Texas BON Study Guide: Jurisprudence Final Exam 1 Questions and Answers, Exams of Nursing

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Texas BON Study Guide, BON Quiz, Jurisprudence Final

Exam 1 Questions with Answers

A nurse who contacts a physician to clarify a medication order is - Correct Answer 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 - Correct Answer 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 - Correct Answer 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 - Correct Answer 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? - Correct Answer 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? - Correct Answer 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 - Correct Answer 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. - Correct Answer 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 - Correct Answer 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 - Correct Answer 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 - Correct Answer 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? - Correct Answer 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 - Correct Answer 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 - Correct Answer 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 - Correct Answer 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 - Correct Answer protections for a nurse who requests a peer review determination One way the board carries out its mission to protect the public is by - Correct Answer 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 - Correct Answer 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 - Correct Answer 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? - Correct Answer 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? - Correct Answer 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 - Correct Answer may not practice until the license has been renewed In a nurse-patient relationship, the most vulnerable patients are those who are - Correct Answer under anesthesia or sedation. Action by a nurse that would constitute unprofessional conduct according to Board Rule 217.12 Unprofessional Conduct describes which of the following? - Correct Answer 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 - Correct Answer 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 - Correct Answer a registered nurse or a licensed vocational nurse When deciding what course of action to follow, the nurse - Correct Answer 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 - Correct Answer 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? - Correct Answer The continuing competency info sheet In the NPA, "conduct subject to reporting" includes - Correct Answer 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 - Correct Answer 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 - Correct Answer 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: - Correct Answer 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 - Correct Answer can be completed only by a registered nurse The board has adopted Disciplinary Sanction Policies regarding all of the following EXCEPT - Correct Answer Guaranteed student loan According to Board Rule 217.3(a), Temporary Authorization to Practice, a new graduate, either a graduate vocational nurse (GVN) or a graduate professional nurse (GN), is required to avoid - Correct Answer being placed in a supervisory or charge position, and working in any independent practice setting Which of the following would NOT be required to establish a nursing peer review committee to conduct nursing peer review according to Section 303.0015 of the Nursing Peer Review Law? - Correct Answer Independent school district employing 7 nurses (4 RNs and 3 LVNs) Rule 216 related to Continuing Competency requires nurses to complete - Correct Answer 20 contact hours of continuing education within two years preceding license renewal Within the nurse licensure compact agreement, the party state that is the nurse's primary state of residence is called the nurse's - Correct Answer home state

When a nurse steals valuables (such as medications, money, jewelry, or credit cards) from a patient, this may be considered criminal as well as unprofessional conduct involving - Correct Answer theft of property Which of the following actions by a nurse would comply with the Standards of Nursing Practice in Board Rule 217.11? - Correct Answer Documenting an aspect of nursing care provided to a patient after the fact by following facility policy for making a "late entry. The BON differs from nursing and healthcare specialty associations since the BON - Correct Answer protects and promotes the welfare of the people of Texas Implement measures to promote a safe environment for clients and others describes A. The nurse's ability to invoke Safe Harbor. B. The employer's requirement for safe staffing levels. C. The nurse's duty to the patient. D. The employer's requirement to ensure the workplace meets OSHA safety standards. - Correct Answer B. The employer's requirement for safe staffing levels. The purpose of the Position Statements, guidelines and other documents in the Nursing Practice section of the BON webpage is to guide nurses in A. presenting a professional demeanor in a work setting. B. making decisions related to their patient care assignments. C. obtaining specialty certification. D. preparing for the NCLEX exam. - Correct Answer B. making decisions related to their patient care assignments. Which of the following is an example of the nurse maintaining professional boundaries of the nurse-client relationship? A. Accepting a $100 gift from the family of a hospitalized patient. B. Inviting the patient to come to dinner at her home after the patient is discharged.

C. Sharing candy from a patient with other staff and telling them the source of the candy. D. Providing her personal cell phone number to the patient. - Correct Answer C. Sharing candy from a patient with other staff and telling them the source of the candy. A nurse finds an elderly woman helpless and alone after the unlicensed caretaker quit without notifying the agency. The nurse is then fired for reporting the caretaker for possible abuse and neglect. Does the nurse have protection from negative employment action for reporting the above incident to the appropriate authorities? A. No, the nurse is not protected in this example. The nurse must always follow any directive from his or her boss. B. No, the nurse is not protected in this example as the employer can terminate the nurse for any reason at any time. C. It depends. The nurse may be protected, but only if the nurse can prove that the client was in an unsafe situation. D. Yes, the nurse is protected from negative employment action for reporting a situation that exposed the client to substantial risk of harm. This is known as "whistleblower protections." - Correct Answer C. It depends. The nurse may be protected, but only if the nurse can prove that the client was in an unsafe situation. A graduate vocational nurse (GVN) with current temporary authorization to practice is in a practice setting where no other licensed nurse is physically present. This situation would best be described as A. an acceptable practice due to the nursing shortage and the recent school experience of the GVN. B. an acceptable practice if a supervising nurse is telephonically available to supervise and advise the GVN. C. an unacceptable practice due to the lack of a licensed nurse who is physically present and readily available to directly supervise the GVN. D. an unacceptable practice because there must be a physician present in the practice setting to supervise the GVN. - Correct Answer C. an unacceptable practice due to the lack of a licensed nurse who is physically present and readily available to directly supervise the GVN.

