TEXAS JURISPRUDENCE EXAM AND PRACTICE EXAMS, Exams of Nursing

Download TEXAS JURISPRUDENCE EXAM AND PRACTICE EXAMS and more Exams Nursing in PDF only on Docsity! 1 | P a g e TEXAS JURISPRUDENCE EXAM AND PRACTICE EXAMS WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED RATIONALES ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |LATEST 2024 |ALREADY GRADED A+ | GUARANTEED PASS TEXAS JURISPRUDENCE EXAM If a physician is treating a patient suffering from chronic pain with extended drug therapy, and enters into a written pain management agreement with a patient, which of the following is not required to be included in the agreement? C. the patient agrees to see a mental health professional If a physician is going to treat a patient with an alternative treatment instead of the standard of care, the treatment plan must: D. All of the above Which of the following is true regarding the corporate practice of medicine in Texas? B. Corporate practice of medicine is prohibited If patient medical records are requested in an emergency, you may still charge the patient. B. False Dr. K's sister asks her to prescribe antibiotics to her minor child. Dr. K does not believe that antibiotics are indications... is insistent so Dr. K writes the prescription. Is this a violation of the Medical Practice Act or Board rules? A? Texas law requires that when a physician dispenses a controlled substance, they must maintain prescribing records under the Controlled Substances Act be kept for a minimum of how many years? C. 2 years and any other minimum required by federal law After your Texas License is issued to you by the Medical Board, you must: C. Register 2 | P a g e A physician who has just completed residency in any specialty may advertise as being "board eligible" in that specialty. B. False Patient Sally requests her medical records from Dr. P. However, Dr.P's staff person who copies is on maternity leave. How long does Dr.P have to comply with the patient's request? C. 15 business days The Medical Board will notify you by mail at least 30 days before your registration permit expires. B. False 60 days Dangerous drugs or devices are those that are unsafe for self-medication and that are not classified as controlled substances under the Texas Controlled Substances Act. A. True A licensed physician who suffers from an impairment that affects their ability to actively practice medicine must report this impairment to the Medical Board at the time they renew their license. A. True A physician is required to notify the Medical Board within 30 days of the following events except: C. Obtaining board certification You have been practicing in Texas for a couple of years when you realize that your registration has been expired for 24 days. Which is the best course of action? B. Go online and renew In Texas, a pregnant minor is emancipated for all purposes. B. False Is a free standing clinic owned by a hospital considered a facility-based practice for the purposes of supervising a PA or APRN? No Generally, a physician may only delegate prescribing authority to how many physician assistants or advanced practice registered nurses combined? C.7 Medical Board complaints filed at the State Office of Administrative Hearings against a physician are disclosed in the physician's public profile. B. False The definition of "dangerous drug" includes scheduled narcotics. B. False 5 | P a g e A physician or surgeon may not accept or agree to accept any payment, fee, reward or anything of value for soliciting patients or patronage for any physician or surgeon. A violation constitutes a Class A misdemeanor and each payment, reward, or fee or agreement to accept a reward or fee is a separate offense. You are the clerkship director for pediatrics at a Texas medical school. A physician you know from residency contacts you and asks if he can teach in the pediatric clerkship program. The physician has recently had his license suspended by the Medical Board. Can you allow the physician to teach at the medical school? If the treatment plan for chronic pain included extended drug therapy, the physician should consider signing a written pain management agreement between the physician and he patient outlining patient responsibilities. Can you cease to hold face-to-face meetings with an APRN to whom you have delegated prescriptive authority after the physician/delegate relationship has been firmly established and still allow the delegate to continue prescribing to patients? Can a patient successfully sue a doctor if there is no physician-patient relationship? No If there is no prior physician-patient relationship, are you legally obliged to respond to a call from a patient for treatment? No Does being on call give rise to a physician-patient relationship? No How can one terminate a physician-patient relationship, without abandonment if there is ongoing treatment? 30 days written notice; must provide for emergency Does a physician's duty extend to the unborn child or potential victims of an ill patient? Yes What is "proximate cause"? Prove that negligence caused harm and that the cause was not too remote; what is required to hold a defendant liable in a civil lawsuit What are the two components of proximate cause? Cause-in-fact (but-for test) and foreseeability Does an expert witness have to be actively practicing medicine? Yes 6 | P a g e Does an expert witness have to know standards of care? Yes Does an expert witness have to have enough training to express an opinion on whether standard of care was provided? Yes Does an expert witness have to be board certified? No, board certified or eqivalent In a medical malpractice case, are expert witnesses required? Yes, with two exceptions In a medical malpractice setting, what 2 instances do not need expert testimony? Res ipsa loquitur (e.g., amputation of wrong leg) and negligence per se (a law was broken) What are "exemplary damages"? Damages above compensatory designed to punish the defendant and deter the behavior Is there a cap to noneconomic damages? How much? $250,000 for physicians, $500,000 for hospitals Does the cap on noneconomic damage depend on the number of defendants or claimants? No What is "proportional responsibility"? Percentage of liability apportioned according to percentage of fault Can the claimant have part of the proportional responsibility? Yes If the claimant's proportionate responsibility is more than what %, he/she may not recover damages? If > 50%, no damages awarded How long is the statute of limitations for adults? For minors? 2 years; for minors 2 years after becoming 18 years of age By how much can the statute of limitations be extended and how? File complaint—extra 60-day, notice letter extends statute by 75 days What is the statute of limitations for wrongful death? 