FNP MSN 560 > Complete Test Bank> ANSWERS AND RATIONALES FNP MSN 560

CHAPTER1: ANSWERS AND RATIONALES 1. Which change represents the primary impetus for the end of the era of the female lay healer? 1. Perception of health promotion as an obligation 2. Development of a clinical nurse specialist position statement 3. Foundation of the American Association of Nurse-Midwives 4. Emergence of a medical establishment Page: 4 Feedback 1. . Lay healers traditionally viewed their role as being a function of their community obligations; however, the emerging medical establishment viewed healing as a commodity. The emergence of a male medical establishment represents the primary impetus for the end of the era of the female lay healer. 2. . The American Nurses Association (ANA) position statement on educational requirements for the clinical nurse specialist (CNS) was developed in 1965; the ANA’s position statement on the role of the CNS was issued in 1976. The emergence of a male medical establishment represents the primary impetus for the end of the era of the female lay healer. 3. . The American Association of Nurse-Midwives (AANM) was founded in 1928. The emergence of a male medical establishment represents the primary impetus for the end of the era of the female lay healer. 4. The emergence of a male medical establishment represents the primary impetus for the end of the era of the female lay healer. Whereas lay healers viewed their role as being a function of their community obligations, the emerging medical establishment viewed healing as a commodity. The era of the female lay healer began and ended in the 19th century. The American Association of Nurse-Midwives (AANM) was founded in 1928. The American Nurses Association (ANA) position statement on educational requirements for the clinical nurse specialist (CNS) was developed in 1965; the ANA’s position statement on the role of the CNS was issued in 1976. 2. The beginning of modern nursing is traditionally considered to have begun with which event? 1. Establishment of the first school of nursing 2. Incorporation of midwifery by the lay healer 3. Establishment of the Frontier Nursing Service (FNS) 4. Creation of the American Association of Nurse-Midwives (AANM) Pages: 4–5 Feedback 1. Traditionally, modern nursing is considered to have begun in 1873, when the first three U.S. training schools for nurses opened. The role of the lay healer as a midwife is documented to have occurred in the 19th century, before the establishment of schools of nursing. The Frontier Nursing Service (FNS), which provided nurse-midwifery services, was established in 1925. In 1928, the Kentucky State Association of Midwives, which was an outgrowth of the FNS, became the American Association of Nurse-Midwives (AANM). 2. . The role of the lay healer as a midwife is documented to have occurred in the 19th century, before the establishment of schools of nursing. Traditionally, modern nursing is considered to have begun in 1873, when the first three U.S. training schools for nurses opened. 3. . The Frontier Nursing Service (FNS), which provided nurse- midwifery services, was established in 1925. Traditionally, modern nursing is considered to have begun in 1873, when the first three U.S. training schools for nurses opened. 4. . In 1928, the Kentucky State Association of Midwives, which was an outgrowth of the FNS, became the American Association of Nurse- Midwives (AANM). Modern nursing is considered to have begun in 1873, at which time the first three U.S. training schools for nurses opened. 3. In 1910, which factors most significantly influenced the midwifery profession? Select all that apply. 1. Strict licensing requirements 2. Negative public perception 3. Dedicated funding for training 4. Poor maternal-child outcomes 5. Mandatory professional supervision Pages: 6–7 Feedback 1. . In 1910, the midwifery profession was significantly influenced by poor maternal-child outcomes and a public perception as unprofessional. Though legislation ultimately was passed to tighten requirements related to licensing and supervision of midwives, in the early 20th century, midwives were largely unregulated and generally perceived as unprofessional. 2. In 1910, the midwifery profession was significantly influenced by poor maternal-child outcomes and a public perception as unprofessional. At that time, approximately 50% of all U.S. births were reportedly attended by midwives. However, especially with regard to perinatal health indicators, the national population’s general health was poor. Unfavorable outcomes among both mothers and infants were attributed to midwives who, at that time, were largely unregulated and generally perceived as unprofessional. Poor maternal-child outcomes, negative perceptions of midwives, obstetricians’ targeted efforts to take control of the birthing process, and a movement away from home births prompted major changes. Legislation was passed to tighten requirements related to licensing and supervision of midwives. One aim of the Sheppard-Towner Maternity and Infancy Act involved allotting funds to train public health nurses in midwifery; however, the bill lapsed in 1929. 3. . Goals of the Sheppard-Towner Maternity and Infancy Act included allocating funds to train public health nurses in midwifery, but the bill lapsed in 1929. In 1910, poor maternal-child outcomes and a public perception as unprofessional significantly influenced the midwifery profession. 4. In 1910, the midwifery profession was significantly influenced by poor maternal-child outcomes and a public perception as unprofessional. At that time, approximately 50% of all U.S. births were reportedly attended by midwives. However, especially with regard to perinatal health indicators, the national population’s general health was poor. Unfavorable outcomes among both mothers and infants were attributed to midwives who, at that time, were largely unregulated and generally perceived as unprofessional. Poor maternal-child outcomes, negative perceptions of midwives, obstetricians’ targeted efforts to take control of the birthing process, and a movement away from home births prompted major changes. Legislation was passed to tighten requirements related to licensing and supervision of midwives. One aim of the Sheppard-Towner Maternity and Infancy Act involved allotting funds to train public health nurses in midwifery; however, the bill lapsed in 1929. 5. . In 1910, the midwifery profession was largely unregulated. Factors that influenced the profession included poor maternal-child outcomes and a public perception as unprofessional. 4. Which advanced practice nursing role is unique in that the practitioners view their role as comprising a combination of two distinct disciplines? 1. Nurse practitioner 2. Certified registered nurse anesthetist 3. Clinical nurse specialist 4. Certified nurse-midwife Page: 9 Feedback 1. . The role of the certified nurse-midwife (CNM) is unique in that the CNM views the practice role as combining two disciplines: nursing and midwifery. 2. . The role of the certified nurse-midwife (CNM) is unique in that the CNM views the practice role as combining two disciplines: nursing and midwifery. 3. . The role of the certified nurse-midwife (CNM) is unique in that the CNM views the practice role as combining two disciplines: nursing and midwifery. 4. The role of the certified nurse-midwife (CNM) is unique in that the CNM views the practice role as combining two disciplines: nursing and midwifery. 5. In the 19th century, which factors led to the administration of anesthesia by nurses? Select all that apply. 