Overview/Description: The final assignment will synthesize what you have discovered about the different advanced practice roles and scope of practice found in the master of nursing curriculum: NP, nurse educator, nurse informaticist, and nurse administrator. You will review all roles and then examine the specialty for which you were admitted, focusing on the scope of practice, core competencies, certification requirements, and legal aspects of practice for that specific role. You will also identify the practice environment and population you will be working with, as well as peers and colleagues. In addition, you will discuss your future leadership role and participation in professional organizations.

Your paper is to be based on current literature, standards of practice, core competencies, and certification bodies for your chosen role. The paper should be 10–12 pages excluding the title and reference, and APA format is required.

Criteria:

• Advanced Practice Roles in Nursing:
  • Compare and contrast the roles of the NP, nurse educator, nurse informaticist, and nurse administrator in advanced practice nursing pertaining to clinical practice, primary care, education, administration, and research.
• Selected Advanced Practice Role:
  • Examine regulatory and legal requirements for the state in which you plan to practice.
  • Describe the professional organizations available for membership based on your selected role.
  • Identify required competencies, including certification requirements for your selected role.
  • Predict the organization and setting, population, and colleagues with whom you plan to work.
• Leadership Attributes of the Advanced Practice Role:
  • Determine your leadership style (http://psychology.about.com/library/quiz/bl-leadershipquiz.htm).
  • Identify leadership attributes you currently possess, and attributes you may need to develop.
  • Determine how to attain and evaluate those missing attributes.
• Health Policy and the Advanced Practice Role
• Visit the Robert Wood Johnson Foundation (http://www.rwjf.org/en/about-rwjf/newsroom/features-and-articles/health-policy.html) and identify a health policy issue.Conduct a review of literature and address the following:
  • Describe the current policy and what needs to change; justify your conclusions with citations from the literature.
  • Provide the process required to make the change with key players and parties of interest.
  • Explain how you could lead the effort to make or influence the change in policy.

QUESTION 1

1. A 51-year-old male is at the health clinic for an annual physical exam. After walking from the car to the clinic, he developed substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting 2 to 3 minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. The nurse suspects he is most likely experiencing:

	a.	Stable angina
	b.	Unstable angina
	c.	Prinzmetal angina
	d.	Myocardial infarction (MI)

1 points   

QUESTION 2

1. An 82-year-old female was admitted to the hospital with confusion and severe hypotension. Her body’s compensatory mechanisms are increased heart rate, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular compartment. What kind of shock does the nurse suspect the patient is experiencing?

	a.	Anaphylactic
	b.	Hypovolemic
	c.	Neurogenic
	d.	Septic

1 points   

QUESTION 3

1. Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension.

	a.	Primary
	b.	Secondary
	c.	Congenital
	d.	Acquired

1 points   

QUESTION 4

1. A 65-year-old male presents for a routine checkup. A blood pressure check reveals a systolic pressure of 160 mm Hg and a diastolic pressure of 70 mm Hg. Which of the following is the most likely cause of this type of pressure elevation?

	a.	Vasospasm
	b.	Rigidity of the aorta
	c.	Decreased sodium intake
	d.	Lung disease

1 points   

QUESTION 5

1. A 65-year-old female presents to the emergency department reporting difficulty swallowing and shortness of breath. A CT scan would most likely reveal an aneurysm in the:

	a.	Cerebral vessels
	b.	Renal arteries
	c.	Inferior vena cava
	d.	Thoracic aorta

1 points   

QUESTION 6

1. A 30-year-old Caucasian female was recently diagnosed with primary hypertension. She reports that she eats fairly well, usually having red meat and potatoes daily. She also reports that her father has hypertension as well. A nurse determines which of the following risk factors is most likely associated with this diagnosis?

	a.	Race
	b.	Diet
	c.	Age
	d.	Genes

1 points   

QUESTION 7

1. While planning care for a patient with superior vena cava syndrome (SVCS), which principle should the nurse remember? SVCS is a progressive _____ of the superior vena cava (SVC) that leads to venous distention of the upper extremities and head.

	a.	Inflammation
	b.	Occlusion
	c.	Distention
	d.	Sclerosis

1 points   

QUESTION 8

1. A 65-year-old male is transported to the ER for chest pain. An electrocardiogram reveals a prolonged QRS interval. What is the nurse monitoring when the nurse observes the QRS complex on the electrocardiogram? The QRS complex reflects:

	a.	Ventricular activity
	b.	Pulmonary artery closure
	c.	Mitral valve opening
	d.	Aortic valve closing

1 points   

QUESTION 9

1. A 32-year-old female presents with lower leg pain, with swelling and redness. While obtaining the patient’s history, which finding could have caused her condition?

	a.	Venous thrombus
	b.	Heart valve damage
	c.	Bacterial infection
	d.	Atherosclerosis

1 points   

QUESTION 10

1. A 50-year-old male visits the cardiologist for an EKG. Results indicate that he has no PR interval and a variable QRS rate with rhythm irregularity. Which of the following is the most likely diagnosis to be recorded on the chart?

	a.	Atrial tachycardia
	b.	Atrial fibrillation
	c.	Sinus dysrhythmia
	d.	Idioventricular rhythm

