Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
TEST BANK
Advanced Practice Nursing
Essential Knowledge for the Profession
Susan M. DeNisco, Anne M. Barker
3rd Edition
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
Table of Contents
PART 1 Professional Roles for the Advanced Practice Nurse
1 Introduction to the Role of Advanced Practice Nursing
2 The Nurse Practitioner: Historical Perspectives on the Art and Science of Nurse Practitionering
3 Overview of the Doctor of Nursing Practice Degree
4 Emerging Roles for the DNP Nurse Educator
5 Influencing and Leading Change in the Complex Healthcare Environment: The Role of the Advanced Practice
Nurse
6 Interprofessional Collaboration for Improving Patient and Population Health
PART 2 Healthcare Delivery and Health Policy for Advanced Practice: Core Knowledge
7 An Overview of U.S. Healthcare Delivery
8 Beliefs, Values, and Health
9 The Healthcare Interdisciplinary Context: A Focus on the Microsystem Concept
10 Microeconomics in the Hospital Firm: Competition, Regulation, the Profit Motive, and Patient Care
11 Government Regulation: Parallel and Powerful
PART 3 Quality, Safety, and Information Systems for Advanced Practice Nurses
12 Factors Influencing the Application and Diffusion of CQI in Health Care
13 Patient Safety Movement: The Progress and the Work That Remains
14 Accelerating Patient Safety Improvement
15 Health Information Technology
16 The Electronic Health Record and Clinical Informatics
17 IOM Core Competency: Utilize Informatics
PART 4 Theoretical Foundations, Research, and Evidence-Based Practice
18 The Evolution of Nursing Science
19 Theory-Based Advanced Nursing Practice
20 Research: How Health Care Advances
21 Evidence-Based Practice
22 Clinical Scholarship and Evidence-Based Practice
PART 5 The Role of Race, Culture, Ethics, and Advocacy in Advanced Nursing Practice
23 Birth of Transcultural Nursing to Current Theories and Conceptual Models for Cultural Diversity
24 Global Diversity
25 Health Services for Special Populations
26 Introduction to Ethics
27 Advanced Practice Nursing: The Nurse–Patient Relationship and General Ethical Concerns
PART 6 Leadership and Role transition for the Advanced Practice nurse
28 Developing Leadership Skills for the Advance Practice Nurse Through Mentorship
29 Managing Personal Resources: Time and Stress Management
30 Role Transition: Strategies for Success in the Marketplace
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
Advanced Practice Nursing: Essential Knowledge for the Profession 3rd Edition Denisco
Test Bank
Chapter1 Introduction to the Role of Advanced Practices Nursing
Multiple Choice
1. In which year did the American Association of College of Nursing (AACN) introduced the
Doctorate of Nursing Practice (DNP)?
a. 2006
b. 2004
c. 2000
d. 2002
The AACN introduced the DNP degree in 2004 to prepare advanced practice nurses (APRNs) to
meet challenges and standardize practice beyond master’s degree programs.
2. Which of the following is the best explanation for the creation of the Doctorate of Nursing
Practice (DNP) degree?
a. To compete against master’s degree programs
b. To ensure standardized curriculum ensuring independent practice
c. To validate APRN’s for financial reimbursement
d. To address increasing curriculum requirements of master’s degree programs
ANS: D
Although all answers are influenced by the DNP core competencies, the DNP program creation in
2004 by the AACN was designed to address curriculum requirements of master’s degree programs.
3. Which of the following was the first recognized area of advanced practice nursing?
a. Clinical Nurse Specialist
b. Family nurse practitioner
c. Pediatric nurse practitioner
d. Certified Registered Nurse Anesthetist
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
ANS: D
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.
4. Which factor is broadly perceived to solidify and standardize the role of the APNs over the last
25 years?
a. Lack of access to health care providers
b. Standardized curriculum development
c. Payment for services
d. Societal forces
ANS: B
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.
5. During the formation of early APN roles in anesthesia, which of the following increased
demand for access to health care?
a. Poverty
b. War
c. Rural access to care
d. Availability of training
ANS: B
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.
6. 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. Pediatrics
b. Anesthesia
c. Obstetrics
d. Research and statistics
e. Family nursing
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
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.
7. In 1893, Lillian Wald established the Henry Street Settlement (HSS) House for which purpose?
a. Access to health care of rural areas
b. Create inner-city nursing awareness
c. Provide the disadvantaged access to care
d. Establish guidelines for advanced nursing roles
ANS: C
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.
8. The Frontier Nursing Service (FNS) founded in Kentucky in 1925 by Mary Breckenridge
initially provided Appalachia with nursing resources and which type of advanced nursing care?
a. Pediatric care
b. Anesthesia
c. Midwifery
d. Surgical services
ANS: C
The original FNS provided nursing services and obstetric services to Appalachian residents. Later
working from standard orders developed from their medical advisory committee nurses treated
patients, made diagnoses, and dispensed medications.