1. Surgeon entitlement to collecting anesthesia fees 2. Collaborative practice between physician-anesthetists and nurses 3. Lack of recognition of anesthesiology as a medical specialty 4. Opposition to anesthesia administration by physicians 5. Formation of a national organization by nurse anesthetists , 3 Pages: 10–11 Feedback 1. In the 19th century, anesthesia was in its early stages. Because of a lack of recognition as a medical specialty and the surgeon’s entitlement to collecting anesthesia fees, other physicians had little to no interest in anesthesia administration. However, physicians were not opposed to administering anesthesia; rather, anesthesia was viewed as a means by which to transform surgery into a scientific modality for treating health alterations. Collaboration between physicians and nurses did not contribute to administration of anesthesia by nurses; contentiousness is a hallmark of the relationship between nurse anesthetists and anesthesiologists even in the present day. In the 19th century, no national organization of nurse anesthetists yet existed. The National Association of Nurse Anesthetists, which was renamed the American Association of Nurse Anesthetists (AANA), was founded in 1931. 2. . With the introduction of anesthesia, collaboration between physicians and nurses did not contribute to administration of anesthesia by nurses. By contrast, contentiousness is a hallmark of the relationship between nurse anesthetists and anesthesiologists even in the present day. In the 19th century, anesthesia was in its early stages. Administration of anesthesia by nurses occurred primarily because of anesthesiology’s lack of recognition as a medical specialty and the surgeon’s entitlement to collecting anesthesia fees. 3. In the 19th century, anesthesia was in its early stages. Because of a lack of recognition as a medical specialty and the surgeon’s entitlement to collecting anesthesia fees, other physicians had little to no interest in anesthesia administration. However, physicians were not opposed to administering anesthesia; rather, anesthesia was viewed as a means by which to transform surgery into a scientific approach to treating with health alterations. Collaboration between physicians and nurses did not contribute to administration of anesthesia by nurses; contentiousness is a hallmark of the relationship between nurse anesthetists and anesthesiologists even in the present day. In the 19th century, no national organization of nurse anesthetists yet existed. The National Association of Nurse Anesthetists, which was renamed the American Association of Nurse Anesthetists (AANA), was founded in 1931. 4. . In the 19th century, anesthesia was in its early stages. Physicians were in favor of the administration of anesthesia, viewing this advancement as a means by which to transform surgery into a scientific modality for treating health alterations. Because of a lack of recognition as a medical specialty and the surgeon’s entitlement to collecting anesthesia fees, other physicians had little to no interest in anesthesia administration. As such, the administration of anesthesia was assigned to nurses. 5. . The National Association of Nurse Anesthetists, which was renamed the American Association of Nurse Anesthetists (AANA), was founded in 1931. In the 19th century, anesthesia was in its early stages. Because of a lack of recognition as a medical specialty and the surgeon’s entitlement to collecting anesthesia fees, other physicians had little to no interest in anesthesia administration. Thus, anesthesia administration was performed by nurses. 6. Which factor contributed to expansion of the role of the clinical nurse specialist (CNS) during the 1960s? 1. Increased numbers of practicing physicians 2. Tightening of female role definitions 3. Return of nurses from military conflict 4. Lack of medical specialization Page: 17 Feedback 1. . During the 1960s, a shortage of physicians occurred. The role of the CNS was expanded in part because of the return of nurses from the Vietnam War. Nurse veterans searched for opportunities to increase their knowledge and skills, and practiced in advanced roles as well as nontraditional specialties (such as anesthesia and trauma or anesthesia). 2. . During the 1960s, role definitions for women became less restrictive. The role of the CNS was expanded in part because of the return of nurses from the Vietnam War. Nurse veterans searched for opportunities to increase their knowledge and skills, and practiced in advanced roles as well as nontraditional specialties (such as anesthesia and trauma or anesthesia). 3. Expansion of the CNS role during the 1960s occurred in part because of the return of nurse veterans from the Vietnam War who sought to increase their knowledge and skills, and to work in advanced roles and nontraditional fields, such as anesthesia and trauma. 4. . In the 1960s, medical specialization was prevalent, and the need for competent nurses who were proficient at caring for patients with complex health needs increased. Thus, the CNS role expanded. The role of the CNS also expanded because of the return of nurses from the Vietnam War. Many of these nurse veterans searched for opportunities to increase their knowledge and skills, and practiced in advanced roles as well as nontraditional specialties (such as anesthesia and trauma or anesthesia). 7. Differentiation between the role of the clinical nurse specialist (CNS) and the nurse practitioner (NP) is primarily based on which premise? 1. Designation as an advanced practice nurse 2. Diagnosis of patient health conditions 3. Nature of practice setting environments 4. Authority to prescribe medications Pages: 20–21 Feedback 1. . Both the clinical nurse specialist (CNS) and the nurse practitioner (NP) are designated as advanced practice nurses (APNs). A primary differentiation between the roles of CNS and NP centers on the nature of the practice setting. Although the CNS most often practices in a secondary or tertiary care setting, the NP often practices in a primary care setting. 2. . Both the clinical nurse specialist (CNS) and the nurse practitioner (NP) are prepared to diagnose patient health alterations. A primary differentiation between the roles of CNS and NP centers on the nature of the practice setting. Although the CNS most often practices in a secondary or tertiary care setting, the NP often practices in a primary care setting. 3. A primary differentiation between the roles of clinical nurse specialist (CNS) and nurse practitioner (NP) centers on the nature of the practice setting. Although the CNS most often practices in a secondary or tertiary care setting, the NP often practices in a primary care setting. Both the CNS and the NP are designated as advanced practice nurses (APNs), educationally prepared to diagnose patient health alterations, and eligible to apply for prescriptive authority. 4. . Both the clinical nurse specialist (CNS) and the nurse practitioner (NP) are eligible to apply for authority to prescribe medications. A primary differentiation between the roles of CNS and NP centers on the nature of the practice setting. Although the CNS most often practices in a secondary or tertiary care setting, the NP often practices in a primary care setting. 8. The National Council of State Boards of Nursing’s Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation prompted gains related to which aspects of the role and function of the nurse practitioner (NP)? Select all that apply. 1. Legal authority 2. Reimbursement 3. Consumer recognition 4. Prescriptive privilege 5. Autonomy , 2, 4 Page: 29 Feedback 1. The 2008 adoption of the Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation by the National Council of State Boards of Nursing prompted gains related to several aspects of the role and function of the nurse practitioner (NP), including legal authority, reimbursement mechanisms in the United States, and prescriptive privilege. At present, NPs still face challenges related to autonomy, as well as consumer recognition in health care. 2. The 2008 adoption of the Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation by the National Council of State Boards of Nursing prompted gains related to several aspects of the role and function of the nurse practitioner (NP), including legal authority, reimbursement mechanisms in the United States, and prescriptive privilege. At present, NPs still face challenges related to autonomy, as well as consumer recognition in health care. 3. . At present, nurse practitioners (NPs) still face challenges related to consumer recognition in health care. The 2008 adoption of the Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation by the National Council of State Boards of Nursing prompted gains related to several aspects of the role and function of the NP, including legal authority, reimbursement mechanisms in the United States, and prescriptive privilege. 