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Nursing Jurisprudence and Ethics for Texas
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According to BON Position Statement 15.24 Engaging in Reinsertion of Permanently Placed Feeding Tubes, it would be within the scope of practice for a nurse to replace a gastrostomy tube provided that A. the tube has been in place for 8 - 12 weeks, the nurse has a physician's order to replace the tube, and the nurse has completed specific competency training to safely replace the tube. B. the tube has been in place for 8 - 12 weeks, the facility policy allows replacement of a tube with a specific physician's order, and the nurse has not completed the required skills check-off. C. the tube has been in place for 4 - 6 weeks and the nurse observed a supervisor completed the procedure. D. the tube has been in place 4-6 weeks and the nurse as been determined to be competent in reinserting permanently placed tubes that have an established fistulous tract. - ✔✔A. the tube has been in place for 8-12 weeks, the nurse has a physicians to replace the tube, and the nurse has completed specific competency training to safely replace the tube. The BON differs from nursing and healthcare specialty associations since the BON A. lobbies for legislation favorable to the practice of nursing. B. sets criteria for evaluating nursing career ladders. C. offers liability insurance at discounted rates for members D. protects and promotes the welfare of the people of Texas - ✔✔D. protects and promotes the welfare of the people of Texas. The Standards of Nursing Practice, Board Rule 217.11 state that the LVN scope of practice includes including doing which of the following with regard to care plans? A. Initiate the development of a comprehensive nursing care plan independently B. May not document on the nursing care plan
C. Participate in the modification and development of the nursing care plan. D. Review the nursing care plan only if directed to do so by the physician. - ✔✔C. Participate in the modification and development of the nursing care plan. A nurse who contacts a physician to clarify a medication order is A. fulfilling a duty to keep the patient safe. B. likely to detract from a collegial nurse-physician relationship. C. engaging in action that is the duty of the pharmacist. D. not fulfilling nursing tasks with other patients. - ✔✔A. fulfilling a duty to keep the patient safe. Nurses often ask the Board about what it means to abandon their patients. Though the Board does not use this term in the rules, what specific portion of Board Rule 217.12, Unprofessional Conduct, provides directions for the nurse regarding job abandonment and conduct that may also be Board-reportable? A. Paragraph (5) B. Paragraph (7) C. Paragraph (12) D. Paragraph (8) - ✔✔C. Paragraph (12) Which of the following situations is an example of a nurse MAINTAINING appropriate professional boundaries between the nurse and the client? A nurse A. rewards a patient with a small stuffed mascot of his favorite football team for progress made in rehabilitation. B. responds less frequently to a demanding patient's call light. C. shares personal information regarding her recent bankruptcy because the patient seems genuinely interested. D. is personally attracted to a patient and calls and visits him on her days off "to check on how he is doing." - ✔✔A. rewards a patient with a small stuffed mascot of his favorite football team for progress made in rehabilitation.
According to Board Rule 2 13.29, Criteria and Procedure Regarding Intemperate Use and Lack of Fitness in Eligibility and Disciplinary Matters, a person desiring to obtain or retain his or her nursing license must provide a sworn certificate to the board that he or she has NOT A. had any alcohol within the last five years. B. been under the influence of any alcohol or other illegal substance for the last five years. C. been addicted to or treated for the use of alcohol or any other drug in the last five years. D. been in the hospital for any type of surgery within the last five years. - ✔✔B. been under the influence of any alcohol or other illegal substance for the last five years. According to board rule, after a nurse refuses a float assignment and invokes Safe Harbor, the nurse A. should demand that the supervisor must provide a more appropriate float assignment. B. is required to communicate with the supervisor and must accept the assignment as given. C. must accept an alternate assignment even if it still beyond the nurse's scope of practice. D. must collaborate with the supervisor to determine a safe assignment. - ✔✔D. must collaborate with the supervisor to determine a safe assignment. When an applicant for a nursing license receives a final conviction for first degree murder, the NPA mandates that the applicant A. will be required to complete an ethics and jurisprudence course annually B. will have to pay $1000 as part of the initial license application process. C. will not be eligible to apply for an initial nursing license until five years after being released from community supervision or parole. D. must provide three letters of reference from law enforcement or parole officers and successful retake the NCLEX exam. - ✔✔C. will not be eligible to apply for an initial nursing license until five years after being released from community supervision or parole. A person with a history f a substance use disorder who desires to obtain or retain a license to practice nursing may be required to provide evidence that includes all of the following EXCEPT:
