Test Bank For Hamric and Hanson's Advanced Practice Nursing, 6th Edition
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Advanced Practice Nursing, 6 th
Edition TESTBANK
Chapter 1: Highlights from the History of Advanced Practice Nursing in the United States
Test Bank
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
ANS: B
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
Edition TESTBANK
Chapter 1: Highlights from the History of Advanced Practice Nursing in the United States
Test Bank
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
ANS: B
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
Advanced Practice Nursing, 6 th
Edition TESTBANK
Chapter 1: Highlights from the History of Advanced Practice Nursing in the United States
Test Bank
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
ANS: B
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
Edition TESTBANK
Chapter 1: Highlights from the History of Advanced Practice Nursing in the United States
Test Bank
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
ANS: B
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
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
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
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
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
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 the University
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.
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 the University
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.
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.
Tracy: Hamric & Hanson's Advanced Practice Nursing, 6 th Edition
Chapter 2: Conceptualizations of Advanced Practice Nursing
Test Bank
Multiple Choice
15. 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
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.
Tracy: Hamric & Hanson's Advanced Practice Nursing, 6 th Edition
Chapter 2: Conceptualizations of Advanced Practice Nursing
Test Bank
Multiple Choice
15. 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
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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.
16. 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.
17. 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.
18. 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
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.
16. 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.
17. 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.
18. 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
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Calkins model of Advanced Nursing Practice was the first to explicitly distinguish experience
levels of advanced practitioners for nurse administrators to differentiate advanced practice nursing
from other levels of clinical practice.
19. The circular and continuous threads of direct comprehensive patient care, support of systems,
education, research, and publication and professional leadership make up the five domains of
which advanced nursing conceptual model?
a. Strong Memorial Hospital’s Model of Advanced Nursing Practice
b. Calkin’s model of Advanced Nursing Practice
c. NACNS Clinical Nurse Specialists Model
d. Fenton’s and Brykczynski’s Expert Practice
e. Shuler’s Model of NP Practice
ANS: A
Direct and indirect activities across five domains including: direct comprehensive patient care,
support of systems, education, research, and publication and professional leadership make up the
Strong Memorial Hospital’s Model of Advanced Practice Nursing.
20. Texas Children’s Hospital Transformational Advanced Professional Practice (TAPP) APRN
Model added what unifying conceptual strand?
a. Ethics
b. Culture
c. Informatics
d. Education
ANS: A
The TAPP model added two additional domains: quality and safety, and credentialing and
regulatory practice, to the Strong model. It additionally added professional ethics as a unifying
conceptual strand.
21. Poghosyan, Boyd, and Clarke (2016) proposed a comprehensive conceptual model including
three factors: scope of practice regulations, institutional policies, and practice environments.
What was their primary purpose?
a. To discourage role ambiguity among CNS providers
b. To enhance patient education provided by the APRN
c. To maximize NP Contributions to primary care
d. To provide educational practice guidelines to enhance NP education
ANS: C
levels of advanced practitioners for nurse administrators to differentiate advanced practice nursing
from other levels of clinical practice.
19. The circular and continuous threads of direct comprehensive patient care, support of systems,
education, research, and publication and professional leadership make up the five domains of
which advanced nursing conceptual model?
a. Strong Memorial Hospital’s Model of Advanced Nursing Practice
b. Calkin’s model of Advanced Nursing Practice
c. NACNS Clinical Nurse Specialists Model
d. Fenton’s and Brykczynski’s Expert Practice
e. Shuler’s Model of NP Practice
ANS: A
Direct and indirect activities across five domains including: direct comprehensive patient care,
support of systems, education, research, and publication and professional leadership make up the
Strong Memorial Hospital’s Model of Advanced Practice Nursing.
20. Texas Children’s Hospital Transformational Advanced Professional Practice (TAPP) APRN
Model added what unifying conceptual strand?
a. Ethics
b. Culture
c. Informatics
d. Education
ANS: A
The TAPP model added two additional domains: quality and safety, and credentialing and
regulatory practice, to the Strong model. It additionally added professional ethics as a unifying
conceptual strand.
