,Chapter1: Foundations of Nursing Practice
Stem: A licensed nurse conducting an initial comprehensive
assessment discovers the patient is taking a herbal supplement
that may interact with prescribed anticoagulants. According to
the ANA Scope and Standards, which action best reflects the
nurse’s professional responsibility?
A. Document the supplement use but leave medication
decisions to the prescriber.
B. Notify the prescribing clinician, assess for bleeding signs, and
incorporate findings into the plan of care.
C. Immediately discontinue the anticoagulant to avoid
interaction.
D. Advise the patient to stop the herbal supplement without
consulting others.
Correct Answer: B
Rationale — Correct: B is correct because ANA standards
require nurses to assess, synthesize information, and coordinate
care—identifying potential interactions and communicating
with the care team to ensure patient safety. This aligns with the
nursing process and safe medication management.
Rationale — A: Documenting only is incomplete; the standard
expects active assessment and interprofessional
communication.
Rationale — C: Nurses cannot unilaterally stop prescribed
medications without an order; this violates scope and
delegation.
,Rationale — D: Advising cessation without clinician
involvement or patient education undermines shared decision-
making and accountability.
Teaching Point: Assess, document, and communicate suspected
medication interactions to the care team.
2.
Chapter 1 — Section: Introduction — Title: Nursing: Scope and
Standards of Practice (ANA) 5th Ed.
Stem: A nurse-manager evaluates staff performance against the
ANA Standards of Professional Performance. Which behavior
best demonstrates adherence to the standard on “quality of
practice”?
A. Completing assigned tasks efficiently without soliciting
feedback.
B. Routinely auditing nursing outcomes and implementing
improvements.
C. Restricting practice to tasks explicitly listed in job
descriptions.
D. Avoiding participation in facility performance improvement
activities.
Correct Answer: B
Rationale — Correct: B aligns with the ANA standard requiring
nurses to monitor quality and engage in continuous quality
improvement to enhance patient outcomes.
, Rationale — A: Efficiency alone does not equate to quality or
reflective practice.
Rationale — C: Limiting to written tasks may neglect broader
responsibilities for quality and patient-centered care.
Rationale — D: Avoiding QI activities contradicts professional
obligation to contribute to system improvement.
Teaching Point: Nurses must actively evaluate and improve care
quality.
3.
Chapter 1 — Section: Introduction — Title: Nursing: Scope and
Standards of Practice (ANA) 5th Ed.
Stem: Under the ANA Scope and Standards, which statement
best differentiates a “standard of practice” from a “standard of
professional performance”?
A. Standards of practice describe nursing job titles; standards of
professional performance describe licensure requirements.
B. Standards of practice address the nursing process; standards
of professional performance address professional behaviors and
responsibilities.
C. They are interchangeable—both refer to legal regulations.
D. Standards of practice are optional guidelines; professional
performance standards are mandatory.
Correct Answer: B
Stem: A licensed nurse conducting an initial comprehensive
assessment discovers the patient is taking a herbal supplement
that may interact with prescribed anticoagulants. According to
the ANA Scope and Standards, which action best reflects the
nurse’s professional responsibility?
A. Document the supplement use but leave medication
decisions to the prescriber.
B. Notify the prescribing clinician, assess for bleeding signs, and
incorporate findings into the plan of care.
C. Immediately discontinue the anticoagulant to avoid
interaction.
D. Advise the patient to stop the herbal supplement without
consulting others.
Correct Answer: B
Rationale — Correct: B is correct because ANA standards
require nurses to assess, synthesize information, and coordinate
care—identifying potential interactions and communicating
with the care team to ensure patient safety. This aligns with the
nursing process and safe medication management.
Rationale — A: Documenting only is incomplete; the standard
expects active assessment and interprofessional
communication.
Rationale — C: Nurses cannot unilaterally stop prescribed
medications without an order; this violates scope and
delegation.
,Rationale — D: Advising cessation without clinician
involvement or patient education undermines shared decision-
making and accountability.
Teaching Point: Assess, document, and communicate suspected
medication interactions to the care team.
2.
Chapter 1 — Section: Introduction — Title: Nursing: Scope and
Standards of Practice (ANA) 5th Ed.
Stem: A nurse-manager evaluates staff performance against the
ANA Standards of Professional Performance. Which behavior
best demonstrates adherence to the standard on “quality of
practice”?
A. Completing assigned tasks efficiently without soliciting
feedback.
B. Routinely auditing nursing outcomes and implementing
improvements.
C. Restricting practice to tasks explicitly listed in job
descriptions.
D. Avoiding participation in facility performance improvement
activities.
Correct Answer: B
Rationale — Correct: B aligns with the ANA standard requiring
nurses to monitor quality and engage in continuous quality
improvement to enhance patient outcomes.
, Rationale — A: Efficiency alone does not equate to quality or
reflective practice.
Rationale — C: Limiting to written tasks may neglect broader
responsibilities for quality and patient-centered care.
Rationale — D: Avoiding QI activities contradicts professional
obligation to contribute to system improvement.
Teaching Point: Nurses must actively evaluate and improve care
quality.
3.
Chapter 1 — Section: Introduction — Title: Nursing: Scope and
Standards of Practice (ANA) 5th Ed.
Stem: Under the ANA Scope and Standards, which statement
best differentiates a “standard of practice” from a “standard of
professional performance”?
A. Standards of practice describe nursing job titles; standards of
professional performance describe licensure requirements.
B. Standards of practice address the nursing process; standards
of professional performance address professional behaviors and
responsibilities.
C. They are interchangeable—both refer to legal regulations.
D. Standards of practice are optional guidelines; professional
performance standards are mandatory.
Correct Answer: B