2 years 7 | P a g e What is the discovery rule? Give examples. Statute does not begin until damage is discovered. For example, a retained sponge that is found 3 years post-op Is there immunity from civil action in emergency cases? Yes, except gross negligence Is there immunity from civil action in volunteer care? Yes, except gross negligence When can a physician be charged with "assault and battery"? Un-consented surgery or examination or when exceeding the scope of the consent When can a physician be charged with patient abandonment? Unilateral cessation of treatment when continued treatment is necessary What is "strict liability"? Liability that does not depend on actual negligence, but that is based on a breach of a duty to make something safe. This often applies to product liability Are hospitals liable for the actions of a physician? No, unless the hospital employs the physician Who determines in a criminal case if the medical records of a patient should be released? Judge by inspection How many days do you have to release medical records to an attorney? 45 days Can medical records be admitted as evidence in court? What are the requirements? Yes, but only with affidavit What are schedule 1, 2, 3, 4, 5 drugs? Schedule 1—no known use (e.g., heroin); schedule 2—very addictive (morphine, cocaine); schedule 3- 5—less addictive What are dangerous drugs? Prescription drugs other than schedule 1-5 How many DEA registrations do you need if you prescribe drugs? dispense drugs? One to prescribe; a separate registration for each location where you dispense How often do you renew your DEA license? 10 | P a g e At least 2 physicians with advanced competency How many days do you have to report office-based anesthesia-related complications? 15 days What is considered an anesthesia-related complication? Admission to hospital within 24 hours or death within 72 hours What is considered intractable pain? Pain where cause of pain cannot be removed and where relief or cure has not been found Can a hospital forbid a physician to give dangerous drugs or controlled substances for treatment of intractable pain? No Can the board take disciplinary action against a physician for giving dangerous or controlled substances to a patient with intractable pain? No What must the physician document prior to treatment of intractable pain? Understanding between physician and patient about treatment; dose, type, frequency of medication; consultation with psychologist, psychiatrist, addictions expert Can you guarantee that a drug will work? No Who can be part of a confidential communication? Persons involved, furthering interest of the patient, and those participating in diagnosis or treatment, e.g., patients, doctors, translators, nurses, etc Is the billing record confidential? No, billing record is NOT part of medical record In a criminal proceeding, is the physician-patient privilege communication confidential? NO (except for mental health records); judicial ruling should be obtained In a criminal proceeding, are records of alcohol and drug abuse confidential? Yes Does the physician confidentiality apply to court or administrative proceedings brought by the patient against a physician? No 11 | P a g e Can the physician violate confidentiality if he/she thinks he or someone else is in danger? Yes, must report that to law enforcement agency (NOT for mental health) What information must a release of medical records include? Type of records, reason, and person to whom to release How many days (hospital) or business days (physician) does a hospital/physician have to provide medical records when they are requested? Physician has 15 business days, hospital has 15 days What is "therapeutic privilege," when can it be used, who has access to the information, and what is the protocol the physician must follow? If physician thinks that information would be harmful to the patient, it can be withheld; in writing, copy in the chart; films or tests must be released to patient representative Can the physician charge for medical records and films? For an affidavit? Does he have to give the information if the patient does not pay? What does he do if the patient does not pay? Yes, can charge $25 for first 20 pages, then 15¢ per page plus postage; notarization $15, films $8; patient MUST pay to get records, 10-day notice Can you charge a patient requesting records in order to apply for disability or public aid? How many copies are patients entitled to? Can you charge if federal agency is requesting records? No; one copy; no How many years does a physician MD have to keep records for adults? for minors? How many years do hospitals have to keep records for adults? For minors? 7 years for adults, 7 years or until age 21; hospital 10 years Can a physician or hospital get rid of records after the required years if these records might be part of a litigation? No Can you relate information without patient consent for treatment? Billing? To report abuse? To law enforcement? For funeral directions? For worker's comp? Yes, all of the above What is the "minimum necessary standard" for a medical release? It protects health care information unless it is required to be released (investigation, law enforcement, authorized release, participating care providers, HIPAA compliant release) Does a patient have the right to see his/her own record? Can he/she ask for amendments to the records? Yes; yes, they can request amendments 12 | P a g e What is the Texas medical record privacy act? Is it like HIPAA? It is the state equivalent of HIPAA Within how many days must a hospital send an itemized bill to patients? Is this mandatory? Or done by request? When must the hospital inform patients of this option? Upon request, within 30 business days; hospital must inform patient of availability of itemized bill Can medical records be obtained with a subpoena? Does this include substance-abuse records? Yes; no Are substance abuse records admissible during criminal proceedings? No, unless the crime is EXTREMELY serious Is HIV information confidential? Yes Can you "break" confidentiality in order to tell a spouse that his/her spouse is HIV positive? Yes Can you break confidentiality to tell a partner about notification program?. Yes Are blood bank records confidential? Yes If a blood bank finds a donor with an infectious disease, can they call other blood banks and tell them the name of donor and the disease?Edition. They can tell name of donor, NOT disease If a blood bank finds that blood outbound to hospitals is HIV positive, can they call the hospitals and give name of donor? Type of disease? They can tell name of disease, NOT donor For statistical purposes, can a blood bank give out medical records? Names? Yes, but not names or other identifying information Is genetic information confidential? Yes Can patients have access to the results of their genetic testing? Yes What kind of crime is the unauthorized release of records? 15 | P a g e What is a telemedicine license? Do you have to be board certified to have it? Do you have to pass the jurisprudence exam? A license to do consulting work through internet, etc., in Texas; cannot physically see or treat patients; board certification is required; JP exam required How often do you register your license? Do you need an updated physician profile? Every 2 years; yes How many days prior to the expiration of your license does the TMB notify you? 30 How many days after a license expires are you considered to be practicing without a license? 