21. Poghosyan, Boyd, and Clarke (2016) proposed a comprehensive conceptual model including
three factors: scope of practice regulations, institutional policies, and practice environments.
What was their primary purpose?
a. To discourage role ambiguity among CNS providers
b. To enhance patient education provided by the APRN
c. To maximize NP Contributions to primary care
d. To provide educational practice guidelines to enhance NP education
ANS: C
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The 2016 model provided a comprehensive review of literature and described potential factors that
affect NP care and patient outcomes. This included scope of practice regulations that often cause
barriers for NP provided primary care.
22. Which model of practice intended to impact the NP domain at four levels: theoretical, clinical,
educational, and research in 1993?
a. Hamric’s model
b. Calkin’s model of Advanced Nursing Practice
c. Strong Memorial Hospital’s Model of Advanced Nursing Practice
d. Shuler’s Model of NP Practice
ANS: D
Shuler’s Model of NP Practice is a holistic and wellness oriented model that was designed to
impact the NP domain at four levels: theoretical, clinical, educational, and research. It is designed
to elaborate the NP’s expanded knowledge and skills into medicine including a template for
conducting a visit.
23. Which model for APRN practice addresses all four APRN roles: CNS, CRNA, CNM, and NP?
a. Calkin’s model of Advanced Nursing Practice
b. Hamric’s model
c. Strong Memorial Hospital’s Model of Advanced Nursing Practice
d. Donabedian Model
ANS: B
Many models highlight core competencies among specific APRN roles, while others emphasize
competencies for hiring managers. At the time of this writing, only the Hamric’s model
encompasses all four APRN roles.
24. Which of the following is one of the eight published essentials included in the Essentials of
Doctoral Education for Advanced Nursing Practice developed by the AACN in 2006?
a. Algorithms for advanced patient care
b. Informatics and health care technologies
c. Scientific underpinnings of practice
d. Liberal education for general nursing practice
ANS: C
The AACN publishes their national consensus to provide the core elements for nursing curriculum
creation. Currently published are Baccalaureate Essentials, Master’s Essentials, DNP Essentials,
and Clinical Resources Essentials. Although they are similar in their core approach to education,
listed first in DNP essentials is the scientific underpinnings of practice.
affect NP care and patient outcomes. This included scope of practice regulations that often cause
barriers for NP provided primary care.
22. Which model of practice intended to impact the NP domain at four levels: theoretical, clinical,
educational, and research in 1993?
a. Hamric’s model
b. Calkin’s model of Advanced Nursing Practice
c. Strong Memorial Hospital’s Model of Advanced Nursing Practice
d. Shuler’s Model of NP Practice
ANS: D
Shuler’s Model of NP Practice is a holistic and wellness oriented model that was designed to
impact the NP domain at four levels: theoretical, clinical, educational, and research. It is designed
to elaborate the NP’s expanded knowledge and skills into medicine including a template for
conducting a visit.
23. Which model for APRN practice addresses all four APRN roles: CNS, CRNA, CNM, and NP?
a. Calkin’s model of Advanced Nursing Practice
b. Hamric’s model
c. Strong Memorial Hospital’s Model of Advanced Nursing Practice
d. Donabedian Model
ANS: B
Many models highlight core competencies among specific APRN roles, while others emphasize
competencies for hiring managers. At the time of this writing, only the Hamric’s model
encompasses all four APRN roles.
24. Which of the following is one of the eight published essentials included in the Essentials of
Doctoral Education for Advanced Nursing Practice developed by the AACN in 2006?
a. Algorithms for advanced patient care
b. Informatics and health care technologies
c. Scientific underpinnings of practice
d. Liberal education for general nursing practice
ANS: C
The AACN publishes their national consensus to provide the core elements for nursing curriculum
creation. Currently published are Baccalaureate Essentials, Master’s Essentials, DNP Essentials,
and Clinical Resources Essentials. Although they are similar in their core approach to education,
listed first in DNP essentials is the scientific underpinnings of practice.
