Test Content Outline Effective Date: January 29, 2013

Transcription

1 Board Certification Examination There are 200 questions on this examination. Of these, 175 are scored questions and 25 are pretest questions that are not scored. Pretest questions are used to determine how well these questions will perform before they are used on the scored portion of the examination. The pretest questions cannot be distinguished from those that will be scored, so it is important for a candidate to answer all questions. A candidate's score, however, is based solely on the 175 scored questions. Performance on pretest questions does not affect a candidate's score. This Test Content Outline identifies the areas that are included on the examination. The percentage and number of questions in each of the major categories of the scored portion of the examination are also shown. Category Domains of Practice No. of Percent Questions I Foundations of Advanced 58 33% Practice Nursing II Professional Roles 44 25% III Independent Practice 73 42% Total % 1

2 Note: Each item written within the test content outline classifications IA1 IA8 addresses at least one of the age groups noted below 1. Adolescent 13 to 17 years (L4) 4. Middle-Old 75 to 84 years (L7) 2. Adult 18 to 64 years (L5) 5. Oldest-Old 85 years and Older 3. Young-Old 65 to 74 years (L6) (L8) I. Foundations of Advanced Practice Nursing (33%) A. Advanced Pathophysiology 1. Physiology, pathogenesis, clinical manifestations, and etiology of altered physical/psychological health/disease states across the aging continuum 2. Impact of genetics on health states, risk for disease, and clinical management of health disease states across the aging continuum 3. Impact of aging on health states, function, and clinical management of health disease states 4. Differentiating between normal and abnormal physiologic changes associated with development and aging 5. Analyzing the relationship between normal physiology and pathology 6. Analyzing the complex relationships of comorbid pathologies 7. Synthesizing and applying current evidence-based knowledge regarding pathological changes in disease states 8. Analyzing physiologic responses to illness and treatment modalities Note: Each item written within the test content outline classifications IB1 IB6 addresses at least one of the drug agents noted below 1. Antiinfective (D1) 2. Antineoplastic (D2) 3. Cardiovascular (D3) 4. Endocrine (D4) 5. Eye, ear, and skin (D5) 6. Gastrointestinal (D6) 7. Genitourologic/Reproductive (D7) 8. Immunologic (D8) 9. Musculoskeletal/analgesic (D9) 10. Neurologic (D10) 11. Psychiatric (D11) 12. Respiratory (D12) B. Advanced Pharmacology 1. Pharmacotherapeutics, pharmacokinetics, pharmacodynamics, pharmacogenetics of broad categories of drugs 2. Impact of aging on pharmacological regimens 3. Motivations of patients for seeking prescriptions and willingness to adhere to prescribed regimens 4. Potential barriers for patient adherence to prescribed regimens 5. Drug side effects and interactions (e.g., drug-drug interactions, drug-food interactions, adverse effects) 2

3 6. Analyzing the relationship between pharmacological agents and physiologic/pathologic responses Note: Each item written within the test content outline classifications IC1 IC7 addresses at least one of the body systems noted below 1. Head, eyes, ears, nose, and throat 7. Neurological (including (B1) psychiatric) (B7) 2. Respiratory (B2) 8. Endocrine (B8) 3. Cardiovascular (B3) 9. Hematopoietic (B9) 4. Gastrointestinal (B4) 10. Immune (B10) 5. Genitourinary/Reproductive (B5) 11. Integumentary (B11) 6. Musculoskeletal (B6) C. Advanced Physical Health Assessment 1. Components of history, physical, and psychosocial assessments across the aging continuum (individuals, family, and communities; including development, life stages) 2. Signs and symptoms of common physical and psychological illnesses 3. Age-appropriate examination considerations 4. Developing a comprehensive database, including developmental/functional assessment, comprehensive or problem-focused health history, comprehensive or problem-focused physical examination, and appropriate testing 5. Correlating assessment findings with underlying pathology or physiologic changes across the aging continuum 6. Conducting a risk assessment of the patient, including the assessment of development, genetic, behavioral, lifestyle, and other risk factors, including abuse/neglect, exposure to violence, and traumatic events 7. Evaluating the patient s ability to function in societal roles (e.g., employee, parent, student) D. Theories and Frameworks 1. Theories and frameworks relevant to the adult-gerontology primary care nurse practitioner (e.g., theories of development and aging, nursing conceptual models) 2. Integrating theories and frameworks to guide advanced nursing care (individual, families, and communities) 3

