South University, Savannah – NURSING NSG6020Formative Exam Questions and Answers. 100%.

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Question : Which patient below is at most risk for invasive pneumococcal infection? Student Answer: A 72-year-old man with a history of COPD (Incorrect! The 32-year-old would be the most immu... nized compromised since she does not have the spleen which aids in fighting infection, and thus puts her at risk for any infection.) A 32-year-old woman who underwent a splenectomy after a motor vehicle accident (Correct! The 32-year-old would be the most immunized compromised since she does not have the spleen which aids in fighting infection, and thus puts her at risk for any infection.) A 45-year-old man with a 10 year history of type 2 diabetes (Incorrect! The 32-year-old would be the most immunized compromised since she does not have the spleen which aids in fighting infection, and thus puts her at risk for any infection.) A 80-year-old female with a history of severe osteoporosis and decreased functional status (Incorrect! The 32-year-old would be the most immunized compromised since she does not have the spleen which aids in fighting infection, and thus puts her at risk for any infection.) Points Received: 1.25 of 1.25 Comments: Question 2. Question : What practice by Advanced Practice Nurses (APNs) best promotes safety and reduced escalations in mental health disorders among an aging population? Student Answer: Obtaining certification as a psychiatric nurse practitioner (Incorrect!) Implementing current clinical practice mental health guidelines (Correct!) Seeking continuing education regarding mental health among the aging (Incorrect!) Performing a mental health screening based on age and history (Incorrect!) Points Received: 1.25 of 1.25 Comments: Question 3. Question : A public health nurse is teaching the community about health promotion. When explaining immunity, the APN discusses that innate immunity is: Student Answer: acquired following an illness (Incorrect! Innate immunity is present at birth.) present at birth (Correct! Innate immunity is present at birth.) obtained by IV administration (Incorrect! Innate immunity is present at birth.) acquired during adulthood (Incorrect! Innate immunity is present at birth.) Points Received: 1.25 of 1.25 Comments: Question 4. Question : 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 the developing a secondary infection. The nurse practitioner understands that the most likely etiology of secondary skin infections are caused by which organism? Student Answer: Streptococcus pneumoniae (Incorrect! Staphylococcus aureus is a common causative organism of secondary skin infections.) Proteus (Incorrect! Staphylococcus aureus is a common causative organism of secondary skin infections.) Candida albicans (Incorrect! Staphylococcus aureus is a common causative organism of secondary skin infections.) Staphylococcus aureus (Correct! Staphylococcus aureus is a common causative organism of secondary skin infections.) Points Received: 1.25 of 1.25 Comments: Question 5. Question : 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? Student Answer: A familial, autosomal dominant gene defect (Incorrect! The most common cause of type 1 DM is a slowly progressive autoimmune T cell-mediated disease that destroys the beta cells of the pancreas.) Obesity and lack of exercise (Incorrect! The most common cause of type 1 DM is a slowly progressive autoimmune T cell-mediated disease that destroys the beta cells of the pancreas.) Immune destruction of the pancreas (Correct! The most common cause of type 1 DM is a slowly progressive autoimmune T cell-mediated disease that destroys the beta cells of the pancreas.) Hyperglycemia from eating too many sweets (Incorrect! The most common cause of type 1 DM is a slowly progressive autoimmune T cell-mediated disease that destroys the beta cells of the pancreas.) Points Received: 1.25 of 1.25 Comments: Question 6. Question : What is the purpose of a conceptual model for advance practice nursing? Student Answer: To articulate professional role identity and function, competencies, and population foci (Correct! The purpose as stated in the textbook, is to articulate professional role identity and function, competencies, and population foci giving each advanced practice role a credible definition.) To offer a systemic approach to nursing research, education, administration, and practice (Incorrect! The purpose as stated in the textbook, is to articulate professional role identity and function, competencies, and population foci giving each advanced practice role a credible definition.) To promote communication, resolve conflict, and ensure consistency of advance nursing practice (Incorrect! The purpose as stated in the textbook, is to articulate professional role identity and function, competencies, and population foci giving each advanced practice role a credible definition.) To associate levels of nursing practice,research, and theory development when planning curricula, course content, and clinical experiences for preparing APNs (Incorrect! The purpose as stated in the textbook, is to articulate professional role identity and function, competencies, and population foci giving each advanced practice role a credible definition.) Points Received: 1.25 of 1.25 Comments: Question 7. Question : Which is the gold standard research design for generating evidence? Student Answer: Randomized Control Trial (Correct! RCTs are the gold standard for highest quality research design and their purpose is to generate evidence.) Non-randomized Comparison Cohort Trial (Incorrect! RCTs are the gold standard for highest quality research design and their purpose is to generate evidence.) Case Study (Incorrect! RCTs are the gold standard for highest quality research design and their purpose is to generate evidence.) Systematic Review (Incorrect! RCTs are the gold standard for highest quality research design and their purpose is to generate evidence.) Points Received: 1.25 of 1.25 Comments: Question 8. Question : 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? Student Answer: To improve the health and health care of all Americans through targeted portfolio focused programs. (Incorrect! Answer C describes the purpose of the Affordable Care Act. Answer A is the purposes of the Robert Wood Johnson foundation. Answer B is the purpose of Schneider Institute for Health Policy. Answer D describes the purpose of the Rockefeller Foundation.) To conduct health services research and engage in policy efforts focusing on healthcare financing and service delivery. (Incorrect! Answer C describes the purpose of the Affordable Care Act. Answer A is the purposes of the Robert Wood Johnson foundation. Answer B is the purpose of Schneider Institute for Health Policy. Answer D describes the purpose of the Rockefeller Foundation.) To protect against high out-of-pocket costs by prohibiting insurers from denying coverage based on pre-existing conditions. (Correct! Answer C describes the purpose of the Affordable Care Act. Answer A is the purposes of the Robert Wood Johnson foundation. Answer B is the purpose of Schneider Institute for Health Policy. Answer D describes the purpose of the Rockefeller Foundation.) To support the goal of improving the well-being of humanity through smart globalization. (Incorrect! Answer C describes the purpose of the Affordable Care Act. Answer A is the purposes of the Robert Wood Johnson foundation. Answer B is the purpose of Schneider Institute for Health Policy. Answer D describes the purpose of the Rockefeller Foundation.) Points Received: 0 of 1.25 Comments: Question 9. Question : Development of the first pediatric nurse practitioner program at the University of Colorado in 1965 is credited to which two individuals? Student Answer: Harry Fox, MD (Incorrect! Henry Silver, MD and Loretta Ford, RN, PhD initiated the first pediatric nurse practitioner program.) Henry Silver, MD (Correct! Henry Silver, MD and Loretta Ford, RN, PhD initiated the first pediatric nurse practitioner program.) Luella Jackson, RN (Incorrect! Henry Silver, MD and Loretta Ford, RN, PhD initiated the first pediatric nurse practitioner program.) Loretta Ford, RN (Correct! Henry Silver, MD and Loretta Ford, RN, PhD initiated the first pediatric nurse practitioner program.) Carla Brown, ARNP (Incorrect! Henry Silver, MD and Loretta Ford, RN, PhD initiated the first pediatric nurse practitioner program.) Points Received: 1.25 of 1.25 Comments: Question 10. Question : In order to develop theory-type questions, the practitioner would take which of the following initial series of steps? Student Answer: Ask certain questions, research the topic, implement what is developed, and evaluate the implementation (Incorrect! These would be the initial steps, implementation and evaluation occur later in the process.) Ask certain questions, question the status quo, seek the most plausible answer, and build a narrative for the questions and answers (Correct! These would be the initial steps, implementation and evaluation occur later in the process.) Question the status quo, seek a meaningful answer, Build a program to answer the question and evaluate the program (Incorrect! These would be the initial steps, implementation and evaluation occur later in the process.) Question the status quo, seek a meaningful answer, build a logical structure for the questions and answers, and Review other theories about the situation (Incorrect! These would be the initial steps, implementation and evaluation occur later in the process.) Points Received: 1.25 of 1.25 Comments: Question 11. Question : A Latino patient in your clinic has been perpetually late for his appointments. Which action by the nurse practitioner would be most appropriate? Student Answer: Advise the patient that he should have called to reschedule (Incorrect! Given that the patient has a diverse culture, it is important to first assess what they are thinking about the time. Confronting any patient puts them on the defense, while the other two choices does not change the behavior.) Adjust the appointments