1. What are the four core competencies of advanced nursing practice according to the AACN? Explain each one briefly. - Clinical practice: The ability to provide direct and indirect care to patients, families, groups, communities, and populations across the continuum of care settings and specialties. - Education: The ability to design, implement, and evaluate educational programs for nurses, students, and other health professionals, as well as patients and the public. - Research: The ability to conduct, collaborate, and disseminate research that contributes to the advancement of nursing science and practice. - Leadership: The ability to influence health policy, systems, and outcomes at the local, regional, national, and global levels through advocacy, collaboration, and innovation. 2. What are some of the benefits and challenges of interprofessional collaboration in advanced nursing practice? Provide at least two examples of each. - Benefits: Improved quality and safety of care, enhanced patient satisfaction and outcomes, reduced costs and errors, increased access to care, and enriched professional development and satisfaction. - Challenges: Role ambiguity and conflict, lack of communication and trust, power imbalances and hierarchies, ethical dilemmas and conflicts of interest, and organizational barriers and constraints. 3. What are some of the ethical principles and frameworks that guide advanced nursing practice? How would you apply them to a case scenario of your choice? - Ethical principles: Autonomy, beneficence, nonmaleficence, justice, fidelity, veracity, respect for persons, and confidentiality. - Ethical frameworks: Utilitarianism, deontology, virtue ethics, principlism, care ethics, feminist ethics, and relational ethics. - Case scenario: A 65-year-old woman with advanced dementia is admitted to the hospital with pneumonia. Her family requests aggressive treatment, including antibiotics, fluids, oxygen, and CPR if needed. However, the nurse practitioner caring for her finds a living will in her medical record that states she does not want any lifesustaining interventions in case of terminal illness or irreversible condition. How should the nurse practitioner handle this situation? - Application: The nurse practitioner should respect the patient's autonomy and follow her wishes as expressed in her living will. However, the nurse practitioner should also communicate with the family and explain the rationale for honoring the patient's preferences. The nurse practitioner should use beneficence and nonmaleficence to balance the benefits and harms of the treatment options. The nurse practitioner should also consider the principles of justice and fidelity in allocating resources and honoring