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A series of multiple choice questions and answers related to the aprn consensus model, health policy, and quality improvement in nursing practice. It covers topics such as aprn licensure, education requirements, national certification, accreditation, health indicators, the np role's historical development, standards of practice, quality improvement activities, risk management, medicare and medicaid reimbursement, and scope of practice. Valuable for students and professionals seeking to understand the key concepts and principles related to aprn practice and its impact on healthcare.
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Which of the following is congruent with the APRN Consensus Model? A. APRN license occurs at the level of role and population foci B. APRN education programs must be at the doctoral level C. National certification by a recognized APRN certifying body is optional D. Accreditation by the US Department of Education is the minimum requirement for APRN programs
According to the APRN Consensus Model, APRN licensure must occur at the level of role and population foci. The minimum APRN education is at the master's level. APRNs should be nationally certified, and APRN programs should be accredited by a nursing accrediting agency Which of the following leading health indicators from Healthy People 2020 was getting worse at the mid course review? A. Infant deaths B. Child obesity C. Substance abuse
According to the mid-course review of Healthy People 2020, the number of adolescents reporting depressive episodes in the past 12 months is getting worse The NP role was initially established to: A. Reduce the nursing shortage and improve access to care B. Improve working conditions of nurses while improving access to care C. Improve access to care and partially solve physician shortage
care and partially solve physician shortage The first NP role was the PNP. The original support of the PNP role was a "physician extender" to improve access concerns due to the shortage of PCPs
Early NP-related research focused on: A. The response of policy makers to the nursing shortage B. The effectiveness of the NP as a primary caregiver C. An effort to demonstrate quality and effectiveness of NPs
and effectiveness of NPs Early research focused on quality of care, cost-effectiveness, productivity, clinical decision-making skill and role satisfaction of the PNP Standards of practice are: A. Authoritative statements used to measure quality B. Used to measure outcomes but are not authoritative C. Designed for legal purposes
Authoritative statements used to measure quality Standards of practice were described by the ANA as "authoritative statements of the duties that all registered nurses, regardless of role, population or speciality, are expected to perform competently Quality improvement activities include: A. Patient satisfaction surveys only B. Peer review, patient satisfaction surveys and chart audits C. Defining four practice domains
satisfaction surveys and chart audits
performance Standards of practice establish minimum levels of acceptable performance Scope of practice: A. Is identical across the state B. Is determined by the federal government C. Is mandated by the federal government
Scope of practice is based on what is legally allowable in each state according to a state's Nurse Practice Act and varies widely for APRNs across states Medicaid provides health insurance coverage to: A. Certain categories of people whose personal income falls below a certain percentage of the federal poverty level B. Anyone whose personal income falls below the federal poverty level C. Newborns, pregnant women and those older than 65 years whose personal income falls below the federal poverty level
income falls below a certain percentage of the federal poverty level States set individual eligibility criteria for Medicaid within federal minimum standards. The Affordable Care Act of 2010 (PPACA) created a national minimum Medicaid eligibility criterion of 133% of FPL Which children do not meet the federal minimum financial eligibility criteria for Medicaid? A. Infants born to women who already receive Medicaid ("deemed newborns") B. Ages up to 6 years and family income <133% of FPL C. Ages 6-18 years and family income <100% of FPL
family income >133% of FPL Income >133% of FPL exceeds the federal government minimum financial eligibility criteria for Medicaid. States may choose to expand coverage, and all states have done so Medicare reimbursement for services: A. Is not dependent on the patient's income level B. Depends on the patient's income level C. Is not available to APRNs under any circumstances
dependent on the patient's income level Income level does not affect Medicare eligibility Medicare Part A covers: A. Hospitals, SNF, and hospice care B. All medically necessary services C. SNF care only
Medicare Part A covers hospital care, SNF care, nursing home care (but not if only custodial care), hospice and home health services Medicare Part B covers: A. All medically necessary services B. Inpatient hospital care C. Outpatient physician services only
"Incident to" billing is specific only to: A. Medicare and Medicaid B. Medicaid C. Medicare
