NR 581 FINAL EXAM PREP Foundational Concepts for Advanced Nursing Practice ANSWERED 2026/2027 Updated/Verified (69pages)

1. What are the four domains of advanced nursing practice according to the National Organization of Nurse Practitioner Faculties (NONPF)? Explain each domain briefly and provide an example of how it applies to your practice. - The four domains are: Scientific Foundation, Leadership, Quality, and Practice Inquiry. Scientific Foundation refers to the use of scientific knowledge, theories, and models to guide advanced nursing practice. An example is applying evidence-based guidelines to diagnose and treat patients. Leadership refers to the ability to influence health policy, systems, and outcomes at various levels. An example is advocating for health equity and social justice in your community. Quality refers to the use of best practices, standards, and measures to ensure safe, effective, and efficient care. An example is participating in quality improvement initiatives and audits in your workplace. Practice Inquiry refers to the use of systematic methods to generate, evaluate, and disseminate knowledge that informs and improves practice. An example is conducting a research project or a quality improvement project on a clinical issue. 2. What are the three levels of prevention in public health nursing? Give an example of an intervention for each level that you could implement as an advanced nurse practitioner. - The three levels of prevention are: primary, secondary, and tertiary. Primary prevention aims to prevent disease or injury before it occurs by reducing exposure to risk factors or enhancing resistance to them. An example is providing immunizations or health education to a population. Secondary prevention aims to detect and treat disease or injury early before it causes significant morbidity or mortality by screening, diagnosis, and treatment. An example is performing mammograms or pap smears to detect cancer or prescribing antibiotics to treat infections. Tertiary prevention aims to reduce the impact of disease or injury after it has occurred by minimizing complications, disability, or death by rehabilitation, palliation, or support. An example is providing physical therapy or hospice care to patients with chronic or terminal conditions. 3. What are the five rights of clinical reasoning according to Levett-Jones et al. (2010)? How can you apply them to your practice as an advanced nurse practitioner? - The five rights of clinical reasoning are: collecting the right cues, taking the right action, for the right patient, at the right time, and for the right reason. Collecting the right cues means gathering relevant data from multiple sources, such as history, physical examination, laboratory tests, and diagnostic imaging. Taking the right action means choosing the appropriate intervention based on the best available evidence, clinical judgment, patient preferences, and ethical principles. For the right patient means ensuring that the intervention is tailored to the individual needs, values, and goals of the patient. At the right time means delivering the intervention in a timely manner based on the urgency and priority of the situation. For the right reason means explaining the rationale and expected outcomes of the intervention to the patient and other stakeholders. 4. What are some of the ethical principles that guide advanced nursing practice? How do you resolve ethical dilemmas that may arise in your practice? - Some of the ethical principles that guide advanced nursing practice are: autonomy, beneficence, nonmaleficence, justice, fidelity, veracity, and respect for persons. Autonomy means respecting the patient's right to self-determination and informed consent. Beneficence means doing good or promoting well-being for the patient. Nonmaleficence means avoiding harm or minimizing risk for the patient. Justice means treating patients fairly and equitably according to their needs and resources.