Test Content Outline Effective Date: January 29, Adult-Gerontology Acute Care Nurse Practitioner Board Certification Examination

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 Questions Percent I Foundations of Practice 49 28% II Professional Role 66 38% III Independent Practice 49 28% IV Healthcare Systems 11 6% Total % 1

2 Note: Each item written within the test content outline classifications IA1 to IA12 addresses at least one of the body systems noted below. 1. Head, eyes, ears, nose, and throat (B1) 7. Neurological (including psychiatric) 2. Respiratory (B2) (B7) 3. Cardiovascular (B3) 8. Endocrine (B8) 4. Gastrointestinal (B4) 9. Hematopoietic (B9) 5. Genitourinary (B5) 10. Immune (B10) 6. Musculoskeletal (B6) 11. Integumentary (B11) I. Foundations of Practice (28%) A. Advanced Health/Physical Assessment 1. Components of health history, physical, and psychosocial assessments across the adultolder adult aging spectrum (including patient, family, and communities) 2. Syndromes and constellations of symptoms that may be manifestations of other health problems in the older aging adults 3. Complementary and alternative therapies 4. Individual, population, and global environmental characteristics as they are relate to the adult-older adult age spectrum 5. Assessing complex acute, critical, and chronically ill patients for urgent and emergent conditions, using both physiologically and technologically derived data, to evaluate for physiologic instability and risk for potentially life-threatening conditions 6. Prioritizing the assessment data collection in relation to the dynamic nature of the complex acute, critical, and chronic illness or injury 7. Performing and documenting a pertinent, comprehensive and focused physical, mental, and cognitive assessment, including obtaining health information from collateral sources to develop a clinical database 8. Correlating assessment findings with underlying pathology or physiologic changes across the entire adult-older adult age spectrum 9. Assessing the impact of an acute, critical, and/or chronic illness or injury, and the patient s health promotion needs, iatrogenic risk, genetics, social support, and physical and mental health status using the appropriate standardized assessment instruments 10. Assessing cultural, spiritual, ethnic, gender, sexual orientation and/or age differences in patients with acute, critical, and chronic health conditions 11. Assessing for medical debility, and/or the need for transition to a different level of care or care environment, based on an individual s activity 12. Identifying high-risk and vulnerable populations to prevent and/or minimize injury and exacerbations of acute and chronic conditions 2

3 Note: Each item written within the test content outline classification IA13 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 (D7) 8. Immunologic (D8) 9. Musculoskeletal/analgesic (D9) 10. Neurologic (D10) 11. Psychiatric (D11) 12. Respiratory (D12) 13. Conducting a pharmacological assessment addressing pharmacogenetic risks, complex medical regimens, drug interactions and adverse events, over-the-counter/ complementary/alternative therapies, and the ability of the patient and caregiver to selfmanage medications safely and correctly Note: Each item written within the test content outline classifications IB1 IB5 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) B. Advanced Physiology/Pathophysiology 1. Physiology, pathogenesis, clinical manifestations, and etiology of altered physical/psychological health/disease states across the entire adult-older adult age spectrum 2. Impact of aging, culture and genetics on health states, disease risk, and clinical management of health/disease states across the entire adult-older adult age spectrum 3. Analyzing the relationship between normal and abnormal physiology, and specific system alterations that can be produced by aging and/or disease processes 4. Analyzing both typical and atypical presentations of complex acute and chronic comorbidities, including urgent and emergent physical and mental health conditions 5. Analyzing physiologic responses to illness and the treatment modalities of acute, chronic, and rapidly changing clinical conditions 3