An Incident-Based Nursing Peer Review Committee A. must make decisions about whether or not a nurse's employment should be terminated, and whether or not the nurse will be paid for accrued vacation time. B. may include the nurse's supervisor, charge nurse, and other management-level nurses who have administrative authority over the nurse. C. can prohibit the nurse from calling witnesses or asking questions during the hearing. D. must adhere to due process requirements for the nurse, unless the nurse has already been reported to the board and the committee is only reviewing the possible impact of external factors on the error. - Correct Answer D. must adhere to due process requirements for the nurse, unless the nurse has already been reported to the board and the committee is only reviewing the possible impact of external factors on the error. 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 A. criteria for determining a minor incident. B. rules that apply to RNs and not LVNs. C. criteria for determining safe staffing. D. protections for a nurse who requests a peer review determination. - Correct Answer D. protections for a nurse who requests a peer review determination. A nurse whose license has expired A. may not practice until the license has been renewed. B. has a 14 - day grace period in which to renew. C. may practice if documentation is cosigned by another nurse. D. will have his or her license revoked by the BON. - Correct Answer A. may not practice until the license has been renewed.

A nurse is assisting a physician when she witnesses 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. - Correct Answer A. The nurse cannot be disciplined by the BON or discriminated against by the employer. Board cases involving eligibility or disciplinary issues that are resolved through a board agreed order A. are public records and accessible on the BON's web page. B. are not subject to open records requests or accessible to the public. C. do not have to be sent to the nurse's last known employer or to the nurse. D. do not follow the nurse if the nurse decides to move to another state. - Correct Answer A. are public records and accessible on the BON's web page. One purpose of the BON's Position Statements and Guidelines is to provide A. step-by-step instructions to help the nurse complete complex tasks in the nurse's specialty area of nursing practice. B. guidance to help the nurse apply the NPA and board rules to a given situation so that the nurse can make appropriate decisions that promote safe nursing practice. C. information on employment opportunities, advanced training, and malpractice insurance discounts available through various professional nursing organizations. D. a specific list of tasks that a nurse can or cannot perform based on federal government guidelines. - Correct Answer B. guidance to help the nurse apply the

NPA and board rules to a given situation so that the nurse can make appropriate decisions that promote safe nursing practice. 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. - Correct Answer A. under anesthesia or sedation. The mission of the BON supersedes A. the licensing rules for acute care hospitals. B. the regulations for federal agencies. C. the interests of individuals, the profession, or special interest groups. D. the state laws that apply to medical supply services, medical facilities, and physicians. - Correct Answer C. the interests of individuals, the profession, or special interest groups. According to the Standards of Nursing Practice, Board Rule 217.11, a comprehensive nursing assessment A. focuses only on one aspect of the patient's status and nursing care needs. B. requires the nurse to make a medical diagnosis. C. can be initiated by a licensed vocational nurse and co-signed later by a registered nurse. D. can be completed only by a registered nurse. - Correct Answer D. can be completed only by a registered nurse. Why does the BON require nurses to disclose that they have been diagnosed with, treated for, or hospitalized with certain mental illnesses? A. Nurses diagnosed with these disorders are required to not practice in psychiatric settings due to their mental health issues.

B. Nurses diagnosed with these disorders may lack fitness to practice nursing safely and may require a period of monitored practice by the BON. C. Nurses with these diagnoses are likely to cross professional boundaries. D. The BON just needs the information for statistical tracking of how many nurses have mental health issues. - Correct Answer B. Nurses diagnosed with these disorders may lack fitness to practice nursing safely and may require a period of monitored practice by the BON. Which of the following actions by a nurse would comply with the Standards of Nursing Practice in Board Rule 217.11? A. Documenting the medication administration route as intramuscular (IM) (as per physician order) when the nurse accidently administered the medication intravenously (IV). B. Omitting healthcare information on a patient record at the patient's request. C. Documenting an aspect of nursing care provided to a patient after the fact by following facility policy for making a "late entry." D. Documenting a colleague's assessment findings as your own. - Correct Answer C. Documenting an aspect of nursing care provided to a patient after the fact by following facility policy for making a "late entry." 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. - Correct Answer D. the BON's rule concerning good professional character. A nurse fears that administration of a medication as ordered would place a patient at risk of harm. The nurse would fulfill his duty to the patient if the nurse A. advises the patient of the situation and proceeds only with the patient's consent.