30 day grace period. License expired < 90 days—penalty is? $75 License expired 91-364 days—penalty is? $150 License expired > 364 days—penalty is? Cancellation Do you have to retake JP exam if your license is canceled? Only if the license is canceled for more than 2 years. How can you get another license if it is lost/destroyed? Get affidavit of lost or destroyed document and pay fee to board How many category 1 CMEs yearly? 12 How many CMEs per year? 24 How many category 1 CMEs yearly must be in ethics? 1 How many category 2 CMEs can be from volunteer work? 6 How many CMEs can a license carry forward? And for how many registration periods? 16 | P a g e 48; only once How many CMEs can be applied retroactively? 24; only once How many CMEs do you need if you become "board certified" within 36 months? 24 If you practice pain management, how many CMEs in pain management are required? None, but they are recommended Who can initiate a complaint to the board? Anyone What is the "health professions council"? Council of various professionals that establishes a central telephone complaint system (800-number) Does the TMB have to notify a physician when a complaint is filed? Are there exceptions? How often do the parties get updated on proceedings? Yes, within 30 days, except if it would interfere with the investigation; updates are quarterly When does the TMB release complaint information to the hospital? Upon written request Who investigates issues of "medical competency"? An expert physician panel appointed by the board consisting of physicians ONLY What do medical malpractice carriers have to report to the TMB regarding malpractice? Within what time limit? Who punishes them if they do not report? What does a physician without insurance have to report and when? Is there a difference for NPDB/HCQIA? Within 30 days from a complaint being filed in a lawsuit, settlement; noninsured MDs have to self-report within 30 days; any payment must be reported to NPDB by HCQIA requirements Restrictive action by the TMB: Within what time limit must the board tell the hospital? Tell Medicare? Tell the secretary of health & professional societies & complainant? Next working day for hospitals; in writing for all within 30 days. Restrictive action by the TMB: How often must the board make public notices about disciplinary orders? 2 times per year. Restrictive action by the TMB: Must the board report crimes found during investigations? Yes, to the law enforcement. 17 | P a g e Restrictive action by the TMB: Within how many days must the board report to the NPDB? 30 days. Restrictive action by the TMB: Within how many days must a court report to the board about convictions, felonies, and misdemeanors and addiction issues be filed? 30 days. Are TMB reports confidential? Yes Who can the NPDB give info to? How about to patients? How about statistical data? Hospitals, self-requesting physicians, board, other state or federal agencies, attorneys; for statistical purposes if no identity disclosed When is it not illegal to perform a third-trimester abortion? To prevent mother's death, if unborn has severe irreversible brain damage When is it not illegal to perform an abortion on a minor? In emergency and with court order Is sexual contact between a physician and patient OK if the patient consents? NO, the disparity of power does not allow consent Why is it unprofessional to initially prescribe drugs over the Internet? Did not verify identity of patient, no physician coverage or follow-up guaranteed How can you terminate care to a patient? 30 day notice, certified letter, available for emergencies during that time, give alternative physicians What prescriptions does a physician need to keep records on? Dangerous drugs? Controlled substances? Samples? Samples and dangerous drugs as part of medical record; for schedule 3-5 records and log; for schedule 2 separate log and records; keep record for 2 years; do inventory on schedule drugs every 2 years Can the board administer monetary penalties? Yes What happens to his/her license if a physician goes to prison? TMB is required to suspend How many malpractice claims within what time period automatically open a board investigation? 3 within 5 years 20 | P a g e Yes (e.g., eye prophylaxis) Is a physician liable for the actions of a NP or PA? No, unless vicariously liable due to employment What kind of name identification do PAs need? Name tag identifying themselves as a physician assistant What requirements exist for prescription for PAs and NPs? No schedule 2; maximum 90 days, no refills unless consultation with physician Which drug schedules can PAs and NPs prescribe? How many days? Can they give refills? Can they treat children? What ages? Schedules 3-5, 90 days, refill after consultation with physician; Yes, but children less than 2 years only after consultation with physician How many PA and NP equivalent FTEs can a physician supervise at maximum? 3 FTEs Can CRNAs give all anesthetic drugs? Are they restricted to a particular MD? Yes; no, any MD What authority do pharmacists have? Can they give immunizations? Where does the supervising physician have to be located geographically? Getting histories, ordering drug therapy-related tests, procedures, modifying drug therapy; yes; physician has to be able to be physically present daily What can optometrists prescribe? Eye ointments Can anybody be a surgical assistant? Do they need a license? Yes; yes, if they identify themselves as licensed, otherwise, no Can a physician delegate the taking of X-rays to noncertified technicians? Yes Can they do bone density? Nuclear tests? CT? Skull X-ray? Bone density, skull, spine, extremities, abdomen, chest; NOT CT, nuclear test, etc Do they need to be licensed or registered by the boards? Yes, they need registration What is the difference between a partnership and a limited liability partnership? 21 | P a g e The limited liability partnership can limit individual liability white partner A is liable for the acts of partner B Who can incorporate in Texas? Can physicians practice through corporations? Dentists, PT but NOT MD; MD cannot practice through corporation Are there any corporations that can employ physicians? Yes, Certified Nonprofit Healthcare Corporation Who can grant a title of Certified Nonprofit Healthcare Corporation? TMB What are 5 important characteristics of Certified Nonprofit Healthcare Corporations? Must conduct scientific research, support education, improve capabilities to study and teach, deliver health care to the public, instruct public in medical science, public health Can hospitals provide "physician guarantees"? How do the finances work? Physicians can contract with hospitals but are not employees; guarantees paid for availability, billing, etc Are there federal anti-kickback laws? Yes What does the health care insurance portability and accountability act do to federal anti-kickback provisions? Applies to all federal health care insurances = all insurances Do the anti-kickback laws apply only to Medicare and Medicaid? No Does federal anti-kickback law apply only to patient referrals? No Does this law apply only to giving money as a kickback? Who is