Description

practice quiz 6006 latest version

1.Once a practice problem has been identified the next step would be to use the PICOT format to ask a
question about the problem PICOT stands for
O P population I intervention C concepts O operational definitions T time
O P precision instrument , I intervention , C control , O Operational definitions , T time
O P Population , I internal validity , c comparisons , o outcome , T time
O P Population , I Intervention , C Comparison O Outcome T time
2. The Affordable Care Act has directed the US Department of Health and Human Services
and multiple agencies to develop and disseminate initiatives on meeting the care needs of
patients with Multiple Chronic Conditions (MCC). What is the primary purpose for the national
direction?
 To improve the health and health care of all Americans through targeted portfolio focused
programs
 To conduct health services research and engage in policy efforts focusing on health care
financing and service delivery.
 To protect against high out-of-pocket costs by prohibiting insurers from denying
coverage based on pre-existing conditions.
 To support the goal of improving the well being of humanity through smart
globalization .
3 After thoroughly researching the topic of interest, what is the next step an APN should ask
in selecting a theory/model for use in practice or research?
 Does the theory /model fit with the purpose / topic of interest ?
 Are the relationships of the major concepts delineated ?
 Have several different theories/models been examined?
 Are the assumptions , rationale and suppositions accepted by the APN?
4. Which three roles represent the accepted advanced practice nursing roles?
 Certified Nurse Midwives (CNM)
 Clinical Nurse Specialist (CNS)
 Critical care registered nurses (CCRNs)
 Certified Registered Nurse Anesthetists (CRNAs)
5.What are the three major categories of Nola Pender’s Health promotion model?
 Behavior-specific cognitions and affect
 Characteristics and experiences
 Individual health measures
 Behavioral outcomes
6.Which theorist/s identifies caritive factors as a value system, faith-hope and sensitivity to self
and others? This describes which of the following theories?
 Dorothea Orem
 Paterson and Zderad
 Jean Watson theory
 Margaret Newman
7. What set of components is essential in a scientific theory ?
 Interrelated concepts, definitions, and propositions.
 Interrelated statements which assume all the relationship to be true
 Statements that are based on the authors opinions and experience only
 Propositions and constructs that are not necessarily tied together
8. The term advanced nursing practice (APN)includes nurses who are :
 Certified APRNs with a minimum of a master’s degree
 Graduates of programs in nursing education or a health-related field
 Nurses certified in nursing informatics , nurse administration , policy or public health
 Registered nurses with specialized post baccalaureate training
9. To meet Medicare’s coverage requirements , the nurse practitioners’ services must be
 Provided subject to states restrictions and supervision requirements
 Provided under direct supervision
 Provided in rural health clinic or federally qualified health center
 Billed through a physician directed clinic , health agency or hospital
10. A 20-year-old female comes to the primary care clinic with clinical findings consistent with
acute bronchitis. She is sexually active with a male partner, although she states prior to this
relationship she did have two sexual partners. Her menses occurs every 28 days and is regular.
An example of a primary prevention activity for this patient is:
 Screening for a sexually transmitted disease
 Prescribing therapies to decrease a cough
 Obtaining a Papanicolaou (PAP) test
 Counseling about safer sexual practices
11.Which agency’s initiative establishes national health promotion and prevention efforts and
establishes benchmarks for monitoring the progress of health among Americans over a 10-year
timeframe?
 Agency for health care research and quality
 National institutes of Heath
 Centers for Disease Control and Prevention (CDC)
 Institute of Medicine
12. Development of the first pediatric nurse practitioner program at the University of
Colorado in 1965 is credited to which two individuals?
 Harry Fox, MD
 Henry Silver, MD
 Luella Jackson, RN
 Loretta Ford , RN
 Carla Brown, ARNP
13.Raynaud phenomenon is classified as a type III hypersensitivity reaction and is due to:
 Immune complexes that are deposited in capillary beds, blocking circulation
 Mast cells that are bound to specific endothelial receptors, causing them to degranulate
and creating a localized inflammatory reaction that occludes capillary circulation
 Cytotoxic T cells that attack and destroy the capillaries so that they are unable to perfuse
local tissue
 Antibodies that detect the capillaries as foreign protein and destroy them using lysosomal
enzymes and toxic oxygen species.
14. The nurse practitioner is caring for a 21-year-old female who presents with a pruritic,
erythematous rash matching pattern of her sandal straps. The nurse practitioner advises the
patient to avoid scratching the area due to the risk of developing a secondary infection. The NP
understands that the most likely etiology of secondary skins infections is caused by which
organism.
 Streptococcus pneumoniae
 Proteus
 Candida albicans
 Staphylococcus aureus
15.How can the APN best influence development and passage of a specific health policy agenda?
