,Chapter1: Foundations of Nursing Practice
Stem: A registered nurse is asked to perform a procedure that
falls outside the nurse’s usual education, training, and
institutional policy. According to the ANA Scope and Standards,
the nurse’s most appropriate immediate action is to:
A. Attempt the procedure after watching a short demonstration.
B. Accept the assignment and document any deviations later.
C. Decline the assignment and explain the limitation to the
supervisor.
D. Delegate the procedure to an unlicensed assistant.
Correct Answer: C
Rationales (Correct + Incorrects):
• Correct (C): Declining when a task exceeds one’s
competence preserves patient safety and professional
accountability; the ANA standards require nurses to
practice within their scope and seek appropriate help or
clarification.
• A: Watching a short demonstration does not ensure
competence; the nurse is still accountable for safe practice.
• B: Accepting and documenting later risks patient harm and
violates the standard to practice within competence.
• D: Delegating to an unlicensed assistant is inappropriate
for tasks beyond the nurse’s own scope and may endanger
the patient.
,Teaching Point: Always practice within competence and report
limitations immediately.
Chapter 1, Section 1: The Scope and Standards of Nursing
Practice
2.
Stem: Which statement best describes the relationship
between the ANA Scope of Practice and Standards of Practice?
A. Scope defines measurable competencies; standards describe
the legal penalties.
B. Scope outlines the who/what of nursing practice; standards
define the who/what/when/how of competent care.
C. Scope is optional guidance; standards are only institutional.
D. Scope replaces state law for nursing practice.
Correct Answer: B
Rationales (Correct + Incorrects):
• Correct (B): The scope defines the breadth and boundaries
of nursing practice; standards provide detailed
expectations for competent, ethical care.
• A: Scope is broader than measurable competencies and
standards do not primarily describe legal penalties.
• C: Both scope and standards are authoritative professional
documents informing practice and are not merely optional.
, • D: Scope does not supersede state law; nurses must follow
both professional standards and legal/regulatory
requirements.
Teaching Point: Scope sets boundaries; standards specify
expected professional performance.
Chapter 1, Section 1: The Scope and Standards of Nursing
Practice
3.
Stem: A nurse uses evidence-based protocols to manage a
patient’s wound but documents only brief notes. Which ANA
principle is most directly at risk?
A. Advocacy
B. Documentation as part of accountability
C. Collaboration
D. Social justice
Correct Answer: B
Rationales (Correct + Incorrects):
• Correct (B): Proper documentation demonstrates
accountability, continuity, and quality of care and is a core
component of the standards of practice.
• A: Advocacy concerns protecting patient interests, not
primarily documentation.
Stem: A registered nurse is asked to perform a procedure that
falls outside the nurse’s usual education, training, and
institutional policy. According to the ANA Scope and Standards,
the nurse’s most appropriate immediate action is to:
A. Attempt the procedure after watching a short demonstration.
B. Accept the assignment and document any deviations later.
C. Decline the assignment and explain the limitation to the
supervisor.
D. Delegate the procedure to an unlicensed assistant.
Correct Answer: C
Rationales (Correct + Incorrects):
• Correct (C): Declining when a task exceeds one’s
competence preserves patient safety and professional
accountability; the ANA standards require nurses to
practice within their scope and seek appropriate help or
clarification.
• A: Watching a short demonstration does not ensure
competence; the nurse is still accountable for safe practice.
• B: Accepting and documenting later risks patient harm and
violates the standard to practice within competence.
• D: Delegating to an unlicensed assistant is inappropriate
for tasks beyond the nurse’s own scope and may endanger
the patient.
,Teaching Point: Always practice within competence and report
limitations immediately.
Chapter 1, Section 1: The Scope and Standards of Nursing
Practice
2.
Stem: Which statement best describes the relationship
between the ANA Scope of Practice and Standards of Practice?
A. Scope defines measurable competencies; standards describe
the legal penalties.
B. Scope outlines the who/what of nursing practice; standards
define the who/what/when/how of competent care.
C. Scope is optional guidance; standards are only institutional.
D. Scope replaces state law for nursing practice.
Correct Answer: B
Rationales (Correct + Incorrects):
• Correct (B): The scope defines the breadth and boundaries
of nursing practice; standards provide detailed
expectations for competent, ethical care.
• A: Scope is broader than measurable competencies and
standards do not primarily describe legal penalties.
• C: Both scope and standards are authoritative professional
documents informing practice and are not merely optional.
, • D: Scope does not supersede state law; nurses must follow
both professional standards and legal/regulatory
requirements.
Teaching Point: Scope sets boundaries; standards specify
expected professional performance.
Chapter 1, Section 1: The Scope and Standards of Nursing
Practice
3.
Stem: A nurse uses evidence-based protocols to manage a
patient’s wound but documents only brief notes. Which ANA
principle is most directly at risk?
A. Advocacy
B. Documentation as part of accountability
C. Collaboration
D. Social justice
Correct Answer: B
Rationales (Correct + Incorrects):
• Correct (B): Proper documentation demonstrates
accountability, continuity, and quality of care and is a core
component of the standards of practice.
• A: Advocacy concerns protecting patient interests, not
primarily documentation.
