Standards of Practice & Standards of Professional
Performance
Stem: A registered nurse (RN) is caring for a patient and must
decide whether an action falls within the scope of nursing.
According to ANA’s Scope of Nursing Practice, which factor is
MOST important in determining whether the RN may perform
the action?
A. The nurse’s personal moral beliefs
B. The nurse’s education, experience, and demonstrated
competence
C. The facility’s staffing ratio for that shift
D. The patient’s socioeconomic status
Correct Answer: B
Rationale (Correct): The ANA scope states that the depth and
breadth of nursing practice depend on the nurse’s education,
experience, role, and population served; competence
determines safe performance. This links to medication safety
and clinical decision-making: nurses must be competent to
administer and monitor therapies.
Rationale (A): Personal moral beliefs may guide nurses ethically
but do not determine professional scope; they must still follow
standards and seek appropriate accommodations.
Rationale (C): Staffing ratios may influence workload but do not
expand or limit the legal/professional scope of practice.
Rationale (D): Socioeconomic status of the patient is important
,for care planning but is not a determinant of a nurse’s
professional scope.
Teaching Point: Scope of practice is set by education,
experience, role, and demonstrated competence.
2.
Chapter Reference: Chapter 1 — Scope of Nursing Practice;
Section: “Who/What/Where/When/Why/How” framework
Stem: The ANA describes “where” nursing occurs. Which
statement BEST captures this concept?
A. Nursing is only practiced in hospitals.
B. Nursing occurs whenever and wherever a healthcare
consumer needs nursing knowledge, caring, or advocacy.
C. Nursing occurs only in formal clinical settings during business
hours.
D. Nursing is limited to acute care and community health
settings.
Correct Answer: B
Rationale (Correct): The ANA defines nursing as occurring
anytime, anywhere there is need for nursing knowledge,
wisdom, caring, leadership, practice, or education; this
underscores responsibility beyond traditional settings.
Rationale (A): Limiting nursing to hospitals is inaccurate and
contradicts the ANA’s inclusive definition.
Rationale (C): The ANA emphasizes that nursing is not
constrained by hours or formal settings.
, Rationale (D): While acute care and community health are
settings, the scope is broader than these alone.
Teaching Point: Nursing practice is not confined to a single
setting—care can occur anywhere.
3.
Chapter Reference: Chapter 1 — Scope of Nursing Practice;
Section: Social Contract with Society
Stem: The ANA describes nursing’s social contract. What
obligation does this social contract place on nurses?
A. To practice only within institutional policies regardless of
public need
B. To provide compassionate, competent care that protects and
advocates for the public’s health
C. To prioritize institutional profitability over patient outcomes
D. To perform only tasks delegated by physicians
Correct Answer: B
Rationale (Correct): The social contract obligates nurses to
protect, promote, and optimize health and to advocate for
patients, reflecting society’s expectations of nursing
professionalism.
Rationale (A): Institutional policies matter but do not override
professional obligations to the public.
Rationale (C): Prioritizing profit over patient outcomes conflicts
with the social contract and ethical standards.
Rationale (D): Nursing practice is not limited to physician