 Develop a health policy proposal and independently present it to the house of
representative
 Partner with a legislator to sponsor a bill despite unrelated committed assignment
 Determine the best fit between legislative agenda, supporting organizations, and health
policy issue.
 Join a national committee to advocate for issues that impact APRNs
16. Which is the gold standard research design for generating evidence?
 Randomized Control Trial
 Nonrandomized comparison cohort trial
 Case study
 Systematic review
17.The APN is examining a client with new onset HTN. The NP recognizes that HTN may result
in significant complications associated with which of the following three organs
 Kidney
 Liver
 Eyes
 Skin
 Brain
18.which organization allows the use of the “BC” credential (e.g., FNP-BC)
 commission on Collegiate Nursing Education (CCNE)
 National Council of State Boards of Nursing (NCSBN)
 American Nurses Credentialing Center (ANCC)
 National Association of Pediatric Nurse Practitioners (NAPNAP)
19. which agency houses the United States Protective and Safety Task Force (USPSTF)?
 The US Department of Health and Human Services
 Centers for Disease Control and Prevention
 Agency for Health, Research and Quality
 National Clearing House Guidelines
20.: which two organizations administer nurse practitioner certification
Programs?
 State boards of nursing
 American Nurses Association
 National Organization of Nurse Practitioner Faculties
 American Association of Nurse Practitioners
 American Nurses Credentialing Center
21. Transformational leadership is best defined as:
 a variable leadership style based on the environment, task, competency of works, or
situation
 A style that is relational , driven by common goal and satisfies the leader and the
follower
 An autocratic style with maximal follower input
 A style that allows followers to act on their own decisions
22. A metaparadigm must include which of the following 3 characteristics†
 Identification of a domain that is similar to domains of other disciplines.

Encompass all phenomena of interest. ”

Be perspective neutral.

Be global in scope
23. Which statement best reflects King’s theory?
 The coping process responses constitute the outputs of the human adaptive
system which are reflected in behaviors.
 A person is a system of behavior characterized by repetitive, predictable, and goal
—directed behaviors that strive toward balance.
 Nursing goals are negotiated with the client and taking into account both the
clients and the nurses perceptions
 If nurses with special knowledge and skills communicate appropriate information to
clients, mutual goal-setting and goal attainment will occur
24. which agency will the APN reference when seeking the current evidence- based
guidelines directing standards of care?
 Patient Centered Outcomes Research Institute (PCORI)
 Agency for Health Research and Quality
 Centers for Disease Control and Prevention
 US Protective and Safety Task Force
25. A 43-year old woman has a 12-hour history of sudden onset of right upper quadrant
abdominal pain with radiation to the shoulder, fever, and chills. She has had similar, milder
episodes in the past. Examination reveals marked tenderness to right upper quadrant abdominal
palpation. Her most likely diagnosis is:
 Hepatoma
 Acute cholecystitis
 Acute hepatitis
 Appendicitis
26. what theory is used to describe the cause of endometriosis?
 Obstruction within the fallopian tubes prevents the endometrial tissue from
 Endometrial tissue passes through the fallopian tubes and into the peritoneal cavity and
remains responsive to hormones.
 Inflammation of the endometrial tissue develops after recurrent sexually transmitted
diseases
 Endometrial tissue lies dormant in the uterus until the ovaries produce sufficient hormone
to stimulate its growth .
27. Chronic pain, physical disability, social support, age and gender are related to perceived
daily stress, which is related to depression. This is an example of which type of theory?
 Explanatory
 Predictive
 Descriptive
 Inter-relational
28.The leadership core competency of advanced practice nursing includes which three
characteristics?
 Mentoring
 Innovation
 Consultation
 Collaboration
 Activism
29. What initiative specifically focuses on the aging American, under the Affordable Care Act?
 Team STEPPS
 Multiple Chronic Conditions
 Shared decision making
 Literacy tool kit
30.Which of the following philosophies of work view would characterize human beings as
holistic; parts are viewed only in the context of the whole?
 Reaction
 Simultaneous action
 Holistic interaction
 Reciprocal interaction
31. A difficult aspect of determining occupational exposure to disease is the:
 Confidentiality of the information with company records
 Inaccuracy of occupational exposure
 Long latency period between exposure and disease reporting
 Reliance on workers recall
32. A novice nurse practitioner is experiencing feeling of inferiority toward more experienced
clinicians in the practice. She has identified that time constraints for visits and expectations to
increase productivity limits her ability to address these non-adherent issues during client visits.
Which barrier to ethical practice is influencing practice?
