Nurse Practitioner's Business Practice and Legal Guide 6th Edition Test Bank

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Nurse Practitioner's Business Practice andLegal Guide 6thEd. Testbank / Study GuideChapter 1 What Is a Nurse Practitioner?1.Are NPs now considered “prescribers”?ANS.For the purpose of obtaining a DEA number for (ordering) Schedule II, III, IV, VtheNP with a furnishing number is considered by the DEA to be a prescriber.2.Does the NP need a furnishing number issued by the BRN to obtain a DEA number?ANS.Yes, annurse practitioner furnishing number is required to obtain a DEA number forSchedule II through V Controlled Substances3.Can a nurse practitioner request and sign for complimentary samples of dangerous drugsand devices from a manufacture’s sales representative?ANS. Yes, the certified nurse practitioner and the certified nurse midwife may sign for therequest and receipt of complimentary samples of dangerous drugs and devices identifiedin their standardized procedures or protocol that has been approved by the physician.4.May I call myself a nurse practitioner once I have completed my nurse practitionerprogram?ANS. No. You cannot use the title nurse practitioner until you have been certified by theBRN as a nurse practitioner. Furthermore, registered nurses who use the title NP withoutBRN certification may subject their RN license to possible discipline.5.Can a nurse practitioner function in the emergency department?ANS.Yes. Nurse practitioners are permitted to perform consultation and treatment inanemergency department under certain conditions. Section 1317.1 of the Health and SafetyCode, relating to emergency services was repealed and amended September 26, 2011,changing definition of emergency service and care to include appropriately licensedpersons, nurse practitioners and physician assistants, under the supervision of a physicianand surgeon, to include medical screening, examination, and evaluation by a physician, orto the extent permitted by applicable law, by other appropriate personnel(NP&PA) underthe supervision of a physician and surgeon, to determine care, treatment, and surgery byphysician necessary to relieve or eliminate the emergency medical condition or activelabor, within the capability of the facility.6.What are the rolesof a Family Nurse Practitioner?ANS. Family nurse practitioners (FNPs) are graduate-educated, nationally-certified andstate licensed advanced practice registered nurses (APRNs) who care for medically stable

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patients across the lifespan, frominfants to geriatric patients. “Family” in this casedescribes the NP’s chosen patient population focus and denotes national certificationthrough one of two certifying bodies that certify NPs as having the specialized skillsnecessary to work with this patient group: the American Nurses Credentialing Center(AACN) or the American Academy of Nurse Practitioners (AANP).

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Chapter 2 Legal Nurse Practitioner Scope of Practice1.What is the nurse practitioners scope ofpractice?ANS.“Nurse practitionersarelicensed,independent practitionerswho practiceinambulatory, acute and long-term care as primary and/or specialty care providers. Nursepractitioners assess, diagnose, treat, and manage acute episodic and chronicillnesses.Nurse practitioners are experts in health promotion and disease prevention. They order,conduct,supervise,andinterpretdiagnosticandlaboratorytests,prescribepharmacological agents and non-pharmacologic therapies, as well as teach and counselpatients, among other services.As licensed, independent clinicians, Nurse practitionerspractice autonomously and in coordination with healthcare professionals and otherindividuals. They may serve as healthcare researchers, interdisciplinary consultants, andpatient advocates. Nurse practitioners provide a wide-range of healthcare services toindividuals, families, groups, and communities.”2.What is the patient centered nature of an NP?ANS. The patient-centered nature of the NP role requires acareer-long commitment tomeet the evolving needs of society and advances in health care science. NPs are responsibleto the public and adaptable to changes in health care. As leaders in health care, NPscombine the roles of provider, mentor, educator, researcher, and administrator. NPs takeresponsibilityforcontinuedprofessionaldevelopment,involvementinprofessionalorganizations, and participation in health policy activities at the local, state, national andinternational levels. Five decades of research affirms that NPs provide safe, high-qualitycare.3.What element of education is required to be an NP?ANS. NPs are advanced practice registered nurses who obtain graduate education, post-master’s certificates, and doctoral degrees. Educational preparation provides NPs withspecialized knowledge and clinical competency which enable them to practice in varioushealth care settings, make differential diagnoses, manage and initiate treatment plans andprescribe medicationsandtreatment.National NPeducationprogramaccreditationrequirements and competency-based standards ensure that NPs are equipped to providesafe, high-quality patient care from the point of graduation. Clinical competency andprofessional development are hallmarks of NP education.4.What are the professional roles of a nurse practioner?ANS. Nurse practitioners (NPs) are licensed, independent practitioners who practice inambulatory, acute and long-term care as primary and/or specialty care providers. Nursepractitioners assess, diagnose, treat, and manage acute episodic and chronic illnesses.NPsare experts in health promotion and disease prevention. They order, conduct, supervise,and interpret diagnostic and laboratory tests, prescribe pharmacological agents and non-pharmacologic therapies, as well as teach and counsel patients, among other services. Aslicensed, independent clinicians, NPs practice autonomously and in coordination withhealth care professionals and other individuals. They may serve as health care researchers,

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interdisciplinary consultants, and patient advocates. NPs provide a wide-range of healthcare services to individuals, families, groups, and communities.