to allow for this lateness (Incorrect! Given that the patient has a diverse culture, it is important to first assess what they are thinking about the time. Confronting any patient puts them on the defense, while the other two choices does not change the behavior.) Assess how the patient interprets the appointment time (Correct! Given that the patient has a diverse culture, it is important to first assess what they are thinking about the time. Confronting any patient puts them on the defense, while the other two choices does not change the behavior) Ignore the situation to avoid having the patient go elsewhere (Incorrect! Given that the patient has a diverse culture, it is important to first assess what they are thinking about the time. Confronting any patient puts them on the defense, while the other two choices does not change the behavior.) Points Received: 0 of 1.25 Comments: Question 12. Question : 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: Student Answer: P --population, I-- intervention, C-- Concepts, O--operational definitions, T –Time (Incorrect! Population, intervention, comparison, outcome and time) P—precision instrument, I—intervention, C—control, O—operational definitions, T—Time (Incorrect! Population, intervention, comparison, outcome and time) P—population, I – internal validity, C –Comparisons, O –outcome, T – time (Incorrect! Population, intervention, comparison, outcome and time) P—population, I – intervention, C – comparisons, O – outcome, T – time (Correct! Population, intervention, comparison, outcome and time) Points Received: 1.25 of 1.25 Comments: Question 13. Question : 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: Student Answer: Escherichia coli (Correct! Gram negative E.coli is the most likely causative organism for uncomplicated urinary tract infections.) Staphylococcus aureus (Incorrect! Gram negative E.coli is the most likely causative organism for uncomplicated urinary tract infections.) Neisseria gonorrhoeae (Incorrect! Gram negative E.coli is the most likely causative organism for uncomplicated urinary tract infections.) Ureaplasma urealyticum (Incorrect! Gram negative E.coli is the most likely causative organism for uncomplicated urinary tract infections.) Points Received: 1.25 of 1.25 Comments: Question 14. Question : The Dreyfus Model of Skill Acquisition includes which four stages of APN performance? Student Answer: Expert (Correct! Dreyfus model lists novice, advanced beginner, competent, proficient, expert as APRN performance stages / concepts.) Advanced Beginner (Correct! Dreyfus model lists novice, advanced beginner, competent, proficient, expert as APRN performance stages / concepts.) Competent (Correct! Dreyfus model lists novice, advanced beginner, competent, proficient, expert as APRN performance stages / concepts.) Efficient (Incorrect! Dreyfus model lists novice, advanced beginner, competent, proficient, expert as APRN performance stages / concepts.) Proficient (Correct! Dreyfus model lists novice, advanced beginner, competent, proficient, expert as APRN performance stages / concepts.) Points Received: 1.25 of 1.25 Comments: Question 15. Question : 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)? Student Answer: High fat diet (Incorrect! The greatest risk factor for BPH is increased age.) Recurrent prostatitis (Incorrect! The greatest risk factor for BPH is increased age.) Increased age (Correct! The greatest risk factor for BPH is increased age.) Cigarette smoking (Incorrect! The greatest risk factor for BPH is increased age.) Points Received: 1.25 of 1.25 Comments: Question 16. Question : How can the APN best influence development and passage of a specific health policy agenda? Student Answer: Develop a health policy proposal and independently present it to the House of Representatives (Incorrect!) Partner with a legislator to sponsor a bill despite unrelated committee assignment. (Incorrect!) Determine the best fit between legislative agenda, supporting organizations, and health policy issue (Correct!) Join a national committee to advocate for issues that impact APRNs (Incorrect!) Points Received: 0 of 1.25 Comments: Question 17. Question : Utilizing Fawcett’s evaluation of the Conceptual-Theoretical-Empirical Structure (CTE) of a theory the APN knows that the empirical indicators of a theory are examined for _____? Student Answer: Internal consistency (Incorrect! Operational adequacy is the appropriateness of the empirical indicators as measures of the theory concepts. Internal consistency and parsimony focuses on the theory component. Empirical adequacy is examined during evaluation of the research findings.) Parsimony (Incorrect! Operational adequacy is the appropriateness of the empirical indicators as measures of the theory concepts. Internal consistency and parsimony focuses on the theory component. Empirical adequacy is examined during evaluation of the research findings.) Operational adequacy (Incorrect! Operational adequacy is the appropriateness of the empirical indicators as measures of the theory concepts. Internal consistency and parsimony focuses on the theory component. Empirical adequacy is examined during evaluation of the research findings.) Empirical adequacy (Correct! Operational adequacy is the appropriateness of the empirical indicators as measures of the theory concepts. Internal consistency and parsimony focuses on the theory component. Empirical adequacy is examined during evaluation of the research findings.) Points Received: 0 of 1.25 Comments: Question 18. Question : What specific developments have primarily occurred because of the Affordable Care Act (ACA)? Student Answer: ACA has been appealed and no longer enacted (Incorrect! There have been changes as a direct effect of the ACA.) Development of patient centered outcomes, use of comparative effectiveness research, quality payment structures that impact APN reimbursement (Correct! There have been changes as a direct effect of the ACA.) Nothing has been changed by the ACA other than Medicaid Expansion and Affordable Health Care (Incorrect! There have been changes as a direct effect of the ACA.) ACA has provided limited access to care (Incorrect! There have been changes as a direct effect of the ACA.) Points Received: 1.25 of 1.25 Comments: Question 19. Question : The clinical manifestations of dyskinetic cerebral palsy include: Student Answer: Increased muscle tone and prolonged primitive reflexes (Incorrect! Movements are uncontrolled, jerky, and abrupt.) Exaggerated deep tendon reflexes, clonus, and rigidity of extremities (Incorrect! Movements are uncontrolled, jerky, and abrupt.) Scoliosis, contractures, and stiffness of trunk muscles (Incorrect! Movements are uncontrolled, jerky, and abrupt.) Jerky uncontrolled and abrupt fine musculoskeletal movements (Correct! Movements are uncontrolled, jerky and abrupt.) Points Received: 1.25 of 1.25 Comments: Question 20. Question : Which learning theory would be most applicable as a guide for the development of a program to help families of patients in palliative care? Student Answer: Behaviorist Learning Theory (Incorrect! Humanistic: correcting situations that dehumanize and depersonalize; Behaviorist: simple behaviors, skill learning; Cognitive: acquiring knowledge; Psychodynamic: conflict situations.) Cognitive Learning Theory (Incorrect! Humanistic: correcting situations that dehumanize and depersonalize; Behaviorist: simple behaviors, skill learning; Cognitive: acquiring knowledge; Psychodynamic: conflict situations.) Psychodynamic Learning theory (Incorrect! Humanistic: correcting situations that dehumanize and depersonalize; Behaviorist: simple behaviors, skill learning; Cognitive: acquiring knowledge; Psychodynamic: conflict situations.) Humanistic Learning theory (Correct! Humanistic: correcting situations that dehumanize and depersonalize; Behaviorist: simple behaviors, skill learning; Cognitive: acquiring knowledge; Psychodynamic: conflict situations.) Points Received: 1.25 of 1.25 Comments: Question 21. Question : Transformational leadership is best defined as: Student Answer: a variable leadership style based on the environment, task, competency of works, or situation (Incorrect! Transformational leadership is a style that is relational, driven by a common goal, and satisfies the leader and the follower.) a style that is relational, driven by a common goal, and satisfies the leader and the follower (Correct! Transformational leadership is a style that is relational, driven by a common goal, and satisfies the leader and the follower.) an autocratic style with maximal follower input (Incorrect! Transformational leadership is a style that is relational, driven by a common goal, and satisfies the leader and the follower.) a style that allows followers to act on their own decisions (Incorrect! Transformational leadership is a style that is relational, driven by a common goal, and satisfies the leader and the follower.) Points Received: 1.25 of 1.25 Comments: Question 22. Question : In septic shock, which mediators are anti-inflammatory? Student Answer: Interleukin (IL)–4 (IL-4), IL-10, and IL-13 (Correct! Interleukin is anti-inflammatory where as other choices are pro-inflammatory.) Tumor necrosis factor–alpha (TNF-α) and granulocyte cell-stimulating factor (Incorrect! Interleukin is anti-inflammatory where as other choices are pro-inflammatory.) IL-1, IL-2, and IL-6 (Incorrect! Interleukin is anti-inflammatory where as other choices are pro-inflammatory.) Prostaglandin, leukotrienes, and bradykinin (Incorrect! Interleukin is anti-inflammatory where as other choices are pro-inflammatory.) Points Received: 1.25 of 1.25 Comments: Question 23. Question : Pre-invasive epithelial tumors of glandular or squamous cell origin describes which of the following? Student Answer: Tumor in differentiation (Incorrect! Early stage growths that are localized to the epithelium and have not invaded are called cancer in situ.) Dysplastic (Incorrect! Early stage growths that are localized to the epithelium and have not invaded are called cancer in situ.) Cancer in situ (Correct! Early stage growths that