Joel essentials in role development

Social deterrents to health - Ethical Considerations - Culture Care Theory

.Principle of justice- Fair and equitable access to high-quality health-care services • Integration of cultural competence into all care roles .Culturally congruent care to patients from diverse populations • Both universal and culture-specific care patterns acknowledged

In the 19th century, which factors led to the administration of anesthesia by nurses? Select all that apply. 1. Surgeon entitlement to collecting anesthesia fees 2. Collaborative practice between physician-anesthetists and nurses 3. Lack of recognition of anesthesiology as a medical specialty 4. Opposition to anesthesia administration by physicians 5. Formation of a national organization by nurse anesthetists

1 & 3 Because of a lack of recognition as a medical specialty and the surgeon's entitlement to collecting anesthesia fees, other physicians had little to no interest in anesthesia administration

The National Council of State Boards of Nursing's Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation prompted gains related to which aspects of the role and function of the nurse practitioner (NP)? Select all that apply. 1. Legal authority 2. Reimbursement 3. Consumer recognition 4. Prescriptive privilege 5. Autonomy

1, 2& 4 The 2008 adoption of the Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation by the National Council of State Boards of Nursing prompted gains related to several aspects of the role and function of the nurse practitioner (NP), including legal authority, reimbursement mechanisms in the United States, and prescriptive privilege.

6. Which of the following describes the historical progression of advanced practice registered nurses' (APRNs') attainment of prescriptive authority? Select all that apply. 1. Standardization of educational programs 2. Lack of primary care in underserved areas 3. Complexity of the federal legislation process 4. Persuasion of legislators and state governors 5. Lack of title recognition in nurse practice acts

1,2,4,5

1. Which activity does the advanced practice nurse (APN) anticipate when completing a doctor of philosophy (PhD) research residency? 1. Literature review in nursing science 2. Participation in quality improvement 3. Presentation at practice conferences 4. Development of capstone with mentors

1. Literature review in nursing science

4. For nurse practitioners (NPs), which issue represents a current barrier to autonomy. 1. Restrictions on reimbursement for services 2. Absence of state-based prescriptive authority 3. Limited ability to serve in acute care settings 4. Lack of authority to manage medical problems

1. Restrictions on reimbursement for services

The beginning of modern nursing is traditionally considered to have begun with which event? 1. Establishment of the first school of nursing 2. Incorporation of midwifery by the lay healer 3. Establishment of the Frontier Nursing Service (FNS) 4. Creation of the American Association of Nurse-Midwives (AANM)

1. Traditionally, modern nursing is considered to have begun in 1873, when the first three U.S. training schools for nurses opened. The role of the lay healer as a midwife is documented to have occurred in the 19th century, before the establishment of schools of nursing. The Frontier Nursing Service (FNS), which provided nurse-midwifery services, was established in 1925. In 1928, the Kentucky State Association of Midwives, which was an outgrowth of the FNS, became the American Association of Nurse-Midwives (AANM).

10. Which action should the advanced practice nurse (APN) avoid when attempting to resolve role strain? 1. Using alcohol to escape stress 2. Taking meditation breaks during a shift 3. Talking with coworkers 4. Voicing opinions at a staff meeting

1. Using alcohol to escape stress

The advanced practice nurse (APN) is experiencing burnout and recognizes the need for self-care. Which action should the APN avoid? 1. Work through stressful situations and then take a break. 2. Plan self-care as seriously as client care. 3. Determine who owns each problem. 4. Examine the quality of peer support.

1. Work through stressful situations and then take a break.

9. The advanced practice nurse (APN) is working with a new nurse. Which action by the nurse does the APN interpret as the social integration phase of resocialization? 1. Working well with others in the profession 2. Mastering skills 3. Integrating values into work setting 4. Displaying competency in routine

1. Working well with others in the profession

Which of the following contributes to the increase in the likelihood of advanced practice registered nurses (APRNs) attaining nationwide prescriptive authority? 1. Quality of care 2. Cost-effectiveness 3. Uniform nurse practice acts 4. Designation as a midlevel practitioner 5. Endorsement of APRN Consensus Model

1.quality of Care 2. Cost - effectiveness 5. Endorsement of APRN Consensus Model- Though totally unfettered authority by all advanced practice registered nurses (APRNs) has not yet been achieved, the experience of prescribing medications for patients under the care of these providers has been found to be safe and beneficial. The practicality, the enhancement of quality of care, and the cost-effectiveness of the practice of these groups has enhanced the logic and desirability of giving prescriptive authority to APRNs nationwide.

9. The doctor of nursing practice (DNP) degree was developed to support the achievement of which goal related to advanced practice nursing education? 1. Eliminating master's degree programs 2. Promoting excellence in clinical practice 3. Replacing doctor of philosophy programs 4. Emphasizing nursing research

2 Promoting excellence in clinical practice

3. In 1910, which factors most significantly influenced the midwifery profession? Select all that apply. 1. Strict licensing requirements 2. Negative public perception 3. Dedicated funding for training 4. Poor maternal-child outcomes 5. Mandatory professional supervision

2. & 4 In 1910, the midwifery profession was significantly influenced by poor maternal-child outcomes and a public perception as unprofessional.