4 E. Clinical Prevention and Population Health 1. Health promotion and population-based health policy 2. Environmental, global, and social determinants of health 3. Epidemiology 4. Designing and delivering clinical prevention interventions and strategies (e.g., immunizations, disaster preparedness, health screenings) 5. Evaluating the effectiveness of clinical prevention interventions 6. Advocating for equitable and efficient prevention services and populationbased health policies (e.g., frailty, underserved populations, other vulnerable populations) F. Management for Diverse Populations 1. Cultural competencies (including common beliefs, values, practices, and behaviors shared by subgroups or individuals that influence the meaning of their health and health-related behaviors) 2. Influence of aging, socioeconomic status, culture, gender, ethnicity, and spirituality on the mental and physical health of the individual and family in various health care settings 3. Patient-centered care 4. Incorporating individual, cultural, ethnic, and spiritual preferences, values, and beliefs into health care in a non-biased and respectful manner II. Professional Roles (25%) A. Translational Science/Evidence-Based Practice 1. Research process 2. Evidence-based practice 3. Integrating evidence, clinical judgment, research, and inter-professional perspectives using translational processes to improve patient outcomes and practice 4. Critiquing meaningful evidence for practice (including identifying gaps in evidence for practice, determining cultural relevance, patterns of behavior, and outcomes) 5. Applying clinical investigative skills to practice 6. Disseminating evidence from inquiry to diverse audiences using multiple modalities 4

5 B. Legal and Ethical Issues/Scope and Standards/Regulation 1. Ethical and legal issues (e.g., informed consent/assent, guardianship, decisional capacity, surrogate decision-making, patient privacy, confidentiality, research participation, advance care planning, accountability) 2. Role, scope, and standards of the adult-gerontology primary care nurse practitioner 3. Concepts and principles associated with bioethics 4. Identifying and referring situations beyond scope of practice 5. Complying with regulatory guidelines (e.g., reimbursement regulations; reporting of communicable disease, abuse/neglect; Health Insurance Portability and Accountability Act [HIPAA]) 6. Applying ethical principles to issues related to the care of patients, populations, and systems 7. Evaluating the ethical consequences of decisions C. Quality Improvement and Safety 1. Methods, tools, performances measures, quality improvement models, culture of safety principles, and standards related to quality 2. Monitoring, analyzing, and prioritizing outcomes to improve quality of clinical practice 3. Identifying actual or potential failures in processes and systems that lead to breakdowns and errors 4. Implementing quality improvement initiatives (including peer review, safety, error reduction, self-monitoring, use of technology) D. Leadership, Advocacy, and Inter-Professional Communication and Collaboration 1. Leadership concepts, including interdisciplinary communication, collaboration, and coordination (e.g., group dynamics, negotiation, conflict resolution, safe and healthy work environments, team building, mentoring) 2. Communicating (orally or in writing) and collaborating with other professionals to manage and coordinate patient-centered care across systems (e.g., multidisciplinary teams, integration of care, transitions of care, medical home, documentation) 3. Developing and implementing innovations incorporating principles of change 4. Advocating for the needs of patients and their families 5

6 5. Advocating for the role of the nurse practitioner 6. Documenting in accordance with current regulatory processes and payor systems E. Health Policy and Delivery 1. Interdependence between policy and practice (e.g., health care economics, health disparity, globalization, organizational structure, federal health care policies) 2. Organizational practices and complex systems to improve practice (e.g., systems theory, root cause analysis, change theory) 3. Advocating for policies that improve health (e.g., autonomy, social justice, access to care, equity, quality, and cost) 4. Evaluating the impact of health care delivery/policy on patients, providers, other stakeholders, and the environment 5. Minimizing risk to patients and providers at the individual and systems level 6. Analyzing the implications of health policy across the aging continuum F. Informatics and Health Care Technologies 1. Health care technologies 2. Legal and ethical issues related to the use of informatics and health care technologies (e.g., confidentiality, privacy, copyright, standardized language) 3. Integrating technology systems into the delivery and coordination of care (e.g., electronic records, decision support systems, telehealth, data management) III. Independent Practice (42%) A. Advanced Patient-Centered Communication 1. Adapting communications to specific patients needs/situations across the aging continuum (e.g., surrogate decision-makers, adolescents, cognitive impairments, fostering trusting relationships) 2. Using observational skills/nonverbal communication to enhance decisionmaking 3. Identifying barriers to communication (e.g., language, nonverbal, sensory level) 4. Using multiple modalities (including technology, print) to enhance communication 6

