professional

Question 1

The obligation to help the patient—to remove harm, prevent harm, and promote good (“do no harm”). Acting in the patient’s best interest. Compassionate patient care. The core principle in patient advocacy. Examples:

Educating patient with a new prescription about how to take the medication
Encouraging a patient to stop smoking and enroll in smoking cessation program
Prescribing or advocating for effective postoperative pain medication

Answer 1

Beneficience

Question 2

The obligation to avoid harm. Protecting a patient from harm. Example: A patient with osteoporosis wants to be treated with bisphosphonates. The nurse practitioner (NP) advises that the patient is not a good candidate for these drugs because of a past medical history of gastrointestinal (GI) bleeding and peptic ulcer disease (PUD). The NP decides not to prescribe bisphosphonates.

Answer 2

Nonmaleficence

Question 3

The obligation to act in a way that is useful to or benefits the majority.

Answer 3

Utilitarianism

Question 4

The obligation to maintain trust in relationships.

Answer 4

Fidelity

Question 5

describes situations in which one person interferes with or overrules the autonomy of another. In healthcare, it occurs when a provider or family member makes decisions for an elderly patient because they “believe” that it is in the patient’s best interest. The opinion (or desire) of the patient is minimized or ignored. The patient is “powerless.”

Answer 5

Paternalism

Question 6

he obligation to present information honestly and truthfully. In order for patients to make an informed and rational decision about their healthcare, pertinent information (including “bad” news) should not be withheld or omitted. Example: The mammogram result of a 64-year-old female patient is highly indicative of breast cancer. The patient’s adult son does not want his mother to know about the results. The NP has a duty to discuss the mammogram results with the patient and refer her to a breast surgeon.

Answer 6

Veracity

Question 7

A person who acts as an intermediary (or as a liaison) between the patient and an organization (long-term care facilities or nursing homes, hospitals, governmental agencies, courts). The ombudsman investigates and mediates the complaint from both sides and attempts to reach a fair conclusion.

Answer 7

ombudsman

Question 8

An individual who is assigned by a court (and has the legal authority) to act in the best interest of the ward. The ward is usually a person who is a child or someone who is frail or vulnerable. Adults who are incompetent may be assigned a guardian ad litem by the court.

Answer 8

Guardian Ad Litem

Question 9

is the organization that does the processing of claims and administrative work for another company (health insurer, health plan, retirement plan).

Answer 9

What is a Third-party Administrator?

Question 10

NPs receive their “right to practice” from the

Answer 10

state legislature

Question 11

insurance will cover claims only if the NP is still enrolled with the same insurance company at the time the claim is filed in court.

Answer 11

claims based malpractice

Question 12

occurrence type malpractice

Answer 12

will cover a lawsuit in the future even if the NP no longer carries the policy, as long as the NP had an active policy during the alleged incident.

Question 13

Tail coverage insurance will cover the NP for malpractice claims that

Answer 13

claims that may be filed against them in the future.

Question 14

he IRB’s most important role is to

Answer 14

protect the rights of the human subjects enrolled in a study.

Question 15

Assent refers to

Answer 15

minors because they legally cannot give consent

Question 16

Variable that is being manipulated and is used to influence the dependent variable.

Answer 16

independent variable

Question 17

This is the result of the manipulation of the independent variable.

Answer 17

dependent variable

Question 18

mean is the

Answer 18

averagem

Question 19

median is the

Answer 19

number in the middle

Question 20

N is the

Answer 20

total number of subjects This letter indicates the total size of the population.

Question 21

n is the

Answer 21

subgroup the number of subjects in the subpopulation.

Question 22

Ability of a screening test to correctly identify a person with the disease.

Answer 22

sensitivity

Question 23

Ability of a screening test to correctly identify a person without the disease.

Answer 23

specificity

Question 24

Immunity to a disease developed either through vaccination or by infection.

Answer 24

active immunity

Question 25

Immunity to a disease after receiving antibodies (immunoglobins) from another host. Example: Colostrum from breastfeeding gives the neonate antibodies from the mother.

Answer 25

passive immunity

Question 26

A baseline level of a particular disease in a population.

Answer 26

endemic

Question 27

Rapid increase of a disease in a population that involves a large number of people.