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25. Which model of conceptualization identifies that health care needs are not met in a system
dominated by medical language as a basis for reimbursement?
a. Donabedian Model
b. Dunphy and Winland-Brown’s Circle of Caring model
c. Shuler’s Model of NP Practice
d. Calkin’s model of Advanced Nursing Practice
ANS: B
Dunphy and Winland-Brown’s transformative model (Dunphy, Winland-Brown, Porter, Thomas,
and Gallagher, 2011; Fig. 2.12) proposed a circle of caring to encourage medical collaboration and
enhance the nursing presence in the health care system. Their model incorporates both strengths
of medicine and nursing with process of assessment, planning, intervention, and evaluation, with
a feedback loop.
26. Without additional application of conceptual models which model would be best chosen to
model the skill level of beginning nurses, experienced nurses, or advanced nurse practitioners
with the appropriate level of patient care?
a. Dunphy and Winland-Brown’s Circle of Caring model
b. Strong Memorial Hospital’s Model of Advanced Nursing Practice
c. Donabedian Model
d. Calkin’s model of Advanced Nursing Practice
ANS: D
Calkin’s model of Advanced Nursing Practice outlines skills and knowledge of beginning nurses,
experienced nurses, and advance practice nurses as they relate the patient responses for health care
problems.
27. The 2005 Donabedian model has been used to evaluate the quality of APRN care using which
conceptual outline?
a. Assessment, diagnosis, planning, intervention, and evaluation
b. Structure, process, and outcome
c. Diagnosis and outcome
d. Diagnosis, morbidity, and mortality
ANS: D
The Donabedian model encompasses structure (health care systems and facilities), process
(diagnosis, treatment, education), and outcomes.
dominated by medical language as a basis for reimbursement?
a. Donabedian Model
b. Dunphy and Winland-Brown’s Circle of Caring model
c. Shuler’s Model of NP Practice
d. Calkin’s model of Advanced Nursing Practice
ANS: B
Dunphy and Winland-Brown’s transformative model (Dunphy, Winland-Brown, Porter, Thomas,
and Gallagher, 2011; Fig. 2.12) proposed a circle of caring to encourage medical collaboration and
enhance the nursing presence in the health care system. Their model incorporates both strengths
of medicine and nursing with process of assessment, planning, intervention, and evaluation, with
a feedback loop.
26. Without additional application of conceptual models which model would be best chosen to
model the skill level of beginning nurses, experienced nurses, or advanced nurse practitioners
with the appropriate level of patient care?
a. Dunphy and Winland-Brown’s Circle of Caring model
b. Strong Memorial Hospital’s Model of Advanced Nursing Practice
c. Donabedian Model
d. Calkin’s model of Advanced Nursing Practice
ANS: D
Calkin’s model of Advanced Nursing Practice outlines skills and knowledge of beginning nurses,
experienced nurses, and advance practice nurses as they relate the patient responses for health care
problems.
27. The 2005 Donabedian model has been used to evaluate the quality of APRN care using which
conceptual outline?
a. Assessment, diagnosis, planning, intervention, and evaluation
b. Structure, process, and outcome
c. Diagnosis and outcome
d. Diagnosis, morbidity, and mortality
ANS: D
The Donabedian model encompasses structure (health care systems and facilities), process
(diagnosis, treatment, education), and outcomes.
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28. Which of the following are the functions of a conceptualization of advanced practice nursing?
(Select all that apply.)
a. Basis for furthermore development of knowledge
b. Articulate professional role identity and function
c. Identify specific procedures to provide
d. Deliver holistic and collaborative care
e. Provide guidelines on billing
ANS: A, B, D
Conceptual models allow for articulation of professional role identity, provide a basis for
furthermore development of knowledge and assist in clinical practice for the delivery of holistic,
comprehensive, and collaborative care. Models may assist but in general do not provide assistance
with clinical decision making or billing.