 Internal to the APN
 Inter-professional
 Patient provider
 Organizational/environmental
33. Utilizing Johnson’s Behavioral systems model (JBSM), the APN discovers that a patient is
not sure who he can depend on because his wife is emotionally distant. This data would be
characteristic of which subsystem of the JBSM
 Restorative subsystem
 Aggressive protective subsystem
 Dependency subsystem
 Affiliative protective subsystem
34 A purposeful, complex, dynamic, collaborative, and holistic interpersonal process aimed at
supporting and facilitating patients and families through health-related experiences and
transitions to achieve health-related goals (mutually determined when possible)” defines which
APN role?
 Coach
 Collaborator
 Direct care provider
 Mentor
35.A 60 year old female with a history of emphysema presents to the primary care office with
complaints of cough and shortness of breath at rest. During the physical exam, the nurse
practitioner recognizes clubbing, barrel chest, and prolonged expiration. The nurse practitioner
understands that the patient is exhibiting symptoms resulting from which type of pulmonary
disease process?
 Restrictive
 Obstructive
 Pleuritic
 Atelectatic
36.Which of the following statements accurately defines Hamric’s conceptual definition of
advanced practice nursing?
 The patient-focused application of an expanded range of competencies to improve health
outcomes for patients and populations within a specialized clinical area of the larger
discipline of nursing.
 A mid-level position that incorporates advanced clinical knowledge and skills to impact
patient care
 A nurse who has achieved education and specialized certification beyond that basic
nursing education
 None of the above
37.When caring for a client who presents with pain and swelling to location of the
metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. Which diagnostic test is
most specific to diagnosis of rheumatoid arthritis?
 Elevated rheumatoid factor level
 Elevated uric acid level
 Positive antinuclear antibody titer
 Elevated erythrocyte sedimentation rate
 The Consensus Model for Advanced Practice Registered Nurse Regulations addresses
which four areas?
 Specialty areas
 Roles and titles to be used

 Population foci
 Preparation for emerging APRN roles
 Licensure blueprints for testing
Which statement best supports primary prevention of burns for geriatric clients?
 Douse flames with a fire extinguisher
 Avoid smoking in bed
 Install a smoke detector
 Use a planned emergency escape route
Which of the following three complications are associated with chronic hepatitis B?
 Continued infectivity
 Malignant hypertension
 Uncompensated cirrhosis
 Hepatocellular carcinoma
 Renal encephalopathy
The central competency, direct clinical practice, is characterized by which three of the following?
 Uniform approach to health management
 Expert clinical performance
 Formation of a therapeutic partnership with patients
 Holistic approach
 Direct physician supervision
 Which payment system seeks Medicare reimbursement under the MACRA legislation for
providing high quality patient-specific care and improved outcomes?
 Accountable care organization
 Advanced payment models
 Merit Incentive Based Payment
 Bundle payment programs
 What four components of advanced practice nursing (APN) are specified by the National
Council for State Boards of Nursing Consensus Model for APRN regulation?
 Licensure,
 Accreditation
 Competence
 Education
 Certification
44.Which learning theory would be most applicable as a guide for the development of a
program to help families of patients in palliative care?
 Behaviorist learning theory
 Cognitive learning theory
 Psychodynamic learning theory
 Humanistic Learning Theory
45. What terms indicate appropriate progression associated with the history and evolution of
advance practice nursing?
 Specialist, Expanded Role, Advanced Practice
 Expanded role, advanced practice , specialist
 Advanced practice , specialist , expanded role
 Specialist, advanced practice , expanded role
46. An experienced NP, has two separate but equally important ethical obligations that he is
unfortunately unable to carry out. This is an example of which barrier to ethical practice?
 Moral distress
 Moral uncertainty
 Moral Dilemma
 Moral distraction
47. Pre-invasive epithelial tumors of glandular or squamous cell origin describes which of the
following?
 Tumor in differentiation
 Dysplastic
 Cancer in situ
 Cancer beyond (meta) situ
48. Which two options are barriers to the conceptualization of Advanced Practice Nursing?
Interprofessional education and practice
 Lack of obscurity
 Interprofessional education and practice
 Need to differentiate between advanced practice nursing and medicine
 Consistency of state practice act that regulate APNs
49. The Dreyfus Model of Skill Acquisition includes which four stages of APN performance?
 Expert,
 Advanced Beginner,
 Competent
 Efficient
 Proficient
50. The nurse practitioner is caring for a client who has undergone a recent gastrectomy who
complains of fatigue, palpitations, shortness of breath, and numbness and tingling to their fingers
on both hands. The nurse suspects pernicious anemia related to:
 Dietary deficiency of vit b 12
 Deficiency of intrinsic factor production
 Red blood cell enzyme deficiency
 Multiple micronutrient deficiencies
51. The analysis of a theory or conceptual model includes examining the origins. Which would
not be considered an aspect of origin of the theory/model?