Which consideration led to designation of the nurse practitioner (NP) rather than the clinical nurse specialist (CNS) as the advanced practice nurse (APN) who would deliver care related to psychiatric or mental health services? 1. Level of educational preparation 2. Eligibility for prescriptive authority 3. Ability to serve in community settings 4. Practice based on core competencies

2. A heightened emphasis on a biopsychological approach to treating clients with psychiatric/mental health needs has underscored the importance of prescriptive authority for this advanced practice nursing role.

5. Which changes have contributed to the evolution of the present-day nurse practitioner (NP)'s role? Select all that apply. 1. Focus on delivering care to low-income patients 2.Development of retail patient care clinics 3. Increased access to Medicaid recipients 4. Inclusion of patients from suburban areas 5. Emphasis on serving uninsured immigrants

2. Development of retail patient care clinics 4. Inclusion of patients from suburban areas

3. Which of the following was found to be the most practical formulary for regulating prescriptive authority? 1. Open 2. Exclusionary 3. Collaborative 4. Regulator established

2. Exclusionary formularies were found to be a more practical approach to regulation of prescriptive authority.

The advanced practice nurse (APN) is working in a busy emergency room. Which action can the APN take to reduce role strain? 1. Own the problem and work through it. 2. Find a quiet place to retreat. 3. Focus on helping others. 4. Become more involved in the work environment.

2. Find a quiet place to retreat.

Reorder the steps for changing a state's nurse practice act (first to last). 1. Hearing to give testimony 2. Introduction of legislation 3. Sent to floor of both chambers 4. Referral to committee of jurisdiction 5. Passage through appropriate committees

2. Legislation must be introduced that amends or adds to current law. 4. Once legislation is introduced, it is referred to a committee of jurisdiction (usually a professional licensure committee) for consideration. 1. Once the legislation is in committee, the chair of that committee generally calls for a hearing to allow proponents and opponents of the legislation to give testimony regarding the introduced legislation. 5. After passing through all appropriate committees, the legislation, at the discretion of the majority party leadership, is taken to the floor of the voting chamber for a vote. In some states, proposed legislation must also go through the appropriations committee of at least one of the voting chambers to determine cost and evaluate fiscal impact on the state. 3. After passing through all appropriate committees, the legislation is taken to the floor of the voting chambers. Sometimes this is done simultaneously in both chambers of the state legislature; in others, the legislation passes through one chamber at a time

An advanced practice nurse (APN) consistently identifies each client by the five rights upon every encounter. This behavior is an example of which of the following? 1. First-order change 2. Second-order change 3. Role-making 4. Subrole internalization

2. Second-order change

4. Which action by the advanced practice nurse (APN) demonstrates role-making? 1. Practicing autonomy when working in a busy practice 2. Suggesting a change in treatment to the supervising physician 3. Changing a client's medication to a lower dosage 4. Teaching a client how to self-administer insulin

2. Suggesting a change in treatment to the supervising physician

Nurses working in a Magnet facility have low staff turnover rates and report high job satisfaction, making others aspire to have the longevity in employment experienced by those at the Magnet facility. Which of the following reference groups is this an example of? 1. Evaluative 2. Normative 3. Comparison 4. Audience

3. Comparison

2. Which action should the advanced practice nurse (APN) take to be successful in socialization? 1. Be better at multitasking. 2. Develop a rapport with colleagues. 3. Develop skills in empathic communication. 4. Practice sympathetic listening

3. Develop skills in empathic communication.

1. Which of the following changed the ability of all advanced practice nurses (APNs) to prescribe medications? 1. Risk of harm to patients 2. Lack of a physician on site 3. Nurse practitioner (NP) practice in primary care 4. Interruption of patient flow

3. Nurse practitioner (NP) practice in primary care

Which activity does the advanced practice nurse (APN) complete when participating in a doctor of nursing practice (DNP) residency? 1. Participate in quality improvement 2. Present at research conferences 3. Pilot research projects for dissertation 4. Submit research grant proposals

3. Pilot research projects for dissertation

3. Which type of grant proposal does the advanced practice nurse (APN) submit when completing a doctor of philosophy (PhD) residency? 1. Practice 2. Business 3. Research 4. Leadership

3. research

Which factor contributed to expansion of the role of the clinical nurse specialist (CNS) during the 1960s? 1. Increased numbers of practicing physicians 2. Tightening of female role definitions 3. Return of nurses from military conflict 4. Lack of medical specialization

3. return of nurse veterans from the Vietnam War who sought to increase their knowledge and skills, and to work in advanced roles and nontraditional fields, such as anesthesia and trauma.

