Ch 4: Nursing Licensure and Certification

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22. The primary purpose of licensure is protection of the ___________.

public DIF: Knowledge REF: p. 65

16. A nurse is completing the degree requirements for an advanced practice role as a nurse practitioner and is concerned about certification requirements. Which statement concerning certification for advanced practice is true? a. All states require certification for all specialty roles that are identified as advanced practice. b. Nurse anesthetists and nurse-midwives are the only advanced practice role that require certification in the state nurse practice acts. c. Scope of practice remains unclear in state nurse practice acts due to the increasing number of new advanced practice roles. d. Certification is automatic when the nurse applies for an advanced practice license.

A All states require evidence of certification in the specialty area, and many require periods of practice in the specialty prior to awarding certification status. DIF: Comprehension REF: p. 68

8. A nurse who is licensed in Georgia and moves to Oregon: a. must check Oregon's nurse practice act related to licensure for endorsement. b. will automatically be grandfathered in as a licensed registered nurse. c. may request certification in Oregon rather than licensure, so as not to have to retake the NCLEX-RN®. d. should contact the American Nurses Credentialing Center to determine whether he or she is eligible to practice in an another state.

A Endorsement refers to the original program whereby a nurse who is licensed in one state can apply and seek licensure in another without undergoing repeat examination, in accordance with the nurse practice act of that state. DIF: Application REF: p. 68

3. Nurse practice acts: a. are written and passed by legislators. b. cannot be influenced by special interest groups. c. reflect only the concerns of RNs. d. are affected by the practice of dentists.

A Just as other sections of state codes are written and passed by legislators, so is the nurse practice act of each state. DIF: Knowledge REF: p. 69

12. A nurse holds a license in one state but wishes to practice in a second state that is not participating in a nurse licensure compact agreement. The nurse is granted licensure on payment of a fee but does not retake the licensure examination. The nurse obtains licensure in the second state: a. by licensure and by endorsement. b. through mandatory continuing education. c. by the statutory process known as being grandfathered. d. through sunset legislation.

A Licensure by endorsement allows a nurse licensed in one state to obtain licensure to practice in a second state without examination. DIF: Comprehension REF: p. 68

15. Who establishes the "rules" for nursing practice? a. Individual state boards of nursing b. Employer, based on area of practice c. United States Department of Health and Human Services d. Local health officials

A The State Practice Act of each state establishes the rules for practice within that state. DIF: Knowledge REF: pp. 68-69

10. When participating in a nurse licensure compact, the nurse: a. is held responsible for complying with the nursing practice laws in the state where practicing at the time care is rendered. b. must purchase a license in each state but does not retake the licensure examination. c. determines residency based on the state where educated as registered nurse. d. may practice using one license in any state or territory in the United States that recognizes the NCLEX as the source of licensure.

A The nurse is accountable for practicing according to the state practice laws where patient care was provided, although disciplinary action is the responsibility of the state of the nurse's residency. DIF: Knowledge REF: pp. 70-71

13. A nurse practicing in the early 1900s was awarded a permissive license. These licenses: a. were voluntary; however, a nurse who failed the examination could not use the title RN. b. required a maximum of 1 year of formalized nurse training. c. allowed nurses who did not pass the licensure examination to still practice. d. allowed nurses the choice of taking a written or oral licensure examination.

A These permissive licenses permitted but did not require nurses to become registered. DIF: Comprehension REF: p. 65

21. A nursing student is in the final term of an Associate Science of Nursing (ASN) program and is preparing for licensure. Prior to licensure the candidate must provide evidence of: (select all that apply) a. graduation from a nursing program. b. graduation from high school or high school equivalency. c. evidence of current malpractice insurance. d. evidence of plan to continue study to obtain a minimum of a BSN within 2 years. e. validation of skills competence provided by a certifying agency.

A, B Candidates for licensure must provide evidence of graduation through transcripts of course work or letter from the Dean/Director of the nursing program. All candidates must show evidence of graduating from high school or earning a GED. DIF: Comprehension REF: pp. 67-68

20. A group of graduates were just notified that they had successfully passed the licensure examination. During the orientation process at the hospital, one asks, "I am looking at my license, but I don't really know the duties performed by the board of nursing." The staff development nurse explains that the board of nursing: (select all that apply) a. grants nursing licensure. b. constructs the licensure examination. c. assigns disciplinary action when the nurse acts in a manner that results in harm to a patient. d. members are appointed. e. conducts certification examinations for advanced practice nurses.

A, C, D The board of nursing ensures that nursing licenses are granted and renewed. The board of nursing assigns disciplinary action when provisions of the nurse practice act are violated. Members are appointed. DIF: Comprehension REF: pp. 68-69

18. A nurse who wishes to practice in another state: (select all that apply) a. must retake the NCLEX-RN for that state. b. should determine whether the state is a compact state. c. may obtain licensure by endorsement. d. must revoke licensure in the current state because nurses cannot be licensed in more than one state concurrently.

B, C If the state is a member of a compact state, that state has established an agreement with other states under which nurses are permitted to practice within the state without additional licensure. Licensure by endorsement refers to the original program whereby nurses who are licensed in one state seek licensure in another state without repeat examination. DIF: Comprehension REF: p. 68

14. A group of registered nurses with ADN degrees are concerned that the minimum educational standard for licensure as a registered nurse is being raised to the bachelor's (BSN) level. After contacting the American Nurses Association, they learn they will be "grandfathered" in. Under the "grandfather clause," nurses with associate degrees will: a. be required to complete a bridge program to earn a BSN and then be tested only on material that was not part of the ASN curriculum. b. continue to use the title "registered nurse." c. have 10 years to obtain a BSN or the license will be revoked. d. use whatever title is established for associate degree nurses.