are localized to the epithelium and have not invaded are called cancer in situ.) Cancer beyond (meta) situ (Incorrect! Early stage growths that are localized to the epithelium and have not invaded are called cancer in situ.) Points Received: 1.25 of 1.25 Comments: Question 24. Question : How does health policy specifically influence health care practice in the United States? Student Answer: Health Policy directs efforts by the CDC and protects Americans against population based diseases. (Correct! Health policy defines decisions, plan and actions for health of a specific population. In that case, all of the above choices encompass influences on the health of the Unites States.) Health policy does not directly influence how health care is reimbursed and determines APN payment for services. (Incorrect! Health policy defines decisions, plan and actions for health of a specific population. In that case, all of the above choices encompass influences on the health of the Unites States.) Health policy does not direct specific evidence based practice guideline development and dissemination (Incorrect! Health policy defines decisions, plan and actions for health of a specific population. In that case, all of the above choices encompass influences on the health of the Unites States.) Health policy is broad and does specifically focus on population based disease efforts. (Incorrect! Health policy defines decisions, plan and actions for health of a specific population. In that case, all of the above choices encompass influences on the health of the Unites States.) Points Received: 0 of 1.25 Comments: Question 25. Question : Which leadership style involves development of unity between the leader and followers to achieve a collective purpose? Student Answer: Laissez-Faire (Incorrect! Definition of transformation leadership. Laissez-Faire style is hands off, no intervention. Democratic style seeks input from followers to carry out the wishes of the group. Transactional style is more managerial, using rewards and punishments to optimize performance.) Transactional (Incorrect! Definition of transformation leadership. Laissez-Faire style is hands off, no intervention. Democratic style seeks input from followers to carry out the wishes of the group. Transactional style is more managerial, using rewards and punishments to optimize performance.) Transformational (Correct! Definition of transformation leadership. Laissez-Faire style is hands off, no intervention. Democratic style seeks input from followers to carry out the wishes of the group. Transactional style is more managerial, using rewards and punishments to optimize performance.) Democratic (Incorrect! Definition of transformation leadership. Laissez-Faire style is hands off, no intervention. Democratic style seeks input from followers to carry out the wishes of the group. Transactional style is more managerial, using rewards and punishments to optimize performance.) Points Received: 0 of 1.25 Comments: Question 26. Question : 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? Student Answer: Internal consistency (Incorrect! CTE linkages include specification adequacy and linkage adequacy; the others are criteria for evaluation of a theory.) Specification adequacy (Correct! CTE linkages include specification adequacy and linkage adequacy; the others are criteria for evaluation of a theory.) Parsimony (Incorrect! CTE linkages include specification adequacy and linkage adequacy; the others are criteria for evaluation of a theory.) Empirical Adequacy (Incorrect! CTE linkages include specification adequacy and linkage adequacy; the others are criteria for evaluation of a theory.) Points Received: 0 of 1.25 Comments: Question 27. Question : 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: Student Answer: Screening for a sexually transmitted disease (Incorrect! Primary prevention is defined as an intervention that prevents a disease or injury before it occurs. Therefore, counseling about safer sexual practices prevents the occurrence of STIs. Choice A and C are secondary, while B is tertiary.) Prescribing therapies to decrease a cough (Incorrect! Primary prevention is defined as an intervention that prevents a disease or injury before it occurs. Therefore, counseling about safer sexual practices prevents the occurrence of STIs. Choice A and C are secondary, while B is tertiary.) Obtaining a Papanicolaou (PAP) test (Incorrect! Primary prevention is defined as an intervention that prevents a disease or injury before it occurs. Therefore, counseling about safer sexual practices prevents the occurrence of STIs. Choice A and C are secondary, while B is tertiary.) Counseling about safer sexual practices (Correct! Primary prevention is defined as an intervention that prevents a disease or injury before it occurs. Therefore, counseling about safer sexual practices prevents the occurrence of STIs. Choice A and C are secondary, while B is tertiary.) Points Received: 1.25 of 1.25 Comments: Question 28. Question : Which theorist/s identifies carative factors as a value system, faith-hope and sensitivity to self and others? This describes which of the following theories? Student Answer: Dorothea Orem (Incorrect! Jean Watson theory of human caring.) Paterson and Zderad (Incorrect! Jean Watson theory of human caring.) Jean Watson (Correct! Jean Watson theory of human caring.) Margaret Newman (Incorrect! Jean Watson theory of human caring.) Points Received: 1.25 of 1.25 Comments: Question 29. Question : What statement concerning the pathogenetic mechanisms of polycystic ovarian syndrome (POS) is true? Student Answer: POS causes a decrease in leptin levels; this decrease reduces the hypothalamic pulsatility of gonadotropin-releasing hormone, which reduces the number of follicles that mature. (Incorrect! POS is due to multiple factors from multiple cysts on the ovaries that impact hormonal levels and ovarian function.) POS is a result of a disorder in the anterior pituitary that increases the follicle-stimulating hormone, which reduces the luteinizing hormone released. (Incorrect! POS is due to multiple factors from multiple cysts on the ovaries that impact hormonal levels and ovarian function.) POS is a result of a combination of conditions that include oligo-ovulation or anovulation, elevated levels of androgens, or clinical signs of hyperandrogenism and polycystic ovaries. (Correct! POS is due to multiple factors from multiple cysts on the ovaries that impact hormonal levels and ovarian function.) POS inhibits testosterone, which stimulates androgen secretion by the ovarian stroma and indirectly reduces sex hormone–binding globulin.(Incorrect! POS is due to multiple factors from multiple cysts on the ovaries that impact hormonal levels and ovarian function.) Points Received: 1.25 of 1.25 Comments: Question 30. Question : Which of the following statements best describes a middle range theory? Student Answer: A conceptual model of nursing that guides patient care of the elderly. (Incorrect! Middle-range theories address a particular patient experience or problem and have a relatively narrow range of applicability.) A theory of caring that can be incorporated into a program for RN’s in a hospital setting (Incorrect! Middle-range theories address a particular patient experience or problem and have a relatively narrow range of applicability.) A theory of unpleasant symptoms to guide care of diabetes. (Correct! Middle-range theories address a particular patient experience or problem and have a relatively narrow range of applicability.) A theory of health promotion to guide a smoking cessation program. (Incorrect! Middle-range theories address a particular patient experience or problem and have a relatively narrow range of applicability.) Points Received: 0 of 1.25 Comments: Question 31. Question : What are the primary tenets of Team STEPPS training? Student Answer: Interdisciplinary collaboration, communication, teamwork (Correct! Team STEPPS involves interdisciplinary collaboration, communication, and teamwork.) Individualized training, continuing education, safety (Incorrect! Team STEPPS involves interdisciplinary collaboration, communication, and teamwork.) Autonomous monitoring, team building, communication (Incorrect! Team STEPPS involves interdisciplinary collaboration, communication, and teamwork.) Interdisciplinary knowledge, skills, attitude (Incorrect! Team STEPPS involves interdisciplinary collaboration, communication, and teamwork.) Points Received: 0 of 1.25 Comments: Question 32. Question : Hamric’s Integrative Model of Advanced Practice Nursing identify the central competency of advance practice nursing that directs the other six core competencies. Student Answer: Evidence-based practice (Incorrect! Core competencies of advanced practice include: direct clinical practice: guidance and coaching, collaboration, leadership, collaboration, evidence based practice, ethical decision making.) Guidance and Coaching (Incorrect! Core competencies of advanced practice include: direct clinical practice: guidance and coaching, collaboration, leadership, collaboration, evidence based practice, ethical decision making.) Ethical decision making (Incorrect! Core competencies of advanced practice include: direct clinical practice: guidance and coaching, collaboration, leadership, collaboration, evidence based practice, ethical decision making.) Direct clinical practice (Correct! Core competencies of advanced practice include: direct clinical practice: guidance and coaching, collaboration, leadership, collaboration, evidence based practice, ethical decision making.) Points Received: 1.25 of 1.25 Comments: Question 33. Question : A metaparadigm must include which of the following 3 characteristics? Student Answer: Identification of a domain that is similar to domains of other disciplines. (Incorrect! The domain should be distinctive, encompass all phenomena and be global in scope, and perspective) Encompass all phenomena of interest. (Correct! The domain should be distinctive, encompass all phenomena and be global in scope, and perspective) Be perspective –neutral. (Correct! The domain