punished, giver or taker? No, any money or monetary value; both are punished What kind of crime is a violation of anti-kickback law, and what is the penalty for physicians and hospitals? Felony; up to $250,000 for individuals and $500,000 for institutions 22 | P a g e What are safe harbors in anti-kickback law? Give examples. Acts NOT in violation of anti-kickback regulation; e.g., space and equipment rental, sale of practice, discounts, etc Are STARK laws federal? Yes What is a STARK law? Can you refer to family? Anti-self-referral law; no What is the difference between STARK 1 and STARK 2? Stark 1 applies to laboratories, Stark 2 to PT, OT services, etc What is the CIVIL FALSE CLAIMS act? Is it state or federal? How long has it been around? What does it prohibit? Submitting false claims to government for payment; federal law since War Between the States Does Texas prohibit remuneration in exchange for referral volume? Yes, prohibition on the solicitation of patients What kind of crime is it to tamper with Texas Medical Board documents? Class A Misdemeanor Barratry—what is it? Is it illegal? Contacting prospective patients in attempts to solicit them; it is illegal Who can be part of a medical peer review committee? Physicians, health care workers, anybody in the hospital Does physician competency include membership in societies, participation in education, participation in group plans? No Who makes rules (by laws) for hospitals? The governing body Can a hospital reject an orthopedist because he is a DO and not an MD? No Can a hospital deny you privileges because you don't accept HMOs? Participate in other hospitals? No Who makes the final decision in a hospital to grant or deny privileges to a physician? 25 | P a g e No In what instance can a child give consent? If on active duty, when restrictions of minor removed, for communicable disease, if pregnant for counseling, and addiction treatment Does the Consent to Medical Treatment Act apply to "incapacitated" individuals? Does it apply to psychiatry patients? Yes; yes, but not for patients in FREE-STANDING psychiatric hospitals Who can be a surrogate decision maker? What are the requirements? Spouse, adult child, majority of children, parents, or a person identified by patient before becoming incapacitated Can surrogate decision maker consent to voluntary inpatient psych treatment? ECT treatment? Appoint another surrogate decision maker? Not psych treatment, not ECT, cannot appoint another decision maker What are 3 examples of "advanced directive"? Directive to physician, out-of-hospital DNR, medical power of attorney How many witnesses do you need, and what are the witness requirements for advanced directives? 2 witnesses, one cannot be related, beneficiary, attending physician or hospital employee Can a directive to a physician be oral or must it be in writing? Can be verbal and must be documented in chart with names of witnesses Does an advanced directive have to be notarized? No How many witnesses for an oral directive? 2 How long is a directive good for? No limit, until revoked What are the 3 ways to revoke an advance directive? Written, oral, or VOID across the pages When a directive is orally revoked, what should the physician do with it? Destroy or write note on verbal revocation or write VOID across pages What happens if a physician disagrees with the directive given to him? 26 | P a g e Does not have to follow; can request ethics or medical committee with 48-hour notification for all parties What is the transfer registry? Directory of physicians or hospitals willing to accept patients in transfer who have advanced directives Is "mercy killing" allowed in Texas? No Who must sign an "out-of-hospital DNR"? Can it be verbal? Are witnesses needed? Attending physician, patient, and two witnesses; yes/no; yes/no What is the effect of an "out-of-hospital DNR"? Legally binding; patient's wishes written as a physician order If a patient's family disagrees with a patient's decision, what can they do? Must apply for temporary guardianship under Texas probate code If you see a DNR device on a patient but have not seen the form, is that enough not to give treatment? Yes, DNR device is enough Can an incompetent patient revoke their DNR? Yes Should this form accompany patients on transfers? Yes What kind of treatment can the power of attorney NOT consent to? Admission to mental health institution, ECT, psychosurgery, abortion, neglect of minimal treatment (nutrition, hydration, comfort measures) Does the power of attorney have an expiration date? No, unless specified What happens if on the expiration date the patient is incompetent? It is continued until patient becomes competent again, then expires Who cannot be the power of attorney? Principal health care provider or residential care provider or employee of those Does the power of attorney have access to the patient's medical records? Yes 27 | P a g e When can you withhold treatment to an infant? If chronically and irreversibly comatose or terminally ill and further treatment would be futile Can you withhold nutrition/hydration from a terminally ill infant? No Is the mental health directive an advanced directive act? Yes, but with differences What are the requirements for mental health directive? What are requirements for witnesses? Age 18 or not a legal minor, not incapacitated; 2 witnesses both of who cannot be related, beneficiaries, attending physician, or employees of hospital Does a mental health directive have an expiration date? Yes, 3 years or until revoked What happens if on the expiration date of a mental health directive, the patient is incapacitated? It continues until competent When can you use restraints? When can you use behavioral measures? If there is danger of harm to self or others and other measures have failed; never Does the donor have rights of a parent in artificial insemination? Does the husband? Donor NO, husband YES What prenatal maternal tests must a physician check? HIV, hepB, syphilis How many times must a physician check prenatal maternal tests? Twice; upon first examination and on admission for delivery Are prenatal maternal tests confidential and anonymous? Confidential; anonymous upon request Does the physician have to tell the mother that he/she will do prenatal maternal tests? What if she wants anonymous testing? Yes, must inform but not specifically consent; if anonymous is wanted must refer patient to anonymous testing center; patient can refuse If prenatal maternal tests are positive, what must the physician do? Refer for treatment, provide counseling, and provide information about diseases How long does a physician have to keep prenatal maternal test results? 