ANCC AGACNP - Frances Guide Review
ANCC AGACNP
FRANCES GUIDE REVIEW
500+ Practice Qs w/ Ans
board-exam preparation
Main Features:
• Focused ANCC AGACNP board-exam review
• Extensive collection of practice questions
• Helpful for identifying knowledge gaps
• Covers high-yield acute care concepts
• Supports structured study and final revision
Page 1
, ANCC AGACNP - Frances Guide Review
1. Which of the following is most important to evaluate statistical significance
when reviewing the literature?
-Consider the sample size
-Make sure the confidence interval is tight
-See if the p-value is less than the α-coefficient
-Determine the error rate
(Answers are worded differently. "Ensure confounding variables were
eliminated" & "P
value is less than null hypothesis" were two of them.
Consider the sample size
-higher sample size; more likely to get an appropriate p-value (low p-value)
2. When closing a practice, the NP is required to do all of the following except:
-Give the pt adequate time to find another provider (2 months)
-Keep all of the patient's records for a minimum of five years
-Send a certified letter with a return receipt requested
-Provide names of other providers for future care
Send a certified letter with a return receipt requested
-this is for discharging/firing a patient from your practice
3. Which of the following components of an evidenced based research process is
the most important for NP to participate in?
-Specifying methods of data collection
-Formulating the hypothesis
-Carefully reviewing the literature
-Formulating the research problem
Formulating the research problem
-highest level of research; develop own research problem as a Master's degree
1. identify problem
2. literature review
3. specify hypothesis
4. data collection
Page 2
, ANCC AGACNP - Frances Guide Review
4. A former pt of an NP is writing blog posts, sending emails, and distributing
false, accusatory statements about the NP's practice. Which of the following
forms of defamation is this?
-libel
-slander
Libel
-Libel = literature (written)
-Slander = spoken (verbal)
5. Can you tell the pt's wife, for her protection, that her husband has HIV?
No, not without his permission.
-HIPPA violation
-reportable disease: chlamydia, gonorrhea, Syphilis, TB, HIV - report to health
department only
6. How can the ANCP prepare to get involved in future mass casualty event?
Pre-enroll in disaster volunteer program
7. An 80-year-old male patient with dementia requires long-term care placement.
To which funding agency does the patient apply after "spending down" to
qualify?
Medicaid
-Medicaid to help poor
-Medicare to help retired
-"spending down" - become poor to qualify
8. You want to get more funding for your hospital's Rapid Response Team. How
should you present this issue to the committee?
-Stress importance of the team
-Describe how to improve and expand the team.
Stress importance of the team
(answer is worded as looking up evidence about how the team affects
outcomes, like
a meta-analysis)
-highest level of research: meta-analysis (multiple studies)
Page 3
, ANCC AGACNP - Frances Guide Review
9. What is the best way for the AGACNP to get involved in policy making?
-Attend legislative days at the state capitol
-Join a hospital committee
-Write to your local congressman
-Review literature and give more in-services
Join a hospital committee
-start at local level
10. What is the best way for the AGACNP to demonstrate and advocate for full
scope of practice?
-Join a hospital committee
-Petition the government
-Bill for independent services
-Start your own practice
Bill for independent services
-"demonstrate and advocate"; proving you are your own provider
11. Which of the following is considered a high acuity role for the AGACNP?
-Primary care clinic -Cardiology office -Community health department -Minute Clinic
Cardiology Office
12. What is the best way to advocate for gay and lesbian population in your area?
-Participate at a high state or national level
-Join a non-profit advocacy group
-Consider lobbying the government
-Start at your facility
Start at your facility
(answers are worded differently. One of them is "decrease bias in healthcare"
and
another is something like "create inservices in healthcare" and another is
"obtain
funding to increase access.") -local level
13. Your pt is worried about insurance coverage and asks you for advice on
Medicaid. You instruct the patient that Medicaid:
Pays after insurance and 3rd party payers have paid
Page 4
, ANCC AGACNP - Frances Guide Review
14. You are giving a dinner presentation to a group. The pharmaceutical rep calls
you the night before and wants you to say that their drug is the only one that
works. What ethical principles does this challenge?