7 B. Health Promotion and Disease Prevention 1. Anticipatory guidance (e.g., developmental, functional, cognitive, and/or behavioral expectations for both patients and caregivers, disease progression, crisis management, palliative care, end-of-life care) 2. Health behavior modification 3. Patient-specific primary, secondary, and tertiary prevention (e.g., immunizations/vaccines, nutrition and exercise, injury prevention/safety, health literacy, screenings) 4. Life transitions (e.g., role changes, care giving, sexuality, loss) 5. Conducting an age-/developmental-/life stage-appropriate wellness visit, including health promotion, disease prevention, psychosocial assessment, anticipatory guidance, and counseling 6. Ordering and Interpreting appropriate screenings based on age and/or situation 7. Selecting interventions for the maintenance of health/wellness (including pharmacologic, nonpharmacologic, psychosocial) 8. Evaluating patient outcomes/response and modifying the plan of care accordingly 9. Facilitating advance care planning 10. Using technology for patient education and/or counseling C. Illness/Disease Management 1. Clinical guidelines and standards of care 2. Risk, cost, and benefits of interventions 3. Illness, injury, disease management 4. Complications and comorbidities as related to disease management 5. Effects of the aging process on disease management 6. Considerations for prescribing medications across the aging continuum (e.g., polypharmacy, potentially inappropriate drugs in the older adult) 7. Common geriatric syndromes Note: Each item written within the test content outline classification IIIC9 addresses at least one of the drug agents noted below 1. Antiinfective (D1) 7. Genitourologic (D7) 2. Antineoplastic (D2) 8. Immunologic (D8) 3. Cardiovascular (D3) 9. Musculoskeletal/analgesic (D9) 4. Endocrine (D4) 10. Neurologic (D10) 5. Eye, ear, and skin (D5) 11. Psychiatric (D11) 6. Gastrointestinal (D6) 12. Respiratory (D12) 7

8 8. Selecting nonpharmacological interventions (e.g., nutrition, physical therapy, complementary/alternative therapies, psychotherapy) for the management of illness, injury, and/or disease across the aging continuum 9. Selecting pharmacologic agents for the management of illness, injury, and/or disease across the aging continuum 10. Selecting appropriate interventions for the management of comorbid conditions across the aging continuum 11. Managing disease/health status over time (episodic, chronic, end-of-life, palliative care, sexual/reproductive health, mental health) 12. Engaging the patient and/or family in the management of illness, injury, and/or disease (e.g., educating, counseling, coaching, motivating, negotiating) 13. Evaluating patient outcomes/response and modifying the plan of care accordingly Note: Each item written within the test content outline classifications IIID1 IIID6 addresses at least one of the body systems noted below 1. Head, eyes, ears, nose, and throat 7. Neurological (including (B1) psychiatric) (B7) 2. Respiratory (B2) 8. Endocrine (B8) 3. Cardiovascular (B3) 9. Hematopoietic (B9) 4. Gastrointestinal (B4) 10. Immune (B10) 5. Genitourinary/Reproductive (B5) 11. Integumentary (B11) 6. Musculoskeletal (B6) D. Diagnostic Reasoning/Critical Thinking 1. Selecting appropriate tests and procedures (e.g., laboratory, diagnostic) 2. Interpreting laboratory and diagnostic data 3. Synthesizing data from multiple sources (e.g., assessment, diagnostic, laboratory, screening, etc.) to inform clinical decision-making (e.g., need for further testing, verification of data, follow up, referral/consultation) 4. Establishing and prioritizing differential diagnoses 5. Prioritizing current and potential problems within a climate of patient-centered care 6. Formulating a patient-centered, mutually acceptable plan of care Last Updated 4/4/2012 Copyright 2012 by. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or by any information storage or retrieval system. 8