30 | P a g e What kind of crime is it if you don't submit a birth certificate? Misdemeanor What kind of crime is it if you submit false data on a birth certificate? Felony 3rd degree How old or young must a baby be in order for a care provider to be able to take possession of an abandoned baby? 60 days Can any money transaction be done during an adoption? Yes; only to cover expenses When is a person considered dead? Cardiac and respiratory functions cease to exist When is a ventilated person considered dead? Irreversible cessation of brain function What is the time of death for ventilated people? At time of determined brain death For your ventilated person, do you pronounce death before or after you turn off ventilator? Before Who can pronounce somebody dead? MD, PA, NP, RN Who must file the death certificate? Person in charge of interment How many days does the physician have to fill it out once it is given to him/her? 5 days for MD to fill out medical portion, 10 days to send in death certificate Do fetuses require death certificates? If 350 grams or more or 20 weeks or older Sudden infant death syndrome (SIDS) applies to children ages or younger 1 year In SIDS, is an autopsy required? Yes 31 | P a g e To whom and how fast must you report SIDS? To a justice of the peace, medical examiner, or other proper official immediately Who pays for autopsy in SIDS? State If at the time of death the physician knows that the patient had a communicable disease, what must be done to the body? Report to TDSHS and tag body to indicate caution required due to communicable disease The death of a child under ____ years must be reported. 6 years Whom do you report it to? Medical examiner or justice of the peace What must the medical examiner do for the death of a child under 6 years? Hold inquest How many days must have passed since the person was last seen in order to issue a "certificate of death by catastrophe"? 10 days Can you issue a certificate of death by catastrophe for a minor? Yes, with affidavit What is the difference between an inquest and an autopsy? Inquest is investigation only into causes of death, autopsy is postmortem body examination Who does the inquest after the death of a child under 6 years old? Medical examiner or justice of the peace Who has rights to consent to autopsy? In what order? Spouse, child, court or guardian, parent, next of kin, any person assuming custody If a person higher in hierarchy is not available, can the next person down consent to autopsy? No If a member of a class (1 out of 4 children) consents to autopsy but the other 3 do not agree, can they still do the autopsy? Yes, only one needs to consent What kind of crime is it if you assist in suicide and patient does not die? What if patient dies? 32 | P a g e Class C misdemeanor, if patient dies felony How many witnesses do you need to donate an organ if there is no will? 2 witnesses, signed Who has the power to donate the organ of a dead person? Spouse, child, parent, siblings, guardian, any authorized person How can you revoke an organ gift? Do you have to tell the donee? Yes; no Can you pronounce the death and transplant an organ in the same patient? Physician who determines death CANNOT participate in transplantation At what age and how can a mentally retarded person donate a kidney? Age 12, by petitioning the district court Can a blood bank pay for blood? How? After how many days? Yes, by mailed check, 15 days after donation What is the duty of a medical professional when treating an adult with family violence? What languages to use? Duty to treat and provide information (and document that information was provided) in English and Spanish; no need to report Does the physician have to call the police in cases of adult family violence? No, just inform victim of options What is the difference between a professional and a medical professional? Medical professional = MD; professional = anybody else, e.g., teacher Reporting of child abuse? By whom? How fast? Can it be delayed? To whom (3 entities)? Report immediately but MUST be within 48 hours, cannot be delegated; to Texas Department of Protective and Regulatory Services, any law enforcement, Texas Youth Commission Will the TDPRS act on anonymous calls regarding child abuse? Does it satisfy a professional duty to report? Yes, they will be acted upon but DO NOT satisfy duty to report How much time do professionals and medical professionals have to report the death of a child secondary to suspected abuse? 48 hours 35 | P a g e If you treat a patient with a communicable disease that dies, what are your 2 responsibilities and within what time frame? Report death immediately and put toe tag on What kind of crime is nonreporting communicable disease? Class B misdemeanor If you are a police officer, firefighter, etc., can you make somebody have an HIV test if you think you might have been exposed? Who do you call? Yes, request TDH Is the police officer, etc., required to be tested himself/herself? No If an employee is exposed, can the hospital check if the person is harboring an infective agent? Yes, to HepB, C, HIV What diseases must they test for? Hep B, C, HIV Do they need the patient's consent? No Who must report occupational exposure? Does that include labs? Physicians, labs, health care workers; labs must report abnormal lead levels What occupational exposure must be reported? Asbestosis, silicosis Do you have to report birth defects? Yes Which diseases have to be reported immediately? Diphtheria, measles, anthrax, pertussis, hemophilus, plague, rabies, SARS, smallpox, yellow fever, etc Which diseases must microbiology labs report immediately? Vancomycin-resistant staph, VRE, HIV, neisseria meningitis Can you make somebody have HIV test? What are the 4 exceptions? No, unless during pregnancy, criminal proceedings, accidental exposure, consented What kind of crime is it if you force somebody to take an HIV test? 36 | P a g e Misdemeanor A Does HIV testing consent have to be written? No Do you have to sign an HIV consent if you have signed a consent for treatment? No Do you need consent for lab testing after accidental exposure? No Does a physician have to contact the partner notification program if a patient is HIV positive and the physician suspects sexual activity? Yes Can a health care worker with exudative lesions or weeping dermatitis participate in direct patient care or handling of medical equipment? No If you are a health care worker that has HIV or hepB or HbeAg, can you perform invasive procedures that are "exposure-prone"? What are the 2 requirements? No, unless patient has been educated and has sought expert panel What if you do invasive procedures that are not exposure-prone, and you are positive for HIV, HepB or HbeAg? Do you need to inform? No need to inform Can you force rapists to undergo HIV and HepC tests? Yes Which neoplasm must be reported to the cancer registry? All Which traumatic injuries must be reported? To whom? Who is responsible to report? Spinal cord, traumatic brain, anoxia including near-drowning; to TDH; physician Do you have to report overdosing and gunshot wounds? How fast? Who are the 2 people who can report that? Yes; immediately; by physician or hospital administrator or official What kind of offense is nonreporting of traumatic injuries, overdoses or gunshot wounds? Misdemeanor 37 | P a g e What is a "commitment order"? Court order for involuntary mental health admission Who is considered an "adult" in order to proceed with voluntary psych admission? 