Veracity and Fidelity
Veracity = honest/truth
Fidelity = faithful
15. Health Literacy grade level
Average American-8th grade education level
16. Quality Assurance Quality improvement Continuous process improvement
a process for evaluating the care of pts using established standards of care to
ensure
quality
pg 126
17. CPI measures what 3 measures to improve nursing?
Structure,
processes of care
outcomes
18. A root cause analysis of a crisis situation in the ICU identified a lack of
clinician- family communication as the basis for the resulting adverse outcome.
As part of the performance improvement plan, the NP is asked to develop
evidence-based polices to establish clinician-family communication standards in
the unit. These policies should include:
guidelines for having discussions with family members that are geared toward
establishing treatment goals.
19. Which clinical scenario does the NP evaluate for a quality improvement
process change?
An increased incidence of postoperative sternal wound infections
20. Goals set forth in "Healthy People 2020" by the United States Department of
Health and Human Services include:
elimination of health disparities.
-Increase the quality of healthy life
-increase the years of healthy life
Page 5
, ANCC AGACNP - Frances Guide Review
21. Based on the individual's culture, ethnicity, and personal choices, the NP can
optimize the therapeutic partnership w/the patient by:
Tailoring his or her communication style to the patient's preference.
22. A 70-year-old pt with a hx of DM, HTN, OAs, and a new diagnosis of coronary
artery disease, is being discharged. The adult-gerontology acute care nurse
practitioner teaches the patient that the first point of contact for health care
needs is the:
primary care provider
23. The NP is asked to provide evidence to the hospital administration about the
safety of NP placing central lines. Which resource provides the strongest level of
evidence?
A systematic review (meta-analysis is even stronger)
24. What legislation allowed nurse practitioners to be recognized Medicare
providers in all geographical areas with their own provider number?
Balanced Budget Act
25. True/False: restraining an unwilling patient is grounds for malpractice?
False
-if they are a danger you can restrain
26. Pt presents to the clinic for routine f/u and passes out. You revive the pt and
admit overnight. Which of the following would qualify as incident-to-billing?
Temperature and weight recording
-billing outpatient services
27. The NP program initiated, primarily, because of what issue in healthcare at
the time?
Pediatric physician shortage
28. Elderly female pt takes a turn for the worse. The husband is crying when you
enter the room and begins telling you what end-of-life care he prefers. What do
you do?
Ask him to speak candidly with you
Page 6
, ANCC AGACNP - Frances Guide Review
29. Pt calls to complain about bills and states he has Medicare, which should
cover all costs. You explain:
Since you are healthy, exams are not covered.
30. Doc calls from another center asking if you can tell him what kind of orders
he should give for maintenance of patient...
No, HIPPA violation
31. Pt in ER not doing well, primary md calls:
Give him info
32. NP working on ESRD research project . A colleague renal specialist asks for pt
info on your patients:
HIPPA breach.
33. Who enforces HIPPA?
Office of Civil Rights /Dept. Health and Human Services
34. Who ISN'T covered by HIPPA?
Law enforcement/Municipal Offices
CPS/Schools
Employers/Workman's Comp
Life insurance
Covered Entities:
-Health Plans (health insurance)
-HCP
-health care clearinghouses
35. Insurance company calling to verify some patient appointments.
there is already a medical release signed by the patient. The answer is to give
the
requested information to them.
36. Root Cause Analysis (RCA)
process to identify underlying factors that contribute to variation in outcomes
in sentinel
event
Page 7
, ANCC AGACNP - Frances Guide Review
37. Benchmarking
how institution compares with similar organizations
38. Managed Care
A health care system whose goals are to provide cost effective quality care.
Putting caps on payments
39. Peer review
Timely, not anonymous, and NP knows how peer review will impact yearly
evaluation
40. Sensitivity vs specificity
sensitivity is positive
-A negative result in a test with high sensitivity is useful for ruling out disease
-A positive result in a test with high sensitivity is not necessarily useful for
ruling in
disease
specificity is negative
-test's ability to correctly reject healthy patients without a condition
-A positive result in a test with high specificity is useful for ruling in disease
-The test rarely gives positive results in healthy patients.
-A positive result signifies a high probability of the presence of disease.