should be distinctive, encompass all phenomena and be global in scope, and perspective) Be global in scope. (Correct! The domain should be distinctive, encompass all phenomena and be global in scope, and perspective) Points Received: 1.25 of 1.25 Comments: Question 34. Question : How has the Quality Chasm Report been used to direct US health care? Student Answer: The report integrates international directives for provision of quality health care. (Incorrect! The Quality Chasm Report is used as a foundation for multiple health policy initiatives.) The Institute of Medicine (IOM) designed this document to direct medical practices in the US. (Incorrect! The Quality Chasm Report is used as a foundation for multiple health policy initiatives.) As a framework for safe, effective, efficient, equitable, timely, and patient centered care. (Correct! The Quality Chasm Report is used as a foundation for multiple health policy initiatives.) It outlines processes for determining interdisciplinary root cause etiologies. (Incorrect! The Quality Chasm Report is used as a foundation for multiple health policy initiatives.) Points Received: 0 of 1.25 Comments: Question 35. Question : Which statement provides the most accurate information regarding the transmission of herpes simplex virus (HSV)? Student Answer: HSV is transmitted only when vesicles are present (Incorrect! Transmission is possible any time. Condoms do not completely protect due to skin to skin contact.) HSV is transmitted only while lesions are present (Incorrect! Transmission is possible any time. Condoms do not completely protect due to skin to skin contact.) The use of condoms prevents the transmission of HSV (Incorrect! Transmission is possible any time. Condoms do not completely protect due to skin to skin contact.) The risk of transmission is present even during latent periods (Correct! Transmission is possible any time. Condoms do not completely protect due to skin to skin contact.) Points Received: 1.25 of 1.25 Comments: Question 36. Question : What theory is used to describe the cause of endometriosis? Student Answer: Obstruction within the fallopian tubes prevents the endometrial tissue from adhering to the lining of the uterus. (Incorrect! Endometrial tissue passes through the fallopian tubes and continues to respond to hormones.) Endometrial tissue passes through the fallopian tubes and into the peritoneal cavity and remains responsive to hormones. (Correct! Endometrial tissue passes through the fallopian tubes and continues to respond to hormones.) Inflammation of the endometrial tissue develops after recurrent sexually transmitted diseases. (Incorrect! Endometrial tissue passes through the fallopian tubes and continues to respond to hormones.) Endometrial tissue lies dormant in the uterus until the ovaries produce sufficient hormone to stimulate its growth. (Incorrect! Endometrial tissue passes through the fallopian tubes and continues to respond to hormones.) Points Received: 1.25 of 1.25 Comments: Question 37. Question : The link between major depression and cortisol secretion is that individuals with depression: Student Answer: Show suppression of plasma cortisol when given dexamethasone (Incorrect! Elevated plasma cortisol leads to inflammation and can be a trigger for depression.) b. Have a decreased plasma cortisol level, despite the administration of exogenous corticosteroids (Incorrect! Elevated plasma cortisol leads to inflammation and can be a trigger for depression.) Show that persistently elevated plasma cortisol levels can result in inflammation that is believed to trigger depression (Correct! Elevated plasma cortisol leads to inflammation and can be a trigger for depression.) Have normal plasma cortisol levels throughout the day when they take antidepressant medication as prescribed (Incorrect! Elevated plasma cortisol leads to inflammation and can be a trigger for depression.) Points Received: 1.25 of 1.25 Comments: Question 38. Question : Which two options are barriers to the conceptualization of Advanced Practice Nursing? Student Answer: Lack of obscurity (Incorrect! Five issues of conceptual confusion or uncertainty in the evolution of advanced practice nursing are identified as 1) the absence of well-defined and consistently applied terms of reference; 2) the many attempts to articulate models of advanced practice nursing fail to consider extant literature that is directly relevant to such conceptualizing activities; 3) lack of clarity regarding conceptualizations that differentiate between and among levels of clinical practice; 4) need to clarify the differences between advanced practice nursing and medicine; and 5) interprofessional education and practice.) Interprofessional education and practice (Correct! Five issues of conceptual confusion or uncertainty in the evolution of advanced practice nursing are identified as 1) the absence of well-defined and consistently applied terms of reference; 2) the many attempts to articulate models of advanced practice nursing fail to consider extant literature that is directly relevant to such conceptualizing activities; 3) lack of clarity regarding conceptualizations that differentiate between and among levels of clinical practice; 4) need to clarify the differences between advanced practice nursing and medicine; and 5) interprofessional education and practice.) Need to differentiate between advanced practice nursing and medicine (Correct! Five issues of conceptual confusion or uncertainty in the evolution of advanced practice nursing are identified as 1) the absence of well-defined and consistently applied terms of reference; 2) the many attempts to articulate models of advanced practice nursing fail to consider extant literature that is directly relevant to such conceptualizing activities; 3) lack of clarity regarding conceptualizations that differentiate between and among levels of clinical practice; 4) need to clarify the differences between advanced practice nursing and medicine; and 5) interprofessional education and practice.) Consistency of state practice act that regulate APNs (Incorrect! Five issues of conceptual confusion or uncertainty in the evolution of advanced practice nursing are identified as 1) the absence of well-defined and consistently applied terms of reference; 2) the many attempts to articulate models of advanced practice nursing fail to consider extant literature that is directly relevant to such conceptualizing activities; 3) lack of clarity regarding conceptualizations that differentiate between and among levels of clinical practice; 4) need to clarify the differences between advanced practice nursing and medicine; and 5) interprofessional education and practice.) Points Received: 1.25 of 1.25 Comments: Question 39. Question : 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: Student Answer: Direct clinical practice (Incorrect! As represented in Hamric’s model in the outermost ring, critical environmental elements affecting advanced practice is health policy.) Consultation (Incorrect! As represented in Hamric’s model in the outermost ring, critical environmental elements affecting advanced practice is health policy.) Health policy (Correct! As represented in Hamric’s model in the outermost ring, critical environmental elements affecting advanced practice is health policy.) Certification (Incorrect! As represented in Hamric’s model in the outermost ring, critical environmental elements affecting advanced practice is health policy.) Points Received: 0 of 1.25 Comments: Question 40. Question : 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? Student Answer: “How many cigarettes per day are you currently smoking?” (Incorrect! A known side effect that is identified in the prescriber insert is depression. B may be a symptom of depression, but can also have their etiologies. The other choices are screening questions that should be completed earlier than 3 weeks into treatment.) “Are you having any difficulty sleeping?” (Incorrect! A known side effect that is identified in the prescriber insert is depression. B may be a symptom of depression, but can also have their etiologies. The other choices are screening questions that should be completed earlier than 3 weeks into treatment.) “Have you noticed change in your mood?” (Correct! A known side effect that is identified in the prescriber insert is depression. B may be a symptom of depression, but can also have their etiologies. The other choices are screening questions that should be completed earlier than 3 weeks into treatment.) “On a scale of 1–10, what is your current desire to stop smoking?” (Incorrect! A known side effect that is identified in the prescriber insert is depression. B may be a symptom of depression, but can also have their etiologies. The other choices are screening questions that should be completed earlier than 3 weeks into treatment.) Points Received: 1.25 of 1.25 Comments: Question 41. Question : What four components of advanced practice nursing (APN) are specified by the National Council for State Boards of Nursing Consensus Model for APRN regulation? Student Answer: Licensure (Correct! LACE document—Licensure, Accreditation, Certification, Education. ) Accreditation (Correct! LACE document—Licensure, Accreditation, Certification, Education.) Competence (Incorrect! LACE document—Licensure, Accreditation, Certification, Education.) Education (Correct! LACE document—Licensure, Accreditation, Certification, Education.) Certification (Correct! LACE document—Licensure, Accreditation, Certification, Education.) Points Received: 1.25 of 1.25 Comments: Question 42. Question : “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? Student Answer: Coach (Correct! Coach is defined as 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).) Collaborator (Incorrect! Coach is defined as 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).) Direct care provider (Incorrect! Coach is defined as 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).) Mentor (Incorrect! Coach is defined as 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).) Points Received: 0 of 1.25 Comments: Question 