4. Adoption of the Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation in 2008 by the National Council of State Boards of Nursing prompted gains related to several aspects of the role and function of the nurse practitioner (NP), including legal authority, reimbursement mechanisms in the United States, and prescriptive privilege. At present, NPs still face challenges related to autonomy, as well as consumer recognition in health care. 5. . At present, nurse practitioners (NPs) still face challenges related to autonomy. The 2008 adoption of the Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation by the National Council of State Boards of Nursing prompted gains related to several aspects of the role and function of the NP, including legal authority, reimbursement mechanisms in the United States, and prescriptive privilege. At present, NPs still face challenges related to autonomy, as well as consumer recognition in health care. 9. The doctor of nursing practice (DNP) degree was developed to support the achievement of which goal related to advanced practice nursing education? 1. Eliminating master’s degree programs 2. Promoting excellence in clinical practice 3. Replacing doctor of philosophy programs 4. Emphasizing the generation of nursing research Pages: 31, 33 Feedback 1. . Rather than seeking to eliminate master’s degree programs designed to prepare advanced practice registered nurses (APRNs), current legislation exists to preserve such programs. The doctor of nursing practice (DNP) is focused on preparing the nurse clinician to demonstrate excellence in nursing practice. 2. The doctor of nursing practice (DNP) is not intended to replace the doctor of philosophy (PhD). Whereas the PhD emphasizes research, the DNP is focused on preparing the nurse clinician to demonstrate excellence in nursing practice. Current legislative efforts related to nursing education do not include elimination of master’s degree programs for advanced practice registered nurses (APRNs). Rather, current legislation exists to preserve existing master’s degree programs designed to prepare APRNs. 3. . The doctor of nursing practice (DNP) is not intended to replace the doctor of philosophy (PhD). The DNP is focused on preparing the nurse clinician to demonstrate excellence in nursing practice. 4. . Unlike the doctor of philosophy (PhD), which emphasizes research, the doctor of nursing practice (DNP) is focused on preparing the nurse clinician to demonstrate excellence in nursing practice. 10. Among national nursing leaders, which argument serves as a basis for opposition to the requirement that advanced practice nurses (APNs) earn a doctor of nursing practice (DNP) degree? 1. Greater professionalization is needed among advanced practice nurses. 2. The number of graduate nursing programs should be limited. 3. Advanced practice nursing certification should not require a doctoral degree. 4. The need for care providers should be prioritized. Page: 33 Feedback 1. . National nursing leaders have opposed a proposition to require completion of a doctor of nursing practice (DNP) degree by advanced practice nurses (APNs) who seek certification based on a perception that the need for care providers should be prioritized above professionalization of advanced practice registered nurses (APRNs) by way of completing a DNP program. 2. . National nursing leaders have not sought to limit graduate nursing education programs for advanced practice registered nurses (APRNs). The basis for opposition among national nursing leaders related to requiring advanced practice nurses (APNs) to complete a doctor of nursing practice (DNP) degree centers on the perception that the need for care providers takes precedence over professionalization of APRNs by way of completing a DNP program. 3. . National nursing leaders have not sought to require advanced practice nurses (APNs) to complete a doctor of philosophy (PhD) degree. Rather, national nursing leaders have opposed a mandate that would require completion of a doctor of nursing practice (DNP) degree before seeking certification as an advanced practice registered nurse (APRN) based on a perception that the need for care providers should be prioritized over professionalization of APRNs. 4. National nursing leaders have opposed a mandate that would require completion of a doctor of nursing practice (DNP) degree before seeking certification as an advanced practice registered nurse (APRN) based on a perception that the need for care providers should be prioritized over professionalization of APRNs. National nursing leaders have neither sought to limit graduate nursing education programs for APRNs nor recommended that advanced practice nurses (APNs) be required to complete a doctor of philosophy (PhD) degree. Chapter 2: Emerging Roles of the Advanced Practice Nurse ANSWERS AND RATIONALES 1. Entry into which advanced practice nursing specialty will require a doctoral degree by 2022? 1. Clinical nurse specialist (CNS) 2. Certified registered nurse anesthetist (CRNA) 3. Nurse practitioner (NP) 4. Certified nurse-midwife (CNM) Page: 5 Feedback 1. . Clinical nurse specialists (CNSs) are not required to complete a doctoral degree. However, the American Association of Nurse Anesthetists (AANA) has set forth a mandate requiring all graduates to complete a doctoral degree. Beginning in 2022, a doctorate will be the minimum requirement to enter practice as a certified registered nurse anesthetist (CRNA) (AANA, 2016). 2. Beginning in 2022, the American Association of Nurse Anesthetists (AANA) will require a doctoral degree as a minimum requirement to enter practice as a certified registered nurse anesthetist (CRNA) (AANA, 2016). 3. . Nurse practitioners (NPs) are not currently required to complete a doctoral degree. Presently, only the American Association of Nurse Anesthetists (AANA) has set forth a mandate requiring all graduates to complete a doctoral degree. Beginning in 2022, a doctorate will be the minimum requirement to enter practice as a certified registered nurse anesthetist (CRNA) (AANA, 2016). 4. . At present, certified nurse-midwives (CNMs) are not required to obtain a doctoral degree. Only the American Association of Nurse Anesthetists (AANA) has set forth a mandate requiring all graduates to complete a doctoral degree. Beginning in 2022, a doctorate will be the minimum requirement to enter practice as a certified registered nurse anesthetist (CRNA) (AANA, 2016). 2. According to the Consensus Model for APRN Regulation, advanced practice nursing should abide by which recommendation? 1. Emphasizing state-based regulation of advanced practice nursing standards 2. Ensuring regulation of advanced practice registered nurses (APRNs) as a unified, collective group 3. Preparing clinical nurse specialists (CNSs) to function primarily in acute care 4. Changing the population focus of adult nurse practitioners to adult gerontology Pages: 6, 20 Feedback 1. . The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education was developed by the APRN Consensus Work Group and the National Council of State Boards of Nursing (Consensus Model, 2008). Rather than emphasizing state-based regulation of advanced practice nursing, general goals of the Consensus Model include promoting consistency of advanced practice nursing standards to increase the potential for interstate licensure reciprocity. The Consensus Model recommends shifting the population focus of adult nurse practitioners (NPs) to adult gerontology. 