B. informs the physician of his concern and requests clarification of the order. C. documents the rationale in the nurse's notes of the patient's medical record. D. requests that the physician release the nurse from responsibility. - Correct Answer B. informs the physician of his concern and requests clarification of the order. A temporary permit to practice nursing issued to a graduate of a board-approved nursing educational program A. is only necessary if the nurse does NOT plan to seek employment in nursing until licensed. B. is required only for candidates for a vocational nursing license. C. allows a GN or GVN to practice independently with no other licensed nurse present in the practice setting. D. may be denied based on a licensure candidate's criminal history. - Correct Answer D. may be denied based on a licensure candidate's criminal history. Revisions to the NPA can only occur through A. majority popular vote of all nurses. B. petitions from nursing professional organizations. C. bills passed by the U. S. Congress. D. bills passed by the Texas Legislature. - Correct Answer D. bills passed by the Texas Legislature. Within the nurse licensure compact agreement, the party state that is the nurse's primary state of residence is called the nurse's A. place of birth. B. contract state. C. jurisdiction. D. home state. - Correct Answer D. home state. One way the board carries out its mission to protect the public is by

A. ensuring that each nurse is competent to practice safely. B. mandating student admission requirements for schools of nursing. C. ensuring a positive image of nursing. D. facilitating a nurse's ability to practice in other states. - Correct Answer A. ensuring that each nurse is competent to practice safely. A nurse was terminated from three different jobs because 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. - Correct Answer A. the nurse will repeat similar conduct and exploit patients who trust the nurse to act in their best interest. 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 as least once. - Correct Answer B. obtain a list of tasks a nurse may perform from the BON. In Texas, advanced practice registered nurses (APRNs) may delegate which of the following to unlicensed assistive personnel?

A. APRNs can delegate anything a physician would delegate, as APRNs are educated to engage in some aspects of medical diagnosis and medical management. B. Medical diagnosis and nursing assessment in compliance with BON Rules 224 and 225 on RN delegation. 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. - Correct Answer D. Activities of daily living, health maintenance activities, and nursing tasks in compliance with BON Rules 224 and 225 on RN Delegation. A person with a history of 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. - Correct Answer C. attendance at Alcoholics Anonymous meetings 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 A. the LVN must have a supervisor, as outlined in Rule 217.11, accessible at least telephonically or by some other similar means. B. the LVN must have a registered nurse present at all times while they are providing direct patient care. C. a social worker can be the LVN's resource person but the LVN must still work with other healthcare personnel. D. this is a requirement for hospitals so LVNs that work in long-term care facilities are exempt from having a directed scope of practice. - Correct Answer B. the LVN must have a registered nurse present at all times while they are providing direct patient care.

According to the NPA, Section 301.452 Grounds for Disciplinary Action, the definition of "intemperate use" includes A. drinking alcohol at a social engagement. B. demonstrating unprofessional conduct and displays of anger against co-workers. C. being on-call or on duty while under the influence of alcohol or drugs. D. improperly administering medications to assigned clients. - Correct Answer C. being on-call or on duty while under the influence of alcohol or drugs. According to the NPA section 301.403, the Peer Review Committee must report which of the following to the board? A. Any minor incidents the nurse makes while caring for patients. B. A description of any corrective action taken against the nurse. C. The names and addresses of the Peer Review Committee members. D. An organizational chart that reflects the reported nurse's position in the agency. - Correct Answer B. A description of any corrective action taken against the nurse. 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: A. the nurse may convince the committee the errors were not her fault, and the committee can then withdraw the CNO's report to the BON. B. the IBPR Committee can decide to reverse the CNO's decision to terminate the nurse's employment. C. the IBPR Committee may decide to re-orient and re-train the nurse even though she was fired. D. 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. - Correct Answer D. 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.