B All ASNs licensed before the change would be "grandfathered" in, allowing them to use the title of RN. DIF: Comprehension REF: p. 63

17. Nurses in Tennessee, Mississippi, and Arkansas gather for a conference related to improving quality and safety in practice and nursing education. They are awarded continuing education (CE) credit for participation and evaluation of the conference. One nurse from California states, "I need these CEs to renew my license." The nurse from Mississippi replies, "You do not need CEs for license renewal or advance practice certification renewal." Which statement about CEs would help these nurses? a. All states require proof of continuing education for renewal of license with the number of hours varying. b. The purpose of continuing education is to ensure competence of the workforce after graduation, but each state determines if CEs are required. c. Continuing education is required if nurses work across state lines. d. Initial licensure provides evidence of a minimum safety and competence, so it is illegal for states to require continuing education for renewal of license.

B CE is important to ensure continued competency, and each state determines if CEs are mandatory for renewal and how many units are needed. DIF: Comprehension REF: p. 68

9. When practicing in a compact state: a. the nurse must abide solely by the practice act of the largest state. b. patients' rights in relation to the nurse practice act are protected by the mutual recognition model. c. the nurse must pay for a license in all states that participate in the mutual recognition model. d. the nurse must refer to the nurse practice act for the list of skills that can be performed.

B Nurses who practice in a compact state are responsible for following the laws and regulations of each state in which they practice. DIF: Comprehension REF: pp. 70-71

4. To ensure that nursing legislation is current and is reviewed by specific dates, if a nurse practice act fails to be reviewed, it is automatically rescinded under which law? a. Nurse review act b. Sunset legislation c. Mandatory revocation d. Grandfathering

B Sunset legislation may be included in a state's nurse practice act, and this means that the act must be reviewed by a specific date; if not, it is automatically rescinded. DIF: Comprehension REF: p. 70

5. Current trends in telecommunications and increased mobility of nurses have led to the approval of a mutual recognition model of nursing regulation, in which nurses are allowed to practice in states that are compact states without obtaining a license in each state. On which website would a nurse find a list of current compact states? a. National League for Nursing (NLN) b. National Council of State Boards of Nursing (NCSBN) c. American Association of Colleges of Nursing (AACN) d. Commission on Collegiate Nursing Education (CCNE)

B The NCSBN website contains this information. DIF: Knowledge REF: pp. 70-71

2. The primary purpose of licensure for RNs is to: a. prevent others from using the title nurse. b. demonstrate a specialized body of knowledge. c. protect the public. d. enhance recognition for the profession.

C Protecting the public is one of the essential purposes of the state board of nursing, which regulates licensure. DIF: Knowledge REF: p. 65

1. The advanced practice nurse who is seeking information about requirements for practice in a specialized area should contact the: a. American Nurses Association (ANA). b. National League for Nursing (NLN). c. American Nurses Credentialing Center (ANCC). d. National Council of State Boards of Nursing (NCSBN).

C The nurse should contact the ANCC to determine the education, experience, and examination requirements that must be met if one is to become certified. DIF: Comprehension REF: p. 63 |p. 71

19. Which statements concerning licensure as a registered nurse are correct? (select all that apply) a. Nurses who graduate from different types of nursing education programs are granted different types of licenses, those with a baccalaureate degree having the most expanded role. b. A nursing license cannot be revoked, only suspended. c. Each nurse practice act describes requirements for initial licensure. d. It is illegal for states to ask about the mental or physical status of an applicant. e. Students who graduate in the top 10% of their class are exempt from taking the NCLEX-RN for licensure. f. Candidates for licensure must present proof of graduation as required by the state.

C, F A section of each nurse practice act describes requirements and procedures that are necessary for initial licensure. Candidates for licensure must submit evidence of graduation as defined by each state. DIF: Comprehension REF: pp. 67-68

7. A graduate of a nursing school in the United States plans to practice nursing in Paris, France. To request licensure to practice in Paris, the nurse: a. must contact the Graduates of Foreign Nursing Schools to complete a special examination. b. realizes that education in the United States is so generalized that he or she is eligible to practice in other countries without additional licensure. c. is required to take a language proficiency examination for the primary language of that particular country, as well as a cultural assessment test, prior to licensure. d. should contact the International Council of Nurses or the nursing regulatory board of that country.

D A nurse who is interested in practicing internationally may contact the International Council of Nurses or the nursing regulatory board of the country in which he or she wishes to practice. DIF: Comprehension REF: p. 69

11. A new graduate from a master's entry program in nursing announces, "I just passed my clinical nurse leader certification examination." Certification as a clinical nurse leader: a. is granted by the state board of nursing. b. denotes minimum level of knowledge and skills to practice safely. c. allows independent nursing practice, often in primary care. d. recognizes achievement of advanced skills and knowledge.

D Certification provides validation of achievement of advanced education and competence. DIF: Comprehension REF: p. 71

6. The first field of nursing to certify advanced practitioners was the field of: a. adult nurse practitioners. b. nurse-midwifery. c. clinical nurse specialist. d. nurse anesthesia.

D In 1946, nurse anesthesia became the first field of nursing practice to certify advanced practitioners. DIF: Knowledge REF: pp. 71-72


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