2. . The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education was developed by the APRN Consensus Work Group and the National Council of State Boards of Nursing (Consensus Model, 2008). Instead of ensuring regulation of advanced practice registered nurses (APRNs) as a collective group, the Consensus Model recommends regulation of APRNs in one of four accepted roles. Recommendations also include shifting the population focus of adult nurse practitioners (NPs) to adult gerontology. 3. . The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education was developed by the APRN Consensus Work Group and the National Council of State Boards of Nursing (Consensus Model, 2008). Based on the Consensus Model, the practice of clinical nurse specialist (CNS) practices occurs across both acute and primary care settings. The Consensus Model also recommends shifting the population focus of adult nurse practitioners (NPs) to adult gerontology. 4. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education was developed by the APRN Consensus Work Group and the National Council of State Boards of Nursing (Consensus Model, 2008). Per the Consensus Model, the population focus of adult nurse practitioners (NPs) has shifted to adult gerontology. As opposed to emphasizing state-based regulation of advanced practice nursing, broad goals of the Consensus Model include developing more consistent standards for advanced practice nurses (APNs) that promote eligibility for interstate licensure reciprocity. Instead of ensuring regulation of advanced practice registered nurses (APRNs) as a collective group, the Consensus Model recommends regulation of APRNs in one of four accepted roles. The Consensus Model describes the practice of clinical nurse specialists (CNSs) as including both acute and primary care settings. 3. The relationship to which aspect of the function of the clinical nurse specialist (CNS) shows the greatest need for research? 1. Patient satisfaction 2. Care outcomes 3. Income generation 4. Role adaptability Pages: 8, 10 Feedback 1. . Research has identified a correlation between clinical nurse specialist (CNS)-patient interaction and patient satisfaction. Further research is needed to examine the relationship between utilization of the CNS and income generation. 2. . Existing research studies have identified a correlation between clinical nurse specialist (CNS)-patient interaction and favorable patient care outcomes. Additional research is needed to examine the relationship between utilization of the CNS and income generation. 3. Additional research is needed to examine the relationship between utilization of the clinical nurse specialist (CNS) and income generation. Role adaptability is a central feature of the CNS. Research has identified a correlation between CNS-patient interaction and favorable patient care outcomes, as well as patient satisfaction. 4. . Role adaptability, which is a primary characteristic of the clinical nurse specialist (CNS), is regarded as contributing to role ambiguity for this advanced practice role. Available research is limited related to the economic impact of the CNS, including income generation. 4. For nurse practitioners (NPs), which issue represents a current barrier to autonomy? 1. Restrictions on reimbursement for services 2. Absence of state-based prescriptive authority 3. Limited ability to serve in acute care settings 4. Lack of authority to manage medical problems Pages: 12, 15 Feedback 1. One barrier to autonomy for nurse practitioners (NPs) stems from restrictions on reimbursement for services. Among advanced practice nurses (APRNs), NPs comprise the largest group. All 50 states, as well as the District of Columbia, grant prescriptive privileges to qualified NPs (Phillips, 2016). NPs serve in primary and acute care settings. Assessment and management of patients related to medical and nursing problems is within the NP’s scope of practice. 2. . All 50 states, as well as the District of Columbia, grant prescriptive privileges to qualified NPs (Phillips, 2016). For NPs, barriers to autonomy include restrictions on reimbursement for services. 3. . Nurse practitioners (NPs) serve in both primary and acute care settings. Barriers to autonomy for NPs include restrictions on reimbursement for services. 4. . Nurse practitioners (NPs) are qualified to assess and manage a wide range of patient problems, including both medical and nursing issues. Barriers to the NP’s autonomy include restrictions on reimbursement for services. 5. Which changes have contributed to the evolution of the present-day nurse practitioner (NP)’s role? Select all that apply. 1. Focus on delivering care to low-income patients 2. Development of retail patient care clinics 3. Increased access to Medicaid recipients 4. Inclusion of patients from suburban areas 5. Emphasis on serving uninsured immigrants Pages: 10, 12 Feedback 1. . For the nurse practitioner (NP), the traditional patient population has included uninsured immigrants, as well as low-income individuals who receive Medicaid. Evolution of the NP’s role has been impacted by factors including an increase in the number of walk-in, retail, and urgent care clinics. A shift to providing services to patients who live in urban and suburban outpatient settings also has promoted evolution of the NP’s role. 2. The increasing number of walk-in, retail, and urgent care clinics has provided increased opportunities for patients to access nurse practitioners (NPs) who are providing primary care services. The NP’s practice has also expanded because of an increase in the provision of services to patients who live in urban and suburban outpatient settings. Traditionally, the patient population served by NPs has included low-income individuals who received Medicaid and uninsured immigrants. 3. . For the nurse practitioner (NP), the traditional patient population has included low-income individuals who receive Medicaid, as well as uninsured immigrants. Changes that have contributed to evolution of the NP’s role include an increase in the number of walk-in, retail, and urgent care clinics, as well as the provision of services to patients who live in urban and suburban outpatient settings. 4. With expansion of services to include patients who seek care in urban and suburban outpatient settings, the nurse practitioner (NP)’s practice has expanded. An increase in the number of walk-in, retail, and urgent care clinics has also increased opportunities for patients to access NPs who serve as primary care providers. 5. . Traditionally, the patient population served by nurse practitioners (NPs) has included uninsured immigrants, as well as low-income individuals who receive Medicaid. Factors that have promoted evolution of the NP’s role include an increase in the number of walk-in, retail, and urgent care clinics, as well as the provision of services to patients who live in urban and suburban outpatient settings. 6. Which consideration led to designation of the nurse practitioner (NP) rather than the clinical nurse specialist (CNS) as the advanced practice nurse (APN) who would deliver care related to psychiatric or mental health services? 