16 and over OR anybody who has ever been legally married What are the 3 types of involuntary psych admissions? Who can order them? Emergency or temporary detention, protective custody; they are court ordered Does being on ETOH, senile, mental retardation, epilepsy constitute grounds to deny voluntary psych admission? No When you are admitted involuntarily, when can a patient be forced to take psychoactive mediations (3 cases)? (1) a medication-related emergency, (2) under a court order, (3) patient is a ward and guardian consents Do you need a separate court order to give psychoactive medications in addition to the court order for involuntary admission? Yes, you need 2 separate court orders Do you need a physician order to put patient in restraints? Yes When should you consider prescribing psychoactive medications? Medication emergency—threat to self or others ECT may not be used in people less than ___ years of age. Any exceptions? 16, no Can anyone, including courts, force somebody to have ECT without their written consent? No, ECT cannot be court ordered How often do you need consent for ECT? Before each treatment How about people > 65 years of age, who must sign for ECT? Patient and 2 physicians Can psychiatry hospitals employees' pay be based on # of admissions, length of stay, calls to referring sources? No 40 | P a g e What are the 3 penalties for hospitals and physicians for violation of EMTALA? What is the maximum damage? Civil money penalties, termination of provider agreement, civil action. Up to $50,000 per violation ($25,000 for < 100 beds) Can a patient initiate his/her own transfer? Yes How many people on the Texas Medical board? 19 How many MDs on the TMB? 12 How many layperson on the TMB? 7 How often does the police run a check on physicians? Monthly How often does the TMB put out reports on physicians? Every 6 months How many years of postgraduate training to apply for full license? 1 If a resident does not show up to begin his training, how many days does the program director have to report that to the board? 30 Institutional permit: how many months for initial license? How many renewals? How many months for each renewal? 14 months; 7; 12 months Physician-in-training permit: how many months for initial license? How many renewals? How many months for each renewal? 18 months; 6; 18 months How often do you register your license with the TMB? Every 2 years How many days prior to expiration of your license does the board notify you? 41 | P a g e 30 How many days after expiration are you considered practicing without a license? 30 How many days after expiration is license canceled? 365 How many category 1 CMEs per year? 12 How many ethics CME credits? 1 yearly How many CME credits can be from volunteering? 6 How many CMEs can you carry forward? 48 How often must the board give update to all participants in a complaint? Every 3 months (quarterly) How much time do insurances have to report malpractice to the board? 30 days If disciplinary action is taken by the board, how much time to report to the hospital verbally? In writing? To the NPDB? Verbally immediately to hospitals on first working day; in writing to all hospitals and agencies within 30 days. How much time to report court reports to the board? 30 days How many malpractice claims in what time frame to trigger board investigation? 3 within 5 years How many people from the board to emergency suspend license? 3 How many days does a physician have to file appeal to a board decision? Which county? 30 days; Travis county 42 | P a g e How soon and how often can you file for reinstatement of a license? After one year; once a year. Maximum administrative penalty by board? By attorney general? $5000 per violation; $1000 per violation. How much time to pay an administrative penalty by the board? 30 days. How many days can NPs and PAs prescribe? How many refills? For patients how old? 30 days, no refills; older than 2 years. How many PA equivalents can an MD supervise? 3 full-time employees What percentage of random charts of the PA must the physician review? 10% How far can secondary practice sites be located from primary? 60 miles How many days does board have to give information to requesting hospitals? 15 days How many days do you have to correct changes in your TMB profile? 30 days How many days do you get to review your data the FIRST time the board releases it? 15 business days. How often does a physician have to resubmit his core data if there were no changes? Once a year. How many days before hospital hearing must a physician be notified? 30 days. A suspension in the hospital must be reported if it lasts for how long? Within what time must it be reported? More than 30 days; 15 days. Until what age is one considered a minor? 18 years 45 | P a g e How many days does the physician have to fill out death certificate? 5 days. Over what weight must a death certificate be filled out for a fetus? 350 grams. If weight is not known, over what gestational age? 20 weeks. SIDS is for children of less than what age? 12 months. When do you have to report SIDS? Immediately. Death of a child of what age or younger must be reported to the medical examiner? Within what time frame? 6 years; immediately How many days after catastrophe to get "certificate of death by catastrophe"?Xlibris. Kindle Edition. 10 days. If a patient dies within how many hours of admission must an inquest be ordered? 24 hours. A mentally retarded person of what age can donate a kidney if the guardian petitions the court? 12 years. After how many days can a blood bank pay for blood donation? 15 days. A person older than what age can voluntarily commit self to psychiatry? 16 years How often do private psychiatry hospitals file reports? Yearly. What age do you have to be to get ECT? 16 How often do you renew DEA license? DPS license? Every 3 years; yearly. 46 | P a g e How many days to you have to inform the DPS of change in information? 7. How many days of pills can a patient get of schedule 2-5 when discharged from the hospital? 7. How many days to send written prescription to pharmacy of schedule 2 drug? 7. How long is a schedule 2 script valid? How many refills? Schedule 3-5 valid? Refills? Dangerous drugs valid? Refills? 7 days; no refills; 6 months; 5 refills; unlimited; unlimited. How often do you need to do inventory on your drugs? Every 2 years. How often do you have to register with the board and pay a fee to administer anesthesia? Every 2 years. How many days do you have to report an office-based anesthesia complication? 15 days. How much time do you have to report a death from communicable disease? Immediately. How much time to report a gunshot wound? Immediately. What is the monetary penalty for violation of anti-kickback laws for physicians? Hospitals? $25,000-$250,000 / $50,000-$500,000. How much time does a physician have to report child abuse? Immediately; 48 hours in writing. How much time does a professional (not medical professional) have to report child abuse? 48 hours. How much time do professionals/physicians have to report death of a child secondary to abuse? 48 hours. How much time do you have to report nursing home abuse verbally? In writing? Immediately; 5 days. 47 | P a g e If a nursing home resident dies after transfer to a hospital, within what time frame must be reported? 