,Chapter 1 — Nursing as a profession
Key Concept: Professional autonomy
ANA Standard(s): Professional Practice, Ethics
Nursing Process: Planning
Stem: Which action best demonstrates professional
autonomy by a registered nurse in an acute-care setting?
Options:
A. Deferring all clinical decisions to the attending physician.
B. Following standing orders to adjust a patient's IV rate
after assessment.
C. Asking a senior nurse to write the care plan for every
patient.
D. Waiting for an interprofessional team meeting before
modifying care.
Correct Answer: B — following standing orders after
assessment
Rationale:
Correct (2–3 sentences): A registered nurse exercising
professional autonomy assesses the patient and uses
authorized standing orders to make timely clinical
adjustments (Fundamentals of Nursing, 12th Ed., Ch. 1, pp.
1–12). This aligns with ANA standards for professional
practice and the Planning step of the nursing process.
A (incorrect): Deferring all decisions removes autonomy
and can delay necessary care.
, B (incorrect): (duplicate — not applicable)
C (incorrect): Relying on others to write care plans
undermines the RN’s accountability and scope.
D (incorrect): Waiting for team meetings may delay
essential bedside decisions.
Teaching Point: Autonomy includes assessment-driven
decisions within scope and orders.
2. Question /stem
Chapter 1 — Nursing as a profession
Key Concept: Accountability and scope
ANA Standard(s): Professional Performance, Accountability
Nursing Process: Implementation
Stem: An RN delegates a dressing change to a nursing
assistant. Which is the RN’s primary responsibility after
delegation?
Options:
A. Leaving the area until the task is complete.
B. Assessing the patient and ensuring competence before
delegation.
C. Asking the assistant to document without review.
D. Assuming the assistant completed the task correctly
without follow-up.
Correct Answer: B — assess patient and ensure
competence
Rationale:
, Correct (2–3 sentences): The RN remains accountable;
before delegating the RN must assess the patient and
verify the delegatee’s competence (Fundamentals of
Nursing, 12th Ed., Ch. 1, pp. 1–12). This is part of safe
Implementation and meets ANA accountability
expectations.
A (incorrect): Leaving the area fails supervisory
responsibility.
C (incorrect): Documentation should be reviewed by the
RN for accuracy.
D (incorrect): Assumption without verification breaches
accountability.
Teaching Point: Delegation requires assessment,
supervision, and verification.
3. Question /stem
Chapter 1 — Nursing as a profession
Key Concept: Professional identity
ANA Standard(s): Ethics, Professional Practice
Nursing Process: Assessment
Stem: Which behavior best reflects development of a
professional nursing identity in a new graduate?
Options:
A. Wearing casual clothing instead of the uniform at work.
B. Routinely seeking feedback and reflecting on clinical
performance.
Key Concept: Professional autonomy
ANA Standard(s): Professional Practice, Ethics
Nursing Process: Planning
Stem: Which action best demonstrates professional
autonomy by a registered nurse in an acute-care setting?
Options:
A. Deferring all clinical decisions to the attending physician.
B. Following standing orders to adjust a patient's IV rate
after assessment.
C. Asking a senior nurse to write the care plan for every
patient.
D. Waiting for an interprofessional team meeting before
modifying care.
Correct Answer: B — following standing orders after
assessment
Rationale:
Correct (2–3 sentences): A registered nurse exercising
professional autonomy assesses the patient and uses
authorized standing orders to make timely clinical
adjustments (Fundamentals of Nursing, 12th Ed., Ch. 1, pp.
1–12). This aligns with ANA standards for professional
practice and the Planning step of the nursing process.
A (incorrect): Deferring all decisions removes autonomy
and can delay necessary care.
, B (incorrect): (duplicate — not applicable)
C (incorrect): Relying on others to write care plans
undermines the RN’s accountability and scope.
D (incorrect): Waiting for team meetings may delay
essential bedside decisions.
Teaching Point: Autonomy includes assessment-driven
decisions within scope and orders.
2. Question /stem
Chapter 1 — Nursing as a profession
Key Concept: Accountability and scope
ANA Standard(s): Professional Performance, Accountability
Nursing Process: Implementation
Stem: An RN delegates a dressing change to a nursing
assistant. Which is the RN’s primary responsibility after
delegation?
Options:
A. Leaving the area until the task is complete.
B. Assessing the patient and ensuring competence before
delegation.
C. Asking the assistant to document without review.
D. Assuming the assistant completed the task correctly
without follow-up.
Correct Answer: B — assess patient and ensure
competence
Rationale:
, Correct (2–3 sentences): The RN remains accountable;
before delegating the RN must assess the patient and
verify the delegatee’s competence (Fundamentals of
Nursing, 12th Ed., Ch. 1, pp. 1–12). This is part of safe
Implementation and meets ANA accountability
expectations.
A (incorrect): Leaving the area fails supervisory
responsibility.
C (incorrect): Documentation should be reviewed by the
RN for accuracy.
D (incorrect): Assumption without verification breaches
accountability.
Teaching Point: Delegation requires assessment,
supervision, and verification.
3. Question /stem
Chapter 1 — Nursing as a profession
Key Concept: Professional identity
ANA Standard(s): Ethics, Professional Practice
Nursing Process: Assessment
Stem: Which behavior best reflects development of a
professional nursing identity in a new graduate?
Options:
A. Wearing casual clothing instead of the uniform at work.
B. Routinely seeking feedback and reflecting on clinical
performance.