Answer 27

epidemic

Question 28

Gender symbols

Answer 28

Gender Symbol Description
Healthy male □ Empty square
Diseased male ■ Filled square
Healthy female ○ Empty circle
Diseased female ● Filled circle
Death ⧄ Diagonal dash across a symbol

Question 29

The oncology nurse practitioner (NP) sees a new patient who is 85 years old. The patient is recently diagnosed with stage 4 metastatic cancer and speaks only Farsi. The NP calls for a certified medical Farsi interpreter to interpret during the office visit. The patient’s adult child states that the interpreter is not needed and that they are capable of interpreting correctly for their parent. The NP’s commitment to using a certified medical translator is most closely related to which ethical concept?

A.Veracity
B.Nonmaleficence
C.Beneficence
D.Justice

Answer 29

Answer: A. Veracity

The NP has an obligation to use the certified medical translator to ensure that the diagnosis and treatment plan are communicated truthfully to the patient in a manner they can understand. Veracity is the NP’s responsibility to present information truthfully and honestly. Nonmaleficence is the obligation to protect the patient from harm. Beneficence is the obligation to promote good and act in the patient’s best interest. Justice is the duty to act fairly and without bias.

Question 30

Meta analysis is the fist/systemic review

Answer 30

top reviews

Question 31

levels of evidence

Answer 31

1 meta analysis
2 controls
3 editorials - opinion

Question 32

quasi experimental

Answer 32

no random

Question 33

random control

Answer 33

placebo get but random

Question 34

validity is the

Answer 34

actual accuracy of adult

Question 35

autosomal dominant

Answer 35

50 percent chance

Question 36

autosomal receptive

Answer 36

requ both parents to be carriers child has a 25% having illness

Question 37

social hx ask about

Answer 37

relationship, sexual, live with, education, alchol , employed, social support , exercise

Question 38

medicaid is funded at

Answer 38

federal and state

Question 39

Hitech act

Answer 39

mandated that we all have Electronic medical records

Question 40

COBRA

Answer 40

allows pt to have access to healthcare when left job same insurance

Question 41

health belief model

Answer 41

person will change health due to possible risk in health

Question 42

Transitional model is to

Answer 42

prevent readmission to hospitals

Question 43

The nurse practitioner is participating in a research study group. She is examining data from multiple studies about the same topic. Which of the following types of research is this?

Incorrect

A.
Randomized control trials

B.
Editorials

C.
Case studies

D.
Meta-analysis

Answer 43

The correct answer is meta-analysis. Meta-analysis and systematic reviews are the highest tier of evidence in research. These are the reviews that put together multiple studies that have already been done. The second tier is all the “c’s” like case studies, cohorts, and cross studies, and finally editorials or opinion pieces are the lowest tier of evidence.

Question 44

what organization requires NPI numbers for NP’s

Answer 44

The balanced budge act

Question 45

Which organization has established standards that help the nurse practitioner determine which clinical actions fall under the scope of nursing practice?

A.American Nurses Association
B.National League for Nursing
C.International Council of Nurses
D.National Council of State Boards of Nursing

Answer 45

American Nurses Association.

The American Nurses Association (ANA) has established standards of clinical nursing practice that define the specific and unique activities of nurses. Standards serve as protection for the nurse, the client, and the institution where healthcare is given. The National Council of State Boards of Nursing has nurse practice acts, which define state-specific guidelines for nurses to practice. The National League for Nursing is a national organization for faculty nurses and leaders in nurse education. The International Council of Nurses is a federation of more than 130 national nurses associations.

Question 46

Nurse practitioners and clinical nurse specialists derive their legal right to practice from:

A.The nurse practice act in the state where they practice
B.The laws of the state where they practice
C.The Medicare statute
D.The board of nursing in the state where they practice

Answer 46

Answer: A. The nurse practice act in the state where they practice

The nurse practice act is a statute enacted by the legislature of each state. The act delineates the legal scope of the practice of nursing within the geographic boundaries of the jurisdiction. The purpose of the act is to protect the public. The state board of nursing is the agency that enforces the nurse practice act. The Medicare statute provides the funds for paying for health services for those age 65 years and older.

