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An overview of various rules, regulations, and guidelines set by the texas board of nursing (bon). It covers topics such as the nurse's duty to keep patients safe, reporting requirements, scope of practice, professional boundaries, and disciplinary actions. The document aims to educate nurses on their responsibilities and the bon's expectations to ensure safe and ethical nursing practices in texas. It addresses key aspects of the nursing practice act, bon rules, and position statements that nurses should be aware of to maintain compliance and provide quality patient care.
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A nurse who contacts a physician to clarify a medication order is - fulfilling a duty to keep the patient safe. 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 with the nurse about the BON's formal charges, Board Rule 213.16(i) on Practice and Procedure requires that - the case proceed and the board's charges be deemed to be true. When the BON considers imposing disciplinary action, it is most concerned with the nurse consistently - acting in the best interest of clients A nurse quits his job, and submits a written notice at the end of his shift, telling his supervisor that he will not be back at work the following morning. The supervisor tells the nurse he has to complete the entire month's schedule or he will be committing "patient abandonment," and will be reported to the BON. This is - false. Quitting a job at the end of a shift is not considered "patient abandonment" by the BON and is not grounds for reporting to, or action by, the BON. Which of the following would indicate that an applicant for licensure is likely to possess the good professional character necessary to hold a nursing license in Texas? - the applicant provides satisfactory evidence that he/she has not committed a violation of the Nursing Practice Act or a Board rule Which of the following statements correctly reflects Board Rule 217.20 regarding the Safe Harbor Peer Review? - 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 places patients at risk of harm The identity of a person submitting a complaint against a nurse to the BON is kept confidential - throughout the entire investigation process A nurse assesses a patient, makes a medical diagnosis of "hypertension," and determines which specific anti-hypertensive medication (including dose, route, and frequency) is appropriate for this patient. The
nurse then writes a prescription for an anti-hypertensive medication and instructs the patient to have it filled at a pharmacy of her choice. - the nurse must be authorized by the BON as an advanced practice registered nurse with prescriptive authority in a role and population focus appropriate for the patients being treated Revisions to the NPA can only occur through - bills passed by the Texas Legislature The Position Statement 15.27 The Licensed Vocational Nurse Scope of Practice on the board's website outlines that LVNs have a "directed" scope of practice "under supervision." This means that - the LVN must have a registered nurse present at all times while they are providing direct patient care A nurse providing nursing services to a young child in a home setting asks the parent to bring the child to the nurse's home for nursing care. The nurse asks the parent to keep this arrangement confidential. This could be considered - a violation of professional boundaries of the nurse-client relationship 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? - Position Statement 15.14 Duty of a Nurse in Any Setting Chart audits find the following practice 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 - 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 A nurse would be fulfilling his or her duty to safeguard patients from harm if the nurse - recognizes that a patient's condition is deteriorating, acts to stabilize the patient, and reports the patient's status to the physician A person with a history of chemical dependency on controlled substances who desires to obtain or retain a license to practice nursing may be required to provide evidence of - current sobriety and fitness to practice
A nurse may not be reported to the BON, may not have his or her license sanctioned by the BON, and may not be suspended or terminated from his or her employment for either appropriately invoking Safe Harbor or for advising another nurse of their right to invoke Safe Harbor. These are - protections for a nurse who requests a peer review determination One way the board carries out its mission to protect the public is by - ensuring that each nurse is competent to practice safely Which of the following situations is an example of a nurse MAINTAINING appropriate professional boundaries between the nurse and the client? A nurse - rewards a patient with a small stuffed mascot of his favorite football team for progress made in rehabilitation According to BON Position Statement 15.24 Nurses 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 - 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 Which of the following is an example of the nurse maintaining professional boundaries of the nurse- client relationship? - Sharing candy from a patient with other staff and telling them the source of the candy Why does the BON require nurses to disclose that they have been diagnosed with, treated for, or hospitalized with certain mental illnesses? - Nurses diagnosed with these disorders may lack fitness to practice nursing safely and may require a period of monitored practice by the BON A nurse whose license has expired - may not practice until the license has been renewed In a nurse-patient relationship, the most vulnerable patients are those who are - under anesthesia or sedation. Action by a nurse that would constitute unprofessional conduct according to Board Rule 217. Unprofessional Conduct describes which of the following? - Failing to repay a guaranteed student loan
A nurse injects a medication by IV (intravenous) Push instead of IM (intramuscular) as ordered by the physician. The patient goes into cardiac arrest and dies as a result of this medication error. The nurse has worked at the facility for 15 years and this is his first error. A correct determination by the Peer Review Committee would be that - the error is subject to reporting because it contributed to the death of a patient 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 registered nurse or a licensed vocational nurse When deciding what course of action to follow, the nurse - has a duty to always keep the patient safe A LVN learns that a facility licensing law requires that a registered nurse always perform a specific task related to admission of new patients. The LVN understands that this means he or she - may not perform the task, as the RN level of licensure is necessary to perform the task Which of the following resources on the BON web page would assist a nurse in determining his or her scope of nursing practice? - The continuing competency info sheet In the NPA, "conduct subject to reporting" includes - conduct that causes a person to suspect that the nurse's practice is impaired by chemical dependency or drug or alcohol abuse The best method of notifying the BON about reportable violations by a nurse of the NPA and board rules is to - complete the reporting form on the BON website though you may remain anonymous and not provide a signature To help a nurse decide if a task is within his or her individual scope of practice, a prudent nurse should - obtain a list of tasks a nurse may perform from the BON A nurse is terminated and reported to the BON for committing repeated practice errors. As required in the NPA, the CNO also sends the case to the Incident Based Peer Review (IBPR) Committee because: - the IBPR Committee is required to review external factors surrounding the practice errors and to report to the facility's Patient Safety Committee as appropriate
According to the Standards of Nursing Practice, Board Rule 217.11, a comprehensive nursing assessment