4 Note: Each item written within the test content outline classifications IC1 to IC6 addresses 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 (D7) 8. Immunologic (D8) 9. Musculoskeletal/analgesic (D9) 10. Neurologic (D10) 11. Psychiatric (D11) 12. Respiratory (D12) C. Advanced Pharmacology 1. Pharmacotherapeutics, including pharmacokinetics, pharmacodynamics, and pharmacogenetics of broad categories of drugs across the adult-older adult aging spectrum 2. Pharmacologic treatments for emergent or urgent conditions and complex medical regimes, especially in high-risk and vulnerable populations 3. Motivations of patients for seeking prescriptions (e.g., drug dependence, social media marketing, inappropriate use of antibiotics) 4. Potential barriers for patient adherence to prescribed regimens (e.g., cost, convenience, polypharmacy, tolerance) 5. Evaluating the impact of pharmacological agents on physiologic/pathologic processes 6. Selecting pharmacologic agents for the management of patient health conditions based on patient variations, the problems being managed, and cost-effectiveness. 7. Selecting pharmacological agents used in sedation and analgesia (including local, regional, and systemic agents) II. Professional Role (38%) A. Scope of Practice 1. Role, scope, and standards of the adult-gerontology acute care nurse practitioner 2. Complex and advanced leadership roles to lead and guide change 3. Principles of billing, reimbursement, and documentation 4. Identifying and referring patients beyond one s scope of practice 5. Advocating for the full-scope of the adult-gerontology acute care nurse practitioner role 6. Coordinating comprehensive care for patients with acute and chronic illnesses, in and across care settings, through practice, policy, and other venues 7. Using effective communication, collaboration, negotiation, and conflict management, with both formal and informal caregivers and professional staff, when treating patients with complex acute, critical, and chronic illness and attending to variations across the adultolder adult aging spectrum (e.g., multidisciplinary teams, integration of care, transitions of care, documentation of clinical decision making) 8. Mentoring, consulting, guiding, and providing educational experiences to students, nurses, and other health professionals 9. Using performance appraisals and peer review for professional development 10. Documenting in accordance with current regulatory processes and payer systems 11. Using stress management strategies in complex acute or traumatic situations 4

5 B. Patient/Family-Centered Care 1. Principles of adult learning, coaching, role modeling, anticipatory guidance, and counseling 2. Self-care management 3. Using appropriate and effective communication to build therapeutic relationships with diverse individuals, family units, and caregivers facing an acute onset or exacerbation of a complex chronic physical and/or psychological condition 4. Facilitating patient and family decision-making regarding complex acute, critical, and chronic illness treatment decisions, end-of-life care, and organ/tissue donation in a manner that ensures informed decisions 5. Teaching patients and/or families the skills required for navigating the health care system 6. Discussing sensitive issues with patients, families, and caregivers 7. Adapting teaching-learning approaches based on physiological and psychological changes, age, culture, developmental stage, cognitive status, readiness to learn, health literacy, the environment, and available resources 8. Providing anticipatory guidance and counseling to patients, families, and caregivers to support or enhance patients rights of self-determination, sense of safety, autonomy, worth, and dignity C. Ethical and Legal Concepts 1. Regulations pertaining to health care confidentiality and portability (including patient information, transfer to higher level of care, or interfacility transfer of care) 2. Ethical and legal issues (e.g., personal bias, medical futility, reporting negligence and/or abuse, fraud) 3. Advocating for patients and family rights regarding health care decision making (e.g., emancipation, conservatorship, guardianship, durable power of attorney, health care proxy, advance directives and informed consent, taking into account ethical and legal standards) D. Evidence-based Practice 1. Scientific methodologies (e.g., evidence-based practice, research process) 2. Using critical appraisal skills to evaluate research and evidence-based literature 3. Translating and disseminating evidence-based knowledge into practice 4. Evaluating evidence-based, age-appropriate professional standards and guidelines for care 5

6 III. Independent Practice (28%) Note: Each item written within the test content outline classifications IIIA1 IIIA9 addresses at least one of the body systems noted below. 1. Head, eyes, ears, nose, and throat (B1) 7. Neurological (including psychiatric) 2. Respiratory (B2) (B7) 3. Cardiovascular (B3) 8. Endocrine (B8) 4. Gastrointestinal (B4) 9. Hematopoietic (B9) 5. Genitourinary (B5) 10. Immune (B10) 6. Musculoskeletal (B6) 11. Integumentary (B11) A. Diagnosis of Complex Acute, Critical and Chronic Illness 1. Risk, benefits, and complications of invasive and noninvasive diagnostic tests and procedures, including cost-effectiveness 2. Selecting and prioritizing invasive and noninvasive diagnostics to monitor and sustain physiological function and ensure patient safety (e.g., EKG interpretation, radiologic interpretations, invasive hemodynamic interpretations, lumbar puncture) 3. Performing invasive and noninvasive diagnostic procedures to monitor and sustain physiological function and ensure patient safety (e.g., EKG interpretation, radiologic interpretations, invasive hemodynamic interpretations, lumbar puncture) 4. Interpreting laboratory and diagnostic data 5. Identifying comorbidities and age-related changes, including their impact on presenting health problems, the potential for rapid physiologic and mental health deterioration or lifethreatening instability, and the risk for iatrogenesis 6. Prioritizing differential diagnoses for new or recurring complex acute, critical, and chronic physical, mental health and behavioral disorders and problems 7. Diagnosing complex acute, critical, and chronic physical illness and common behavioral and mental health conditions; recognizing disease progression, multisystem health problems, and associated complications, and iatrogenic conditions 8. 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) 9. Reformulating diagnoses based on new or additional assessment data and the dynamic nature of complex acute, critical, and chronic illness B. Restorative Care 1. Risks, benefits and complications of invasive and noninvasive therapeutic tests, interventions, and procedures, including cost-effectiveness 2. Nonpharmacologic interventions for the treatment of complex acute, chronic, and critical illness (e.g., LVAD, renal replacement therapy, hypothermia protocol, mechanical ventilation) 3. Evidence-based clinical guidelines/standards of care 4. Supportive services and complementary/alternative therapies (e.g., physical therapy, respiratory therapy, occupational therapies, nutritional therapy, music therapy) 6