"Incident to" rules apply only to Medicare billing What is the most important. Aspect of the MACRA of 2015? A. The MACRA shift the fee for service reimbursement payment model to a value based payment plan for Medicare part B providers B. The MACRA eliminates incident to billing for APRNs for Medicare part A C. The MACRA allows 100% reimbursement of the physician fee schedule for all Medicare Part B providers D. The MACRA reduces reimbursement to 85% of the usual physician fee schedule for all Medicare Part
model to a value based payment plan for Medicare part B providers The MACRA of 2015 shifts the fee-for-service reimbursement payment model to a value-based payment plan for Medicare Part B providers Legal authority for APRN practice is granted by: A. Federal law B. Regulations from the US Department of Health and Human Services C. State law and regulations
The scope of practice of APRNs is based on what is legally allowable in each state under its Nurse Practice Act
Malpractice insurance: A. protects an APRN from charges of practicing medicine without a license when they are practicing outside the legal scope of practice B. does not protect an APRN from charges of practicing medicine without a license when they are practicing outside the legal scope of practice C. does not pay for legal defense if the APRN is practicing beyond the legal scope of practice D. is important, but should not be purchase if the facility in which the APRN is employed carries good
without a license when they are practicing outside the legal scope of practice Malpractice insurance does not protect an APRN from charges of practicing medicine without a license if the APRN is practicing outside the legal scope of practice for that state Which of the following is one of the four general core competency domains of interprofessional collaborative practice according to the IECEP? A. Working with individuals of other professions to maintain a climate of mutual respect and shared values B. Maintaining a silo perspective so that all benefit from expert knowledge C. Understanding that hierarchical team-based care is the best care, and therefore teams should be led by physicians
and shared values Working with individuals of other professions describes the values/ethics general core competency for interprofessional collaborative practice. Maintaining a silo perspective means maintaining a limited worldview of one's discipline perspective. Implementing hierarchical team-based care supports a silo perspective. Although the patient is the most important member of the interprofessional team, this is not one of the four competencies described in the IPEC Expert panel report. Certification is: A. A procedure through which the government appraises and grants a certificate to the APRN B. Granted by the individual states
A. Nurses should practice to a limited extent of their education and training as defined by boards of medicine B. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression C. Nurses should be full partners, with physicians and other healthcare professionals, in redesigning health care in the US D. Effective workforce planning and policymaking require better data collection and an improved
education and training as defined by boards of medicine The Future of Nursing report says the opposite, that nurses should practice to the fullest extent of their education and training Which of the following is not congruent with US prescribing laws and nurse practitioners? A. Physician signature on prescriptions written by NP is required in all states B. Controlled substance prescriptions must include the NP's name and DEA number C. As of 1998, all states have approved and/or implemented some degree of prescriptive authority for nurse practitioners D. Pharmacology education within graduate programs and CE is required to maintain authority- specific
by NP is required in all states All answers are true except A. Physician signature on prescriptions written by NPs is not required in all states What is true about the Merit Based Incentive Payment System (MIPS)? A. MIPS allows 100% reimbursement of the physician fee schedule for all Medicare Part B providers B. MIPS applies to providers who bill both Medicare Part A and Part B C. MIPS is one of two Quality Payment Program (QPP) tracks that adjusts clinicians' Medicare Part B reimbursement based on quality and value of care provided
of two Quality Payment Program (QPP) tracks that adjusts clinicians' Medicare Part B reimbursement based on quality and value of care provided The MIPS is one of two payment model tracks of the QPP. The QPP was part of the MACRA of 2015 How many states have enacted the APRN Compact model legislation? A. 32 states B. 3 states C. 11 states
Three states have enacted the APRN Compact If a nurse practitioner bills "incident to" a physician, what is the allowed reimbursement rate for Medicare Part B patients? A. 100% B. 85% C. 75%
When an NP bills "incident to" a physician, the reimbursement rate is 100% of the usual physician fee schedule, and the "incident to" rules must be followed. When the NP bills directly to the NP's NPI number, the rate is 85%. This applies only to Medicare part B reimbursement