41. Reliability
When implementing a new study, tested over and over, the consistency of a
measurement or the degree to which an instrument measures the same way
over time
42. Validity of results in an article
P-value, probability of falsely rejecting the null hypothesis, want it to be <0.05
43. Statistical significance
Look at sample size and p value
44. Medical futility
unlikely to produce any significant good for the pt
Page 8
, ANCC AGACNP - Frances Guide Review
45. Privileging
May be granted in full or part by the hospital, credentialing committee is made
of
physicians
46. Who determines scope of practice?
State practice acts but institutional bylaws may further restrict practice (facility
limited
scope of practice)
47. Informed Consent
A state indicating patient has received adequate instruction/information
regarding
aspects of care to make a prudent, personal choice regarding such, includes
risks and
benefits, competence: ability to communicate, understand, reason, differentiate
good
and bad
48. Case management
Mobilize, monitor, and control resources that a patient uses during course of
an illness
while balancing quality and cost, "move patients through the system
appropriately"
49. 50-60 year old patient ith a new diagnosis of cancer. To appropriately plan
for discharge, what should the NP do?
-consult CM
-Consult SW
-refer to Oncology
-refer to Hospice
Consult CM
50. Nondisclosure
Not disclosing patient PHI without permission (confidentiality)
Page 9
, ANCC AGACNP - Frances Guide Review
51. Negligence
Failure of individual to do what any reasonable person would do, resulting in
injury to
the patient
52. When serving as a nurse researcher, the NP is guided by which ethical
principle to ensure that research participants are protected from harm or
exploitation?
Nonmaleficence
53. Quantitative and Qualitative
Quantitative: amount/numbers
Qualitative: descriptive, like case studies
54. Living Will
POA/healthcare proxy
55. NP sees a patient for HF and performs an H&P. What % is expected to be paid?
Medicare pays 80% of the total bill, pt pays 20%, NP is reimbursed 85% of what
the MD
is reimbursed for physician services, and for procedure 80% of that 85%
56. Focus of palliative care
Basic improvement in QOL of anyone with an illness at any stage
57. Hospice
< 6 months to live
58. Scope of practice: integration of care across the acute illness continuum with:
-collaboration -coordination of care
-research based clinical practice
Collaboration
59. Collaboration
True partnership in which all players have the desire power, share common
goals, and
recognize/accept separate areas of responsibility/activity
Page 10
ANCC AGACNP
FRANCES GUIDE REVIEW
500+ Practice Qs w/ Ans
board-exam preparation
Main Features:
• Focused ANCC AGACNP board-exam review
• Extensive collection of practice questions
• Helpful for identifying knowledge gaps
• Covers high-yield acute care concepts
• Supports structured study and final revision
Page 1
, ANCC AGACNP - Frances Guide Review
1. Which of the following is most important to evaluate statistical significance
when reviewing the literature?
-Consider the sample size
-Make sure the confidence interval is tight
-See if the p-value is less than the α-coefficient
-Determine the error rate
(Answers are worded differently. "Ensure confounding variables were
eliminated" & "P
value is less than null hypothesis" were two of them.
Consider the sample size
-higher sample size; more likely to get an appropriate p-value (low p-value)
2. When closing a practice, the NP is required to do all of the following except:
-Give the pt adequate time to find another provider (2 months)
-Keep all of the patient's records for a minimum of five years
-Send a certified letter with a return receipt requested
-Provide names of other providers for future care
Send a certified letter with a return receipt requested
-this is for discharging/firing a patient from your practice
3. Which of the following components of an evidenced based research process is
the most important for NP to participate in?
-Specifying methods of data collection
-Formulating the hypothesis
-Carefully reviewing the literature
-Formulating the research problem
Formulating the research problem
-highest level of research; develop own research problem as a Master's degree
1. identify problem
2. literature review
3. specify hypothesis
4. data collection
Page 2
, ANCC AGACNP - Frances Guide Review
4. A former pt of an NP is writing blog posts, sending emails, and distributing
false, accusatory statements about the NP's practice. Which of the following
forms of defamation is this?
-libel
-slander
Libel
-Libel = literature (written)
-Slander = spoken (verbal)
5. Can you tell the pt's wife, for her protection, that her husband has HIV?
No, not without his permission.
-HIPPA violation
-reportable disease: chlamydia, gonorrhea, Syphilis, TB, HIV - report to health
department only
6. How can the ANCP prepare to get involved in future mass casualty event?
Pre-enroll in disaster volunteer program
7. An 80-year-old male patient with dementia requires long-term care placement.
To which funding agency does the patient apply after "spending down" to
qualify?