43. Question : 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? Student Answer: The historical evolution (Incorrect! The unique focus is a step in the analysis but is not part of the origins.) The motivation for development (Incorrect! The unique focus is a step in the analysis but is not part of the origins.) The unique focus (Correct! The unique focus is a step in the analysis but is not part of the origins.) The philosophical beliefs and values about nursing that it is based on (Incorrect! The unique focus is a step in the analysis but is not part of the origins.) Points Received: 0 of 1.25 Comments: Question 44. Question : A 42-year-old male presents to the clinic with the chief complaint of sinus congestion for 2 weeks associated with facial pain. He is 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.” The most appropriate response is that, he Student Answer: “needs to return for the shot after he has completed his antibiotic therapy.” (Incorrect! The influenza vaccine is appropriate for this patient since there is no fever. An acute infection is not a contraindication in of itself.) “is not an appropriate candidate for the shot due to his age.” (Incorrect! The influenza vaccine is appropriate for this patient since there is no fever. An acute infection is not a contraindication in of itself.) “is at risk of developing a reaction if the shot is given today.” (Incorrect! The influenza vaccine is appropriate for this patient since there is no fever. An acute infection is not a contraindication in of itself.) “can receive the shot in the clinic today.” (Correct! The influenza vaccine is appropriate for this patient since there is no fever. An acute infection is not a contraindication in of itself.) Points Received: 1.25 of 1.25 Comments: Question 45. Question : Which of the following three complications are associated with chronic hepatitis B? Student Answer: Continued infectivity (Correct! Malignant hypertension causes brain hemorrhage and renal failure, but does not have any effect on the liver.) Malignant hypertension (Incorrect! Malignant hypertension causes brain hemorrhage and renal failure, but does not have any effect on the liver.) Uncompensated cirrhosis (Correct! Malignant hypertension causes brain hemorrhage and renal failure, but does not have any effect on the liver.) Hepatocellular carcinoma (Correct! Malignant hypertension causes brain hemorrhage and renal failure, but does not have any effect on the liver.) Renal encephalopathy (Incorrect! Malignant hypertension causes brain hemorrhage and renal failure, but does not have any effect on the liver.) Points Received: 0.75 of 1.25 Comments: Question 46. Question : What set of components is essential in a scientific theory? Student Answer: Interrelated concepts, definitions, and propositions. (Correct! In a scientific theory, some of the relationships are assumed to be true, not all, the statements are based on experience, research and observation. The propositions and constructs are tied together to explain and predict events or situations.) Interrelated statements which assume all the relationships to be true. (Incorrect! In a scientific theory, some of the relationships are assumed to be true, not all, the statements are based on experience, research and observation. The propositions and constructs are tied together to explain and predict events or situations.) Statements that are based on the author’s opinions and experience only. (Incorrect! In a scientific theory, some of the relationships are assumed to be true, not all, the statements are based on experience, research and observation. The propositions and constructs are tied together to explain and predict events or situations.) Propositions and constructs that are not necessarily tied together. (Incorrect! In a scientific theory, some of the relationships are assumed to be true, not all, the statements are based on experience, research and observation. The propositions and constructs are tied together to explain and predict events or situations.) Points Received: 1.25 of 1.25 Comments: Question 47. Question : 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? Student Answer: elevated rheumatoid factor level (Correct! Elevated rheumatoid factor is the most specific marker indicative of rheumatoid arthritis.) elevated uric acid level (Incorrect! Elevated rheumatoid factor is the most specific marker indicative of rheumatoid arthritis.) positive antinuclear antibody titer (Incorrect! Elevated rheumatoid factor is the most specific marker indicative of rheumatoid arthritis.) elevated erythrocyte sedimentation rate (Incorrect! Elevated rheumatoid factor is the most specific marker indicative of rheumatoid arthritis.) Points Received: 1.25 of 1.25 Comments: Question 48. Question : A novice nurse practitioner (NP) 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? Student Answer: Internal to the APN (Incorrect! Time constraints for visits and productivity expectations are organizational barriers.) Inter-professional (Incorrect! Time constraints for visits and productivity expectations are organizational barriers.) Patient-provider (Incorrect! Time constraints for visits and productivity expectations are organizational barriers.) Organizational/Environmental (Correct! Time constraints for visits and productivity expectations are organizational barriers.) Points Received: 0 of 1.25 Comments: Question 49. Question : Which of the following philosophies of work view would characterize human beings as holistic; parts are viewed only in the context of the whole? Student Answer: Reaction (Incorrect! Reaction sees human beings as bio-psycho-social-spiritual beings; Simultaneous action sees human beings as unitary and unified by pattern; Holistic interaction is not a world view) Simultaneous Action (Incorrect! Reaction sees human beings as bio-psycho-social-spiritual beings; Simultaneous action sees human beings as unitary and unified by pattern; Holistic interaction is not a world view) Holistic interaction (Incorrect! Reaction sees human beings as bio-psycho-social-spiritual beings; Simultaneous action sees human beings as unitary and unified by pattern; Holistic interaction is not a world view) Reciprocal Interaction (Correct! Reaction sees human beings as bio-psycho-social-spiritual beings; Simultaneous action sees human beings as unitary and unified by pattern; Holistic interaction is not a world view) Points Received: 1.25 of 1.25 Comments: Question 50. Question : 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? Student Answer: Does the theory/model fit with the purpose/ topic of interest? (Incorrect! Consider several theories and models and then begin to the analysis with the fit, relationships and assumptions, rationale and suppositions.) Are the relationships of the major concepts delineated? (Incorrect! Consider several theories and models and then begin to the analysis with the fit, relationships and assumptions, rationale and suppositions.) Have several different theories/models been examined? (Correct! Consider several theories and models and then begin to the analysis with the fit, relationships and assumptions, rationale and suppositions.) Are the assumptions, rationale and suppositions accepted by the APN? (Incorrect! Consider several theories and models and then begin to the analysis with the fit, relationships and assumptions, rationale and suppositions.) Points Received: 0 of 1.25 Comments: Question 51. Question : 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? Student Answer: Moral Distress (Incorrect! Moral dilemma occurs when obligations require or appear to require that a person adopt two (or more) alternative actions, but the person cannot carry out all the required alternatives. Moral distress - is the experience of being seriously compromised as a moral agent in practicing in accordance with accepted professional values and standards. Moral uncertainty – the right action is not clear. Moral distraction is not an option.) Moral Uncertainty (Incorrect! Moral dilemma occurs when obligations require or appear to require that a person adopt two (or more) alternative actions, but the person cannot carry out all the required alternatives. Moral distress - is the experience of being seriously compromised as a moral agent in practicing in accordance with accepted professional values and standards. Moral uncertainty – the right action is not clear. Moral distraction is not an option.) Moral Dilemma (Correct! Moral dilemma occurs when obligations require or appear to require that a person adopt two (or more) alternative actions, but the person cannot carry out all the required alternatives. Moral distress - is the experience of being seriously compromised as a moral agent in practicing in accordance with accepted professional values and standards. Moral uncertainty – the right action is not clear. Moral distraction is not an option.) Moral Distraction (Incorrect! Moral dilemma occurs when obligations require or appear to require that a person adopt two (or more) alternative actions, but the person cannot carry out all the required alternatives. Moral distress - is the experience of being seriously compromised as a moral agent in practicing in accordance with accepted professional values and standards. Moral uncertainty – the right action is not clear. Moral distraction is not an option.) Points Received: 0 of 1.25 Comments: Question 52. Question : Which three roles represent the accepted advanced practice nursing roles? Student Answer: Certified Nurse Midwives (CNMs) (Correct! The four accepted advanced practice roles are CNM, CNS, CRNA, NP.) Clinical Nurse Specialists (CNSs) (Correct! The four accepted advanced practice roles are CNM, CNS, CRNA, NP.) Critical Care Registered Nurses (CCRNs) (Incorrect! The four accepted advanced practice roles are CNM, CNS, CRNA, NP.) Certified Registered Nurse Anesthetists (CRNAs) (Correct! The four accepted advanced practice roles are CNM, CNS, CRNA, NP.) Points Received: 1.25 of 1.25 Comments: Question 53. Question : Which two organizations administer nurse practitioner certification programs? Student Answer: