ANCC AGACNP FRANCES GUIDE REVIEW|300
COMPREHENSIVE QUESTIONS AND ANSWERS GRADED
A+ GET IT 100% RIGHT ALL PASSED|NEWEST UPDATE!!!!
SECTION 1: PROFESSIONAL PRACTICE, POLICY, & ETHICS (Questions 1-50)
1. An AGACNP is negotiating a new contract. Which clause specifically protects the
NP from having to perform procedures outside of their national certification
scope?
A) Hold harmless clause
B) Termination clause
C) Scope of practice clause
D) Indemnification clause
Correct Answer: C
Rationale: A scope of practice clause explicitly defines the duties, procedures, and
populations the NP is responsible for, aligning with their certification and state
regulations. Hold harmless and indemnification relate to liability, while
termination covers contract ending.
2. A patient with advanced dementia is admitted with sepsis. The family demands
full aggressive care, but the patient has a valid advance directive stating "no
intubation." What is the AGACNP's best action?
A) Honor the family's wishes to avoid conflict.
B) Initiate a palliative care consult to discuss goals of care.
,C) Intubate the patient because sepsis is an acute, reversible condition.
D) Ignore the directive as it is outdated.
Correct Answer: B
Rationale: The NP must honor the patient's autonomous decision as expressed in
the advance directive. A palliative care consult helps facilitate communication
with the family regarding the patient's previously stated wishes. Intubation would
violate the directive.
3. Which federal act explicitly established the criteria for "meaningful use" of
electronic health records (EHRs) to improve patient care?
A) Patient Protection and Affordable Care Act (PPACA)
B) Health Insurance Portability and Accountability Act (HIPAA)
C) Health Information Technology for Economic and Clinical Health Act (HITECH)
D) Balanced Budget Act (BBA)
Correct Answer: C
Rationale: The HITECH Act promoted the adoption of EHRs and established
"meaningful use" criteria, which require providers to demonstrate that they are
using certified EHR technology in ways that improve quality, safety, and efficiency.
4. The AGACNP is precepting a new graduate. The graduate administers a
medication via the wrong route, and the patient experiences a non-injury adverse
event. What is the primary legal responsibility of the supervising AGACNP?
A) Report the graduate to the state Board of Nursing.
B) Terminate the graduate's clinical rotation immediately.
C) Document the event and ensure the graduate completes an incident report.
D) Take full responsibility for the delegated act.
,Correct Answer: D
Rationale: Under the doctrine of *respondeat superior* and supervisory liability,
the supervising NP is responsible for the actions of those under their supervision
during a clinical rotation, regardless of whether the student made the error.
5. A pharmaceutical representative offers the AGACNP tickets to a sold-out
concert in exchange for prescribing their new anticoagulant. Which ethical
principle is most directly being challenged?
A) Beneficence
B) Nonmaleficence
C) Fidelity
D) Veracity
Correct Answer: C
Rationale: Fidelity is the duty to keep promises and remain loyal to the patient's
best interests. Accepting kickbacks undermines the NP's loyalty to the patient by
introducing personal gain into clinical decision-making.
6. What is the primary purpose of a root cause analysis (RCA) when a sentinel
event occurs in the ICU?
A) To assign blame to the individual who made the error.
B) To identify system-based vulnerabilities that led to the error.
C) To determine the financial cost of the error to the hospital.
D) To expedite the patient's discharge to prevent further litigation.
Correct Answer: B
, Rationale: RCA is a systematic process used to identify the underlying systemic
processes and variations that contributed to the event, with the goal of preventing
future occurrences, not assigning individual blame.
7. Which piece of legislation allowed Nurse Practitioners to be recognized as
Medicare providers and bill for their services independently, reducing the
requirement for physician co-signatures?
A) Omnibus Budget Reconciliation Act (OBRA)
B) Balanced Budget Act (BBA)
C) Patient Protection and Affordable Care Act (PPACA)
D) Tax Equity and Fiscal Responsibility Act (TEFRA)
Correct Answer: B
Rationale: The Balanced Budget Act of 1997 was pivotal in granting NPs the ability
to bill Medicare directly for their services, even in inpatient settings, under their
own National Provider Identifier (NPI).
8. The AGACNP is caring for a 68-year-old patient with septic shock. The family
requests a "Do Not Resuscitate" (DNR) order because the patient has a poor
baseline functional status. The patient is currently sedated and unable to
communicate. What is the appropriate legal step?
A) Write the DNR order as the family is the surrogate.
B) Refuse to write the order until the patient is awake.
C) Request an ethics committee consult to overrule the family.
D) Evaluate if the patient has a designated healthcare proxy or advance directive.