9. Which organization founded in 1941 under Mary Breckenridge’s leadership merged with the
American College of Nurse-Midwives (ACNM) in 1969?
a. American Association of Nurse-Midwives (AANM)
b. American Nurses Association (ANA)
c. Association for National Nurse-Midwifery (ANNM)
d. Council of Nursing Midwifery (ANM)
ANS: A
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
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
development. In 1955, the American College of Nurse-Midwives was formed and the two
organizations merged in 1969 after the death of Mary Breckenridge.
10. 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 scope of practice included anesthesia
c. Nurse anesthesia was legal, if under guidance of a supervising physician
d. Only trained nursing professionals could administer anesthesia independently
ANS: C
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.
11. The first known establishment of the nurse practitioner role occurred in 1965 at theUniversity
of Colorado. In which area of training did this role specialize?
a. Pediatrics
b. Geriatrics
c. Midwifery
d. Anesthesia
ANS: A
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.
12. The DNP program curriculum outlined which of the following clinical requirements in an
effort to standardize training?
a. 1000 supervised clinical hours and 200 unsupervised clinical hours
b. 1000 supervised clinical hours
c. 900 supervised clinical hours
d. 800 supervised clinical hours and 200 unsupervised clinical hours
ANS: B
In 2004, the AACN outlined the DNP curriculum in an effort to standardize and relieve challenges
of master’s degree programs. This includes a standardized curriculum requiring 1000 supervised
clinical hours.
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
13. Which state became the first to recognize diagnosis and treatment as part of the
scope of practice of specialty nurses?
a. Idaho
b. Oklahoma
c. South Dakota
d. Maryland
ANS: A
Idaho Governor Cecil Andrus signed HB 46 and HB 207 into law on February 11,
1971. This amended the states’ nurse practice act making it the first state to officially
recognize diagnosis and treatment of specialty nurses. The recognition of the ability
to diagnose and treat overcame an initial hurdle toward independent nursing practice.
14. The American Nursing Association (ANA) defines which requirement for the
designation of a clinical nurse specialist in any specialty?
a. Specialty training certificate
b. Successful completion of certification examination
c. Masters or doctoral degree
d. 1000 hours relevant supervised training
e. Two or more years of clinically relevant experience
ANS: C
In 1980, the ANA specifically outlined criteria for the acknowledgment of clinical
nurse specialist training programs. At that time they required graduate level training
to become an expert in a relevant specialty area of nursing. Additionally, they must
meet any requirements set forth by the specific professional society.
Chapter2 The Nurse Practitioner: Historical Perspective on the Art and Science of Nurse
Practitionering
1. Which of the following is the primary mission of the National Organization of Nurse
Practitioner Faculties (NONPF)?
a. Provide leadership in promoting quality NP education
b. NP Faculty training program assistance
c. Provide financial assistance to NP students
d. Lobbying legislature on behalf of NPs
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
ANS: A
The NONPF’s primary mission is to provide leadership in promoting quality NP education. The
organization has published domains and core competencies for primary care and these serve as a
framework for NP education and practice.
2. A model of competencies that are encompassed around three spheres of influence known as
patient, nurses and nursing practice, and organization and influence is known as?
a. NACNS Model of clinical nurse specialist competencies
b. Fenton’s and Brykczynski’s Expert Practice
c. Calkin’s model of Advanced Nursing Practice
d. Shuler’s Model of NP Practice
ANS: A
The NACNS’s initial 2008 statement was revised in 2004. The statement outlined competencies
that aligned to each of the three spheres of influence: patient, nurses and nursing practice, and
organization and influence.
3. Building upon Benner’s seven domains of expert nursing practice, which conceptual model
adds an additional domain “The consulting role of the nurse”?
a. Calkin’s model of Advanced Nursing Practice
b. Fenton’s and Brykczynski’s Expert Practice
c. Strong Memorial Hospital’s Model of Advanced Nursing Practice
d. Shuler’s Model of NP Practice
e. NACNS Clinical Nurse Specialists Model
ANS: B
Fenton’s and Brykczynski’s Expert Practice Domains of the CNS and NP expanded on Benner’s
seven domains adding consultation provided by CNS’s to other nurses and management of health
and illness in ambulatory care settings.