Medicaid
-Medicaid to help poor
-Medicare to help retired
-"spending down" - become poor to qualify
8. You want to get more funding for your hospital's Rapid Response Team. How
should you present this issue to the committee?
-Stress importance of the team
-Describe how to improve and expand the team.
Stress importance of the team
(answer is worded as looking up evidence about how the team affects
outcomes, like
a meta-analysis)
-highest level of research: meta-analysis (multiple studies)
Page 3
, ANCC AGACNP - Frances Guide Review
9. What is the best way for the AGACNP to get involved in policy making?
-Attend legislative days at the state capitol
-Join a hospital committee
-Write to your local congressman
-Review literature and give more in-services
Join a hospital committee
-start at local level
10. What is the best way for the AGACNP to demonstrate and advocate for full
scope of practice?
-Join a hospital committee
-Petition the government
-Bill for independent services
-Start your own practice
Bill for independent services
-"demonstrate and advocate"; proving you are your own provider
11. Which of the following is considered a high acuity role for the AGACNP?
-Primary care clinic -Cardiology office -Community health department -Minute Clinic
Cardiology Office
12. What is the best way to advocate for gay and lesbian population in your area?
-Participate at a high state or national level
-Join a non-profit advocacy group
-Consider lobbying the government
-Start at your facility
Start at your facility
(answers are worded differently. One of them is "decrease bias in healthcare"
and
another is something like "create inservices in healthcare" and another is
"obtain
funding to increase access.") -local level
13. Your pt is worried about insurance coverage and asks you for advice on
Medicaid. You instruct the patient that Medicaid:
Pays after insurance and 3rd party payers have paid
Page 4
, ANCC AGACNP - Frances Guide Review
14. You are giving a dinner presentation to a group. The pharmaceutical rep calls
you the night before and wants you to say that their drug is the only one that
works. What ethical principles does this challenge?
Veracity and Fidelity
Veracity = honest/truth
Fidelity = faithful
15. Health Literacy grade level
Average American-8th grade education level
16. Quality Assurance Quality improvement Continuous process improvement
a process for evaluating the care of pts using established standards of care to
ensure
quality
pg 126
17. CPI measures what 3 measures to improve nursing?
Structure,
processes of care
outcomes
18. A root cause analysis of a crisis situation in the ICU identified a lack of
clinician- family communication as the basis for the resulting adverse outcome.
As part of the performance improvement plan, the NP is asked to develop
evidence-based polices to establish clinician-family communication standards in
the unit. These policies should include:
guidelines for having discussions with family members that are geared toward
establishing treatment goals.
19. Which clinical scenario does the NP evaluate for a quality improvement
process change?
An increased incidence of postoperative sternal wound infections
20. Goals set forth in "Healthy People 2020" by the United States Department of
Health and Human Services include:
elimination of health disparities.
-Increase the quality of healthy life
-increase the years of healthy life
Page 5
, ANCC AGACNP - Frances Guide Review
21. Based on the individual's culture, ethnicity, and personal choices, the NP can
optimize the therapeutic partnership w/the patient by:
Tailoring his or her communication style to the patient's preference.
22. A 70-year-old pt with a hx of DM, HTN, OAs, and a new diagnosis of coronary
artery disease, is being discharged. The adult-gerontology acute care nurse
practitioner teaches the patient that the first point of contact for health care
needs is the:
primary care provider
23. The NP is asked to provide evidence to the hospital administration about the
safety of NP placing central lines. Which resource provides the strongest level of
evidence?
A systematic review (meta-analysis is even stronger)
24. What legislation allowed nurse practitioners to be recognized Medicare
providers in all geographical areas with their own provider number?
Balanced Budget Act
25. True/False: restraining an unwilling patient is grounds for malpractice?
False
-if they are a danger you can restrain
26. Pt presents to the clinic for routine f/u and passes out. You revive the pt and
admit overnight. Which of the following would qualify as incident-to-billing?
Temperature and weight recording
-billing outpatient services
27. The NP program initiated, primarily, because of what issue in healthcare at
the time?
Pediatric physician shortage
28. Elderly female pt takes a turn for the worse. The husband is crying when you
enter the room and begins telling you what end-of-life care he prefers. What do
you do?