A. current sobriety and fitness to practice. B. 45 contact hours of continuing nursing education. C. attendance at Alcoholics Anonymous meetings. D. positive employer evaluations - ✔✔C. attendance at Alcoholics Anonymous meetings. A nursing error that contributes to the death or serious harm of a patient A. can be considered a minor incident if the nurse is accountable for his or her practice and understands his or her error. B. can be considered a minor incident if the patent had a do-not-resuscitate order. C. cannot be considered a minor incident, even if the nurse appears to have the knowledge and skills to practice safely. D. cannot be considered a minor incident unless the nurse has a previous pattern of similar nursing practice errors. - ✔✔C. cannot be considered a minor incident, even if the nurse appears to have the knowledge and skills to practice safely. A nurse was terminated from three different jobs beause he or she was stealing from staff members. The nurse has no pending criminal issues and no criminal history. Though this activity does not involve patients, it may indicate that A. the nurse will repeat similar conduct and exploit patients who trust the nurse to act in their best interest. B. the nurse only steals from fellow employees and would not steal from unsuspecting and vulnerable patients. C. the nurse will delegate tasks to unlicensed assistive personnel that are beyond their scope of practice. D. the nurse is unable to supervise nursing care provided by other licensed nurses. - ✔✔A. the nurse will repeat similar conduct and exploit patients who trust the nurse to act in their best interest. A BON investigator in the enforcement division collected evidence that supports the BON's formal charges against a nurse regarding violations of the NPA and board rules. Attempts to notify the nurse via standard and certified mail at the nurse's last address of record have been returned to the BON office as being "undeliverable or not at this address." Since the investigator has been unable to communicate
A. An employer or supervisor can refuse to allow a nurse to invoke Safe Harbor if they resolve the staffing issues. B. Safe Harbor must be invoked prior to engaging in the assignment or at any time the assignment changes as long as the nurse believes it place patients at risk of harm. C. A nurse can invoke Safe Harbor after committing an error that caused patient harm. D. The Chief Nursing Offer (CNO) or Nurse Administrator does not have to assure compliance with the Nursing Peer Review Law or Board Rule 217.20 Safe Harbor Peer Review. - ✔✔ A nurse is counseled for questioning a physician's order that made the physician mad. Which of the following documents on the BON web site BEST explains why the nurse was correct to question a physician's order that the nurse believed could be harmful to a patient? A. Guideline for Nurses Transitioning to a New Practice Setting. B. Statistics on the number of nurses living in each county in Texas. C. Position Statement 15.14 Duty of a Nurse in Any Setting. D. Guideline for LVN Scope of Practice under Board Rule 217.11 - ✔✔C. Position Statement 15.14 Duty of a Nurse in Any Setting. While interacting with the public in a nursing role, each nurse must wear a clearly legible insignia (such as a name badge) that identifies the nurse as A. an employee of the institutional setting. B. a registered nurse or a licensed vocational nurse. C. a member of a professional organization. D. an experienced nurse in the service area. - ✔✔B. a registered nurse or a licensed vocational nurse. In a nurse-patient relationship, the most vulnerable patients are those who are A. under anesthesia or sedation. B. wearing a patient or exam gown.
C. undergoing chemotherapy. D. using an interpreter. - ✔✔A. under anesthesia or sedation. In the NPA, "conduct subject to reporting" includes A. conduct that causes a person to suspect that the nurse's practice is impaired by chemical dependency or drug or alcohol abuse. B. the occurrence of 2 minor incidents within a twelve month period in a facility with no nursing peer review. C. mandatory overtime resulting in sixteen consecutive hours worked. D. a nurse who disagrees with the supervisor over a patient assignment. - ✔✔A. conduct that causes a person to suspect that the nurse's practice is impaired by chemical dependency or drug or alcohol abuse. Which of the following resources on the BON web page would assist a nurse in determining his or her scope of nursing practice? A. Disciplinary Action: Individual's Report to the BON. B. Memorandum of Understanding between the BON and the Texas State Board of Pharmacy. C. The continuing competency into sheet. D. Scope of Practice Decision-Making Model. - ✔✔C. The continuing competency into sheet. If a nurse has reason to believe a medication order is inaccurate or contraindicated, the Standards of Nursing Practice require the nurse to do all of the following EXCEPT: A. consult with the ordering practitioner to clarify the order. B. give the medication as ordered and document concerns in the medical record. C. tell the ordering practitioner if the nurse decide not to give the medication. D. collaborate with other members f the health care team for more information about the medication and why it was ordered. - ✔✔B. give the medication as ordered and document concerns in the medical record.