In order for a nurse to appropriately carry out his or her "duty to the patient," the nurse must A. demonstrate strict adherence to professional dress code requirements. B. follow facility policies, whether they are congruent with what the nurse learned in school or not. C. consistently act in the best interest of every patient under the nurse's care. D. achieve a score of 70 percent or better on his or her annual employment performance evaluation. - Correct Answer C. consistently act in the best interest of every patient under the nurse's care. 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. - Correct Answer C. Position Statement 15.14 Duty of a Nurse in Any Setting. The initial step to invoke Safe Harbor requires that a nurse A. notify the supervisor and submit a written Quick Request for Safe Harbor to the supervisor before accepting the assignment. B. complete a written request to Petition for a Declaratory Order. C. hire an attorney so that all correspondence can be sent through the nurse's legal counsel. D. complete a Licensure Renewal Form, give it to the supervisor, and wait to be notified of the date and time for the peer review hearing. - Correct Answer A. notify the supervisor and submit a written Quick Request for Safe Harbor to the supervisor before accepting the assignment.

An advertisement for a "licensed nurse" states the following as routine job responsibilities: "Must work independently without supervision; have expertise in developing nursing care plans, including establishing appropriate nursing diagnoses for assigned patients; and, must be able to complete comprehensive nursing assessments." Based on these responsibilities, this advertisement would require, at a minimum, the nurse to hold a valid A. Advanced Practice Registered Nurse license. B. Physician Assistant license. C. Vocational Nurse license. D. Registered Nurse license. - Correct Answer D. Registered Nurse license. An advanced practice registered nurse in an outpatient clinic could delegate which of the following tasks to an unlicensed clinical staff member? A. Administering intramuscular (IM) and subcutaneous (SQ) injections other than insulin. B. Calling in prescription refills of a PRN pain medication for which no refills have been authorized. C. Reviewing routine laboratory results and calling the patient to tell the patient what the results mean. D. Cleansing and dressing a minor leg wound in accordance with step-by-step instructions. - Correct Answer D. Cleansing and dressing a minor leg wound in accordance with step-by-step instructions. 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 reports a patient's communicable disease to the health department. - Correct Answer A. A nurse borrows money from a patient to repair the nurse's car. A professional nursing association determines that a nurse cheated on a national certification exam. The association disqualifies the nurse from being eligible to seek certification, and suspends the nurse's membership privileges for the association. According to the NPA Section 301.406, Duty of Professional Associations and Organizations to Report, the professional association A. has authority to mandate that the BON suspend the nurse's license in Texas. B. also has a duty to report the nurse to the BON. C. must publish this disciplinary action against the nurse in the yearly newsletter to its members. D. is required to make a report to local law enforcement authorities as the nurse's deliberate act of cheating may also be considered criminal conduct. - Correct Answer B. also has a duty to report the nurse to the BON. A DON terminates a nurse's employment after the nurse reports unsafe conditions to the facility's licensing entity. Whistleblower protection would apply to the nurse A. dependent upon the nurse having liability insurance. B. if the accusations were made in good faith. C. if he or she cannot afford legal counsel. D. after a peer review committee determination. - Correct Answer B. if the accusations were made in good faith. Conduct by a nurse that is subject to reporting to the BON includes all of the following EXCEPT: A. conduct that violates the NPA or a board rule and contributed to the death or serious injury of a patient. B. conduct that constitutes a single minor incident in compliance with Board Rule 217.16, Minor Incidents.

C. conduct that indicates the nurse lacks the knowledge, skill, judgment, or conscientiousness to such an extent that the nurses continued practice could reasonably be expected to result in patient harm. D. conduct that constitutes abuse, exploitation, fraud, or a violation of professional boundaries. - Correct Answer B. conduct that constitutes a single minor incident in compliance with Board Rule 217.16, Minor Incidents. 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. - Correct Answer D. protects and promotes the welfare of the people of Texas. According to Rule 217.12(1), Unprofessional Conduct, one example of an unsafe practice includes failing to A. provide a two-week notice when leaving employment. B. attend a scheduled staff meeting. C. arrive at work on time twice during the last month. D. manage client records properly. - Correct Answer D. manage client records properly. The Standards of Nursing Practice, Board Rule 217.11 state that the LVN scope of practice includes 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. - Correct Answer C. Participate in the modification and development of the nursing care plan.