4. Which model of conceptual practice was the first to explicitly distinguish the experience level
of advanced practitioners?
a. Calkin’s model of Advanced Nursing Practice
b. Shuler’s Model of NP Practice
c. NACNS Clinical Nurse Specialists Model
d. Strong Memorial Hospital’s Model of Advanced Nursing Practice
e. Fenton’s and Brykczynski’s Expert Practice
ANS: A
TEST BANK
Advanced Practice Nursing
Essential Knowledge for the Profession
Susan M. DeNisco, Anne M. Barker
3rd Edition
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
Table of Contents
PART 1 Professional Roles for the Advanced Practice Nurse
1 Introduction to the Role of Advanced Practice Nursing
2 The Nurse Practitioner: Historical Perspectives on the Art and Science of Nurse Practitionering
3 Overview of the Doctor of Nursing Practice Degree
4 Emerging Roles for the DNP Nurse Educator
5 Influencing and Leading Change in the Complex Healthcare Environment: The Role of the Advanced Practice
Nurse
6 Interprofessional Collaboration for Improving Patient and Population Health
PART 2 Healthcare Delivery and Health Policy for Advanced Practice: Core Knowledge
7 An Overview of U.S. Healthcare Delivery
8 Beliefs, Values, and Health
9 The Healthcare Interdisciplinary Context: A Focus on the Microsystem Concept
10 Microeconomics in the Hospital Firm: Competition, Regulation, the Profit Motive, and Patient Care
11 Government Regulation: Parallel and Powerful
PART 3 Quality, Safety, and Information Systems for Advanced Practice Nurses
12 Factors Influencing the Application and Diffusion of CQI in Health Care
13 Patient Safety Movement: The Progress and the Work That Remains
14 Accelerating Patient Safety Improvement
15 Health Information Technology
16 The Electronic Health Record and Clinical Informatics
17 IOM Core Competency: Utilize Informatics
PART 4 Theoretical Foundations, Research, and Evidence-Based Practice
18 The Evolution of Nursing Science
19 Theory-Based Advanced Nursing Practice
20 Research: How Health Care Advances
21 Evidence-Based Practice
22 Clinical Scholarship and Evidence-Based Practice
PART 5 The Role of Race, Culture, Ethics, and Advocacy in Advanced Nursing Practice
23 Birth of Transcultural Nursing to Current Theories and Conceptual Models for Cultural Diversity
24 Global Diversity
25 Health Services for Special Populations
26 Introduction to Ethics
27 Advanced Practice Nursing: The Nurse–Patient Relationship and General Ethical Concerns
PART 6 Leadership and Role transition for the Advanced Practice nurse
28 Developing Leadership Skills for the Advance Practice Nurse Through Mentorship
29 Managing Personal Resources: Time and Stress Management
30 Role Transition: Strategies for Success in the Marketplace
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
Advanced Practice Nursing: Essential Knowledge for the Profession 3rd Edition Denisco
Test Bank
Chapter1 Introduction to the Role of Advanced Practices Nursing
Multiple Choice
1. In which year did the American Association of College of Nursing (AACN) introduced the
Doctorate of Nursing Practice (DNP)?
a. 2006
b. 2004
c. 2000
d. 2002
The AACN introduced the DNP degree in 2004 to prepare advanced practice nurses (APRNs) to
meet challenges and standardize practice beyond master’s degree programs.
2. Which of the following is the best explanation for the creation of the Doctorate of Nursing
Practice (DNP) degree?
a. To compete against master’s degree programs
b. To ensure standardized curriculum ensuring independent practice
c. To validate APRN’s for financial reimbursement
d. To address increasing curriculum requirements of master’s degree programs
ANS: D
Although all answers are influenced by the DNP core competencies, the DNP program creation in
2004 by the AACN was designed to address curriculum requirements of master’s degree programs.
3. Which of the following was the first recognized area of advanced practice nursing?
a. Clinical Nurse Specialist
b. Family nurse practitioner
c. Pediatric nurse practitioner
d. Certified Registered Nurse Anesthetist
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
ANS: D
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.
4. Which factor is broadly perceived to solidify and standardize the role of the APNs over the last
25 years?
a. Lack of access to health care providers
b. Standardized curriculum development
c. Payment for services
d. Societal forces
ANS: B
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.
5. During the formation of early APN roles in anesthesia, which of the following increased
demand for access to health care?
a. Poverty
b. War
c. Rural access to care
d. Availability of training
ANS: B
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.
6. 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. Pediatrics
b. Anesthesia
c. Obstetrics
d. Research and statistics
e. Family nursing
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
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.
7. In 1893, Lillian Wald established the Henry Street Settlement (HSS) House for which purpose?
a. Access to health care of rural areas
b. Create inner-city nursing awareness
c. Provide the disadvantaged access to care
d. Establish guidelines for advanced nursing roles
ANS: C
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.
8. The Frontier Nursing Service (FNS) founded in Kentucky in 1925 by Mary Breckenridge
initially provided Appalachia with nursing resources and which type of advanced nursing care?
a. Pediatric care
b. Anesthesia
c. Midwifery
d. Surgical services
ANS: C
The original FNS provided nursing services and obstetric services to Appalachian residents. Later
working from standard orders developed from their medical advisory committee nurses treated
patients, made diagnoses, and dispensed medications.