1 points   

QUESTION 11

1. A 70-year-old female is in the hospital for pelvic fracture. She develops pulmonary thromboembolism. The nurse realizes this embolus is composed of:

	a.	Fat
	b.	Air
	c.	Tissue fragment
	d.	Blood clot

1 points   

QUESTION 12

1. When a nurse checks the patient for orthostatic hypotension, what did the nurse have the patient do?

	a.	Physical exertion
	b.	Eat
	c.	Stand up
	d.	Lie down

1 points   

QUESTION 13

1. When a patient has a massive pulmonary embolism (PE), what complications will the nurse monitor for?

	a.	Damage to the lung microcapillaries
	b.	Chronic obstructive pulmonary disease (COPD)
	c.	Disseminated intravascular coagulation (DIC)
	d.	Shock and death

1 points   

QUESTION 14

1. A 50-year-old male is diagnosed with orthostatic hypotension. Which of the following symptoms would he most likely experience?

	a.	Headache and blurred vision
	b.	Nausea and vomiting
	c.	Chest pain and palpitations
	d.	Syncope and fainting

1 points   

QUESTION 15

1. A 60-year-old male undergoes surgery for a bone fracture. Which of the following nursing measures would be most effective for preventing pulmonary embolism (PE) in this patient?

	a.	Ensure that patient uses supplemental oxygen.
	b.	Prevent deep vein thrombosis formation.
	c.	Check hematocrit and hemoglobin levels frequently during the postoperative period.
	d.	Promote aggressive fluid intake.

1 points   

QUESTION 16

1. A 50-year-old female presents with a low heart rate and low blood pressure. She is given an intravenous (IV) infusion of fluids. The increase in atrial distension results in:

	a.	Renal retention of fluids
	b.	Depressed myocardial contractility
	c.	Release of acetylcholine
	d.	Increased heart rate

1 points   

QUESTION 17

1. A 54-year-old male is diagnosed with left bundle branch block. Which of the following structures would not receive an electrical impulse?

	a.	Atrioventricular (AV) node
	b.	Sinoatrial (SA) node
	c.	Bundle of His
	d.	The left ventricle

1 points   

QUESTION 18

1. What term should the nurse document for a detached blood clot?

	a.	Thrombus
	b.	Atherosclerosis
	c.	Thromboembolus
	d.	Infarction

1 points   

QUESTION 19

1. Which organ should the nurse monitor closely since it is often the first to fail in patients with multiple organ dysfunction syndrome (MODS)?

	a.	Liver
	b.	Heart
	c.	Lungs
	d.	Pancreas

1 points   

QUESTION 20

1. Which condition should cause the nurse to assess for high-output failure in a patient?

	a.	Increase in thiamine
	b.	Hypothyroidism
	c.	Hypovolemia
	d.	Severe anemia

1 points   

QUESTION 21

1. Which of the following findings in the patient with Raynaud disease would indicate a need for further teaching?

	a.	The patient eats bananas twice a day.
	b.	The patient smokes cigarettes.
	c.	The patient wears mittens outside.
	d.	The patient takes calcium channel blockers.

1 points   

QUESTION 22

1. A 5-year-old female is found to have hypertension during three separate visits to her primary care provider. The nurse would expect tests to suggest that the hypertension is secondary to:

	a.	Renal disease
	b.	Brain tumor
	c.	Hypocalcemia
	d.	Hyponatremia

1 points   

QUESTION 23

1. A 50-year-old female received trauma to the chest that caused severe impairment of the primary pacemaker cells of the heart. Which of the following areas received the greatest damage?

	a.	Atrioventricular (AV) node
	b.	Sinoatrial (SA) node
	c.	Bundle of His
	d.	Ventricles

1 points   

QUESTION 24

1. A 28-year-old female presents with severe chest pain and shortness of breath. She is diagnosed with pulmonary embolism, which most likely originated from the:

	a.	Left ventricle
	b.	Systemic arteries
	c.	Deep veins of the leg
	d.	Superficial veins of the arm

1 points   

QUESTION 25

1. A 68-year-old female is experiencing left heart failure. Physical exam reveals elevated blood pressure. The nurse understands this is most likely caused by:

	a.	Sympathetic nervous system compensation for decreased cardiac output
	b.	Stress hormones promoting increased cardiac contractility
	c.	Cardiotoxic effects of catecholamines and angiotensin
	d.	Diastolic dysfunction

1 points   

QUESTION 26

1. A 62-year-old male presents to his primary care provider reporting chest pain at rest and with exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina?

	a.	Unstable
	b.	Stable
	c.	Prinzmetal
	d.	Silent

1 points   

QUESTION 27

1. A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures should the nurse assess for in this patient?

	a.	Right heart failure
	b.	Left heart failure
	c.	Low-output failure
	d.	High-output failure

1 points   

QUESTION 28

1. A 52-year-old male is diagnosed with primary hypertension. He has no other health problems. Present treatment would cause the nurse to anticipate administering which drug to the patient?

	a.	A beta-adrenergic agonist
	b.	An alpha-adrenergic agonist
	c.	A diuretic
	d.	A calcium channel agonist

1 points   

QUESTION 29

1. A 59-year-old female is diagnosed with left ventricular failure. If a decrease in kidney perfusion occurs, the nurse knows this would ultimately cause:

	a.	Decreased left ventricular preload
	b.	Increased pulmonary capillary permeability
	c.	Increased systemic vascular resistance
	d.	Decreased cardiac oxygen demand

1 points   

QUESTION 30

1. A 60-year-old male presents to his primary care provider reporting chest pain. He is diagnosed with atherosclerosis. This disease is caused by:

	a.	Arterial wall thinning and weakening
	b.	Abnormally dilated arteries and veins
	c.	Abnormal thickening and hardening of vessel walls
	d.	Autonomic nervous system imbalances

1 points