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, Chapter 1: Introduction to the Role of Advanced Practices Nursing
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m Multiple Choice m
1. In which year did the American Association of College of Nursing (AACN) introduced the
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Doctorate of Nursing Practice (DNP)?
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a. 2006
b. 2004
c. 2000
d. 2002
ANS: B m
Introduced the DNP degree in 2004 to prepare advanced practice nurses (APRNs) to meet challenges
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and standardize practice beyond master’s degree programs.
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2. Which of the following is the best explanation for the creation of the Doctorate of Nursing
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Practice (DNP) degree?
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a. To compete against master’s degree programs
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b. To ensure standardized curriculum ensuring independent practice
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c. To validate APRN’s for financial reimbursement
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d. To address increasing curriculum requirements of master’s degree programs
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ANS: D m
Although all answers are influenced by the DNP core competencies, the DNP program creation in
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2004 bythe AACN was designed to address curriculum requirements of master’s degree programs.
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3. Which of the following was the first recognized area of advanced practice nursing?
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a. Clinical Nurse Specialist m m
b. Family nurse practitioner m m
c. Pediatric nurse practitioner m m
d. Certified Registered Nurse Anesthetist m m m
ANS: D
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In 1931, the National Association of Nurse Anesthetists (NANA), renamed in 1939 to the
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American Association of Nurse Anesthetists (AANA) was the first recognized group promoting
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advanced nursing practice. Agatha Hodgins founded the AANM at Lakeside Hospital in Cleveland,
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Ohio.
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4. Which factor is broadlyperceived to solidifyand standardize the role of the APNs over the last 25
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years? m
a. Lack of access to health care providers
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b. Standardized curriculum development m m
c. Payment for services m m
d. Societal forces m
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, ANS: B m
As the evolution of Advanced Practice Nursing advances specific specialties and needs are
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identified. Through the evolution of organization and standardization these roles have solidified the
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APN’s role in today’s health care environment.
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5. During the formation of early APN roles in anesthesia, which of the following increased
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demand for access to health care?
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a. Poverty
b. War
c. Rural access to care m m m
d. Availability of training m m
ANS: B m
Earliest demand for nursing-provided anesthesia spiked during periods of war when numbers of
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physicians were inadequate. The earliest records date back to the American Civil War with the
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administration of chloroform. During World War I in 1917 more than 1000 nurses, some trained
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anesthetists, traveled into battle. Other factors such as need for rural health care came later in the
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validation and need for APNs.
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6. In 1889, Dr. William Worrall Mayo built and opened St. Mary’s hospital in Rochester, NY. He is
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known for some of the earliest recruitment and specialized training of nurses in which of the
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following roles?
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a. Pediatrics
b. Anesthesia
c. Obstetrics
d. Research and statistics m m
e. Family nursing m
ANS: B m
In 1889, Dr. William Worrall Mayo began formally training and recognizing nurse anesthetists.
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This has been regarded as the earliest training in nurse-provided anesthesia.
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7. In 1893, Lillian Wald established the HenryStreet Settlement (HSS) House for which purpose?
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a. Access to health care of rural areas m m m m m m
b. Create inner-city nursing awareness m m m
c. Provide the disadvantaged access to care m m m m m
d. Establish guidelines for advanced nursing roles m m m m m
ANS: C m
The HHS was established to provide nursing services to immigrants and low-income patients and
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their families in Manhattan. As resistance to nurse-provided care grew, standing orders were
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drafted from a group of Lower East Side physicians thereby circumventing then-existing legal
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ramifications.
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, 8. The Frontier Nursing Service (FNS) founded in Kentucky in 1925 by Mary Breckenridge
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initially provided Appalachia with nursing resources and which type of advanced nursing
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care?m
a. Pediatric care m
b. Anesthesia
c. Midwifery
d. Surgical services m
ANS: C m
The original FNS provided nursing services and obstetric services to Appalachian residents. Later
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working from standard orders developed from their medical advisory committee nurses treated
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patients, made diagnoses, and dispensed medications.
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9. Which organization founded in 1941 under Mary Breckenridge’s leadership merged with the
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American College of Nurse-Midwives (ACNM) in 1969?
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a. American Association of Nurse-Midwives (AANM) m m m m
b. American Nurses Association (ANA) m m m
c. Association for National Nurse-Midwifery (ANNM) m m m m
d. Council of Nursing Midwifery (ANM) m m m m
ANS: A m
The American College of Nurse-Midwives (ACNM) formed under the leadership of Mary
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Breckenridge in 1941 to provide nurse-midwife development and collaboration for midwife
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development. In 1955, the American College of Nurse-Midwives was formed and the
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two organizations merged in 1969 after the death of Mary Breckenridge.
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10. In a landmark ruling by the Supreme Court as a result of Chalmers-Frances v. Nelson, 1936,
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what legal precedent was established?
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a. Nurse anesthesia was allowed under the nurse practice act
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b. Nurse anesthesia scope of practice included anesthesia
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c. Nurse anesthesia was legal, if under guidance of a supervising physician
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d. Only trained nursing professionals could administer anesthesia independently
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ANS: C m
The landmark decision from the Chalmers-Frances v. Nelson case set national precedent for the
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advanced nursing practice role. It proved to be the basis for other cases over the following few
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decades and established that trained nurses could legally provide anesthesia care under supervision of
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a physician.
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11. The first known establishment of the nurse practitioner role occurred in 1965 at theUniversity of
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Colorado. In which area of training did this role specialize?
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a. Pediatrics
b. Geriatrics
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