Question 47

A 78-year-old patient with advanced heart failure has a document that outlines their specific wishes regarding life-sustaining treatments, including preferences about cardiopulmonary resuscitation (CPR), mechanical ventilation, and artificial nutrition. This document, signed by both the patient and their physician, provides medical orders to guide the healthcare team in accordance with these wishes. Which term best describes this document?

A.Living will
B.Durable power of attorney for healthcare
C.Do not resuscitate (DNR) order
D.Physician Orders for Life Sustaining Treatment (POLS

Answer 47

Answer: D. Physician Orders for Life Sustaining Treatment (POLST)

A POLST is a medical order that outlines a patient’s preferences regarding treatments at the end of life. It is signed by both the patient (or their surrogate) and the physician, and it provides specific instructions about life-sustaining treatments. A living will is a legal document that outlines a person’s wishes regarding medical treatments if they become unable to communicate their decisions, but it does not take the form of a physician’s order. Durable power of attorney for healthcare designates another person (an agent or proxy) to make healthcare decisions on behalf of the patient if they become incapacitated. It does not provide specific medical orders like the POLST. A DNR is a medical order that states that no attempts should be made to revive a patient if they stop breathing or if their heart stops beating. While it is a specific medical order, it does not encompass the broader range of treatment preferences that a POLST does.

Question 48

Which type of leader shares decisions and activities with group participants?

A.Democratic
B.Authoritarian
C.Laissez-faire
D.Situational

Answer 48

Answer: A. Democratic

Democratic leadership is characterized by equality among the leader and other participants. Decisions and activities are shared. Authoritarian leadership, also known as autocratic leadership, is a leadership style characterized by individual control over all decisions and little input from group members. Laissez-faire leadership, also known as delegative leadership, is a type of leadership style in which leaders are hands-off and allow group members to make the decisions. Situational leadership is not based on a specific skill of the leader; instead, the leader modifies the style of management to suit the requirements of the organization.

Question 49

According to evidence-based medicine (EBM) experts, which of the following types of research provides the highest level of evidence?

A.Meta-analysis
B.Randomized controlled trial (RCT)
C.Cohort study
D.Expert opinion

Answer 49

Answer: A. Meta-analysis

Meta-analyses and systematic reviews offer the highest level of evidence. The ranking of types of research is as follows: (1) meta-analysis, (2) RCT, (3) cohort study, and (4) expert opinion.

Question 51

Which of the following definitions describes the term “epidemic”?

A.Rapid increase of a disease in a population that involves a large number of people
B.Resistance to a disease in a large number of people in a population
C.Baseline level of a particular disease in a population
D.Rapid increase of a disease that occurs over a very large area (several countries or continents)

Answer 51

Answer: A. Rapid increase of a disease in a population that involves a large number of people

Epidemic is the rapid increase of a disease in a population that involves a large number of people. A pandemic is the rapid increase of a disease (epidemic) that occurs over a very large area (several countries or continents). Endemic is the baseline level of a particular disease in a population, and herd immunity is the resistance to a disease in a large number of people in a population.

Question 52

According to evidence-based medicine (EBM) experts, which of the following types of research has the lowest ranking?

A.Randomized controlled trial (RCT)
B.Experimental study
C.Cohort study
D.Editorial

Answer 52

Answer: D. Editorial

Editorials and professional society opinions are considered the lowest level of evidence because they are subjective and not based on research. The ranking of types of research is as follows: (1) RCT, (2) experimental study, (3) cohort study, and (4) editorial.

Question 53

Which type of evidence identifies, selects, and analyzes multiple research articles concerning a health condition, disease, or other health-related topic?

A.Meta-analysis
B.Cohort study
C.Systematic review
D.Case series

Answer 53

Answer: C. Systematic review

A systematic review is a literature review that identifies, selects, and analyzes multiple research articles concerning a health condition, disease, or other health-related topic. A meta-analysis is a statistical method that combines data from multiple studies (systematic review), resulting in higher statistical power and a single conclusion. A case series is a collection of case reports (a case report is the report of one patient with a disease or an unusual condition) that features multiple individuals who are given similar treatment. A cohort study is used to investigate risk factors and causes of disease. An example of a cohort study is the Framingham Study.

