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Nurse Practitioner's Business Practice and Legal Guide 6th Edition Test Bank

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    Nurse Practitioner's Business Practice and Legal Guide 6 th Ed. Testbank / Study Guide Chapter 1 What Is a Nurse Practitioner? 1. Are NPs now considered “prescribers”? ANS. For the purpose of obtaining a DEA number for (ordering) Schedule II, III, IV, V the NP with a furnishing number is considered by the DEA to be a prescriber. 2. Does the NP need a furnishing number issued by the BRN to obtain a DEA number? ANS. Yes, an nurse practitioner furnishing number is required to obtain a DEA number for Schedule II through V Controlled Substances 3. Can a nurse practitioner request and sign for complimentary samples of dangerous drugs and devices from a manufacture’s sales represent ative? ANS. Yes, the certified nurse practitioner and the certified nurse midwife may sign for the request and receipt of complimentary samples of dangerous drugs and devices identified in their standardized procedures or protocol that has been approved b y the physician. 4. May I call myself a nurse practitioner once I have completed my nurse practitioner program? ANS. No. You cannot use the title nurse practitioner until you have been certified by the BRN as a nurse practitioner. Furthermore, registered n urses who use the title NP without BRN certification may subject their RN license to possible discipline. 5. Can a nurse practitioner function in the emergency department? ANS.Yes. Nurse practitioners are permitted to perform consultation and treatment in an emergency department under certain conditions. Section 1317.1 of the Health and Safety Code, relating to emergency services was repealed and amended September 26, 2011, changing definition of emergency service and care to include appropriately licensed persons, nurse practitioners and physician assistants, under the supervision of a physician and surgeon, to include medical screening, examination, and evaluation by a physician, or to the extent permitted by applicable law, by other appropriate personnel (NP&PA) under the supervision of a physician and surgeon, to determine care, treatment, and surgery by physician necessary to relieve or eliminate the emergency medical condition or active labor, within the capability of the facility. 6. What are the roles of a Family Nurse Practitioner? ANS. Family nurse practitioners (FNPs) are graduate - educated, nationally - certified and state licensed advanced practice registered nurses (APRNs) who care for medically stable

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    patients across the lifespan, from infants to geriatric patients. “Family” in this case describes the NP’s chosen patient population focus and denotes national certification through one of two certifying bodies that certify NPs as having the specialized skills necessary to work with this pa tient group: the American Nurses Credentialing Center (AACN) or the American Academy of Nurse Practitioners (AANP).

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    Chapter 2 Legal Nurse Practitioner Scope of Practice 1. What is the nurse practi ti oners scope of practice? ANS. “Nurse practitioners are licensed, independent practitioners who practice in ambulatory, acute and long - term care as primary and/or specialty care providers. Nurse practitioners assess, diagnose, treat, and manage acute episodic and chronic illnesses. Nurse practitioners are experts in health promotion and disease prevention. They order, conduct, supervise, and interpret diagnostic and laboratory tests, prescribe pharmacological agents and non - pharmacologic therapies, as well as teach and co unsel patients, among other services. As licensed, independent clinicians, Nurse practitioners practice autonomously and in coordination with healthcare professionals and other individuals. They may serve as healthcare researchers, interdisciplinary consult ants, and patient advocates. Nurse practitioners provide a wide - range of healthcare services to individuals, families, groups, and communities.” 2. What is the p atient centered nature of an NP? ANS. The patient - centered nature of the NP role requires a career - long commitment to meet the evolving needs of society and advances in health care science. NPs are responsible to the public and adaptable to changes in health care. As leaders in health care, NPs combine the roles of provider, mentor, educator, res earcher, and administrator. NPs take responsibility for continued professional development, involvement in professional organizations, and participation in health policy activities at the local, state, national and international levels. Five decades of res earch affirms that NPs provide safe, high - quality care. 3. What element of education is required to be an NP? ANS. NPs are advanced practice registered nurses who obtain graduate education, post - master’s certificates, and doctoral degrees. Educational prepar ation provides NPs with specialized knowledge and clinical competency which enable them to practice in various health care settings, make differential diagnoses, manage and initiate treatment plans and prescribe medications and treatment. National NP educa tion program accreditation requirements and competency - based standards ensure that NPs are equipped to provide safe, high - quality patient care from the point of graduation. Clinical competency and professional development are hallmarks of NP education. 4. Wha t are the professional roles of a nurse practioner? ANS. Nurse practitioners (NPs) are licensed, independent practitioners who practice in ambulatory, acute and long - term care as primary and/or specialty care providers. Nurse practitioners assess, diagnose , treat, and manage acute episodic and chronic illnesses. NPs are experts in health promotion and disease prevention. They order, conduct, supervise, and interpret diagnostic and laboratory tests, prescribe pharmacological agents and non - pharmacologic ther apies, as well as teach and counsel patients, among other services. As licensed, independent clinicians, NPs practice autonomously and in coordination with health care professionals and other individuals. They may serve as health care researchers,

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    interdis ciplinary consultants, and patient advocates. NPs provide a wide - range of health care services to individuals, families, groups, and communities.