A nurse is attracted to a patient and insists on being assigned to care for this patient every shift she works. As a result there are reports of the nurse not completing other assignments. In this example the nurse A. is merely demonstrating caring behaviors. B. is ensuring continuity of care. C. has become overly involved and is at risk of committing a boundary violation. D. is acting appropriately in maintaining a therapeutic nurse-patient relationship. - Correct Answer C. has become overly involved and is at risk of committing a boundary violation. When a nurse steals valuables (such as medications, money, jewelry, or credit cards) from a patient, this may be considered criminal as well as unprofessional conduct involving A. violence against a person. B. theft of property. C. illicit drug use. D. lying and falsification. - Correct Answer B. theft of property. 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 A. current sobriety and fitness to practice. B. good employer evaluations. C. attendance at five Alcoholics Anonymous meetings each week. D. support system of family and friends. - Correct Answer A. current sobriety and fitness to practice. 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

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 recently observed a supervisor complete the procedure. D. the tube has been in place for 4 - 6 weeks and the nurse had been determined to be competent in reinserting permanently placed tubes that have an established fistulous tract. - Correct Answer 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. 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. - Correct Answer A. conduct that causes a person to suspect that the nurse's practice is impaired by chemical dependency or drug or alcohol abuse. 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 fine 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 successfully retake the NCLEX exam. - Correct Answer C. will not be eligible to apply

for an initial nursing license until five years after being released from community supervision or parole. 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." - Correct Answer A. rewards a patient with a small stuffed mascot of his favorite football team for progress made in rehabilitation. As a nurse in TX what 2 set of rules should you follow? - Correct Answer Nursing Practice Act- NPA BON Rules & Regulations Where can you download rules from the BON & NPA? - Correct Answer from the BON's website at www.bon.texas.gov Where do the BON's rule changes appear? - Correct Answer In the newsletter How often is the newsletter mailed? - Correct Answer quarterly or every 3 months Where can proposed rules open for public comment be viewed? - Correct Answer - Secretary of states website www.sos.state.tx.us

• in the BON's offices
• in the Texas Register's Office room 245 James Rudder building 1019 Brazos st in Austin

Recite the TX BON mission - Correct Answer The mission of the TXBON is to protect and promote the welfare of the people of TX by ensuring that each person holding a license as a nurse is competent to practice safely. How many board members are on the BON? - Correct Answer 13 Who are the tx BON members appointed by? - Correct Answer governor How does the board fufill its mission? - Correct Answer - regulates practice of nursing

• approves nsg education programs What kind of rules can the board adopt and enforce. (4) - Correct Answer 1. rules to perform its duties and conduct proceedings in front of the board

2. rules to regulate the practice of RN's & LVN's
3. rules to establish standards for professional conduct of license holders
4. determine if an act constitutes professional nursing or vocational nursing. What defines the LVN's scope? - Correct Answer - Nursing Practice Act

• BON's Rules & Regulation What is the LVN responsible for? - Correct Answer providing safe compassionate and focused nursing care to assigned patients with PREDICTABLE health care Where are the TX nursing program competencies located? - Correct Answer In the Board's Differentiated Essential Competencies (DECs) of Graduates of the Texas Nursing Programs Who is required to make sure nursing graduates are up to par with the DEC's? - Correct Answer The Nursing programs What do the DEC's serve as? - Correct Answer guidelines for employers to assist LVN's as they transition from an educational environment into nursing practice.

Who is the LVN an advocate for? - Correct Answer the patient & patient's family Who can LVN's practice under? - Correct Answer 1. RN

2. APRN
3. Physician
4. Physician Assistant
5. Podiatrists
6. Dentist Define Supervision - Correct Answer the active process of directing, guiding, and influencing the outcome of an individual's performance of an activity Can the LVN practice in a completely independent matter? - Correct Answer No Things the LVN scope does not include - Correct Answer - medical diagnosis

• prescription of therapeutic or corrective measures Lvn settings should have... - Correct Answer well defined policies, procedures, & guidelines How long should an LVN work in a structured setting? - Correct Answer 12 - 18 months Examples of structured settings - Correct Answer NSg homes hospitals, rehab facilities skilled nsg; clinics or private dr's offices What kind of approach should the LVN use when caring for multiple patients? - Correct Answer a systematic problem solving approach

What kind of nsg care should the LVN provide? - Correct Answer individualized, goal directed nursing care How many steps are in the nursing process for LVN's? - Correct Answer 4 APIE RN tasks prohibited from delegation - Correct Answer 1. assessment

2. formulation of a nursing care plan
3. implementation of parts of the nursing care plan
4. responsibility and accountability of health education
5. dose calculation
6. injectable meds except insulin
7. meds via a non permanent tube
8. verbal & telephone orders
9. Initial dose What are the 5 rights of delegation? - Correct Answer Right Task Right Circumstance Right Person Right Direction/ Communication Right Supervision/ Evaluation Define CNE - Correct Answer programs beyond the basic nursing preparation that are designed to promote and enrich knowledge, improve skills, and develop attitudes for the enhancement of nursing practice, thus improving healthcare to the public. How often should you renew CNE? - Correct Answer Every 2 years How many CNE hours are required each renewal - Correct Answer 20 contact hours; extra CNE hours do not roll over