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Chapter 3 State Regulation of Nurse PractitionerPractice1.Can nurse practioners practiceoutside of the United States?ANS.Nurse practitioners and physician assistants can alleviate some of theprimarycare shortage facing the United States, but their scope-of-practice is limited bystateregulation.2.How are NPs scope of practice specified?ANS.Nurse practitioner scope-of-practice is specified by statute or regulation. In somestates, state legislatures enact SOP statutes, and in other states, the board of nursing definesthe NP SOP. Regulations and statutes are similarly enforceable. . According to the 2016AANP National Nurse Practitioner Sample Survey, about 75% of NPs accept newMedicare patients and 77.9% of NPs accept new Medicaid patients, 49.9% of NPs holdhospital privileges and 11.3% have long term care privileges. Furthermore, NPs holdprescriptive privileges containing controlled substances in 50 states and D.C., 95.8% ofNPs prescribe medications, and “those in full-time practice write an average of 23prescriptions perday”3.How are NP’s regulated by state?ANS. Depending on the NP practice issue, certain functions of NPs are regulated by stateNP SOP regulations and/or federal law. The NP practice issues that come under stateregulationarerequirementsforlicensure,scope-of-practice,prescriptiveauthority,requirement of collaboration or supervision, basis for license suspension, revocation, ornonrenewal, reimbursement under Medicaid, by indemnity insurances, requirements ofeducational programs, standards of practice110. There is also federal regulation of the NPprofession and federal law prevails over state law if there is any conflict between state andfederal law. Federal regulation entails: care of patients covered by Medicare, Medicaid;billing Medicare; care of hospitalized patients insofar as participation by hospitals in theMedicare program; care of residents in nursing homes; in-office and hospital laboratories,under the Clinical Laboratory Improvement Amendments; self-referral by healthcareproviders,under the Stark Acts; prescription of controlled substances under the DrugEnforcement Administration (DEA); reporting of successful malpractice lawsuits againstNPs to the National Practitioner Data Bank; confidentiality of information about patientsunder the Health Insurance Portability and Accountability Act; discrimination in hiring andfiring; facility access for disabled people; e-prescribing and electronic medical records

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Chapter 4 Federal Regulation of the Nurse PractitionerProfession1.What is practice authority regarding Nurse Pracitoner Profession?ANS.Practiceauthority is the regulation of the duties a nurse can perform, and under whichcircumstances. Primarily originating at the state legislative level, this results in a patchworkof different criteria that nurses must meet, varying significantly by geographical location.According to theAmerican Association of Nurse Practitioners(AANP), practice authority,by state, falls into three categories: full practice, reduced practice, and restricted practice.In a full practice state, nurse practitioners can evaluate and diagnose patients, order andinterpret diagnostic tests, initiate and manage treatments, and prescribe medications. In areduced practice setting, state laws reduce the ability of nurse practitioners to perform atleast one element of practice, requiring them to seek a collaborative agreement with anoutside health discipline to provide components of patient care. In a restricted setting, atleast one part of nursing practice is restricted by the state and requires supervision,delegation, or team management to provide patient care.2.How does the scope of practice relate to federal regulations for NP’s?ANS.The scope of practice acts as a system of regulation and standardization for thenursing community, but instead of relying on physician organizations and state legislaturesto determine a nurse’s practice authority state by state, groups such as the ANA believethat nurses are competent at determining what tasks nurses can complete. They believe thatwhat nurses are skilled to do in Missouri could easily be the same as what they are qualifiedto do across the border in Iowa.Limitedpractice authority, as determined by states, cancause talented nurses to take their skills to states with broader practice authority, whichcan, in effect, create a brain drain from restrictive states and negatively impact patientoutcomes there.3.What are rhe goals of the ACA towards primary care?ANS.The goals of the ACA to increase access to primary care services are linked toefficient use of NPs as care providers. These goals rely on federal initiatives and reliablefunding to support NP training and education as well as models of care where NPs practice.However, the full benefit of federal efforts may be hampered by restrictions occurring atthe state-level, including scope-of-practice barriers. Examining federal policies in tandemwith state-level regulations is essential to achieving increased NP workforce supply andimproved access to care.

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Chapter 5 Prescribing1.Can nurse practioners prescribe medications?ANS.Yes.Nurse practitioners can prescribe medication, including controlled substances,in all 50 states and Washington DC. That said, the degree of independence with whichtheycan prescribe drugs, medical devices (e.g., crutches) or medical services varies bystate NPpractice authority.2.What type of education is required for the prescription of medications?ANS. During graduate programs in nursing, NP students undergo extensive education inassessment, diagnosis, and treatment. They take advanced courses in pharmacotherapeuticsand complete rigorous patient simulations,as well as supervised clinical hours. They studypharmacokinetics and pharmacodynamics while learning how to safely and effectivelyprescribe and monitor medication in different patient populations. In sum, NP educationand subsequent credentialing prepares them for full prescriptive authority, but there arestill differing regional laws regarding NP autonomy.3.Can Nurse Practitioners Prescribe Medication Without Physicans?ANS. In 21 states and Washington DC, nurse practitioners have the explicit legal authorityto prescribe. The application for prescriptive authority may be separate from NP statecredentialing, and NPs prescribing controlled substances generally must register with theDEA.In 29 states, NPs can prescribe medication but must have a“collaborativerelationship” or “protocol agreement” with a specific, supervising physician. In all 50 statesand Washington DC, nurse practitioners can prescribe controlled substances with theappropriate supervision (i.e., collaborative agreement, if required) and credentialing.

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