 The historical evolution
 The motivation for development
 The unique focus
 The philosophical beliefs and values about nursing that it is based on
52. The clinical manifestations of dyskinetic cerebral palsy include:
 Increased muscle tone and prolonged primitive reflexes
 Exaggerated deep tendon reflexes, clonus, and rigidity of extremities
 Scoliosis, contractures, and stiffness of trunk muscles
 Jerky uncontrolled and abrupt fine musculoskeletal movements
53. Which core competency incorporates assuming complex collaborative roles with
stakeholders and communities?
 Independent practice
 Leadership
 Policy
 Ethics
54. A critical environmental element that affects the authority of advanced practice nurses to
practice to their fullest/maximum scope, according to Hamric’s model, is:
 Direct clinical practice c
 Consultation
 Health policy
 Certification
55. For nursing to be considered a discipline, which statement is true?
 Defining the knowledge base of nursing is essential and straightforward.
 The discipline of nursing consists of a well-defined knowledge base.
 The human component of the knowledge base of the discipline does not influence or change
the existing knowledge base
 Context has considerable influence on the development of the knowledge base.
56. The APN wants to develop a community educational program for hypertension and stroke
prevention. She recognizes that the individual’s lifestyle and pattern of behavior need to be
addressed for the program to be successful. Which theory would be most appropriate to guide
the program development?
 Health as Expanding consciousness
 Science of unitary human beings
 Human becoming school of thought
 interpersonal based nursing
57. When considering a theory for use in guiding practice, the APN should examine the
Conceptual-Theoretical-Empirical (C-T-E) linkages by for which criteria?
 Internal consistency
 Specification adequacy
 Parsimony
 Empirical adequacy
58. In septic shock, which mediators are anti-inflammatory?
 Interleukin (IL-4, IL-10, IL13)
 Tumor necrosis factor -alpha (tnf-a) and granulocyte cell stimulating factor
 IL-1, IL2and IL6
 Prostaglandin ,leukotrienes and brady kinin
59. The link between major depression and cortisol secretion is that individuals with
depression:
 Show suppression of plasma cortisol when given dexamethasone
 Have a decreased plasma cortisol level, despite the administration of exogenous
corticosteroids
 Show that persistently elevated plasma cortisol levels can result in inflammation that is
believed to trigger depression
 Have normal plasma cortisol levels throughout the day when they take antidepressant
medication as prescribed
60. Which three primary criteria for advanced practice nursing are identified in Hamric’s
Integrative Model of Advanced Practice Nursing?
 Guidance,
 Graduate education,
 Patient-focused practice,
 Certification
 Ethical decision making
61. Which advance practice nursing was developed to facilitate delivery of high quality, patientcentered
primary care?
 Certified nurse midwife(CNM)
 Certified nurse practitioner (CNP)
 Certified registered nurse anesthetist (CRNA)
 Clinical nurse specialist CNS)
62. An adult-gerontology nurse practitioner is employed in a rural practice that is initiating a
school-based primary healthcare program. All nurse practitioners in the practice are required to
initiate preparations to facilitate conducting patient visits in the new setting. Which role concepts
best describes what the adult-gerontology nurse practitioner is experiencing?
 Role transition
 role incongruity
 role ambiguity
 role stress
63. A MSN student is noting challenges related to attending school while attempting to balance
other work, family, and social responsibilities. Which of the following role concepts illustrates
the MSN student’s experience?
 Role stress
 Role strain
 Role transition
 Role conflict
64. A 24 year old female presents to the primary care office with complaints of dysuria.
Urinalysis lab results indicated positive nitrites. The nurse practitioner plans to initiate antibiotic
coverage for the most likely causative organism which is:
 Escherichia coli
 Staphylococcus aureus
 Neisseria gonorrhoeae
 Ureaplasma urealyticum
65. Place the following four steps of APN core competency of evidence based practice in order.
a. Critically appraise and extract evidence1
b. Formulate a measurable clinical question2
c. Review literature for relevant studies3
d. Implement useful findings in clinical decision making4
66. A 12 year old male is diagnosed with Klinefelter syndrome. His karyotype would reveal
which of the following?
 XY
 XX
 XYY
 XXY
67. Concerning the MMR vaccine, which of the following is a correct statement?
 The link between use of MMR vaccine and autism has been firmly supported
 There is no scientific evidence to support MMR use increases autism risk
 The use of the combination increases autism risk, but dividing them into
separate injections minimized this
 The injection contains thimerosal, a mercury agent
68. You are seeing a 40 year old patient who has started varenicline (Chantix) 3 weeks ago as a
tool for smoking cessation. What is the most important question to ask during the visit?
 How many cigarettes per day are you currently smoking?”
 “Are you having any difficulty sleeping?”
 Have you noticed change in your mood?
 On a scale of 1—10, what is your current desire to stop smoking?”