Tracy: Hamric & Hanson's Advanced Practice Nursing, 6 th Edition
Chapter 3: A Definition of Advanced Practice Nursing
Test Bank
Multiple Choice
29. A registered nurse completes an informal education and training course at his or her place of
work authorizing him or her to use ultrasound guided imagery when placing intravenous lines.
How is this best classified?
a. Advanced practice nursing
b. Nursing Skill Advancement
c. Advanced Licensure
d. Advanced Certification
ANS: B
The addition or advancement of individual skills to the nursing practice is common and encouraged
but does not meet the requirements set forth for advanced practice nursing. Licensure and
certification were not obtained or expressed.
30. The core foundations of all APN education curricula contain advanced courses covering which
of the following?
a. Human anatomy, health and physical assessment, and pharmacology
b. Pathophysiology, research, and pharmacology
c. Health and physical assessment, pathophysiology, and obstetrics and gynecology
d. Pathophysiology, health and physical assessment, and pharmacology
(Select all that apply.)
a. Basis for furthermore development of knowledge
b. Articulate professional role identity and function
c. Identify specific procedures to provide
d. Deliver holistic and collaborative care
e. Provide guidelines on billing
ANS: A, B, D
Conceptual models allow for articulation of professional role identity, provide a basis for
furthermore development of knowledge and assist in clinical practice for the delivery of holistic,
comprehensive, and collaborative care. Models may assist but in general do not provide assistance
with clinical decision making or billing.
Tracy: Hamric & Hanson's Advanced Practice Nursing, 6 th Edition
Chapter 3: A Definition of Advanced Practice Nursing
Test Bank
Multiple Choice
29. A registered nurse completes an informal education and training course at his or her place of
work authorizing him or her to use ultrasound guided imagery when placing intravenous lines.
How is this best classified?
a. Advanced practice nursing
b. Nursing Skill Advancement
c. Advanced Licensure
d. Advanced Certification
ANS: B
The addition or advancement of individual skills to the nursing practice is common and encouraged
but does not meet the requirements set forth for advanced practice nursing. Licensure and
certification were not obtained or expressed.
30. The core foundations of all APN education curricula contain advanced courses covering which
of the following?
a. Human anatomy, health and physical assessment, and pharmacology
b. Pathophysiology, research, and pharmacology
c. Health and physical assessment, pathophysiology, and obstetrics and gynecology
d. Pathophysiology, health and physical assessment, and pharmacology
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ANS: D
While specific specialties may focus on individual areas of clinical knowledge, all aspects of
advanced practice nursing include advanced knowledge of pathophysiology, health and physical
assessment, and pharmacology.
31. Which of the following criteria is required for the attainment of classification as an advanced
practice nurse (APN)?
a. Practice focused on research
b. Baccalaureate degree in area of focus
c. Specialized skill attainment
d. Graduate degree in area of focus
ANS: D
The three basic criteria or qualifications for APNs include graduate education in advanced practice
nursing role, national certification in an advanced role, and a practice focused on patients and their
families. Research and skills are components of core competencies of advanced practice nurses
who achieve a graduate level of education.
32. Which of the following is the central, core competency for advanced practice nursing?
a. Evidence-based practice
b. Direct clinical practice
c. Leadership
d. Ethical decision making
ANS: B
Direct clinical practice is the core competency that lends itself to all others. It also provides the
foundation for APNs to carry out the other competencies adequately.
33. The legal authority granted to a professional to provide and be reimbursed for health care
services refers to:
a. Certification
b. Scope of practice
c. Practicing Role
d. Education
ANS: B
Many things including state and federal laws define scope of practice. The APN NCSBN defines
scope of practice as characterized by specialization, expansion of services provided, including
While specific specialties may focus on individual areas of clinical knowledge, all aspects of
advanced practice nursing include advanced knowledge of pathophysiology, health and physical
assessment, and pharmacology.
31. Which of the following criteria is required for the attainment of classification as an advanced
practice nurse (APN)?
a. Practice focused on research
b. Baccalaureate degree in area of focus
c. Specialized skill attainment
d. Graduate degree in area of focus
ANS: D
The three basic criteria or qualifications for APNs include graduate education in advanced practice
nursing role, national certification in an advanced role, and a practice focused on patients and their
families. Research and skills are components of core competencies of advanced practice nurses
who achieve a graduate level of education.
