Leadership: Nurse Practice Acts
A client newly diagnosed with diabetes mellitus tells the nurse that the prescribed diet does not provide enough variation of choice. It is against the state's nurse practice act for a nurse to order a diet for the client. Which response by the nurse is most appropriate? A) "I will bring you a different menu." B) "I will ask my manager to talk with the dietitian." C) "Let's look at your diet and see what type of variety we can find." D) "I will notify the dietary department to change your diet."
Answer: C Explanation: A) A nurse practice act (NPA) is a series of state statutes that define the scope of practice, standards for education programs, licensure requirements, and grounds for disciplinary actions. The law provides a framework for establishing nursing actions in the care of clients. It is against most states' nurse practice acts for the nurse to order a diet for the client. The nurse is allowed to assist the client to choose appropriate foods as ordered by the physician. The nurse cannot notify the dietary department or enlist the assistance of a manager to change the diet with a healthcare provider prescription. Providing the client with another menu will not help the client choose foods within the prescribed diet.
Which of the following is a licensure examination developed by the National Council of State Boards of Nursing (NCSBN) for state and territory boards of nursing (BONs) to implement as part of their requirements for licensure? A) National Council Licensure Examination for Registered Nurses (NCLEX-RN) B) National Nurse Aide Assessment Program (NNAAP) C) Medication Aide Certification Examination (MACE) D) Nursing Workforce Diversity (NWD) program
Answer: A Explanation: A) The National Council of State Boards of Nursing (NCSBN) has developed two licensure examinations, the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and the National Council Licensure Examination for Practical Nurses (NCLEX-PN), for state and territory BONs to implement as part of their requirements for licensure. The NCSBN also offers two additional examinations: the National Nurse Aide Assessment Program (NNAAP) and the Medication Aide Certification Examination (MACE). The Nursing Workforce Diversity (NWD) program is not a licensure examination.
The nursing instructor asks a student to explain why the American Board of Managed Care Nursing (ABMCN) is an example of a certification program. How should the student respond? A) It formally recognizes nurses who have achieved a high standard of practice in managed care. B) It provides a process for recognizing the professional competence of individuals who pass the program. C) It investigates and adjudicates cases of professional negligence. D) It lists the state requirements for a nursing professional to achieve licensure.
Answer: B Explanation: A) Although a nursing license grants the legal privilege to practice, credentialing is the formal identification of professionals who meet predetermined standards of professional skill or competence. The federal government has used the term certification to define the credentialing process by which a nongovernmental agency or association recognizes the professional competence of an individual who has met certain predetermined qualifications specified by the agency or association. The American Board of Managed Care Nursing is one such organization. Formally recognizing nurses who have achieved a high standard of practice in managed care is an example of credentialing. It is not the ABMCN's role to investigate and adjudicate cases of professional negligence or to simply list requirements for nursing professionals to achieve licensure.
A nurse educator is teaching a group of nursing students about the function of the state board of nursing. Which information will the educator include in the teaching session? Select all that apply. A) Creating the NCLEX-RN examination B) Defining professional standards C) Investigating violations of the nurse practice act D) Suspending or revoking licenses E) Finding drug treatment centers for impaired nurses
Answer: B, C, D Explanation: A) Boards of nursing oversee nursing licensure by defining professional standards, investigating violations of the nurse practice act, sanctioning those who violate the nurse practice act, and suspending or revoking licenses. The National Council for the State Boards of Nursing creates the NCLEX-RN examinations. The state board of nursing is not responsible for finding treatment programs for drug-impaired nurses.
The nurse receives a notice that the state board of nursing has become a member of the Nurse Licensure Compact. How would this change in the state board of nursing structure influence the nurse's ability to practice nursing? Select all that apply. A) The nurse can only practice nursing in the residing state. B) The nurse can practice nursing in other states within the compact. C) The nurse is accountable to the state in which the nurse and clients reside. D) The nursing license will become similar to having a driver's license. E) The nurse has to obtain an additional license.
Answer: B, C, D Explanation: A) The mutual recognition model of nurse licensure allows a nurse to have a single license that confers the privilege to practice in other states that are part of the Nurse Licensure Compact. The nurse is held accountable for following the laws and rules of the state in which the nurse practices or where the client is located. It is similar to the driver's license model: A single license to drive is issued in the state of primary residency, but this license also allows the privilege to drive in other compact states. Multistate licensure privilege means the authority to practice nursing in another state that has signed an interstate compact. It is not an additional license.
Which statement exemplifies the ultimate accountability of nursing students for their actions? A) "State regulatory bodies have the ultimate responsibility for my actions." B) "The client's perception of the care I give determines the correctness of my actions." C) "I am responsible for my own actions, correct or incorrect." D) "No one may judge my actions as correct or incorrect other than me."
Answer: C Explanation: A) Each nurse practice act (NPA) addresses the duties and responsibilities of nursing students in that state. Typically, this includes language that allows nursing students the privilege to practice nursing without a license while engaged in the clinical practicum of an approved nursing education program under the supervision of qualified faculty. Nursing students have the ultimate responsibility (accountability for their actions that includes the obligation to answer for an act done and to repair any injury one may have caused) for their own actions. This responsibility does not rest ultimately with the state and does not depend solely on client perceptions. Responsibility does not mean that no one else but the nursing student may judge the student's actions.