24 hours. How much time does the nursing home have to report elderly death? 10 days after the end of the month of death. What are the age limits to consider abuse a criminal offense? 14 or younger, 65 or older; older than 14 and disabled. To be eligible to be licensed as a physician assistant, an applicant must meet several requirements. What is not a requirement for licensure? Successful completion of a four year degree program at an accredited college or university is not a requirement for licensure. Regarding eligibility to be licensed as a physician assistant, which of the following are true? (1) there is a requirement that applicants pass the jurisprudence examination with a score of 75 or better within three attempts; (2) an applicant who is unable to pass the jurisprudence examination within three attempts must appear before a committee of the Board to address the applicant's inability to pass the examination and to re-evaluate the applicant's eligibility for licensure; (3) it is at the discretion of the committee to allow an applicant additional attempts to take the jurisprudence examination. All three are true The state entity that issues physician assistant licenses to applicants who have met all requirements for this license is: Texas Physician Assistant Board Regarding the membership of the Physician Assistant Board, which of the following are true? (1) the Board consists of nine members appointed by the governor with the advice and consent of the senate; (2) all members of the Board must be practicing physician assistants; (3) at least one member of the Board must be a physician who supervises physician assistants; (4) at least three members of the Board must be public members who are not licensed as either a physician or a physician assistant. The Physician Assistant Board consists of nine members appointed by the governor with the advice and consent of the senate, and at least three members of the Board must be public members who are not licensed as either a physician or a physician assistant. A person may not practice as a physician assistant in Texas unless the person: A person may not practice as a physician assistant in Texas unless the person is licensed as a physician assistant in Texas. 50 | P a g e (3) supervision of a physician assistant by a supervising physician need not be continuous if the period of discontinuity is less than one week and occurs no more than once per year. A physician assistant may have more than one supervising physician. The supervision of a physician assistant: The supervision of a physician assistant does not require the constant physical presence of the supervising physician where physician assistant services are being performed, but, if a supervising physician is not present, the supervising physician and the physician assistant must be, or must be able to easily be, in contact with one another by radio, telephone, or another telecommunication device. A physician who becomes a supervising physician: A physician who becomes a supervising physician assumes responsibility and legal liability for the services rendered by the physician assistant, but is not liable for an act of the PA solely because the physician signed an order or protocol authorizing the PA to provide, carry out, or sign a prescription drug order. Which of the following physicians can be the supervising physician of a physician assistant? (1) a physician who has an active license and has never been disciplined by the Texas Medical Board; (2) a physician who has an active license but was disciplined (required to pay an administrative penalty of $500) by the Texas Medical Board for failing to timely provide properly requested medical records to a patient; (3) a physician who has an active license but was disciplined (required to give up his schedule II and III prescribing authority) for prescribing controlled substances to several patients who exhibited drug- seeking behavior; (4) a physician who has an active license but was disciplined (required to give up his prescribing authority for all scheduled drugs) for prescribing controlled substances to several patients who exhibited drug-seeking behavior. A physician who has an active license and has never been disciplined by the Texas Medical Board and a physician who has an active license but was disciplined (required to pay an administrative penalty of $500) by the Texas Medical Board for failing to timely provide properly requested medical records to a patient can be supervising physicians. A supervising physician must: A supervising physician must notify the Medical Board of the physician's intent to supervise a physician assistant. If a supervising physician will be unavailable to supervise the physician assistant as required by the Physician Assistant Act and Board rules: If a supervising physician will be unavailable to supervise the physician assistant, an alternate physician may provide the required supervision as provided by Board rules. Which of the following are required for an alternate physician to provide supervision of a physician assistant? 51 | P a g e (1) the alternate physician must affirm in writing and document through a log where the physician assistant is located that he or she is familiar with the protocols or standing delegation orders in use and is accountable for adequately supervising care provided pursuant to those protocols or standing delegation orders; (2) the log is kept with the protocols or standing orders and contains dates of the alternate physician supervision and is signed by the alternate physician acknowledging this responsibility; (3) the physician assistant must verify that the alternate physician is a licensed Texas physician holding an unrestricted and active license; (4) a physician assistant may not be supervised by an alternate physician, but must be supervised by his or her supervising physician. For an alternate physician to provide supervision of a physician assistant the following are required: (1) the alternate physician must affirm in writing and document through a log where the physician assistant is located that he or she is familiar with the protocols or standing delegation orders in use and is accountable for adequately supervising care provided pursuant to those protocols or standing delegation orders; (2) the log described in (1) is kept with the protocols or standing orders and contains dates of the alternate physician supervision and is signed by the alternate physician acknowledging this responsibility; (3) the physician assistant must verify that the alternate physician is a licensed Texas physician holding an unrestricted and active license. An alternate physician may provide supervision to a physician assistant: An alternate physician may provide supervision to a physician assistant if both the alternate physician and the physician assistant comply with the requirements of the Physician Assistant Act and Board rules, then for a period of up to 14 days. Before beginning practice, each physician assistant licensed by the state must notify the Physician Assistant Board. The notice is sufficient: The notice is sufficient only if it is on the form prescribed by the Physician Assistant Board and provides the information requested by that form. A physician assistant shall notify the Board of changes regarding his or her supervising physician: A physician assistant shall notify the Board of any change in, or addition to, the person acting as his or her supervising physician not later than the 30th day after the date the change or addition occurs. A physician assistant shall inform the Board of address changes: A physician assistant shall inform the Board of address changes within two weeks of the effective date of the address change. The scope of practice of a physician assistant includes providing: The scope of practice of a physician assistant includes providing all medical services that are delegated by a supervising physician that are within the education, training, and experience of the physician assistant. 