State boards of nursing (Incorrect! AANP and ANCC offers NP certification with the designation FNP-C. State boards of nursing grant licensure, not certification. American Nurses Association is a professional organization for all nurses and do not grant certification or licensure. They serve as advocates for our profession. National Organization of Nurse Practitioner Faculties.) American Nurses Association (Incorrect! AANP and ANCC offers NP certification with the designation FNP-C. State boards of nursing grant licensure, not certification. American Nurses Association is a professional organization for all nurses and do not grant certification or licensure. They serve as advocates for our profession. National Organization of Nurse Practitioner Faculties.) National Organization of Nurse Practitioner Faculties (Incorrect! AANP and ANCC offers NP certification with the designation FNP-C. State boards of nursing grant licensure, not certification. American Nurses Association is a professional organization for all nurses and do not grant certification or licensure. They serve as advocates for our profession. National Organization of Nurse Practitioner Faculties.) American Association of Nurse Practitioners (Correct! AANP and ANCC offers NP certification with the designation FNP-C. State boards of nursing grant licensure, not certification. American Nurses Association is a professional organization for all nurses and do not grant certification or licensure. They serve as advocates for our profession. National Organization of Nurse Practitioner Faculties.) American Nurses Credentialing Center (Correct! AANP and ANCC offers NP certification with the designation FNP-C. State boards of nursing grant licensure, not certification. American Nurses Association is a professional organization for all nurses and do not grant certification or licensure. They serve as advocates for our profession. National Organization of Nurse Practitioner Faculties.) Points Received: 1.25 of 1.25 Comments: Question 54. Question : Which agency will the APN reference when seeking the current evidence based guidelines directing standards of care? Student Answer: Patient Centered Outcomes Research Institute (PCORI) (Incorrect!) Agency for Health Research and Quality (Correct!) Centers for Disease Control and Prevention (Incorrect!) US Protective and Safety Task Force (Incorrect!) Points Received: 1.25 of 1.25 Comments: Question 55. Question : 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? Student Answer: Family and Medical Leave Act benefits (Incorrect! Since the patient can return to another occupation, the vocational rehabilitation services can assist in matching the patient limitations with another job that the patient is qualified to do. Home health services are not necessarily needed. Since the patient does not qualify for disability social security benefits cannot be obtained. Family and Medical Leave Act is suitable if the patient needs time off for rehabilitation to return to their previous job.) Vocational rehabilitation services (Correct! Since the patient can return to another occupation, the vocational rehabilitation services can assist in matching the patient limitations with another job that the patient is qualified to do. Home health services are not necessarily needed. Since the patient does not qualify for disability social security benefits cannot be obtained. Family and Medical Leave Act is suitable if the patient needs time off for rehabilitation to return to their previous job.) Public unemployment services (Incorrect! Since the patient can return to another occupation, the vocational rehabilitation services can assist in matching the patient limitations with another job that the patient is qualified to do. Home health services are not necessarily needed. Since the patient does not qualify for disability social security benefits cannot be obtained. Family and Medical Leave Act is suitable if the patient needs time off for rehabilitation to return to their previous job.) Social security benefits (Incorrect! Since the patient can return to another occupation, the vocational rehabilitation services can assist in matching the patient limitations with another job that the patient is qualified to do. Home health services are not necessarily needed. Since the patient does not qualify for disability social security benefits cannot be obtained. Family and Medical Leave Act is suitable if the patient needs time off for rehabilitation to return to their previous job.) Points Received: 1.25 of 1.25 Comments: Question 56. Question : What initiative specifically focuses on the aging American, under the Affordable Care Act? Student Answer: Team STEPPS (Incorrect!) Multiple Chronic Conditions (Correct!) Shared Decision Making (Incorrect!) Literacy Tool Kit (Incorrect!) Points Received: 1.25 of 1.25 Comments: Question 57. Question : What terms indicate appropriate progression associated with the history and evolution of advance practice nursing? Student Answer: Specialist, Expanded Role, Advanced Practice (Correct! As nursing roles developed and specialized, terminology defining their roles progressed from Specialist, to expanded role, to advanced practice.) Expanded Role, Advanced Practice, Specialist (Incorrect! As nursing roles developed and specialized, terminology defining their roles progressed from Specialist, to expanded role, to advanced practice.) Advanced Practice, Specialist, Expanded Role (Incorrect! As nursing roles developed and specialized, terminology defining their roles progressed from Specialist, to expanded role, to advanced practice.) Specialist, Advanced Practice, Expanded Role (Incorrect! As nursing roles developed and specialized, terminology defining their roles progressed from Specialist, to expanded role, to advanced practice.) Points Received: 0 of 1.25 Comments: Question 58. Question : A 12-year-old male is diagnosed with Klinefelter syndrome. His karyotype would reveal which of the following? Student Answer: XY (Incorrect! A person with Klinefelter syndrome has an XXY karyotype.) XX (Incorrect! A person with Klinefelter syndrome has an XXY karyotype.) XYY (Incorrect! A person with Klinefelter syndrome has an XXY karyotype.) XXY (Correct! A person with Klinefelter syndrome has an XXY karyotype.) Points Received: 1.25 of 1.25 Comments: Question 59. Question : Which of the following best describes the function of the clinical nurse specialist (CNS) as an advanced practice nurse (APN)? Student Answer: Provide expert consultation and direct care to clients with complex health problems, educate and support nursing staff, and lead change within organizations (Correct! The CNS is defined as an APN who practices in three substantive areas, as articulated by Lewandowski and Adamle (2009), to manage the care of complex and vulnerable populations, educate and support nursing and interdisciplinary staff, and facilitate change and innovation in health care systems.) Provide expert, prevention and wellness focused direct care for acute and chronic conditions (Incorrect! The CNS is defined as an APN who practices in three substantive areas, as articulated by Lewandowski and Adamle (2009), to manage the care of complex and vulnerable populations, educate and support nursing and interdisciplinary staff, and facilitate change and innovation in health care systems.) Provide procedural and pharmacological management of patients undergoing anesthesia (Incorrect! The CNS is defined as an APN who practices in three substantive areas, as articulated by Lewandowski and Adamle (2009), to manage the care of complex and vulnerable populations, educate and support nursing and interdisciplinary staff, and facilitate change and innovation in health care systems.) Provide specialized care and intervention related to women’s health and childbearing (Incorrect! The CNS is defined as an APN who practices in three substantive areas, as articulated by Lewandowski and Adamle (2009), to manage the care of complex and vulnerable populations, educate and support nursing and interdisciplinary staff, and facilitate change and innovation in health care systems.) Points Received: 1.25 of 1.25 Comments: Question 60. Question : 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? Student Answer: There are multiple frameworks and models to choose from (Correct! HRQOL encompasses multiple aspects including, biological, physiological, psychosocial variables and individuals’ perceptions. The terms quality of life and HWQOL are not interchangeable. HRQOL refers specifically to the person in terms of their health.) Only biological and physiological variables and symptoms are included (Incorrect! HRQOL encompasses multiple aspects including, biological, physiological, psychosocial variables and individuals’ perceptions. The terms quality of life and HWQOL are not interchangeable. HRQOL refers specifically to the person in terms of their health.) An individual’s perceptions are not addressed in the theory (Incorrect! HRQOL encompasses multiple aspects including, biological, physiological, psychosocial variables and individuals’ perceptions. The terms quality of life and HWQOL are not interchangeable. HRQOL refers specifically to the person in terms of their health.) Quality of life and HRQOL are interchangeable concepts (Incorrect! HRQOL encompasses multiple aspects including, biological, physiological, psychosocial variables and individuals’ perceptions. The terms quality of life and HWQOL are not interchangeable. HRQOL refers specifically to the person in terms of their health.) Points Received: 0 of 1.25 Comments: Question 61. Question : Which organization allows the use of the “BC” credential (e.g., FNP-BC)? Student Answer: Commission on Collegiate Nursing Education (CCNE) (Incorrect! another certification organization, ANCC offers FNP-BC credential.) National Council of State Boards of Nursing (NCSBN) (Incorrect! another certification organization, ANCC offers FNP-BC credential.) American Nurses Credentialing Center (ANCC) (Correct! another certification organization, ANCC offers FNP-BC credential.) National Association of Pediatric Nurse