Question 54

Which of the following definitions describes the term specificity?

A.Ability of a screening test to correctly identify a person with a disease
B.Probability that a person with a negative test result does not have the disease
C.Degree of certainty in a sampling method
D.Ability of a screening test to correctly identify a person without a disease

Answer 54

Answer: D. Ability of a screening test to correctly identify a person without a disease

Specificity measures the ability of a screening test to correctly identify a person without a disease. It is often confused with sensitivity, which measures the ability of a screening test to correctly identify a person with a disease. Negative predictive value is the probability that a person with a negative test result does not have the disease, and confidence interval measures the degree of certainty in a sampling method.

Question 55

What is the best description of a variable?

A.It is an important part of every research study.
B.It is the probability that a factor is important for the research data.
C.It is the value or number that occurs the most frequently.
D.It is a condition, characteristic, or factor that is being measured.

Answer 55

Answer: D. It is a condition, characteristic, or factor that is being measured.

A variable is a condition, characteristic, or factor that is being measured. An independent variable is the one being manipulated that is not affected by the others. A dependent variable changes depending on the manipulation of the independent variable.

Question 56

The research symbol that is used to indicate the “total population” in a research study is:

A.n
B.N
C.P
D.α

Answer 56

Answer: B. N

The correct symbol to indicate the total number of subjects in a study (total population) is N. For example, if a research study has a total number of subjects or total population of 100, then N = 100. The lower-case letter n is used to indicate a subpopulation. For example, if a study uses a total population of N = 100 that is divided into two groups of 50 subjects, then n = 50. The letter p is used to indicate p-value. The symbol α denotes the significance level.

Question 57

Which of the following is an example of how the “utilitarian” principle is applied?

A.Helping a patient decide among the various types of treatment that are available for their condition
B.Using limited financial resources for programs that help the most people and have the lowest possible negative outcomes
C.Minimizing the possible poor outcomes when offering treatment choices to a patient
D.Being more careful when using healthcare financial resources for any purpose

Answer 57

Answer: B. Using limited financial resources for programs that help the most people and have the lowest possible negative outcomes

Generally, the utilitarian principle refers to societal programs that will affect or benefit the largest number of people in a positive manner. It is not used to refer to an individual person.

Question 58

The oncology nurse practitioner (NP) sees a new patient who is 85 years old. The patient is recently diagnosed with stage 4 metastatic cancer and speaks only Farsi. The NP calls for a certified medical Farsi interpreter to interpret during the office visit. The patient’s adult child states that the interpreter is not needed and that they are capable of interpreting correctly for their parent. The NP’s commitment to using a certified medical translator is most closely related to which ethical concept?

A.Veracity
B.Nonmaleficence
C.Beneficence
D.Justice

Answer 58

Answer: A. Veracity

The NP has an obligation to use the certified medical translator to ensure that the diagnosis and treatment plan are communicated truthfully to the patient in a manner they can understand. Veracity is the NP’s responsibility to present information truthfully and honestly. Nonmaleficence is the obligation to protect the patient from harm. Beneficence is the obligation to promote good and act in the patient’s best interest. Justice is the duty to act fairly and without bias.

Question 59

An 83-year-old patient is newly diagnosed with atrial fibrillation with a CHADSVASc score of 2. The patient has a history of multiple gastrointestinal bleeds requiring transfusions, falls with injury, and reports of 6+ alcoholic drinks per day. The nurse practitioner (NP) will have a discussion with the patient about reducing their high bleeding risk before considering starting anticoagulation for stroke prevention. The NP is demonstrating which ethical concept?

A.Justice
B.Nonmaleficence
C.Utilitarianism
D.Confidentiality

Answer 59

Answer: B. Nonmaleficence

Nonmaleficence is the obligation to protect the patient from harm. Starting anticoagulation for stroke prevention in a patient with a high bleeding risk could potentially cause harm. There should be discussion of the risk/benefits with the patient and how to minimize harm before proceeding with anticoagulation. Justice is the duty to act fairly and without bias. Utilitarianism is the obligation to act in a way that benefits the majority. Confidentiality is the obligation to protect the patient’s private health information

Question 60

What is a required provision of the Health Insurance Portability and Accountability Act (HIPAA) signed into law in the United States in 1996?