1. Level of educational preparation 2. Eligibility for prescriptive authority 3. Ability to serve in community settings 4. Practice based on core competencies Page: 15 Feedback 1. . Both the clinical nurse specialist (CNS) and the nurse practitioner (NP) may be prepared at either the master’s or doctoral level. Because of a heightened emphasis on a biopsychological approach to treating clients with psychiatric/mental health needs, the importance of prescriptive authority for this advanced practice nursing role has been underscored. At present, 40 states grant prescriptive privileges to CNSs and NPs (National Association of Clinical Nurse Specialists [NACNS], 2015). However, all 50 states grant prescriptive privileges to NPs. Therefore, the psychiatric/mental health nurse practitioner has become the sole means of educational preparation for this advanced practice role. 2. A heightened emphasis on a biopsychological approach to treating clients with psychiatric/mental health needs has underscored the importance of prescriptive authority for this advanced practice nursing role. At present, 40 states grant prescriptive privileges to clinical nurse specialists (CNSs) and nurse practitioners (NPs) (National Association of Clinical Nurse Specialists [NACNS], 2015). However, as all 50 states grant prescriptive privileges to NPs, the psychiatric/mental health NP has become the sole means of educational preparation for this advanced practice role. Both the CNS and the NP may be prepared at either the master’s or doctoral level. Likewise, both the CNS and the NP may practice in a community setting. Core competencies guide the practice of both the CNS and the NP. 3. . Both the clinical nurse specialist (CNS) and the nurse practitioner (NP) may practice in a community setting. With a heightened emphasis on a biopsychological approach to treating clients with psychiatric/mental health need, the importance of prescriptive authority for this advanced practice nursing role became apparent. At present, 40 states grant prescriptive privileges to CNSs and NPs (National Association of Clinical Nurse Specialists [NACNS], 2015). However, as all 50 states grant prescriptive privileges to NPs, the psychiatric/mental health NP has become the sole means of educational preparation for this advanced practice role. 4. . Core competencies guide the practice of both the clinical nurse specialist (CNS) and the nurse practitioner (NP). A heightened emphasis on a biopsychological approach to treating clients with psychiatric/mental health need has highlighted the importance of prescriptive authority for this advanced practice nursing role. At present, 40 states grant prescriptive privileges to CNSs and NPs (National Association of Clinical Nurse Specialists [NACNS], 2015). However, as all 50 states grant prescriptive privileges to NPs, the psychiatric/mental health NP has become the sole means of educational preparation for this advanced practice specialization. 7. Which of the following defines the current practice of the acute care nurse practitioner? 1. Unit-based versus practice-based assignment 2. Participation on a specialty care team 3. Geographical setting 4. Patient population Page: 18 Feedback 1. . The acute care nurse practitioner (NP) may serve in a unit- based or practice-based capacity. This nursing specialty is defined by the patient population that is served. 2. . The acute care nurse practitioner (NP) may or may not participate as a member of a consultative team related to specialty care. The population that is served defines the acute care NP’s role. 3. . Rather than defining the acute care nurse practitioner (NP) based on the geographical setting in which care is provided, this nursing specialty is now defined by the patient population that is served. 4. Historically, the geographical setting defined the role of the acute care nurse practitioner (NP). However, the role of this nursing specialty is now defined by the patient population that is served. Acute care NPs may be practice based or unit based. The acute care NP may or may not participate as a member of a consultative team related to specialty care. 8. Certified nurse-midwives (CNMs) are most likely to practice in which setting? 1. Hospital organizations 2. Physician-owned practices 3. Nonprofit health agencies 4. Federal facilities Page: 24 Feedback 1. Most certified nurse-midwives (CNMs) practice in hospitals (29.5%) and physician-owned practices (21.7%). However, care settings for the CNM also may include midwife-owned practices, educational institutions, community health centers, birthing centers, nonprofit health agencies, and military or federal government agencies (Schuiling, Sipe, & Fullerton, 2013). 2. . The majority of certified nurse-midwives (CNMs) practice in hospitals (29.5%), followed by physician-owned practices (21.7%). Additional care settings for the CNM also may include midwife-owned practices, educational institutions, community health centers, birthing centers, nonprofit health agencies, and military or federal government agencies (Schuiling, Sipe, & Fullerton, 2013). 3. . Predominantly, certified nurse-midwives (CNMs) practice in hospitals (29.5%) and physician-owned practices (21.7%). However, care settings for the CNM also may include midwife-owned practices, educational institutions, community health centers, birthing centers, nonprofit health agencies, and military or federal government agencies (Schuiling, Sipe, & Fullerton, 2013). 4. . Certified nurse-midwives (CNMs) most often practice in hospitals (29.5%) and physician-owned practices (21.7%). However, CNMs also may practice in a variety of other settings, including midwife-owned practices, educational institutions, community health centers, birthing centers, nonprofit health agencies, and military or federal government agencies (Schuiling, Sipe, & Fullerton, 2013). 9. Which function of the certified registered nurse anesthetist (CRNA) is prohibited in certain states? 1. Induction of general anesthesia 2. Pain management procedures 3. Administration of spinal anesthesia 4. Provision of post-anesthesia care Page: 27 Feedback 1. . All 50 states and the District of Columbia authorize certified registered nurse anesthetists (CRNAs) to provide induction of general anesthesia, as well as numerous other anesthesia-related services (Department of Health and Human Services [DHHS], Public Health Service [PHS] Division of Acquisition Management, 1995). However, the CRNA’s capacity to provide pain management procedures, such as epidural steroid injections, is regulated at the state level. Therefore, not all CRNAs are authorized to provide pain management services (American Association of Nurse Anesthetists [AANA], 2014). 2. Pain management procedures, such as epidural steroid injections, are regulated at the state level; therefore, not all certified registered nurse anesthetists (CRNAs) are authorized to provide pain management services (American Association of Nurse Anesthetists [AANA], 2014). All 50 states and the District of Columbia authorize CRNAs to provide induction of general anesthesia, administration of spinal anesthetics, and delivery of post- anesthesia care (Department of Health and Human Services [DHHS], Public Health Service [PHS] Division of Acquisition Management, 1995). 3. . All 50 states and the District of Columbia authorize certified registered nurse anesthetists (CRNAs) to administer spinal anesthetics, as well as to provide several other anesthesia-related services (Department of Health and Human Services [DHHS], Public Health Service [PHS] Division of Acquisition Management, 1995). However, the CRNA’s capacity to provide pain management procedures, such as epidural steroid injections, is regulated at the state level. Therefore, not all CRNAs are authorized to provide pain management services (American Association of Nurse Anesthetists [AANA], 2014). 4. . All 50 states and the District of Columbia authorize certified registered nurse anesthetists (CRNAs) to provide post-anesthesia care, as well as to deliver several other anesthesia-related services (Department of Health and Human Services [DHHS], Public Health Service [PHS] Division of Acquisition Management, 1995). However, the CRNA’s capacity to provide pain management procedures, such as epidural steroid injections, is regulated at the state level. Therefore, not all CRNAs are authorized to provide pain management services (American Association of Nurse Anesthetists [AANA], 2014). 10. Implementation of the anesthesia care team (ACT) model yielded which direct effect on anesthesia services? 