7. Differentiation between the role of the clinical nurse specialist (CNS) and the nurse practitioner (NP) is primarily based on which premise? . Designation as an advanced practice nurse 2. Diagnosis of patient health conditions 3. Nature of practice setting environments 4. Authority to prescribe medications

3. the nature of the practice setting. Although the CNS most often practices in a secondary or tertiary care setting, the NP often practices in a primary care setting.

6. The advanced practice nurse (APN) is working with a colleague in a busy surgical center and becomes concerned with the colleague's change in behavior. Which sign indicates that the colleague might be experiencing burnout? 1. Empathic behavior 2. Short attention span 3. Sensitivity 4. Intolerance

4. Intolerance

Which of the following defines the current practice of the acute care nurse practitioner (NP)? 1. Unit-based versus practice-based assignment 2. Participation on a specialty care team 3. Geographical setting 4. Patient population

4. Patient population

2. According to the Consensus Model for APRN Regulation, advanced practice nursing should abide by which recommendation? 1. Emphasizing state-based regulation of advanced practice nursing standards 2. Ensuring regulation of advanced practice registered nurses (APRNs) as a unified, collective group 3. Preparing clinical nurse specialists (CNSs) to function primarily in acute care 4. Changing the population focus of adult nurse practitioners to adult gerontology

4. Per the Consensus Model, the population focus of adult nurse practitioners (NPs) has shifted to adult gerontology. As opposed to emphasizing state-based regulation of advanced practice nursing, broad goals of the Consensus Model include developing more consistent standards for advanced practice nurses (APNs) that promote eligibility for interstate licensure reciprocity. Instead of ensuring regulation of advanced practice registered nurses (APRNs) as a collective group, the Consensus Model recommends regulation of APRNs in one of four accepted roles. The Consensus Model describes the practice of clinical nurse specialists (CNSs) as including both acute and primary care settings.

1.Which change represents the primary impetus for the end of the era of the female lay healer? 1. Perception of health promotion as an obligation 2. Development of a clinical nurse specialist position statement 3. Foundation of the American Association of Nurse-Midwives 4. Emergence of a medical establishment

4. The emergence of a male medical establishment represents the primary impetus for the end of the era of the female lay healer. Whereas lay healers viewed their role as being a function of their community obligations, the emerging medical establishment viewed healing as a commodity. The era of the female lay healer began and ended in the 19th century. The American Association of Nurse-Midwives (AANM) was founded in 1928. The American Nurses Association (ANA) position statement on educational requirements for the clinical nurse specialist (CNS) was developed in 1965; the ANA's position statement on the role of the CNS was issued in 1976.

2. Which of the following has been the main source of barriers limiting advanced practice registered nurses' (APRNs') prescriptive authority? 1. Limitations in state legislation and regulations 2. Concerns about patient safety and quality of care 3. Requirement for Drug Enforcement (DEA) number 4. Organized lobbying by medical organization

4. The majority of barriers to practice have roots in organized lobbying by certain parts of the medical community to limit the autonomy of advanced practice registered nurses (APRNs)

10. Among national nursing leaders, which argument serves as a basis for opposition to the requirement that advanced practice nurses (APNs) earn a doctor of nursing practice (DNP) degree? 1. Greater professionalization is needed among advanced practice nurses. 2. The number of graduate nursing programs should be limited. 3. Advanced practice nursing certification should not require a doctoral degree. 4. The need for care providers should be prioritized.

4. The need for care providers should be prioritized.

4. Which advanced practice nursing role is unique in that the practitioners view their role as comprising a combination of two distinct disciplines? 1. Nurse practitioner 2. Certified registered nurse anesthetist 3. Clinical nurse specialist 4. Certified nurse-midwife

4. The role of the certified nurse-midwife (CNM) is unique in that the CNM views the practice role as combining two disciplines: nursing and midwifery.

5. The advanced practice nurse (APN) is mentoring an APN student. The APN recognizes that the student is having a hard time adjusting to the new role. Which action should the mentor take? 1. Allow the student to work through the process. 2. Listen sympathetically to the student. 3. Refer the student to a colleague with similar experiences. 4. Treat each failure as a learning opportunity.

4. Treat each failure as a learning opportunity.

9. The primary document that supports advance practice registered nurses' (APRNs') unrestricted prescriptive authority and provides recommendations for APRNs' education and certification is _______________.

APRN Consensus Model

The following are: The government is responsible for public health activities• A population-based focus is assumed• Public health addresses relationships between the state and the population• Population-based services are delivered grounded in science• Public health officers have the power to coerce individuals and businesses into actions that protect the health of the population

Characteristics of Public Health Law

1• Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death. 2• Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all. 3• Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all. 4• Promote healthy development, healthy behaviors, and well-being across all life stages. 5• Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all."

Healthy People 2030Overarching Goals•

Foundation U.S. Constitution Treaties and federal statutes Federal regulations State constitutions State statutes State regulations Local authority Common Law

Heirarchy

the legal powers and duties of the state that assure conditions of health for the people and limit the use of state powers to constrain autonomy, privacy, liberty, proprietary, or other legal protected rights"

Public Health Law Definition