32. Which of the following is the central, core competency for advanced practice nursing?
a. Evidence-based practice
b. Direct clinical practice
c. Leadership
d. Ethical decision making
ANS: B
Direct clinical practice is the core competency that lends itself to all others. It also provides the
foundation for APNs to carry out the other competencies adequately.
33. The legal authority granted to a professional to provide and be reimbursed for health care
services refers to:
a. Certification
b. Scope of practice
c. Practicing Role
d. Education
ANS: B
Many things including state and federal laws define scope of practice. The APN NCSBN defines
scope of practice as characterized by specialization, expansion of services provided, including
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diagnosing and prescribing, and autonomy to practice. An individual certification would fall under
the umbrella of scope of practice.
34. Which of the following most accurately describes the current four established advanced
practice nurse roles?
a. RN, BSN, MSN, DNP
b. CNM, FNP, CNS, CRNA
c. CNM, FNP, AGNP, PNP
d. CNS, CRNA, NP, CNM
ANS: D
The four established advanced practice nurse roles include CNS, CRNA, CNM, and NP. FNP and
AGNP are specializations of nurse practitioners (NP).
35. Which advanced practice nursing role has seen the largest expansion of growth and is currently
the largest in number?
a. CNS
b. CRNA
c. CNM
d. NP
ANS: D
Nurse practitioner continues to be the largest in number of APN roles. According to the American
Academy of Nurse Practitioners National NP Database there are over 220,000 trained NPs.
36. Which advanced practice nursing role is currently the smallest in number?
a. CNM
b. NP
c. CNS
d. CRNA
ANS: A
The CNM role according to the American College of Nurse-Midwives currently has around 11,000
trained providers based on current estimates. The CNM role is specialized in the care of women’s
health and childbearing.
37. A practicing, certified CNM wishes to change roles and work as a family nurse practitioner
(FNP). Which of the following is required?
the umbrella of scope of practice.
34. Which of the following most accurately describes the current four established advanced
practice nurse roles?
a. RN, BSN, MSN, DNP
b. CNM, FNP, CNS, CRNA
c. CNM, FNP, AGNP, PNP
d. CNS, CRNA, NP, CNM
ANS: D
The four established advanced practice nurse roles include CNS, CRNA, CNM, and NP. FNP and
AGNP are specializations of nurse practitioners (NP).
35. Which advanced practice nursing role has seen the largest expansion of growth and is currently
the largest in number?
a. CNS
b. CRNA
c. CNM
d. NP
ANS: D
Nurse practitioner continues to be the largest in number of APN roles. According to the American
Academy of Nurse Practitioners National NP Database there are over 220,000 trained NPs.
36. Which advanced practice nursing role is currently the smallest in number?
a. CNM
b. NP
c. CNS
d. CRNA
ANS: A
The CNM role according to the American College of Nurse-Midwives currently has around 11,000
trained providers based on current estimates. The CNM role is specialized in the care of women’s
health and childbearing.
37. A practicing, certified CNM wishes to change roles and work as a family nurse practitioner
(FNP). Which of the following is required?
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a. Complete education and training as an NP
b. Take the FNP board examination
c. Nothing is required
d. Apply for immediate reciprocity
ANS: A
The four roles of APN (CNS, CRNA, CNM, and NP) are not interchangeable without additional
training and education. Although there are specific instances of overlap, each of the four roles
should not be confused as interchangeable. Specialty certifications under the NP role may allow
for more flexibility under today’s regulations and are not standard practice. Scenarios are usually
handled on an individual basis.
38. True or False. A registered nurse in an emergency room successfully completes a critical care
course and meets all requirements for certification. He or she is now classified as an advanced
practice nurse.
a. True
b. False
ANS: B
This registered nurse has completed advanced training that increases skill and knowledge and may
have also obtained a certification; however, this does not meet the basic criterion of advanced
practice nurse. He or she may be expertly skilled but requires the completion of a graduate degree
focused in an area of nursing to appropriately be classified as an APN. The acute care nurse
practitioner specialty would be required in this particular setting.