69. A primary care nurse practitioner (NP) is seeking additional support from ancillary health
services for a diabetic client who is noncompliant with nutrition, exercise, and medication.
Which barrier to ethical practice is influencing the NP’s practice?
 Interprofessional
 Patient-provider
 Internal to the APN
 Organizational/environmental
70. Which hospital ownership classification best describes an organization whose excess income
is distributed to its shareholders?
 Public
 Not for profit
 For profit
 commercial
71. How has the Quality Chasm Report been used to direct US health care?
 The report integrates internal directives for provision of quality health care
 The institute of medicine , designed this document to direct medical practices in the us
 As a framework for safe, effective, efficient, equitable, timely, and patient centered care.
 It outlines processes for determining interdisciplinary root cause etiologies
72. A 12 year old female is newly diagnosed with type 1 DM. When the parents ask what causes
this, what is the nurse practitioner’s best response?
 A familial , autosomal dominate gene deficit
 Obesity and lack of exercise
How many cigarettes per day are you currently smoking?”
 Immune destruction of the pancreas
 Hyperglycemia from eating too many sweets
73. Which patient below is at most risk for invasive pneumococcal infection?
 A 72 year old man with a history of COPD
 A 32 year old woman who underwent a splenectomy after a motor vehicle accident
 A 45 year old man with a 10 year history of type 2 diabetes
 An 80 year old female with a history of sever osteoporosis and decreased functional
status
74. A Latino patient in your clinic has been perpetually late for his appointment. Which action by
the nurse practitioner would be most appropriate?
 Advise the patient that he should have called to reschedule
 Adjust the appointments to allow for this lateness
 Assess how the patient interprets the appointment time
 Ignore the situation to avoid having the patient go elsewhere
75. What specific developments have primarily occurred because of the Affordable Care Act
(ACA)?
 ACA has been appealed and no longer enacted
 Development of patient centered outcomes, use of comparative effectiveness research,
quality payment structures that impact APN reimbursement
 Nothing has been changed by the ACAother than Medicaid expansion and affordable
health care
 ACA has provided limited access to care
76. Hamric’s Integrative Model of Advanced Practice Nursing identify the central competency of
advance practice nursing that directs the other six core competencies.
 Evidence based practice
 Guidance and coaching
 Ethical decision making
 Direct Clinical Practice
77. A public health nurse is teaching the community about health promotion. When explaining
immunity, the APN discusses that innate immunity is:
 Acquired following an illness
 Present at birth
 Obtained by IV administration
 Acquired during adulthood
78. According to Madeline Leininger, cultural care/accommodation/negotiation refers to
actions/decisions that help a particular culture:
 Retain and preserve care values
 Adapt to or negotiate with others for satisfying healthcare outcomes
 Change or modify behaviors affecting their lifestyles
 Work with each other to set up goals for improved health outcomes
79. The nurse practitioner is conducting annual physical exam on a 62 year old male. Which of
the following risk factors will prompt the nurse practitioner to screen the patient for development
of benign prostatic hypertrophy (BPH)?
 High fat diet
 Recurrent prostatitis
 Increased age
 Cigarette smoking
80. The family nurse practitioner examines a patient who has sustained a non-work-related injury
that interferes with his ability to perform his job. The patient does not qualify for medical
disability and has a reasonable chance of engaging in a suitable occupation with proper therapy.
What type of services or benefits should the nurse practitioner recommend?
 Family and medical leave act benefits
 Vocational rehabilitation services
 Public unemployment services
 Social security benefits
81. which statements must be present to be considered a metaparadigm? It should (select all that
apply)
 Identifies a domain that is similar to domains of other disciplines
 Encompasses all phenomenon of interest
 Be perspective neutral
 Be global in scope
 Identifies all reasonable paradigms
82. A philosophy differs from a metaparadigm because it communicates what the members of a
discipline believe to be true about the phenomenon of interest to the discipline., what they
believe about the development of knowledge and the value assigned to their actions and
practices. Which of the following philosophies would be characterized as “human beings are
holistic, parts are viewed only e context of the whole”?
 Reaction world view
 Simultaneous action world view
 Holistic interaction world view
 Reciprocal interaction world view
83. Scientific theories should be complex, contain clearly outlines characteristics and have a
defined purpose. The components that are essential in a theory is set of ?
 Interrelate concepts, definitions and propositions
 Interrelated statements which assume all the relationships to be true
 Statements that are biased on the authors opinions and experience only
 Proposition and constructs that are non-necessary tied together .
84. theory attributes meaning , provides explanation, imposes order and organize logically the
events that healthcare professionals come into contract with . which is an example of the steps
that practitioner take in theorizing ?
