requires
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
ANS: 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
ANS: 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
ANS: A
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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.
mathematics.Calculation and Accuracy: Mathematical exams test a student’s ability to perform accurate calculations and apply mathematical principles in the correct sequence to reach
a solution.Understanding of Concepts: Beyond solving problems, mathematics exams test students’ conceptual understanding of core topics, such as algebra, geometry, calculus, or
statistics.3.4. Preparing for Mathematics ExamsMathematics requires
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
ANS: 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 which
primary 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
ANS: B F4C VDF JN
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, standing
orders 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 Breckenridge
initially provided Appalachia with which type of advanced nursing care?
a. Surgical services
b. Pediatric care
c. Anesthesia
d. Midwifery
ANS: D
The original FNS provided midwifery in addition to other nursing services to Appalachian
residents. 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 with
the 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)
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ANS: 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 midwife
development. 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
ANS: 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.
mathematics.Calculation and Accuracy: Mathematical exams test a student’s ability to perform accurate calculations and apply mathematical principles in the correct sequence to reach
a solution.Understanding of Concepts: Beyond solving problems, mathematics exams test students’ conceptual understanding of core topics, such as algebra, geometry, calculus, or
statistics.3.4. Preparing for Mathematics ExamsMathematics requires
10. The first known establishment of the nurse practitioner role occurred in 1965 at the
University of Colorado. In which area of training did this role specialize?
a. Geriatrics
b. Pediatrics
c. Midwifery
d. Anesthesia
ANS: 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
ANS: C
In 2007 the AANA affirmed support that the doctor of nurse anesthesia practice be the entry
of 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 of
practice of specialty nurses?
a. Oklahoma
b. South Dakota
c. Maryland
d. Idaho
ANS: D
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