Professional Role, Ethics, Health Policy and Evidence-Based Practice Flashcards

A patient with decision-making capacity declines a recommended colonoscopy after a full discussion of risks and benefits. Which ethical principle most directly guides the NP's response?

Answer: Autonomy

Autonomy is the right of a competent patient to make informed decisions about their own care, including refusing recommended treatment. The NP should document the discussion and keep the door open to future care.

Which study design sits at the top of the evidence hierarchy for answering a treatment question?

Answer: Systematic review or meta-analysis of randomized controlled trials

Systematic reviews of RCTs pool the highest-quality interventional evidence and reduce bias. Expert opinion and case reports are at the bottom of the hierarchy.

A screening test has very high sensitivity and the result for a patient is negative. What can the NP conclude?

Answer: The disease is very likely absent (SnNout)

A highly sensitive test has few false negatives, so a negative result helps rule the disease out. This is the 'SnNout' mnemonic.

Which element is essential for valid informed consent?

Answer: Disclosure of risks, benefits, and alternatives to a patient with capacity, given voluntarily

Valid consent requires capacity, adequate disclosure of risks, benefits, and alternatives, comprehension, and voluntariness. A signature alone does not establish informed consent.

In a study, a p-value of 0.03 with alpha set at 0.05 means what?

Answer: The result is statistically significant, and the null hypothesis is rejected

When p is less than alpha, the result is statistically significant and the null hypothesis is rejected. Rejecting a true null hypothesis is a Type I error. A p-value does not show clinical importance or the probability that the treatment works.

What does 'full practice authority' mean for a nurse practitioner?

Answer: The NP can evaluate, diagnose, order tests, and prescribe independently, without physician supervision or a collaborative agreement

Full practice authority is granted at the state level. It lets NPs practice to the full extent of their education and certification without mandated physician oversight. Restricted and reduced practice states require supervision or collaboration.