Correct Answer: D
COMPREHENSIVE QUESTIONS AND ANSWERS GRADED
A+ GET IT 100% RIGHT ALL PASSED|NEWEST UPDATE!!!!
SECTION 1: PROFESSIONAL PRACTICE, POLICY, & ETHICS (Questions 1-50)
1. An AGACNP is negotiating a new contract. Which clause specifically protects the
NP from having to perform procedures outside of their national certification
scope?
A) Hold harmless clause
B) Termination clause
C) Scope of practice clause
D) Indemnification clause
Correct Answer: C
Rationale: A scope of practice clause explicitly defines the duties, procedures, and
populations the NP is responsible for, aligning with their certification and state
regulations. Hold harmless and indemnification relate to liability, while
termination covers contract ending.
2. A patient with advanced dementia is admitted with sepsis. The family demands
full aggressive care, but the patient has a valid advance directive stating "no
intubation." What is the AGACNP's best action?
A) Honor the family's wishes to avoid conflict.
B) Initiate a palliative care consult to discuss goals of care.
,C) Intubate the patient because sepsis is an acute, reversible condition.
D) Ignore the directive as it is outdated.
Correct Answer: B
Rationale: The NP must honor the patient's autonomous decision as expressed in
the advance directive. A palliative care consult helps facilitate communication
with the family regarding the patient's previously stated wishes. Intubation would
violate the directive.
3. Which federal act explicitly established the criteria for "meaningful use" of
electronic health records (EHRs) to improve patient care?
A) Patient Protection and Affordable Care Act (PPACA)
B) Health Insurance Portability and Accountability Act (HIPAA)
C) Health Information Technology for Economic and Clinical Health Act (HITECH)
D) Balanced Budget Act (BBA)
Correct Answer: C
Rationale: The HITECH Act promoted the adoption of EHRs and established
"meaningful use" criteria, which require providers to demonstrate that they are
using certified EHR technology in ways that improve quality, safety, and efficiency.
4. The AGACNP is precepting a new graduate. The graduate administers a
medication via the wrong route, and the patient experiences a non-injury adverse
event. What is the primary legal responsibility of the supervising AGACNP?
A) Report the graduate to the state Board of Nursing.
B) Terminate the graduate's clinical rotation immediately.
C) Document the event and ensure the graduate completes an incident report.
D) Take full responsibility for the delegated act.
,Correct Answer: D
Rationale: Under the doctrine of *respondeat superior* and supervisory liability,
the supervising NP is responsible for the actions of those under their supervision
during a clinical rotation, regardless of whether the student made the error.
5. A pharmaceutical representative offers the AGACNP tickets to a sold-out
concert in exchange for prescribing their new anticoagulant. Which ethical
principle is most directly being challenged?
A) Beneficence
B) Nonmaleficence
C) Fidelity
D) Veracity
Correct Answer: C
Rationale: Fidelity is the duty to keep promises and remain loyal to the patient's
best interests. Accepting kickbacks undermines the NP's loyalty to the patient by
introducing personal gain into clinical decision-making.
6. What is the primary purpose of a root cause analysis (RCA) when a sentinel
event occurs in the ICU?
A) To assign blame to the individual who made the error.
B) To identify system-based vulnerabilities that led to the error.
C) To determine the financial cost of the error to the hospital.
D) To expedite the patient's discharge to prevent further litigation.
Correct Answer: B
, Rationale: RCA is a systematic process used to identify the underlying systemic
processes and variations that contributed to the event, with the goal of preventing
future occurrences, not assigning individual blame.
7. Which piece of legislation allowed Nurse Practitioners to be recognized as
Medicare providers and bill for their services independently, reducing the
requirement for physician co-signatures?
A) Omnibus Budget Reconciliation Act (OBRA)
B) Balanced Budget Act (BBA)
C) Patient Protection and Affordable Care Act (PPACA)
D) Tax Equity and Fiscal Responsibility Act (TEFRA)
Correct Answer: B
Rationale: The Balanced Budget Act of 1997 was pivotal in granting NPs the ability
to bill Medicare directly for their services, even in inpatient settings, under their
own National Provider Identifier (NPI).
8. The AGACNP is caring for a 68-year-old patient with septic shock. The family
requests a "Do Not Resuscitate" (DNR) order because the patient has a poor
baseline functional status. The patient is currently sedated and unable to
communicate. What is the appropriate legal step?
A) Write the DNR order as the family is the surrogate.
B) Refuse to write the order until the patient is awake.
C) Request an ethics committee consult to overrule the family.
D) Evaluate if the patient has a designated healthcare proxy or advance directive.
Correct Answer: D