1. Regulation of conditions related to reimbursable services 2. Mandatory direction of certified registered nurse anesthetists (CRNAs) by an anesthesiologist 3. Reduction in charges related to fraudulent anesthesia care 4. Increased accountability for physicians who employ CRNAs Pages: 28–29 Feedback 1. . Regulations set forth by the Tax Equity and Fiscal Responsibility Act (TEFRA) mandated conditions for reimbursable services that appeared to require physician leadership for anesthesia delivery as a standard of care. The 1982 implementation of the anesthesia care team (ACT) model by the American Society of Anesthesiologists (ASA) resulted in mandatory direction of anesthetic administration by an anesthesiologist (Shumway & Del Risco, 2000). 2. The 1982 implementation of the anesthesia care team (ACT) model by the American Society of Anesthesiologists (ASA) resulted in mandatory direction of anesthetic administration by an anesthesiologist (Shumway & Del Risco, 2000). Also in 1982, Medicare’s introduction of an insurance reimbursement regulation policy aimed to reduce charges of fraud for anesthesia care by delineating specific conditions that maintained anesthesiologists’ accountability for services they claimed to provide when working with or employing certified registered nurse anesthetists (CRNAs) (Shumway & Del Risco, 2000). Regulations set forth by the Tax Equity and Fiscal Responsibility Act (TEFRA) mandated conditions for reimbursable services that appeared to require physician leadership for anesthesia delivery as a standard of care. 3. . In 1982, Medicare’s introduction of an insurance reimbursement regulation policy aimed to reduce charges of fraud for anesthesia care by delineating specific conditions that maintained anesthesiologists’ accountability for services they claimed to provide when working with or employing certified registered nurse anesthetists (CRNAs). The 1982 implementation of the anesthesia care team (ACT) model by the American Society of Anesthesiologists (ASA) resulted in mandatory direction of anesthetic administration by an anesthesiologist (Shumway & Del Risco, 2000). 4. . In 1982, Medicare’s introduction of an insurance reimbursement regulation policy aimed to reduce charges of fraud for anesthesia care by delineating specific conditions that maintained anesthesiologists’ accountability for services they claimed to provide when working with or employing certified registered nurse anesthetists (CRNAs). Implementation of the anesthesia care team (ACT) model by the American Society of Anesthesiologists (ASA), which also occurred in 1982, resulted in mandatory direction of anesthetic administration by an anesthesiologist (Shumway & Del Risco, 2000). Chapter 3: Role Development: A Theoretical Perspective ANSWERS AND RATIONALES 1. Nurses working in a Magnet facility have low staff turnover rates and report high job satisfaction, making others aspire to have the longevity in employment experienced by those at the Magnet facility. Which of the following reference groups is this an example of? 1. Evaluative 2. Normative 3. Comparison 4. Audience Page: 4 1. . The comparison group sets its own standards and becomes a comparison group only when an individual accepts it as such. Nurses at a Magnet facility are considered a comparison group. 2. . The normative group sets explicit standards and expects compliance, and it rewards or punishes relative to that degree of compliance. The church, community, and family are examples of normative groups. 3. The comparison group sets its own standards and becomes a comparison group only when an individual accepts it as such. Nurses at a Magnet facility are considered a comparison group. 4. . The audience group is a collective group whose attention an individual wishes to attract. The audience group holds certain values but does not demand compliance from the person for whom they serve as a referent. 2. Which action should the advanced practice nurse (APN) take to be successful in socialization? 1. Be better at multitasking. 2. Develop a rapport with colleagues. 3. Develop skills in empathic communication. 4. Practice sympathetic listening. Page: 6 1. . Better multitasking does not lead to successful socialization. The individual must project him- or herself into the circumstances of another and then step back to imagine how he or she would feel in the other’s situation. If there is accurate determination of the motives and feelings of the other, the actor can modify his or her own behavior to sustain or alter the other’s response. 2. . Developing a rapport does not lead to successful socialization. The individual must project him- or herself into the circumstances of another and then step back to imagine how he or she would feel in the other’s situation. If there is accurate determination of the motives and feelings of the other, the actor can modify his or her own behavior to sustain or alter the other’s response. 3. Developing skill in empathic communication does lead to successful socialization. The individual must project him- or herself into the circumstances of another and then step back to imagine how he or she would feel in the other’s situation. If there is accurate determination of the motives and feelings of the other, the actor can modify his or her own behavior to sustain or alter the other’s response. 4. . Practicing sympathetic listening does not lead to successful socialization. The individual must project him- or herself into the circumstances of another and then step back to imagine how he or she would feel in the other’s situation. If there is accurate determination of the motives and feelings of the other, the actor can modify his or her own behavior to sustain or alter the other’s response. 3. An advanced practice nurse (APN) consistently identifies each client by the five rights upon every encounter. This behavior is an example of which of the following? 1. First-order change 2. Second-order change 3. Role-making 4. Subrole internalization Page: 6 1. . First-order changes are behavioral shifts that do not permanently achieve a desired result. Old preferences keep resurfacing. 2. Second-order change leads to permanent change. Old behaviors and patterns are gone and are not replaced by a new version. 3. . Role-making is bidirectional and interactive, with both actors presenting behaviors that are interpreted reciprocally for the purpose of creating and modifying their own roles. 4. . Second-order change leads to permanent change. Old behaviors and patterns are gone and are not replaced by a new version. 4. Which action by the advanced practice nurse (APN) demonstrates role-making? 1. Practicing autonomy when working in a busy practice 2. Suggesting a change in treatment to the supervising physician 3. Changing a client’s medication to a lower dosage 4. Teaching a client how to self-administer insulin Page: 7 1. . Although important, this does not demonstrate role-making. 2. This demonstrates role-making, which is bidirectional and interactive. 3. . Although part of the advanced practice nurse (APN)’s role, this is not a demonstration of role-making. 4. . Although part of the advanced practice nurse (APN)’s role, this is not a demonstration of role-making. 5. The advanced practice nurse (APN) is mentoring an APN student. The APN recognizes that the student is having a hard time adjusting to the new role. Which action should the mentor take? 1. Allow the student to work through the process. 2. Listen sympathetically to the student. 3. Refer the student to a colleague with similar experiences. 4. Treat each failure as a learning opportunity. Page: 10 1. . Although the student should be allowed to work through the process, the advanced practice nurse (APN) should be present as a guide. 2. . The advanced practice nurse (APN) should listen empathetically to the student. 3. . The advanced practice nurse (APN) should work closely with the client to overcome obstacles. 