NP Professional Standards & Competencies 3 — Questions and Answers
Question 1: An NP is documenting informed consent for a minor procedure. Which element is NOT required for valid informed consent?
- Description of the procedure
- Disclosure of material risks
- The patient's insurance information (Correct answer)
- Discussion of alternatives
Correct answer: The patient's insurance information
Insurance information is an administrative matter and is not a required component of informed consent, which focuses on clinical information.
Question 2: According to HIPAA, an NP may share a patient's protected health information (PHI) without written authorization for:
- Marketing purposes with a pharmaceutical company
- Treatment, payment, and healthcare operations (Correct answer)
- Employer requests for employee health records
- Media inquiries about a public figure's condition
Correct answer: Treatment, payment, and healthcare operations
HIPAA's TPO exception permits disclosure of PHI for treatment, payment, and healthcare operations without prior written patient authorization.
Question 3: A patient refuses a recommended treatment that the NP believes is necessary. The NP's ethical obligation is to:
- Document the refusal and respect the patient's autonomous decision (Correct answer)
- Obtain a psychiatric consult to assess competency
- Contact family members to override the patient's decision
- Discharge the patient from the practice immediately
Correct answer: Document the refusal and respect the patient's autonomous decision
Respect for autonomy requires that competent patients' refusals be honored; the NP should document and ensure the patient understands the consequences.
Question 4: An NP suspects a colleague is practicing while impaired. The MOST appropriate first action is to:
- Confront the colleague publicly in front of patients
- Report suspicions directly to the state board of nursing
- Follow the institution's chain of command and report to supervisory personnel (Correct answer)
- Document observations and wait to confirm the pattern over several weeks
Correct answer: Follow the institution's chain of command and report to supervisory personnel
Patient safety requires prompt action; the appropriate first step is to report through institutional channels (charge nurse, supervisor, or administrator) immediately.
Question 5: Which organization publishes the document that defines national standards of practice for nurse practitioners?
- American Nurses Association (ANA)
- National Organization of Nurse Practitioner Faculties (NONPF)
- American Association of Nurse Practitioners (AANP)
- Both ANA and AANP collaboratively (Correct answer)
Correct answer: Both ANA and AANP collaboratively
The Nurse Practitioner Core Competencies and standards of practice are shaped collaboratively between ANA (nursing standards) and AANP (NP-specific standards).
Question 6: Cultural humility as an NP professional standard differs from cultural competence in that it:
- Requires mastery of all cultural practices relevant to one's patient population
- Emphasizes ongoing self-reflection and acknowledging power imbalances rather than achieving a fixed state of expertise (Correct answer)
- Is focused solely on language interpretation services
- Is only applicable in underserved community health settings
Correct answer: Emphasizes ongoing self-reflection and acknowledging power imbalances rather than achieving a fixed state of expertise
Cultural humility is a lifelong process of self-reflection and recognizing power dynamics, whereas cultural competence implies achieving a static level of knowledge.
Question 7: Which action by an NP BEST demonstrates the professional standard of 'leadership'?
- Consistently meeting documentation deadlines
- Mentoring a new NP graduate and advocating for policy changes within the institution (Correct answer)
- Maintaining an updated DEA license
- Completing patient satisfaction surveys
Correct answer: Mentoring a new NP graduate and advocating for policy changes within the institution
Leadership competencies include mentoring colleagues and influencing system-level policies that improve patient care and professional practice.
NP Professional Standards & Competencies 3
An NP is documenting informed consent for a minor procedure.
Which element is NOT required for valid informed consent?