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    Chapter 3 State Regulation of Nurse Practitioner Practice 1. Can nurse practioners practice outside of the United States? ANS. Nurse practitioners and physician assistants can alleviate some of the primary care shortage facing the United States, but their scope - of - practice is limited by state regulation. 2. How are NPs scope of practice specified? ANS. Nurse practitioner scope - of - practice is specified by statute or regulation. In some states, state legislatures enact SOP statutes, and in other states, the board of nursing defines the NP S OP. Regulations and statutes are similarly enforceable. . According to the 2016 AANP National Nurse Practitioner Sample Survey, about 75% of NPs accept new Medicare patients and 77.9% of NPs accept new Medicaid patients, 49.9% of NPs hold hospital privileg es and 11.3% have long term care privileges. Furthermore, NPs hold prescriptive privileges containing controlled substances in 50 states and D.C., 95.8% of NPs prescribe medications, and “those in full - time practice write an average of 23 prescriptions per day” 3. How are NP’s regulated by state? ANS. Depending on the NP practice issue, certain functions of NPs are regulated by state NP SOP regulations and/or federal law. The NP practice issues that come under state regulation are requirements for licensure, scope - of - practice, prescriptive authority, requirement of collaboration or supervision, basis for license suspension, revocation, or nonrenewal, reimbursement under Medicaid, by indemnity insurances, requirements of educational programs, standards of prac tice110. There is also federal regulation of the NP profession and federal law prevails over state law if there is any conflict between state and federal law. Federal regulation entails: care of patients covered by Medicare, Medicaid; billing Medicare; car e of hospitalized patients insofar as participation by hospitals in the Medicare program; care of residents in nursing homes; in - office and hospital laboratories, under the Clinical Laboratory Improvement Amendments; self - referral by healthcare providers, under the Stark Acts; prescription of controlled substances under the Drug Enforcement Administration (DEA); reporting of successful malpractice lawsuits against NPs to the National Practitioner Data Bank; confidentiality of information about patients unde r the Health Insurance Portability and Accountability Act; discrimination in hiring and firing; facility access for disabled people; e - prescribing and electronic medical records

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    Chapter 4 Federal Regulation of the Nurse Practitioner Profession 1. What is practice authority regarding Nurse Pracitoner Profession? ANS.Practice authority is the regulation of the duties a nurse can perform, and under which circumstances. Primarily originating at the state legislative level, this results in a patchwork of different criteria that nurses must meet, varying significantly by geographi cal location. According to the American Association of Nurse Practitioners (AANP), practice authority, by state, falls into three categorie s: full practice, reduced practice, and restricted practice. In a full practice state, nurse practitioners can evaluate and diagnose patients, order and interpret diagnostic tests, initiate and manage treatments, and prescribe medications. In a reduced pra ctice setting, state laws reduce the ability of nurse practitioners to perform at least one element of practice, requiring them to seek a collaborative agreement with an outside health discipline to provide components of patient care. In a restricted setti ng, at least one part of nursing practice is restricted by the state and requires supervision, delegation, or team management to provide patient care. 2. How does the scope of practice relate to federal regulations for NP’s? ANS. The scope of practice acts as a system of regulation and standardization for the nursing community, but instead of relying on physician organizations and state legislatures to det ermine a nurse’s practice authority state by state, groups such as the ANA believe that nurses are competent at determining what tasks nurses can complete. They believe that what nurses are skilled to do in Missouri could easily be the same as what they ar e qualified to do across the border in Iowa. Limited practice authority , as determined by states, can cause talented nurses to take their skills to st ates with broader practice authority, which can, in effect, create a brain drain from restrictive states and negatively impact patient outcomes there. 3. What are rhe goals of the ACA towards primary care? ANS. The goals of the ACA to increase access to pri mary care services are linked to efficient use of NPs as care providers. These goals rely on federal initiatives and reliable funding to support NP training and education as well as models of care where NPs practice. However, the full benefit of federal ef forts may be hampered by restrictions occurring at the state - level, including scope - of - practice barriers. Examining federal policies in tandem with state - level regulations is essential to achieving increased NP workforce supply and improved access to care.

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    Chapter 5 Prescribing 1. Can nurse practioners prescribe medications? ANS. Yes . Nurse practitioners can prescribe medication, including controlled substances, in all 50 states and Washington DC. That said, the degree of independence with which they can prescribe drugs, medical devices (e.g., crutches) or medical services varies by state NP practice authority . 2. What type of education is requir ed for the prescription of medications? ANS. During graduate programs in nursing, NP students undergo extensive education in assessment, diagnosis, and treatment. They take advanced courses in pharmacotherapeutics and complete rigorous patient simulations, as well as supervised clinical hours. They study pharmacokinetics and pharmacodynamics while learning how to safely and effectively prescribe and monitor medication in different patient populations. In sum, NP education and subsequent credentialing prepar es them for full prescriptive authority, but there are still differing regional laws regarding NP autonomy. 3. Can Nurse Practitioners Prescribe Medication Without Physicans? ANS. In 21 states and Washington DC, nurse practitioners have the explicit legal aut hority to prescribe. The application for prescriptive authority may be separate from NP state credentialing, and NPs prescribing controlled substances generally must register with the DEA. In 29 states, NPs can prescribe medication but must have a “collaborative relationship” or “protocol agreement” with a specific, supervising physician. In all 50 states and Washington DC, nurse practitioners can prescribe controlled substances with the appropriate supervision (i.e., collaborative agreement, if req uired) and credentialing.

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