Tracy: Hamric & Hanson's Advanced Practice Nursing, 6 th Edition
Chapter 4: Role Development of the Advanced Practice Nurse
Test Bank
Multiple Choice
39. In 1990, Cooper and Sparacino postulate than an APRN’s maximum potential may not be
attained until:
a. After 1 year
b. After 7 years
c. After 3 years
d. After 5 years
ANS: D
b. Take the FNP board examination
c. Nothing is required
d. Apply for immediate reciprocity
ANS: A
The four roles of APN (CNS, CRNA, CNM, and NP) are not interchangeable without additional
training and education. Although there are specific instances of overlap, each of the four roles
should not be confused as interchangeable. Specialty certifications under the NP role may allow
for more flexibility under today’s regulations and are not standard practice. Scenarios are usually
handled on an individual basis.
38. True or False. A registered nurse in an emergency room successfully completes a critical care
course and meets all requirements for certification. He or she is now classified as an advanced
practice nurse.
a. True
b. False
ANS: B
This registered nurse has completed advanced training that increases skill and knowledge and may
have also obtained a certification; however, this does not meet the basic criterion of advanced
practice nurse. He or she may be expertly skilled but requires the completion of a graduate degree
focused in an area of nursing to appropriately be classified as an APN. The acute care nurse
practitioner specialty would be required in this particular setting.
Tracy: Hamric & Hanson's Advanced Practice Nursing, 6 th Edition
Chapter 4: Role Development of the Advanced Practice Nurse
Test Bank
Multiple Choice
39. In 1990, Cooper and Sparacino postulate than an APRN’s maximum potential may not be
attained until:
a. After 1 year
b. After 7 years
c. After 3 years
d. After 5 years
ANS: D
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Studies have shown that the first-year position of an APRN is one of transition, and Cooper and
Sparacino estimate that an APRN’s maximum potential may not be attained until after 5 years or
more in practice.
40. An NP student is performing a thorough neurologic examination for the first time in the clinical
setting. This is an example of:
a. Role implementation
b. Role acquisition
c. Role confusion
d. Role conflict
ANS: B
The changes occurring during role transitions experienced during the educational component of
an APN role are classified as role acquisition. Additionally, role transition is described as when an
APRN begins to practice for the first time in a new role.
41. A new NP student is completing a rotation at an outpatient urgent care clinic and completes an
examination on a patient with chest pain. The nursing assistant hands a 12-lead ECG to the NP
student and asks: “What should we do?” The NP student’s preceptor did not provide clear
instructions on the role of the NP student at this time even though the student is capable of
interpreting ECGs. This is an example of:
a. Role ambiguity
b. Role transition
c. Role strain
d. Role supplementation
ANS: A
Role ambiguity is created by unclear expectations, diffuse responsibilities, and uncertainty of
subroles. The NP student’s preceptor did not provide clear roles to the NP student about what he
or she should do in the absence of the preceptor. If the NP student was placed in a role where he
or she was unaware of how to interpret ECGs this would be an example of role incongruity.
42. An NP is completing the first month in his or her first job. He or she receives a phone call from
an administrator telling him or her that he or she will need to see 30% more patients starting
next week. He or she is told that this is the minimum requirement of all NPs in the same
position. The NP has difficulty using the electronic health record (EHR) software efficiently
and feels overwhelmed. This is an example of:
a. Role supplementation
b. Role ambiguity
c. Role conflict
Sparacino estimate that an APRN’s maximum potential may not be attained until after 5 years or
more in practice.
40. An NP student is performing a thorough neurologic examination for the first time in the clinical
setting. This is an example of:
a. Role implementation
b. Role acquisition
c. Role confusion
d. Role conflict
ANS: B
The changes occurring during role transitions experienced during the educational component of
an APN role are classified as role acquisition. Additionally, role transition is described as when an
APRN begins to practice for the first time in a new role.