The BON rules regarding licensure renewal require the nurse to answer eligibility questions concerning which of the following with regard to the previous two-year licensure cycle A. whether the nurse has completed hours of continuing education. B. whether the nurse has a current CPR card. C. whether the nurse has any criminal background that must be revealed. D. whether the nurse has been fired from employment in the past two years. - ✔✔C. whether the nurse has any criminal background that must be revealed. Chart audits find the following errors committed by a nurse with observed impaired behavior at work. NO physician orders for narcotics signed out by the nurse, and NO documentation that the nurse either administered or wasted the narcotics. The best decision for the Incident Based Peer Review Committee to make is that A. the nurse needs remedial education in how to document the rationale for and response to PRN pain medications. B. the nurse must be reported to the Texas Medical Board for signing out medications without a valid physician's order for controlled substances. C. the nurse should be terminated from employment at the facility for stealing drugs. D. the nurse must be reported to the BON because of the combination of practice errors with possible practice impairment due to substance use or abuse. - ✔✔D. the nurse must be reported to the BON because of the combination of practice errors with possible practice impairment due to substance use or abuse. What type of license is required to utilize the two BON rules on delegation to unlicensed personnel? A. Registered Nurse. B. Physician. C. Physician Assistant. D. Licensed Vocational Nurse. - ✔✔A. Registered Nurse. The BON rules, located in Title 22 of the Texas Administrative Code, help implement and reflect
A. the standards of nursing care developed by various nursing specialty and professional organizations. B. the statues passed by the legislature relating to nursing found in Texas Occupations Code, including the NPA. C. the steps necessary to complete the NCLEX exam application. D. the process necessary to be promoted to higher positions in nursing in different practice settings - ✔✔D. the process necessary to be promoted to higher positions in nursing in different practice settings A school district contracts with a registered nurse (RN) to teach the staff how to monitor a student's blood glucose. The RN then observes each perform this task correctly. The RN does not work for the school district and will not have any further contact with the staff. In this example, the RN is A. training the staff how to perform the task of monitoring blood glucose. B. supervising the staff on a daily basis in performing blood glucose monitoring. C. engaging in RN delegation of nursing tasks to be performed by the staff who are responsible to report to the RN. D. acting outside of the RN's scope in teaching blood glucose monitoring to the staff. - ✔✔A. training the staff how to perform the task of monitoring blood glucose. To help a nurse decide if a task is within his or her individual scope of practice, a prudent nurse should A. consider utilizing the Scope of Practice Decision-Making Model. B. obtain a list of tasks a nurse may perform from the BON. C. ask a physician whether the nurse should perform the assigned task. D. engage in the assigned task as long as the nurse has seen someone else perform the task at least once
- ✔✔B. obtain a list of tasks a nurse may perform from the BON. A nurse's history of substance use disorder or mental illness is relevant to nursing licensure as it may indicate A. the nurse's current lack of fitness for duty.
While a LVN has a "directed" scope of practice, this is NOT true for a RN. This means that the RN A. has full accountability for the LVN. B. is able to engage in making medical diagnoses if signed off by a physician and performed under the physician's delegation. C. must be present in all settings to supervise the LVN's care. D. is permitted to practice nursing independently within the RN's scope of practice. - ✔✔D. is permitted to practice nursing independently within the RN's scope of practice. Which of the following activities would violate a provision of the NPA and Board Rule 217.11(2), Standards of Nursing Practice, relating to the practice of nursing by a LVN? A. Assisting in the evaluation of a client's response to nursing interventions. B. Practicing in any setting without an appropriate practice supervisor who is at least telephonically available. C. Collaborating with the RN to revise the nursing care plans for assigned clients. D. Making assignments to other licensed nurses and to unlicensed assistive personnel when working in a supervisory position. - ✔✔B. Practicing in any setting without an appropriate practice supervisor who is at least telephonically available. The integrated pattern of personal, academic, and occupational behaviors that indicate an individual is able to consistently conform his/her conduct to the requirements of the Nursing Practice Act and the Board's rules relates to A. course requirements of the BON prior to entering nursing school. B. an educational background in liberal arts that complements the nursing profession. C. the Florence Nightingale Pledge. D. the BON's rule concerning good professional character. - ✔✔D. the BON's rule concerning good professional character.
A nurse is assisting a physician when she witness the physician break sterile technique and use a contaminated instrument to finish the procedure. The nurse reports the physician to the Texas Medical Board. Which of the following statements is accurate in relation to this scenario? A. The nurse cannot be disciplined by the BON or discriminated against by the employer. B. The nurse has no recourse if the physician gets angry and terminates her employment. C. If the facility terminates the nurse's employment, the BON can provide the nurse with legal advice. D. The nurse must inform the physician of any reports the nurse files. - ✔✔A. The nurse cannot be disciplined by the BON or discriminated against by the employer. The board's Disciplinary Sanction Policy on Sexual Misconduct explains that A. suggestive language between the nurse and patient are acceptable only in a therapeutic nurse-patient relationship. B. sexual misconduct towards patients or in the workplace raises questions regarding the nurse's ability to provide safe, competent care. C. sex-related criminal activity by a nurse is a private matter and may not need to be reported to the board. D. sex between a nurse and patient is acceptable if the patient consents. - ✔✔C. sex-related criminal activity by a nurse is a private matter and may not need to be reported to the board. Knowing, recognizing, and maintaining professional boundaries of the nurse-patient relationship is a nursing standard. Which of the following is a violation of professional boundaries? A. A nurse borrows money from a patient to repair the nurse's car. B. A nurse accepts a box of candy from the patient and shares it with other staff. C. The patient shares a history of substance abuse that the nurse reports during shift change. D. A nurse report's a patient's communicable disease to the health department. - ✔✔A. A nurse borrows money from a patient to repair the nurse's car. The identity of a person submitting a complaint against a nurse to the BON is kept confidential
C. Advanced practice skills that the APRN learned in his or her advanced practice nursing program of study. D. Activities of daily living, health maintenance activities, and nursing tasks in compliance with BON Rules 224 and 225 on RN Delegation. - ✔✔D. Activities of daily living, health maintenance activities, and nursing tasks in compliance with BON Rules 224 and 225 on RN Delegation.