 Ask certain questions , research the topic , implement what is developed, evaluate the
implementation
 Ask certain questions , question the status quo, seek the most plausible answer, build a
narrative for the questions and answers
 Question the status quo , seek a meaningful answer, build a program to answer the
question and evaluate the program
 Question the status quo , seek a meaningful answer , build a logical structure for the
questions and answer , review other theories about the situation
85. Which of the following statements best address how theory can guide and direct
practice?
a. Nursing theories will guide the way of relating with the person, and
direct the goals of practice with the person.
b. Research studies are the associated methods, procedures and empirical
indicators that guide practice.
c. Nursing theory is essential to the continuing evolution of the discipline of nursing
d. Nursing theories are required when an organization is applying for magnet status.
86. To implement a theory/conceptual model into practice, the nurse would identify the purpose of
the practice, general nature of the practice problem, the setting of the practice, and the
characteristics of the participants in the practice. What would be the next step for the nurse?
a. Decide on the timeframe for implementing the theory/model.
b. Enlist nursing staff and physicians int the practice who would be involved.
c. Determine the process and technology used as well as assessment and
evaluation of outcomes.
d. Review several models to decide on the best approach for the practice.
87. Which theorist identifies caritive factors as a value system, and faith hope and sensitivity to
self and others?
a. Dorothea Orem
b. Paterson’s and Zderad
c Jean Watson
d. Margaret
Newman
88. Which statement below best reflects Imogene King’s theory?
a. The coping process responses constitute the outputs of the human??? Adaptive system.
b. A person is a system of behavior characterized by repetitive, predictable, and goaldirected
behaviors that strive toward balance.
c. Nursing goal are negotiated with the client and take into account both
the client’s and the nurse’s perceptions.
d. If nurses with special knowledge and skills communicate appropriate
information to clients, mutual goal setting and goal attainment will occur.
89. The APN wants to develop a community educational program for hypertension and stroke
prevention. She recognizes that the individual’s lifestyle and pattern of behavior need to be
addressed for the program to be successful. Which theory would be most appropriate to guide the
program development?
a. Theory of health and expanding consciousness.
b. Theory of human caring/
c. Theory of culture care.
d. theory of interpersonal
nursing.
90. According to Madeline Leininger, culture cafe/accommodation/negotiation refers to actions or
decisions that help a particular culture:
a. Retain and preserve values.
b. Adapt to or negotiate with others for satisfying healthcare outcomes.
c. Change or modify behaviors affecting their lifestyles.
d. Work with each other to set up goals for improved health outcomes.
.
91. Which are the three major categories of Nola Pender’s Health promotion model? (select all
that apply)
a. individual characteristics experience.
b. *health outcome.
c. Individual health measure
d. behavior -specific cognitions.
e. Measurable health outcomes.
92. The APN wants to evaluate the effectiveness of a protocol change that has lessened the
waiting time for patients with acute symptoms of an exacerbation of COPD to be seen in a
primary care practice. He is interested in whether the change reflects an improvement in
prevention of hospitalization for COPD as well as the patient’s quality of life.What does he need
to consider if he wants to utilize the Health-related quality of life (HRQOL) theory to guide his
evaluation?
a. There are multiple frameworks and models to choose from.
b. Only biological and physiological variables and symptoms are
included.
c. An individual’s perceptions are not addressed in the theory.
d. Quality of life and HRQOL are interchangeable concepts
93. Which learning theory would be most applicable as a guide for the
development of an educational program for families of patients in palliative care?
a. Behaviorist Learning Theory
b. Cognitive Learning Theory
c. Psychodynamic Learning Theory
d. Humanistic Learning Theory
94. To analyze and evaluate a theory/model for potential use in guiding practice, the APN should
consider what internal factors? (select all that apply)
a. Clarity
b. Consistency
c. Logical development
d. Adequacy
e. Level of theory development
95. The analysis of a theory or conceptual model includes examining the origins. Which would
not be considered an aspect of origin of the theory/model?
a. The historical evolution of the theory/model.
b. The motivation to develop the theory/model.
c. The unique focus of the theory/model.
d. The philosophical beliefs and values about the theory/model.
96. After thoroughly researching the topic of interest, what is the next step an APN should take in
selecting a theory/model for use in practice or research?
a. Decide if the theory/model fits with the purpose topic of interest.
b. Examine major concepts of the theory/model to determine how they
relate to each other.
c. Consider several theory/models for possible use.
d. Decide if the assumptions, rationale and suppositions in the theory/model can
be accepted by the APN.