41. A new NP student is completing a rotation at an outpatient urgent care clinic and completes an
examination on a patient with chest pain. The nursing assistant hands a 12-lead ECG to the NP
student and asks: “What should we do?” The NP student’s preceptor did not provide clear
instructions on the role of the NP student at this time even though the student is capable of
interpreting ECGs. This is an example of:
a. Role ambiguity
b. Role transition
c. Role strain
d. Role supplementation
ANS: A
Role ambiguity is created by unclear expectations, diffuse responsibilities, and uncertainty of
subroles. The NP student’s preceptor did not provide clear roles to the NP student about what he
or she should do in the absence of the preceptor. If the NP student was placed in a role where he
or she was unaware of how to interpret ECGs this would be an example of role incongruity.
42. An NP is completing the first month in his or her first job. He or she receives a phone call from
an administrator telling him or her that he or she will need to see 30% more patients starting
next week. He or she is told that this is the minimum requirement of all NPs in the same
position. The NP has difficulty using the electronic health record (EHR) software efficiently
and feels overwhelmed. This is an example of:
a. Role supplementation
b. Role ambiguity
c. Role conflict
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d. Role insufficiency
ANS: D
Role insufficiency is often seen as APRN graduates’ transition to the workforce or change
positions. This may include feelings of inadequacy or slow speed due to the new role or barriers
such as electronic health record documentation requirements.
43. Which of the following is an example of role acquisition?
a. NP student learning leadership roles in the classroom
b. NP student on graduation day from his or her program
c. NP student beginning a new job as a family nurse practitioner
d. A practicing NP advancing central line skills
ANS: A
The changes occurring during role transitions experienced during the educational component of
an APN role are classified as role acquisition. All of the others are examples of role
implementation.
44. The changes occurring as an APRN performs procedures during job duties are classified as?
a. Role supplementation
b. Role transition
c. Role implementation
d. Role acquisition
ANS: C
The job duties and responsibilities performed by the APRN are an example of role implementation.
Role transition is the transition from student to practicing NP.
45. Which of the following is best classified as roll stress?
a. Maintaining family responsibilities while in school
b. An APN’s feelings of poor self-esteem
c. Starting a first job as an NP
d. Multiple failed attempts to master a procedure during education
ANS: A
There are many examples of role stress. Role stress may include any situation that requires
increased performance above and beyond the expectation of others. This is easily classified as
examples of things that require additional demand in addition to school or work such as
work/family responsibilities or keeping up with new and advancing technologies. Starting a first
job as an NP is an example of role transition.
ANS: D
Role insufficiency is often seen as APRN graduates’ transition to the workforce or change
positions. This may include feelings of inadequacy or slow speed due to the new role or barriers
such as electronic health record documentation requirements.
43. Which of the following is an example of role acquisition?
a. NP student learning leadership roles in the classroom
b. NP student on graduation day from his or her program
c. NP student beginning a new job as a family nurse practitioner
d. A practicing NP advancing central line skills
ANS: A
The changes occurring during role transitions experienced during the educational component of
an APN role are classified as role acquisition. All of the others are examples of role
implementation.
44. The changes occurring as an APRN performs procedures during job duties are classified as?
a. Role supplementation
b. Role transition
c. Role implementation
d. Role acquisition
ANS: C
The job duties and responsibilities performed by the APRN are an example of role implementation.
Role transition is the transition from student to practicing NP.
45. Which of the following is best classified as roll stress?
a. Maintaining family responsibilities while in school
b. An APN’s feelings of poor self-esteem
c. Starting a first job as an NP
d. Multiple failed attempts to master a procedure during education
ANS: A
There are many examples of role stress. Role stress may include any situation that requires
increased performance above and beyond the expectation of others. This is easily classified as
examples of things that require additional demand in addition to school or work such as
work/family responsibilities or keeping up with new and advancing technologies. Starting a first
job as an NP is an example of role transition.
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Subject
Nursing