Practitioners (NAPNAP) (Incorrect! another certification organization, ANCC offers FNP-BC credential.) Points Received: 0 of 1.25 Comments: Question 62. Question : For nursing to be considered a discipline which statement is true? Student Answer: Defining the knowledge base of nursing is essential and straightforward. (Incorrect! Knowledge base of nursing is complex and difficult to define. The discipline of nursing includes other components than just a knowledge base. The human component influences the development of the knowledge base in that judgements are made about what is acceptable science and what are current priorities. Context has great influence on the discipline and knowledge base.) The discipline of nursing consists of a well-defined knowledge base. (Incorrect! Knowledge base of nursing is complex and difficult to define. The discipline of nursing includes other components than just a knowledge base. The human component influences the development of the knowledge base in that judgements are made about what is acceptable science and what are current priorities. Context has great influence on the discipline and knowledge base.) The human component of the knowledge base of the discipline does not influence or change the existing knowledge base. (Incorrect! Knowledge base of nursing is complex and difficult to define. The discipline of nursing includes other components than just a knowledge base. The human component influences the development of the knowledge base in that judgements are made about what is acceptable science and what are current priorities. Context has great influence on the discipline and knowledge base.) Context has considerable influence on the development of the knowledge base. (Correct! Knowledge base of nursing is complex and difficult to define. The discipline of nursing includes other components than just a knowledge base. The human component influences the development of the knowledge base in that judgements are made about what is acceptable science and what are current priorities. Context has great influence on the discipline and knowledge base.) Points Received: 0 of 1.25 Comments: Question 63. Question : The Consensus Model for Advanced Practice Registered Nurse Regulations addresses which four areas? Student Answer: Specialty areas (Correct! The APRN Regulatory Model includes important definitions, the roles and titles to be used, and population foci. Furthermore, it defines specialties and describes how to make room for the emergence of new APRN roles and population foci within the regulatory framework.) Roles and titles to be used (Correct! The APRN Regulatory Model includes important definitions, the roles and titles to be used, and population foci. Furthermore, it defines specialties and describes how to make room for the emergence of new APRN roles and population foci within the regulatory framework.) Population foci (Correct! The APRN Regulatory Model includes important definitions, the roles and titles to be used, and population foci. Furthermore, it defines specialties and describes how to make room for the emergence of new APRN roles and population foci within the regulatory framework.) Preparation for emerging APRN roles (Correct! The APRN Regulatory Model includes important definitions, the roles and titles to be used, and population foci. Furthermore, it defines specialties and describes how to make room for the emergence of new APRN roles and population foci within the regulatory framework.) Licensure blueprints for testing (Incorrect! The APRN Regulatory Model includes important definitions, the roles and titles to be used, and population foci. Furthermore, it defines specialties and describes how to make room for the emergence of new APRN roles and population foci within the regulatory framework.) Points Received: 0 Comments: Question 64. Question : 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: Student Answer: hepatoma (Incorrect! The gallbladder is anatomically located in the RUQ of the abdomen. Acute choleycystitis typically presents with RUQ or epigastric abdominal pain, nausea, vomiting, and fever. Pain may radiate to the right shoulder, scapula, or between shoulder blades.) acute choleycystitis (Correct! The gallbladder is anatomically located in the RUQ of the abdomen. Acute choleycystitis typically presents with RUQ or epigastric abdominal pain, nausea, vomiting, and fever. Pain may radiate to the right shoulder, scapula, or between shoulder blades.) acute hepatitis (Incorrect! The gallbladder is anatomically located in the RUQ of the abdomen. Acute choleycystitis typically presents with RUQ or epigastric abdominal pain, nausea, vomiting, and fever. Pain may radiate to the right shoulder, scapula, or between shoulder blades.) appendicitis (Incorrect! The gallbladder is anatomically located in the RUQ of the abdomen. Acute choleycystitis typically presents with RUQ or epigastric abdominal pain, nausea, vomiting, and fever. Pain may radiate to the right shoulder, scapula, or between shoulder blades.) Points Received: 1.25 of 1.25 Comments: Question 65. Question : 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? Student Answer: Interprofessional (Incorrect! Barriers include provider—patient, internal to the APRN, organizational / environmental, and interprofessional. This example describes a patient—provider relationship related to compliance.) Patient-provider (Correct! Barriers include provider—patient, internal to the APRN, organizational / environmental, and interprofessional. This example describes a patient—provider relationship related to compliance.) Internal to the APN (Incorrect! Barriers include provider—patient, internal to the APRN, organizational / environmental, and interprofessional. This example describes a patient—provider relationship related to compliance.) Organizational / Environmental (Incorrect! Barriers include provider—patient, internal to the APRN, organizational / environmental, and interprofessional. This example describes a patient—provider relationship related to compliance.) Points Received: 0 of 1.25 Comments: Question 66. Question : 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? Student Answer: Agency for Health Care Research and Quality (Incorrect!) National Institutes of Health (Incorrect!) Centers for Disease Control and Prevention (Correct!) Institute of Medicine (Incorrect!) Points Received: 1.25 of 1.25 Comments: Question 67. Question : 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: Student Answer: dietary deficiency of vitamin B12 (Incorrect! Pernicious anemia is the body’s inability to absorb vitamin B-12 due to deficiency in intrinsic factor which is secreted by parietal cells of the gastric mucosa. a.dietary deficiency of vitamin B12) deficiency of intrinsic factor production (Correct! Pernicious anemia is the body’s inability to absorb vitamin B-12 due to deficiency in intrinsic factor which is secreted by parietal cells of the gastric mucosa. a.dietary deficiency of vitamin B12) red blood cell enzyme deficiency (Incorrect! Pernicious anemia is the body’s inability to absorb vitamin B-12 due to deficiency in intrinsic factor which is secreted by parietal cells of the gastric mucosa. a.dietary deficiency of vitamin B12) multiple micronutrient deficiencies (Incorrect! Pernicious anemia is the body’s inability to absorb vitamin B-12 due to deficiency in intrinsic factor which is secreted by parietal cells of the gastric mucosa. a.dietary deficiency of vitamin B12) Points Received: 0 of 1.25 Comments: Question 68. Question : The central competency, direct clinical practice, is characterized by which three of the following? Student Answer: Uniform approach to health management (Incorrect! Directly form text: holistic practice, formation of therapeutic partnerships with patients, expert clinical performance, use of reflective practice, use of evidence based practice as guide, use of diverse approaches and interventions to health and illness management.) Expert clinical performance (Correct! Directly form text: holistic practice, formation of therapeutic partnerships with patients, expert clinical performance, use of reflective practice, use of evidence based practice as guide, use of diverse approaches and interventions to health and illness management.) Formation of a therapeutic partnership with patients (Correct! Directly form text: holistic practice, formation of therapeutic partnerships with patients, expert clinical performance, use of reflective practice, use of evidence based practice as guide, use of diverse approaches and interventions to health and illness management.) Holistic approach (Correct! Directly form text: holistic practice, formation of therapeutic partnerships with patients, expert clinical performance, use of reflective practice, use of evidence based practice as guide, use of diverse approaches and interventions to health and illness management.) Direct physician supervision (Incorrect! Directly form text: holistic practice, formation of therapeutic partnerships with patients, expert clinical performance, use of reflective practice, use of evidence based practice as guide, use of diverse approaches and interventions to health and illness management.) Points Received: 0.75 of 1.25 Comments: Question 69. Question : To meet Medicare’s coverage requirements, the Nurse Practitioner’s services must be: Student Answer: Provided subject to state restrictions and supervision requirements (Correct! Although Medicare is a federal program, it is governed by state regulations. Nurse practitioner can be independent providers, can be in any clinic setting, and can bill independently.) Provided under direct supervision (Incorrect! Although Medicare is a federal program, it is governed by state regulations. Nurse practitioner can be independent providers, can be in any clinic setting, and can bill independently.) Provided in a rural health clinic or federally qualified health center (Incorrect! Although Medicare is a federal program, it is governed by state regulations. Nurse practitioner can be independent providers, can be in any clinic setting, and can bill independently.) Billed