7 Note: Each item written for the test content outline classification IIIB5 addresses at least one of the body systems noted below. 1. Head, eyes, ears, nose, and throat (B1) 7. Neurological (including psychiatric) 2. Respiratory (B2) (B7) 3. Cardiovascular (B3) 8. Endocrine (B8) 4. Gastrointestinal (B4) 9. Hematopoietic (B9) 5. Genitourinary (B5) 10. Immune (B10) 6. Musculoskeletal (B6) 11. Integumentary (B11) 5. Formulating a culturally-sensitive, age-specific plan of care, including pharmacologic and nonpharmacologic interventions to address and minimize the risk of complex acute, critical, and chronic physical and mental health problems 6. Implementing interventions to support the patient with a rapidly deteriorating physiologic condition (e.g., airway, line and tube insertion and management) 7. Performing therapeutic interventions to stabilize acute and critical health problems (e.g., suturing, nerve blocks) 8. Initiating appropriate referrals and consultations 9. Managing pain, sedation, and paralysis for patients with complex acute, critical and chronic illness (nerve block, epidural, opioids, conscience sedation, paralytics) 10. Implementing care to prevent and manage geriatric syndromes (e.g. falls, loss of functional abilities, dehydration, delirium, depression, dementia, malnutrition, incontinence, and constipation) 11. Managing care to sustain or restore physiological and psychological function, including patients with rapidly deteriorating physiologic conditions 12. Ordering and implementing palliative and end-of-life care in collaboration with the patient, family, and members of the health care team 13. Evaluating patient response to treatment and health care-associated risk, and modifying the plan of care based on reassessment 14. Formulating interdisciplinary discharge plans and followup care C. Health Promotion and Health Protection 1. Physiological, psychological and health care risk for patients across the adult-older adult aging spectrum 2. Age-related and condition-related health promotion activities (e.g., vaccines, lifestyle modification, risk factor reduction) 3. Screening for acute and chronic mental health and behavioral problems and disorders, adapting for the cognitively impaired 4. Designing and implementing interventions to promote safety and reduce risk IV. Health Care Systems (11%) A. Health Care Policy and Delivery 1. Finance, payment methods and the relationship between policy and health economics 2. Health care policies influence on the structure and finance of health care practice and health outcomes 3. Emergency response plans 7

8 Effective Date: June 6, Evaluating the relationship between health care delivery/policy on patients, providers, stakeholders, organizational structure, and the global environment 5. Analyzing system barriers to facilitate care delivery and coordination, including access to care 6. Promoting equity in health and health care for peoples of diverse cultural, ethnic and spiritual backgrounds 7. Identifying appropriate use of resources for the provision of safe, high quality care to achieve cost-effective outcomes 8. Identifying the type and level of services provided across the continuum of care settings B. Quality Improvement and Safety 1. Internal and external agencies and resources that can be used to improve practice outcomes within systems (e.g., The Joint Commission, Institute for Healthcare Improvement, Institute of Medicine, quality improvement departments, job descriptions, Six Sigma, patient satisfaction, regulatory guidelines) 2. Using and evaluating information technologies and quality improvement methods to enhance safety, prevent errors, and improve patient care outcomes 3. Evaluating one s own practice against identified benchmarks to improve patient care outcomes Last Updated 4/7/2012 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