97. Fawcett’s Conceptual-Theoretical-Empirical Structure (CTE) involve what linkage?
a. Parsimony
b. Testability
c. Adequacy.
d. Legitimacy
98. Once a practice problem/research question has been identified, the next step would be to
use the PPICOT format to define the question. PICOT means:
a. P- Population, I – Intervention, C – Concepts, 0 – Operational
Definitions, T – Time
b.P – Precision instrument, I – Intervention, C – Control, O – Operational Definitions, T – Time
c. P – Population, I – Internal validity, C – Comparisons, 0 – Outcome, T – Time
d. P – Population, I – Intervention, C – Comparisons, 0 – Outcome, T Time
99. The APM is using Johnson’s Behavior System’s Model (JBSM) to guide the assessment
process for a patient who is being treated for lung cancer and presents to the emergency
department with fever and neutropenia. Some of the assessment included that the patient
realized his ability to care for himself and his family is decreasing as his health worsens. He is
not sure who he can depend on because his wife is emotionally distant. This date would be
characteristic of which subsystem of the JBSM? \
a. Restorative Subsystem.
b. Aggressive subsystem.
c. Dependency subsystem.
d. Affiliative protective subsystem
.
100. A 20-year-old female comes to the primary care clinic with clinical findings consistent with
acute bronchitis. She is sexually active with a male partner, although she states prior to this
relationship she did have two sexual partners. Her menses comes every 28 days and it is regular.
An example of a primary prevention activity for this patient is:
a. Screening for a sexually transmitted disease.
b. Prescribing therapies to decrease a cough.
c. Obtaining a Papanicolaou (PAP) test
. *d. Counseling about safer sexual practices.
101. A 42-year-old male presents to the clinic with the chief complain of sinus congestion for 2
weeks associated with facial pain. He is ultimately diagnosed with acute sinusitis and is
prescribed Amoxicillin/Clavulanic acid. He has not had a fever, shortness of breath, or any
gastrointestinal symptoms. Upon discharge, he is requesting a “flu shot”. You inform him that”
a. He needs to return for the shot after he has completed his antibiotic therapy.
b. Is not an appropriate candidate due to the age of the shot.
c. Is at risk of developing a reaction if the shot is given today.
d. He can receive the shot in the clinic today.
102. Concerting the MMR vaccine, which of the following is a correct statement?
a. The link between use of MMR vaccine and autism has been firmly
supported.
b. There is no scientific evidence to support MMR use increases autism
risk.
c. The use of the combination increases autism risk, but dividing them into separate injections
minimizes this.
d. The injection contains thimerosal, a mercury agent.
103. You are seeing a 40-year-old patient who has started varenicline (Chantix) 3 weeks
ago as a tool for smoking cessation. Which of the following is the most important
question to ask during this visit?
a. “How many cigarettes per day are you currently smoking?”
b. Are you having any difficulty sleeping?”
*c. \’Have you noticed in your mood?”
d. “On a scale of 1-10, what is your current desire to stop spoking?”
104. A nurse practitioner is instructing a senior citizen’s group about hazards in the home.
One of these is identified as burns. Which of the following would support primary
prevention of this hazard?
a. Use of a fire extinguisher.
*b. No smoking in bed.
c. Installation of a smoke detector.
d. Creating a planned escape
route.
105. A nurse practitioner is applying for their first position. In researching different hospital types,
there are various descriptions of their type. Some of these include public, proprietary, and
voluntary (not-for-profit) hospitals. What qualification would determine the hospital type?
a. The degree of reimbursement provided for nurse practitioners.
b. The determination of whether or not profits are made.
c. The type of special services offered.
*d./How profits are distributed.
106. A Latino patient in your clinic has been perpetually late for their appointments. Which action
by the nurse practitioner would be most appropriate?
a. Confront the patient and advise them the next time you will reschedule.
b. missing
c. Assess how the patient interprets the appointment time.
d. Ignore the situation to avoid having the patient go elsewhere.
107. To meet Medicare’s coverage requirements, the Nurse Practitioner’s service must be:
*a. Provided subject to state restrictions and supervision requirements.
b. Provided under direct supervision.
c. Provided in a rural health clinic or federally qualified health center.
d. Billed through a physician-directed clinic, health agency or hospital.
108. The family nurse practitioner examines a patient who has sustained a non-work-related
injury that interferes with the patient’s ability to perform their job. The patient does not qualify
for medical disability and has a reasonable chance of engaging in a suitable occupation with
proper therapy. The nurse practitioner recommends that the patient apply for:
a. Family and Medical Leave Act benefits.
*b. Vocational rehabilitation services.
c. Home health services.
d. Social Security benefits.
109. A difficult aspect of determining occupational exposure to disease is the:
a. Confidentiality of the information with company records.
*b. Inaccuracy of occupational exposure.
*c. Long latency period between exposure and disease reporting.
d. Reliance on worker’s call.
110. In the following patient’s, who is at most risk for invasive pneumococcal
infection?
a. A 72-year-old man with a history of COPD.