through a physician-directed clinic, heath agency or hospital (Incorrect! Although Medicare is a federal program, it is governed by state regulations. Nurse practitioner can be independent providers, can be in any clinic setting, and can bill independently.) Points Received: 0 of 1.25 Comments: Question 70. Question : Which three primary criteria for advanced practice nursing are identified in Hamric’s Integrative Model of Advanced Practice Nursing? Student Answer: Guidance (Correct! As represented in the center of Hamric’s model, graduate education, certification, and patient focused practice describes the primary criteria of all advance practice nurses.) Graduate education (Correct! As represented in the center of Hamric’s model, graduate education, certification, and patient focused practice describes the primary criteria of all advance practice nurses.) Patient-focused practice (Correct! As represented in the center of Hamric’s model, graduate education, certification, and patient focused practice describes the primary criteria of all advance practice nurses.) Certification (Correct! As represented in the center of Hamric’s model, graduate education, certification, and patient focused practice describes the primary criteria of all advance practice nurses.) Ethical decision-making (Incorrect! As represented in the center of Hamric’s model, graduate education, certification, and patient focused practice describes the primary criteria of all advance practice nurses.) Points Received: 1 of 1.25 Comments: Question 71. Question : 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? Student Answer: Role transition (Incorrect! Role Incongruity—incompatibility between skills and abilities, personal values, self- concept, and obligations. Her scope, patient foci, and setting are changing and unclear as she is an adult NP who is being asked to transition to a school based primary care site. She is unable to see children per her certification) Role incongruity (Correct! Role Incongruity—incompatibility between skills and abilities, personal values, self- concept, and obligations. Her scope, patient foci, and setting are changing and unclear as she is an adult NP who is being asked to transition to a school based primary care site. She is unable to see children per her certification) Role ambiguity (Incorrect! Role Incongruity—incompatibility between skills and abilities, personal values, self- concept, and obligations. Her scope, patient foci, and setting are changing and unclear as she is an adult NP who is being asked to transition to a school based primary care site. She is unable to see children per her certification) Role stress (Incorrect! Role Incongruity—incompatibility between skills and abilities, personal values, self- concept, and obligations. Her scope, patient foci, and setting are changing and unclear as she is an adult NP who is being asked to transition to a school based primary care site. She is unable to see children per her certification) Points Received: 0 of 1.25 Comments: Question 72. Question : Which payment system seeks Medicare reimbursement under the MACRA legislation for providing high quality patient-specific care and improved outcomes? Student Answer: Accountable Care Organization (Incorrect!) Advanced Payment Models (Incorrect!) Merit Incentive Based Payment (Correct!) Bundle Payment Programs (Incorrect!) Points Received: 1.25 of 1.25 Comments: Question 73. Question : 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? Student Answer: Restorative subsystem (Incorrect! Dependency subsystem promotes helping or nurturing behaviors, its consequences include, approval, recognition, and physical assistance) Aggressive protective subsystem (Incorrect! Dependency subsystem promotes helping or nurturing behaviors, its consequences include, approval, recognition, and physical assistance) Dependency subsystem (Correct! Dependency subsystem promotes helping or nurturing behaviors, its consequences include, approval, recognition, and physical assistance) Affiliative protective subsystem (Incorrect! Dependency subsystem promotes helping or nurturing behaviors, its consequences include, approval, recognition, and physical assistance) Points Received: 1.25 of 1.25 Comments: Question 74. Question : 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? Student Answer: Restrictive (Incorrect! Emphysema is a form of obstructive pulmonary disease.) Obstructive (Correct! Emphysema is a form of obstructive pulmonary disease.) Pleuritic (Incorrect! Emphysema is a form of obstructive pulmonary disease.) Atelectatic (Incorrect! Emphysema is a form of obstructive pulmonary disease.) Points Received: 1.25 of 1.25 Comments: Question 75. Question : Which statement best reflects King’s theory? Student Answer: The coping process responses constitute the outputs of the human adaptive system which are reflected in behaviors. (Incorrect!) A person is a system of behavior characterized by repetitive, predictable, and goal –directed behaviors that strive toward balance. (Incorrect!) Nursing goals are negotiated with the client and taking into account both the client’s and the nurse’s perceptions. (Incorrect!) If nurses with special knowledge and skills communicate appropriate information to clients, mutual goal-setting and goal attainment will occur.(Correct!) Points Received: 0 of 1.25 Comments: Question 76. Question : What are the three major categories of Nola Pender’s Health promotion model? Student Answer: Behavior-specific cognitions and affect (Correct!) Characteristics and experiences (Correct!) Individual health measures (Incorrect!) Behavioral outcomes (Correct!) Points Received: 1.25 of 1.25 Comments: Question 77. Question : Which agency houses the United States Protective and Safety Task Force (USPSTF)? Student Answer: The US Department of Health and Human Services (Incorrect! The Agency for Health, Research and Quality houses the USPSTF.) Centers for Disease Control and Prevention (Incorrect! The Agency for Health, Research and Quality houses the USPSTF.) Agency for Health, Research and Quality (Correct! The Agency for Health, Research and Quality houses the USPSTF.) National Clearing House Guidelines (Incorrect! The Agency for Health, Research and Quality houses the USPSTF.) Points Received: 1.25 of 1.25 Comments: Question 78. Question : 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? Student Answer: Role stress (Correct! Role Stress—a situation of increased role performance demand; Role strain is Role Strain—subjective feelings of frustration, tension, anxiety in response to role demands, Role Conflict—when role expectations are perceived to be mutually exclusive or contradictory, Role Transition—a dynamic process of change over time as new roles are acquired.) Role strain (Incorrect! Role Stress—a situation of increased role performance demand; Role strain is Role Strain—subjective feelings of frustration, tension, anxiety in response to role demands, Role Conflict—when role expectations are perceived to be mutually exclusive or contradictory, Role Transition—a dynamic process of change over time as new roles are acquired.) Role transition (Incorrect! Role Stress—a situation of increased role performance demand; Role strain is Role Strain—subjective feelings of frustration, tension, anxiety in response to role demands, Role Conflict—when role expectations are perceived to be mutually exclusive or contradictory, Role Transition—a dynamic process of change over time as new roles are acquired.) Role conflict (Incorrect! Role Stress—a situation of increased role performance demand; Role strain is Role Strain—subjective feelings of frustration, tension, anxiety in response to role demands, Role Conflict—when role expectations are perceived to be mutually exclusive or contradictory, Role Transition—a dynamic process of change over time as new roles are acquired.) Points Received: 1.25 of 1.25 Comments: Question 79. Question : The advanced practice nurse is examining a client with new onset hypertension. The nurse practitioner recognizes that hypertension may result in significant complications associated with which of following three organs: Student Answer: kidneys (Correct! Hypertension can affect multiple organ systems in the body with significant complications related to the brain, kidneys, and eyes.) liver (Incorrect! Hypertension can affect multiple organ systems in the body with significant complications related to the brain, kidneys, and eyes.) eyes (Correct! Hypertension can affect multiple organ systems in the body with significant complications related to the brain, kidneys, and eyes.) skin (Incorrect! Hypertension can affect multiple organ systems in the body with significant complications related to the brain, kidneys, and eyes.) brain (Correct! Hypertension can affect multiple organ systems in the body with significant complications related to the brain, kidneys, and eyes.) Points Received: 1.25 of 1.25 Comments: Question 80. Question : The term advanced nursing practice (APN) includes nurses who are: Student Answer: Certified APRNs with a minimum of a master’s degree (Correct! According to the consensus model, APNs must obtain graduate education in one of the advanced practice specialties, certification, and licensure.) Graduates of programs in nursing education or a health related field (Incorrect! According to the consensus model, APNs must obtain graduate education in one of the advanced practice specialties, certification, and licensure.) Nurses certified in nursing informatics, nurse administration, policy or public health (Incorrect! According to the consensus model, APNs must obtain graduate education in one of the advanced practice specialties, certification, and licensure.) Registered nurses with specialized post-baccalaureate training (Incorrect! According to the consensus model, APNs must obtain graduate education in one of the advanced practice specialties, certification, and licensure.) Points Received: 1.25 of 1.25 Comments: * Times are displayed in (GMT-05:00) Eastern Time (US & Canada) [Show More]

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