4. The advanced practice nurse (APN) should treat each failure as a learning opportunity. 6. The advanced practice nurse (APN) is working with a colleague in a busy surgical center and becomes concerned with the colleague’s change in behavior. Which sign indicates that the colleague might be experiencing burnout? 1. Empathic behavior 2. Short attention span 3. Sensitivity 4. Intolerance Page: 14 1. . Empathic behavior is not a sign of burnout. 2. . Short attention span is not a sign of burnout. 3. . Insensitivity is a sign of burnout. 4. Intolerance is a sign of burnout, and should be treated appropriately. 7. The advanced practice nurse (APN) is working in a busy emergency room. Which action can the APN take to reduce role strain? 1. Own the problem and work through it. 2. Find a quiet place to retreat. 3. Focus on helping others. 4. Become more involved in the work environment. Page: 17 1. . The advanced practice nurse (APN) should determine who owns each problem, and allow others to work through theirs. 2. The advanced practice nurse (APN) should manage role strain by finding a quiet place to retreat. 3. . The advanced practice nurse (APN) should focus on self and reducing stress and strain. 4. . The advanced practice nurse (APN) should take adequate time away from the work environment to regroup. 8. The advanced practice nurse (APN) is experiencing burnout and recognizes the need for self-care. Which action should the APN avoid? 1. Work through stressful situations and then take a break. 2. Plan self-care as seriously as client care. 3. Determine who owns each problem. 4. Examine the quality of peer support. Page: 17 1. The advanced practice nurse (APN) should schedule breaks during stressful situations. 2. . The advanced practice nurse (APN) should plan self-care as seriously as client care. 3. . The advanced practice nurse (APN) should determine who owns each problem. 4. . Part of managing role strain involves examining the quality of peer support. 9. The advanced practice nurse (APN) is working with a new nurse. Which action by the nurse does the APN interpret as the social integration phase of resocialization? 1. Working well with others in the profession 2. Mastering skills 3. Integrating values into work setting 4. Displaying competency in routine Page: 15 1. Working well in the profession is an example of the social integration phase of resocialization. 2. . Mastery of skills occurs in the skills and routine mastery phase. 3. . Integrating values into the work setting occurs in the conflict resolution phase. 4. . Competence in routine occurs in the skills and routine mastery phase. 10. Which action should the advanced practice nurse (APN) avoid when attempting to resolve role strain? 1. Using alcohol to escape stress 2. Taking meditation breaks during a shift 3. Talking with coworkers 4. Voicing opinions at a staff meeting Page: 15 1. The advanced practice nurse (APN) should avoid the use of drugs and alcohol when trying to resolve role strain. 2. . The advanced practice nurse (APN) should use meditation as a means to reduce role strain. 3. . The advanced practice nurse (APN) should talk with trusted friends when trying to resolve role strain. 4. . The advanced practice nurse (APN) should voice opinions at a staff meeting when trying to resolve role strain. Chapter 4: Educational Preparation of Advanced Practice Nurses: Looking to the Future ANSWERS AND RATIONALES 1. Which activity does the advanced practice nurse (APN) anticipate when completing a doctor of philosophy (PhD) research residency? 1. Literature review in nursing science 2. Participation in quality improvement 3. Presentation at practice conferences 4. Development of capstone with mentors Page: 16 Feedback 1. When completing a doctor of philosophy (PhD) research residency, the advanced practice nurse (APN) anticipates completing a literature review in nursing science. 2. . This activity is anticipated for a doctor of nursing practice (DNP) degree, not a doctor of philosophy (PhD). 3. . This activity is anticipated for a doctor of nursing practice (DNP) degree, not a doctor of philosophy (PhD). 4. . This activity is anticipated for a doctor of nursing practice (DNP) degree, not a doctor of philosophy (PhD). 2. Which activity is completed for both a doctor of nursing practice (DNP) and doctor of philosophy (PhD) program? 1. Interprofessional education (IPE) collaborative experiences 2. Participation in full scope research 3. Presentation at practice conferences 4. Submission of research grant proposals Page: 16 Feedback 1. Both the doctor of nursing practice (DNP) and doctor of philosophy (PhD) candidate will participate in interprofessional education (IPE) collaborative experiences. 2. . This activity is anticipated during a doctor of philosophy (PhD) research residency. 3. . This activity is anticipated during a doctor of nursing practice (DNP) residency. 4. . This activity is anticipated during a doctor of philosophy (PhD) research residency. 3. Which type of grant proposal does the advanced practice nurse (APN) submit when completing a doctor of philosophy (PhD) residency? Select all that apply. 1. Practice 2. Business 3. Research 4. Leadership Page: 16 Feedback 1. . A practice research proposal is completed when pursing a doctor of nursing practice (DNP) degree. 2. . A business proposal is not completed when pursing a doctor of philosophy (PhD) degree. 3. The advanced practice nurse (APN) will complete a research proposal when pursing a doctor of philosophy (PhD) degree. 4. . A leadership research proposal is completed when pursing a doctor of nursing practice (DNP) degree. 4. Which activity does the advanced practice nurse (APN) complete when participating in a doctor of nursing practice (DNP) residency? 1. Participate in quality improvement 2. Present at research conferences 3. Pilot research projects for dissertation 4. Submit research grant proposals Page: 16 Feedback 1. When completing a doctor of nursing practice (DNP) residency, the advanced practice nurse (APN) anticipates participation in quality improvement. 2. . The advanced practice nurse (APN) participates in this activity when completing a doctor of philosophy (PhD) research residency. 3. . The advanced practice nurse (APN) participates in this activity when completing a doctor of philosophy (PhD) research residency. 4. . The advanced practice nurse (APN) participates in this activity when completing a doctor of philosophy (PhD) research residency. 5. Which is the predominant route to certification for the advanced practice nurse (APN)? 1. Doctor of philosophy (PhD) 2. Doctor of nursing practice (DNP) 3. Master of science in nursing (MSN) 4. Bachelor of science in nursing (BSN) Page: 3 Feedback 1. . The doctor of philosophy (PhD) degree is not the predominant route of certification for the advanced practice nurse (APN). 2. . The doctor of nursing practice (DNP) degree is not the predominant route of certification for the advanced practice nurse (APN). 3. The master of science in nursing (MSN) degree continues to be the predominant route of certification for the advanced practice nurse (APN). 4. . The bachelor of science in nursing (BSN) degree is one route of certification for entry-level nursing. 6. Which doctoral degree may be inappropriate for the nurse educator who seeks a tenure track position in the university setting? 1. Doctor of medicine (MD) 2. Doctor of philosophy (PhD) 3. Educational doctorate (EdD) 4. Doctor of nursing practice (DNP) Page: 11 Feedback 1. . A nurse educator is unlikely to have a doctor of medicine (MD) degree; however, this degree is not inappropriate for tenure track positions in the university setting. 2. . A doctor of philosophy (PhD) is an acceptable doctoral degree for the nurse educator who is seeking a tenure track position in the university setting. 3. . An educational doctorate (EdD) is an acceptable doctoral degree for the nurse educator who is seeking a tenure track position in the university setting. 