A.Patients are not allowed to request corrections to their medical records.
B.Healthcare providers have up to 60 days to provide a patient with a copy of their medical records if requested.
C.Mental health providers can refuse to provide patients with a copy of their medical records.
D.Patient consent is not required for a new outside medical office to request medical records.

Answer 60

Answer: C. Mental health providers can refuse to provide patients with a copy of their medical records.

Mental health providers are allowed to refuse a patient access to their medical records, and mental health records require a separate consent form for release of those records. Patients are allowed to correct their medical records, and patient consent is always required to release medical records to a new office. Healthcare providers must provide medical records to the patient within 30 days of the request.

Question 61

Which type of leader shares decisions and activities with group participants?

A.Democratic
B.Authoritarian
C.Laissez-faire
D.Situational

Answer 61

Answer: A. Democratic

Democratic leadership is characterized by equality among the leader and other participants. Decisions and activities are shared. Authoritarian leadership, also known as autocratic leadership, is a leadership style characterized by individual control over all decisions and little input from group members. Laissez-faire leadership, also known as delegative leadership, is a type of leadership style in which leaders are hands-off and allow group members to make the decisions. Situational leadership is not based on a specific skill of the leader; instead, the leader modifies the style of management to suit the requirements of the organization.

Question 62

Which is a true statement regarding claims-based malpractice insurance policies?

A.If the insurance company’s lawyer finds the nurse practitioner (NP) negligent, it is the NP’s responsibility to pay for the claim.
B.Claims against the NP are covered as long as the NP had an active malpractice policy at the time of the incident.
C.Claims against the NP are usually paid if the NP is found not to be negligent.
D.Claims against the NP are covered if both the incident and the claim happen when the policy is still active.

Answer 62

Answer: D. Claims against the NP are covered if both the incident and the claim happen when the policy is still active.

As long as the NP has been paying the premiums to keep a claims-based policy active, the NP will be covered for any incident that occurs during that time. When the NP stops paying the premiums for a claims-based malpractice insurance policy, it is no longer active.

Question 63

The nurse practitioner is discussing the transmission and patterns of a specific disease with a public health official in the community. The official notes that the disease consistently affects a stable number of individuals in this particular region, without showing significant spikes in cases. The disease is not widespread across countries or globally. What term describes the distribution of this disease?

A.Pandemic
B.Epidemic
C.Endemic
D.Hyperendemic

Answer 63

Answer: C. Endemic

Endemic refers to the consistent presence and/or usual prevalence of a disease or infectious agent in a population within a specific geographic area without importation from outside. The description provided by the public health official points to the disease’s consistent presence in the community, making it endemic. A pandemic relates to an epidemic that has spread over several countries or continents, usually affecting a large number of people. An epidemic is a sudden increase in the number of cases of a disease above what is normally expected in that population in that area. Hyperendemic refers to a disease that is constantly present at a high incidence and/or prevalence rate and affects all groups equally

Question 64

Nurse practitioners and clinical nurse specialists derive their legal right to practice from:

A.The nurse practice act in the state where they practice
B.The laws of the state where they practice
C.The Medicare statute
D.The board of nursing in the state where they practice

Answer 64

Answer: A. The nurse practice act in the state where they practice

The nurse practice act is a statute enacted by the legislature of each state. The act delineates the legal scope of the practice of nursing within the geographic boundaries of the jurisdiction. The purpose of the act is to protect the public. The state board of nursing is the agency that enforces the nurse practice act. The Medicare statute provides the funds for paying for health services for those age 65 years and older.

Question 65

Which organization has established standards that help the nurse practitioner determine which clinical actions fall under the scope of nursing practice?

A.American Nurses Association
B.National League for Nursing
C.International Council of Nurses
D.National Council of State Boards of Nursing

Answer 65

Solution: A

American Nurses Association.

The American Nurses Association (ANA) has established standards of clinical nursing practice that define the specific and unique activities of nurses. Standards serve as protection for the nurse, the client, and the institution where healthcare is given. The National Council of State Boards of Nursing has nurse practice acts, which define state-specific guidelines for nurses to practice. The National League for Nursing is a national organization for faculty nurses and leaders in nurse education. The International Council of Nurses is a federation of more than 130 national nurses associations.