9. Which organization founded in 1941 under Mary Breckenridge’s leadership merged with the
American College of Nurse-Midwives (ACNM) in 1969?
a. American Association of Nurse-Midwives (AANM)
b. American Nurses Association (ANA)
c. Association for National Nurse-Midwifery (ANNM)
d. Council of Nursing Midwifery (ANM)
ANS: A
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
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
development. In 1955, the American College of Nurse-Midwives was formed and the two
organizations merged in 1969 after the death of Mary Breckenridge.
10. 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 scope of practice included anesthesia
c. Nurse anesthesia was legal, if under guidance of a supervising physician
d. Only trained nursing professionals could administer anesthesia independently
ANS: C
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.
11. The first known establishment of the nurse practitioner role occurred in 1965 at theUniversity
of Colorado. In which area of training did this role specialize?
a. Pediatrics
b. Geriatrics
c. Midwifery
d. Anesthesia
ANS: A
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.
12. The DNP program curriculum outlined which of the following clinical requirements in an
effort to standardize training?
a. 1000 supervised clinical hours and 200 unsupervised clinical hours
b. 1000 supervised clinical hours
c. 900 supervised clinical hours
d. 800 supervised clinical hours and 200 unsupervised clinical hours
ANS: B
In 2004, the AACN outlined the DNP curriculum in an effort to standardize and relieve challenges
of master’s degree programs. This includes a standardized curriculum requiring 1000 supervised
clinical hours.
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
13. Which state became the first to recognize diagnosis and treatment as part of the
scope of practice of specialty nurses?
a. Idaho
b. Oklahoma
c. South Dakota
d. Maryland
ANS: A
Idaho Governor Cecil Andrus signed HB 46 and HB 207 into law on February 11,
1971. This amended the states’ nurse practice act making it the first state to officially
recognize diagnosis and treatment of specialty nurses. The recognition of the ability
to diagnose and treat overcame an initial hurdle toward independent nursing practice.
14. The American Nursing Association (ANA) defines which requirement for the
designation of a clinical nurse specialist in any specialty?
a. Specialty training certificate
b. Successful completion of certification examination
c. Masters or doctoral degree
d. 1000 hours relevant supervised training
e. Two or more years of clinically relevant experience
ANS: C
In 1980, the ANA specifically outlined criteria for the acknowledgment of clinical
nurse specialist training programs. At that time they required graduate level training
to become an expert in a relevant specialty area of nursing. Additionally, they must
meet any requirements set forth by the specific professional society.
Chapter2 The Nurse Practitioner: Historical Perspective on the Art and Science of Nurse
Practitionering
1. Which of the following is the primary mission of the National Organization of Nurse
Practitioner Faculties (NONPF)?
a. Provide leadership in promoting quality NP education
b. NP Faculty training program assistance
c. Provide financial assistance to NP students
d. Lobbying legislature on behalf of NPs
, Test Bank - Advanced Practice Nursing Essential Knowledge for the Profession 3rd Edition (DeNisco, 2017)
ANS: A
The NONPF’s primary mission is to provide leadership in promoting quality NP education. The
organization has published domains and core competencies for primary care and these serve as a
framework for NP education and practice.
2. A model of competencies that are encompassed around three spheres of influence known as
patient, nurses and nursing practice, and organization and influence is known as?
a. NACNS Model of clinical nurse specialist competencies
b. Fenton’s and Brykczynski’s Expert Practice
c. Calkin’s model of Advanced Nursing Practice
d. Shuler’s Model of NP Practice
ANS: A
The NACNS’s initial 2008 statement was revised in 2004. The statement outlined competencies
that aligned to each of the three spheres of influence: patient, nurses and nursing practice, and
organization and influence.
3. Building upon Benner’s seven domains of expert nursing practice, which conceptual model
adds an additional domain “The consulting role of the nurse”?
a. Calkin’s model of Advanced Nursing Practice
b. Fenton’s and Brykczynski’s Expert Practice
c. Strong Memorial Hospital’s Model of Advanced Nursing Practice
d. Shuler’s Model of NP Practice
e. NACNS Clinical Nurse Specialists Model
ANS: B
Fenton’s and Brykczynski’s Expert Practice Domains of the CNS and NP expanded on Benner’s
seven domains adding consultation provided by CNS’s to other nurses and management of health
and illness in ambulatory care settings.
4. Which model of conceptual practice was the first to explicitly distinguish the experience level
of advanced practitioners?
a. Calkin’s model of Advanced Nursing Practice
b. Shuler’s Model of NP Practice
c. NACNS Clinical Nurse Specialists Model
d. Strong Memorial Hospital’s Model of Advanced Nursing Practice
e. Fenton’s and Brykczynski’s Expert Practice
ANS: A
