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N5350 Roles Final Exam Study Guide questions with accurate detailed answers

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N5350 Roles Final Exam Study Guide questions with accurate detailed answers

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N5350 Roles Final Exam Study Guide questions with ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




accurate detailed answers
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1. What are the 4 settings for prescriptive authority? Describe the requirements in each
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setting for physician supervision, # of NPs, chart review, and any other special requirements
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in that site. - correct answer✔✔1. Medically Underserved
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2. Physician Primary Site
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3. Physician Alternate Site
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4. Facility Based Practice Site.
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* General requirements per TBON rule 222.5: regular visits, chart review as determined by
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APRN & physician, periodic face to face meeting of APRN & physician to discuss pt care &
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improvement.



1a) Medically Underserved - correct answer✔✔*site must be official, physician must be
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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 answer✔✔* Must have protocols.
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*Sign drug orders only for pts whom the MD has/will establish a relationship.
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*alternate MD may delegate. ||\\//|| ||\\//|| ||\\//||




*MD may delegate to no more than 7 APNS or PAs.
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*Physician on-site visits should be 50% of the time according to BME. ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




1c) Facility Based Practice - correct answer✔✔*Must be physically present in facility (hospital
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or long term facility).
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*Physician must give prior consent. ||\\//|| ||\\//|| ||\\//|| ||\\//||

,*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 &
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approved by Chief Physician of Facility. ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




*Protocol signed by the Chief Physician. ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




1d) Physician Alternate Site - correct answer✔✔*No longer in effect.
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2. The FOUR Approved Categories of APN in TX? - correct answer✔✔*CRNA, NP, CNS, and
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CNM



3. NP requirements by BON for approval of license/ AP recognition each biennium. - correct
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answer✔✔*Current valid RN licensure. ||\\//|| ||\\//|| ||\\//||




*400 hours of current clinical practice. ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




*20 hours of CEs. ||\\//|| ||\\//|| ||\\//||




*8 hours of continuing education in pharmacotherapeutics.
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*Current board certification. ||\\//|| ||\\//||




*Separate application for dual roles. ||\\//|| ||\\//|| ||\\//|| ||\\//||




4. New NP graduate requirements when applying for the board? - correct answer✔✔*Must
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take and pass national certification exam.
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5. What is the NP's scope of practice based on? - correct answer✔✔*Nurse practice acts
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define legal scope of practice for licensed practitioners.||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




*Includes privileges for diagnosis, treatment, prescriptive authority and reimbursement. ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




11. What are clinical privileges and how are they obtained? - correct answer✔✔*autonomy
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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.
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12. Define Malpractice - correct answer✔✔*Any professional misconduct, unreasonable lack
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of skill, or infidelity in professional or fiduciary duties, or illegal or immoral conduct.
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*Negligence is the failure of an individual to do something that a reasonable person would ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




do, that results in injury to another.
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*The alleged failure on the part of a professional to render services with the degree of care,
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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 answer✔✔1. Duty: provide some level of care,
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had some contact. ||\\//|| ||\\//||




2. Dereliction: reasonable, ordinary care, skill and diligence as NP's in good standing in
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similar practice. ||\\//||




3. Damage: Must have an injury or no malpractice even if violated standard of care; cap
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"pain and suffering" $250,000 to $500, 000.||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




4. Causation of Injury: For malpractice to have occurred, a breach of the standard of care
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must have caused an injury to the patient.
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15. National Practitioner Data Bank - correct answer✔✔*Receives and discloses the reports
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on medical malpractice.
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Who is credited to be the first advanced practice nurse role? - correct answer✔✔Nurse
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Anesthesia in 1800's- perhaps the oldest advanced nursing specialty, Sister Mary Bernard at ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




St. Vincent's Hospital was the first anesthetist
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Who is credited to be the founder of the first nurse practitioner role? - correct
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answer✔✔Loretta Ford-1965- Colorado ||\\//|| ||\\//||

, Who is (are) the oldest primary care providers in the history of advanced practice nurses? -
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correct answer✔✔Midwifes in 1700's- perhaps the oldest primary health care provider
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Martha Bullard, 1785 is the oldest noted in publication
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What are the roles of APRNs? How are they different from each other? - correct
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




answer✔✔To provide health care to individuals, family, groups in a variety of health care ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




settings (homes, hospitals, institutions, offices, clinics, etc)
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APRN includes NP, nurse midwife, nurse anesthetist, and clinical nurse specialist
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What states are responsible for being the first to have advanced practice language in their
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




nurse practice act? - correct answer✔✔Idaho (language read- "assess, diagnose, treat")
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




What is NONPF? What is their influence for APRNs? - correct answer✔✔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 answer✔✔•PA's work directly under a
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




MD, NP's can function independently
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•NP's focus on multiple practice and nursing models
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•PA's focus on medical tasks utilizing a medical framework
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




What are the key elements of OTA, Brown, Safriet and Mundinger - correct answer✔✔• OTA
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




NP's provide equivalent care to MD's.
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Patients who receive care form an NP show decreased patient symptoms.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




• Brown
||\\//||




Patient satisfaction and resolution of pathological conditions were greater for NP's over MD's
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||




NM's use less technology/ analgesia
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