Question 66

A 78-year-old patient with advanced heart failure has a document that outlines their specific wishes regarding life-sustaining treatments, including preferences about cardiopulmonary resuscitation (CPR), mechanical ventilation, and artificial nutrition. This document, signed by both the patient and their physician, provides medical orders to guide the healthcare team in accordance with these wishes. Which term best describes this document?

A.Living will
B.Durable power of attorney for healthcare
C.Do not resuscitate (DNR) order
D.Physician Orders for Life Sustaining Treatment (POLST)

Answer 66

Answer: D. Physician Orders for Life Sustaining Treatment (POLST)

A POLST is a medical order that outlines a patient’s preferences regarding treatments at the end of life. It is signed by both the patient (or their surrogate) and the physician, and it provides specific instructions about life-sustaining treatments. A living will is a legal document that outlines a person’s wishes regarding medical treatments if they become unable to communicate their decisions, but it does not take the form of a physician’s order. Durable power of attorney for healthcare designates another person (an agent or proxy) to make healthcare decisions on behalf of the patient if they become incapacitated. It does not provide specific medical orders like the POLST. A DNR is a medical order that states that no attempts should be made to revive a patient if they stop breathing or if their heart stops beating. While it is a specific medical order, it does not encompass the broader range of treatment preferences that a POLST does.

Question 67

A nurse practitioner is being sued for malpractice in a court of law. What elements must be established to prove that malpractice or negligence has occurred? Select all that apply.

A.Subpar staffing
B.Breach of duty
C.Causation
D.Damages
E.Misrepresentation

Answer 67

Solution: B, C and D

Breach of duty, Causation and Damages.

Elements of liability are duty, breach of duty, causation, and damages. Subpar staffing can contribute to medical errors but is not considered an element of liability. Misrepresentation occurs in fraud.

Question 68

Which of the following statements is correct regarding certification for nurse practitioners?

A.Certification is granted by state boards of nursing.
B.Certification dictates the scope of practice within the United States.
C.Certification grants the ability to practice within a state.
D.Certification is obtained through a nongovernmental entity

Answer 68

Answer: D. Certification is obtained through a nongovernmental entity.

Certification is obtained through a nongovernmental entity such as a professional nursing association or specialty organization. State boards of nursing have the power to license and discipline nurses, but not to grant nurse practitioner certifications. While scope of practice is heavily influenced by the specific certification, scope within each state is ultimately dictated by state legislatures through state nurse practice acts. The right to practice is obtained through licensure, not through certification.

Question 69

The nurse practitioner is reviewing a research article to determine if a new hypertension medication has a statistically significant effect on lowering blood pressure. In the study, the term “p-value” is frequently mentioned. What does a p-value primarily indicate in the context of this research?

A.Probability that the observed results are due to chance alone
B.Percentage of patients who benefited from the medication
C.Average reduction in blood pressure among study participants
D.Number of participants in the study

Answer 69

Answer: A. Probability that the observed results are due to chance alone

A p-value in research primarily indicates the probability that the observed results, or more extreme results, are due to chance alone. In other words, it provides a measure of evidence against a null hypothesis. If the p-value is below a predetermined threshold (often 0.05), the effect is considered statistically significant. Depending on the context of the study, an upper-case or lower-case N can be used to represent the number of participants in a study. In this specific scenario, the researchers may have assigned variables to represent reduction in blood pressure and percentage of patients, but there are no standard statistical variables to represent those elements.

Question 70

Which statement is true regarding a medical malpractice trial?

A.The plaintiff claims that injury or damage could have resulted from malpractice.
B.The discovery phase determines damages after judgment is given.
C.The defendant has the burden of proof.
D.The plaintiff must prove that a breach of duty occurred.

Answer 70

Answer: D. The plaintiff must prove that a breach of duty occurred.

In a malpractice trial, the plaintiff must prove that a breach of duty occurred and that the direct outcome was injury and damage. The potential for injury is insufficient. The discovery phase, which includes the gathering of evidence and expert opinion, occurs after the lawsuit is filed but before the trial. The burden of proof lies with the plaintiff, not with the defendant.