*b. A 32-year-old woman who underwent a splenectomy after a motor vehicle accident.
c. 44 45-year-old man with a 10-year history of type 2 diabetes.
d. A 80-year-old female with a history of severe osteoporosis and
decreased functional status.
111. Risks associated with chronic hepatitis B include all the following except:
a. Continued infectivity.
b. Cirrhosis.
c. Hepatocellular carcinoma.
d. Malignant hypertension.
112. How does health policy specifically influence health care practice in the US?
a. Directs efforts by the CDC and protects Americans against population-based disease.
b. Influences how health care is reimbursed and determines APN payment fof services.
c. Directs specific evidence-based practice guideline development and dissemination.
D. All of the above.
..
..
113. What specific developments have primarily occurred because of the Affordable Care Act
(ACA)?
a. ACA has been appealed and no longer enacted
b. Development of patient centered outcomes, use of comparative
effectiveness research, quality payment structures that impact APN reimbursement.
c. Nothing has been changed by the ACA other than Medicaid Expansion and Affordable
Health Care.
d. None of the above.
114. The United States Protective and Safety Task Force determines specific screening requirements for
age groups in the US – what agency houses the USPSTF?
a. The US Department of Health and Human Services.
b. Centers for Disease Control and Prevention
c. Agency for Health, Research and Quality.
d. National Clearing House Guideline
115. The Affordable Care Act has directed the US Department of Health and Human Services and
multiple agencies to develop and disseminate initiatives on meeting the care needs of patients with
Multiple Chronic Conditions (MCC). What is the primary purpose for this national direction?
a. Medicare reimbursement must meet quality payment standards under MACRA legislation.
b. Advanced Practice Nurses are responsible for addressing the multiple
issues associated with this patient population.
c. Patients with MCCs represent the largest, fastest growing and costliest U$ patient population.
d. None of the above.
116. As an APN seeking the best evidence to ensure optimal patient centered outcomes,
which agency will you refer to when seeking the current evidence-based guidelines
directing standard of care?
a. Patient Centered Outcomes Research Institute (PCORI).
b. Agency for Health Research and Quality.
c. Centers for Disease Control and Prevention.
d. US Protective and Safety Task Force.
117. When seeking specific epidemiology information on disease statistics and prevention of deadly
conditions, what specific agency under the US Department of Health and Human Services would
you rely upon?
a. National Institutes of Health.
b] American Cancer Society.
*c. Centers for Disease Control and Prevention
d. All of the
above.
*118. Advanced Practice Nurses (APNs) committed to ensuring the safety of an aging society
and reducing escalations in mental health disorders will require the following practice to
promote wellness in this patient population:
a. Certification as a Psychiatry Nurse Practitioner.
b. Understanding the current health policy directing clinical practice recommendations.
c. Seeking ongoing continuing education credits in mental health and aging.
d. All of the above.
119. Currently 10,000 Baby Boomers are entering the Medicare system daily. The
Affordable Care Act was designed to improve health care delivery through prevention and
promotion programs. What initiative specifically focuses on the aging American?
a. Team STEPPS
b. Multiple chronic conditions
c. Shared Decision Making.
d. Literacy Tool Kit.
120. How can the APN influence the development and passage of a specific health policy
issue?
a. Develop a health policy proposal and present it to the House of Representatives.
b. Partner with a legislator who is a sponsor of a bill despite his or her specific assigned
committee work.
*c. Determine what the specific legislative agenda is for the nursing organization that you
belong – so that your expertise can be used to push the agenda with your specific legislator.
d. None of the above.
121. How has the Quality Chasm Report been used to direct US health care?
a. It is not used to direct US health care.
b. IOM designed this document to direct medical practices in the US.
c. This report has been used as the framework and foundation for multiple health police initiative
since its release in 2001.
d. None of the above.
122. Medicare Access and Summary CHIP Reauthorization Act of 2015 (MACRA) legislation
is:
a. Bipartisan.
b. Replaces the 1997 Sustainable Growth Index.
c. Requires measurement of quality metrics.
d. All of the above.
123. Team STEPPS training through the Agency for Health, Research and Quality is focused on
patient safety. The primary tenets of this training are focused specifically on:
a. Interdisciplinary collaboration.
b. Communication.
c. Teamwork.
*d. All of the above.
124. As an APN providing patient-specific care and seeking Medicare reimbursement under
MACRA legislation demonstrating value and quality, you will bill under which payment
system?
a. Accountable Care Organization.
b. Advanced Payment Models.
*c. Merit Incentive Based Payment.
d. All the above.
125. Observation study designs are primarily used in public health data collection and help to
determine efficacy of specific interventions. What is an example of a public health concern that is
frequently evaluated by the CDC to ensure population-based health and wellness?
a. Drug safety and efficacy.
b. Pasteurization.
c. Environmental toxins.
d. Vaccinations.
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