Question 1. Professional Practice – Health Policy QID 33750
The FNP knows that, to be covered by Medicare, the NP’s services must be:
A. Directly supervised by a physician
B. Provided in an underserved care area
C. Provided based on state regulations
D. Billed through a physician’s clinic or a hospital
Answer: C. Provided based on state regulations.
The FNP can bill for services subject to state requirements. The FNP must use a National Provider Identification (NPI) number and must meet licensing requirements for advanced practice.
A: Although some states require that a physician be present on the premises where an FNP practices, this is not universal and is not required by Medicare.
B: Many FNPs practice in underserved areas, but this is not a requirement for Medicare reimbursement.
D: Medicare does NOT require that the services of the FNP be billed through a physician’s clinic or hospital. Unless prohibited by the state, Medicare may directly reimburse the FNP for services.
Reference: Zerwekh, JoAnn G, and Jo C. Claborn. Adult Nurse Practitioner Certification Review. Philadelphia: Saunders, 2004. Fitzgerald. Nurse practitioner certification examination and practice preparation. 2010. Maria T. Codina Leik. Adult-Gerontology Nurse Practitioner Certification Intensive Review: Fast Facts and Practice Questions, Second Edition Paperback – August 12, 2013
Question 2. Professional Practice – Ethics and scope of practice QID 33708
The FNP is witnessing a consent for surgery. The patient cannot verbalize the possible negative outcomes of the surgery. The correct response by the FNP is to:
A. Explain the procedure to the patient and have him sign the consent.
B. Have the patient sign the consent and call the surgeon to let him know the patient has questions.
C. Reassure the patient that the surgeon has a good record with very few negative outcomes.
D. Call the surgeon.
Correct: D. Call the surgeon.
It is the responsibility of the surgeon to explain the possible negative outcomes of the surgery. It is the responsibility of the FNP to act as the patient’s advocate. The FNP must call the surgeon to talk to the patient before the consent is signed.
A: The FNP is acting as a witness to the consent and is NOT the individual responsible for explaining the procedure to the patient. The patient should not sign the consent until the surgeon has answered all questions about the procedure.
B: The patient should not sign the consent until all questions and concerns have been addressed by the surgeon.
C: Reassuring the patient that the surgeon has a good record of outcomes with this surgery is important, but it does NOT take the place of ensuring that the patient has been adequately informed about the surgery.