4. Most universities do not accept the doctor of nursing practice (DNP) for tenure track positions. 7. The doctor of nursing practice (DNP) student will complete a final project referred to as a requirement. capstone Page: 13 Feedback: The advanced practice nurse (APN) completing a doctor of nursing practice (DNP) program will complete a final project that is often referred to as a capstone requirement. 8. The doctor of philosophy student will complete a as part of the educational process. dissertation Page: 13 Feedback: The doctor of philosophy (PhD) student will complete a research-based dissertation as part of the educational process. Chapter 5: Global Perspectives on Advanced Nursing Practice ANSWERS AND RATIONALES 1. Which is a factor contributing to the international growth in advanced practice nursing? 1. Decreased inpatient acuity 2. Ignorance of health-care consumers 3. Escalated disease burden worldwide 4. General global excess of health-care workers Page: 1 Feedback 1. . Increased, not decreased, inpatient acuity is a factor contributing to the international growth in advanced practice nursing. 2. . Better informed, not ignorant, health-care consumers is a factor contributing to the international growth in advanced practice nursing. 3. Escalated disease burden for both communicable and noncommunicable disease is a factor contributing to the international growth in advanced practice nursing. 4. . A shortage, not general excess, of health-care workers is a factor contributing to the international growth in advanced practice nursing. 2. Which action from the International Council of Nurses (ICN) establishes title protection when regulating the advanced practice nurse? 1. Rule making 2. Criminal legislation 3. Assessment processes 4. Fitness to practice procedures Page: 10 Feedback 1. The International Council of Nurses (ICN) establishes title protection for the advanced practice nurse (APN) through rule making and civil legislation. 2. . Establishing civil, not criminal, legislation established title protection for the advanced practice nurse (APN). 3. . The International Council of Nurses (ICN) establishes assessment processes as a minimal standard for regulating the advanced practice nurse (APN); however, this action does not establish title protection. 4. . The International Council of Nurses (ICN) establishes fitness to practice procedures as a minimal standard for regulating the advanced practice nurse (APN); however, this action does not establish title protection. 3. A nurse is considering pursuing an advanced degree while practicing in the Republic of South Africa. Which must occur before beginning this journey? 1. Military service 2. Practice abroad 3. Two years of clinical practice 4. Two years of community service Page: 17 Feedback 1. . Military service is not a prerequisite for an advanced practice degree in the Republic of South Africa. 2. . Practicing abroad is not a prerequisite for an advanced practice degree in the Republic of South Africa. 3. Two years of clinical practice is a prerequisite for an advanced practice degree in the Republic of South Africa. 4. . One, not two, years of community service is a prerequisite for an advanced practice degree in the Republic of South Africa. 4. Which level of prescribing is required for the specialist nurse in the Republic of South Africa? 1. Level one 2. Level two 3. Level three 4. Level four Page: 17 Feedback 1. . Level one is the prescribing requirement for the staff nurse. 2. . Level two is the prescribing requirement for the professional nurse. 3. Level three is the prescribing requirement for the specialist, or advanced practice, nurse. 4. . This level is not used in the Republic of South Africa. 5. Which is considered an obstacle by the World Health Organization's Eastern Mediterranean Region (WHO-EMR) Consensus on factors that influence advanced practice nursing development? 1. Desire in the region to improve access to care 2. An increase in the community need for health-care services 3. Research studies that don’t support advanced nursing practice 4. Lack of feasibility studies for advanced practice nursing needs Page: 29 Feedback 1. . This is not considered an obstacle that influences advanced practice nursing development. 2. . This is not considered an obstacle that influences advanced practice nursing development. 3. . This is not considered an obstacle that influences advanced practice nursing development. 4. The lack of feasible studies for advanced practice nursing needs is an obstacle that influences advanced practice nursing development. 6. Which is supportive, per the World Health Organization's Eastern Mediterranean Region (WHO-EMR) Consensus, on factors influencing advanced practice nursing development? 1. Role ambiguity 2. Absence of regulatory systems 3. Lack of feasibility studies for needs 4. Commitment to the development of nursing roles Page: 29 Feedback 1. . This is a noted obstacle on factors influencing advanced practice nursing development. 2. . This is a noted obstacle on factors influencing advanced practice nursing development. 3. . This is a noted obstacle on factors influencing advanced practice nursing development. 4. This is a noted support on factors influencing advanced practice nursing development. 7. Which is considered an obstacle by the World Health Organization's Eastern Mediterranean Region (WHO-EMR) Consensus on factors that influence advanced practice nursing development? Select all that apply. 1. Desire in the region to improve access to care 2. An increase in the community need for health-care services 3. An absence of nursing leadership at the policy level 4. Research studies that don’t support advanced nursing practice 5. Lack of feasibility studies for advanced practice nursing needs , 5 Page: 29 Feedback 1. . This is a noted support factor that influences the development of advanced practice nursing. 2. . This is a noted support factor that influences the development of advanced practice nursing. 3. This is a noted obstacle for the development of advanced practice nursing. 4. . This is a noted support factor that influences the development of advanced practice nursing. 5. This is a noted obstacle for the development of advanced practice nursing. 8. Which is supportive, per the World Health Organization's Eastern Mediterranean Region (WHO-EMR) Consensus, on factors influencing the advanced practice nursing development? 1. Role ambiguity 2. Absence of regulatory systems 3. Lack of feasibility studies for needs 4. Research studies from outside the region 5. Commitment to the development of nursing roles , 5 Page: 29 Feedback 1. . Role ambiguity is not a supportive factor influencing the development of advanced practice nursing. This is a noted obstacle. 2. . The absence of regulatory development is not a supportive factor influencing the development of advanced practice nursing. This is a noted obstacle. 3. . The lack of feasibility studies for needs is not a supportive factor influencing the development of advanced practice nursing. This is a noted obstacle. 4. This is a supportive factor that influences the development of advanced practice nursing. 5. This is a supportive factor that influences the development of advanced practice nursing. 9. Which is an example of the educational preparation needed for an advanced practice nurse (APN) according to the International Council of Nurses (ICN)? 1. Right to diagnose 2. Case management 3. Formal system of licensure 4. Authority to refer to other professionals Page: 4 Feedback 1. . The right to diagnose is an example of a regulatory mechanism, not educational preparation, for the advanced practice nurse (APN) according to the International Council of Nurses (ICN). 2. . Case management is an example of the nature of practice, not educational preparation, for the advanced practice nurse (APN) according to the International Council of Nurses (ICN). 3. 4. . The authority to refer to other professionals is