Answer to Question 1
Correct Answer: 2
Rationale 1: Standards of care pertain to established minimum criteria for competent, proficient actions related to delivery of nursing care.
Rationale 2: Scope of practice is defined as the limits of nursing practice set forth in state statutes.
Rationale 3: Right to privacy involves the legal right of a person to keep her or his person and property free from public scrutiny.
Rationale 4: Informed consent is a legal concept that protects a patient's right to autonomy and self-determination in terms of his or her care.
Answer to Question 2
Correct Answer: 1
Rationale 1: An expert nurse utilizes multiple aspects of a patient's behavior (including the length of each response to a question and sounds the patient produces during contractions) in addition to the more objective findings of the pelvic exam (including dilation of the cervix) in the assessment of a laboring patient. The expert nurse has identified that the grunting and guttural sounds during contractions are involuntary pushing and that the patient is very close to delivery.
Rationale 2: Although most nurses have a routine when admitting a patient, the order of the steps will vary according to the situation at hand.
Rationale 3: Changing the order of the steps of admission is not being inconsistent; changing the order of the steps of admission is responsive to the needs of the patient at that point in time.
Rationale 4: Advanced nurse practice describes educational and certification achievement and is not used to describe the continuum from novice to expert.