Ask him to speak candidly with you
Page 6
, ANCC AGACNP - Frances Guide Review
29. Pt calls to complain about bills and states he has Medicare, which should
cover all costs. You explain:
Since you are healthy, exams are not covered.
30. Doc calls from another center asking if you can tell him what kind of orders
he should give for maintenance of patient...
No, HIPPA violation
31. Pt in ER not doing well, primary md calls:
Give him info
32. NP working on ESRD research project . A colleague renal specialist asks for pt
info on your patients:
HIPPA breach.
33. Who enforces HIPPA?
Office of Civil Rights /Dept. Health and Human Services
34. Who ISN'T covered by HIPPA?
Law enforcement/Municipal Offices
CPS/Schools
Employers/Workman's Comp
Life insurance
Covered Entities:
-Health Plans (health insurance)
-HCP
-health care clearinghouses
35. Insurance company calling to verify some patient appointments.
there is already a medical release signed by the patient. The answer is to give
the
requested information to them.
36. Root Cause Analysis (RCA)
process to identify underlying factors that contribute to variation in outcomes
in sentinel
event
Page 7
, ANCC AGACNP - Frances Guide Review
37. Benchmarking
how institution compares with similar organizations
38. Managed Care
A health care system whose goals are to provide cost effective quality care.
Putting caps on payments
39. Peer review
Timely, not anonymous, and NP knows how peer review will impact yearly
evaluation
40. Sensitivity vs specificity
sensitivity is positive
-A negative result in a test with high sensitivity is useful for ruling out disease
-A positive result in a test with high sensitivity is not necessarily useful for
ruling in
disease
specificity is negative
-test's ability to correctly reject healthy patients without a condition
-A positive result in a test with high specificity is useful for ruling in disease
-The test rarely gives positive results in healthy patients.
-A positive result signifies a high probability of the presence of disease.
41. Reliability
When implementing a new study, tested over and over, the consistency of a
measurement or the degree to which an instrument measures the same way
over time
42. Validity of results in an article
P-value, probability of falsely rejecting the null hypothesis, want it to be <0.05
43. Statistical significance
Look at sample size and p value
44. Medical futility
unlikely to produce any significant good for the pt
Page 8
, ANCC AGACNP - Frances Guide Review
45. Privileging
May be granted in full or part by the hospital, credentialing committee is made
of
physicians
46. Who determines scope of practice?
State practice acts but institutional bylaws may further restrict practice (facility
limited
scope of practice)
47. Informed Consent
A state indicating patient has received adequate instruction/information
regarding
aspects of care to make a prudent, personal choice regarding such, includes
risks and
benefits, competence: ability to communicate, understand, reason, differentiate
good
and bad
48. Case management
Mobilize, monitor, and control resources that a patient uses during course of
an illness
while balancing quality and cost, "move patients through the system
appropriately"
49. 50-60 year old patient ith a new diagnosis of cancer. To appropriately plan
for discharge, what should the NP do?
-consult CM
-Consult SW
-refer to Oncology
-refer to Hospice
Consult CM
50. Nondisclosure
Not disclosing patient PHI without permission (confidentiality)
Page 9
, ANCC AGACNP - Frances Guide Review
51. Negligence
Failure of individual to do what any reasonable person would do, resulting in
injury to
the patient
52. When serving as a nurse researcher, the NP is guided by which ethical
principle to ensure that research participants are protected from harm or
exploitation?
Nonmaleficence
53. Quantitative and Qualitative
Quantitative: amount/numbers
Qualitative: descriptive, like case studies
54. Living Will
POA/healthcare proxy
55. NP sees a patient for HF and performs an H&P. What % is expected to be paid?
Medicare pays 80% of the total bill, pt pays 20%, NP is reimbursed 85% of what
the MD
is reimbursed for physician services, and for procedure 80% of that 85%
56. Focus of palliative care
Basic improvement in QOL of anyone with an illness at any stage
57. Hospice
< 6 months to live
58. Scope of practice: integration of care across the acute illness continuum with:
-collaboration -coordination of care
-research based clinical practice
Collaboration
59. Collaboration
True partnership in which all players have the desire power, share common
goals, and
recognize/accept separate areas of responsibility/activity
Page 10