52 | P a g e Medical services provided by a physician assistant may, if within the scope of practice of the physician assistant, include all of the following, except: Prescribing a controlled substance (scheduled drug) for a period of up to 60(120) days A physician assistant may only prescribe a Schedule III, IV, or V controlled substance, and then only for a period of up to 30 (90) days. PAs cannot exercise independent medical judgement Except for prescribing medications, medical services, if within the scope of practice of the physician assistant, may be performed by a physician assistant: Medical services (other than prescribing medications) provided by a physician assistant may, if within the scope of practice of the physician assistant, be performed in any place authorized by a supervising physician. During a disaster under the state emergency management plan or a disaster declared by the governor or the United States government which of the following are true? (1) a physician assistant may perform medical tasks under the supervision of any physician who is also performing volunteer work in the disaster; (2) a physician assistant may perform medical tasks without the supervision of a physician; (2a) if a physician is not available to provide supervision; (2b) only if the medical tasks performed by the physician assistant are within the scope of tasks assigned to the physician assistant during his or her regular work hours; (2c) only if the medical tasks performed by the physician assistant are not performed for compensation or other remuneration. During a disaster under the state emergency management plan or a disaster declared by the governor or the United States government, a physician assistant may perform medical tasks under the supervision of any physician who is also performing volunteer work in the disaster, or without the supervision of a physician, if a physician is not available to provide supervision, but only if the medical tasks performed by the physician assistant are not performed for compensation or other remuneration. A "dangerous drug" includes: A dangerous drug includes all drugs, other than controlled substances, that may only be dispensed by prescription under federal or state law A physician, by following the procedures and in the circumstances prescribed by law, may delegate to a physician assistant the authority to prescribe which of the following? A physician, by following the procedures and in the circumstances prescribed by law, may delegate to a physician assistant the authority to prescribe dangerous drugs and controlled substances listed in Schedules III, IV and V. The authority of a physician assistant, with appropriate delegation by a physician, to prescribe controlled substances in the authorized schedules is limited to prescriptions for a period not to exceed: 55 | P a g e another order or protocol as defined by the Medical Board, but only if the physician assistant is acting under adequate physician supervision as prescribed by law for the particular practice site. A physician's authority to delegate the carrying out or signing of a prescription drug order at the physician's primary practice site is limited to which of the following? (1) a combined number of four physician assistants or advanced practice nurses or their full-time equivalents practicing at the physician's primary practice site or at an alternate practice site; (2) a combined number of five physician assistants or advanced practice nurses or their full-time equivalents practicing at the physician's primary practice site or at an alternate practice site; (3) the patients with whom the physician has established or will establish a physician-patient relationship. Of the choices provided, a physicians authority to delegate prescriptive authority at the physician's primary practice site is limited to a combined number of four physician assistants or advanced practice nurses or their full-time equivalents practicing at the physician's primary practice site or at an alternate practice site and is limited to the patients with whom the physician has established or will establish a physician-patient relationship. A physician's authority to supervise a physician assistant (without regard to the physician's authority to delegate prescription authority) is limited to what? A physician's authority to supervise a physician assistant (when prescription authority has not been delegated) is limited to five physician assistants or their full-time equivalents, except as otherwise provided Board rule for certain situations. How many supervising physicians may a physician assistant have at any one time? There is no limitation on the number of supervising physicians a physician assistant may have at any one time. With respect to physician supervision of the carrying out and signing of prescription drug orders at the physician's primary practice site, which of the following is true? The supervision: (1) must conform to what a reasonable, prudent physician would find consistent with sound medical judgment; (2) may vary with the education and experience of the particular physician assistant; (3) may not vary with the education and experience of the particular physician assistant; Supervision must conform to what a reasonable, prudent physician would find consistent with sound medical judgment and may vary with the education and experience of the particular physician assistant. Under which of the following is physician supervision adequate for purposes of delegating prescription authority at an alternate practice site? If the delegating physician: (1) is on-site with the physician assistant at least 10 percent of the time; (2) is on-site with the physician assistant at least 20 percent of the time; (3) reviews at least 10 percent of the medical charts at the site; 56 | P a g e (4) is available through direct telecommunication for consultation, patient referral, or assistance with a medical emergency. Physician supervision is adequate for purposes of delegating prescription authority at an alternate practice site if the delegating physician is on-site with the physician assistant at least 10 percent of the time; reviews at least 10 percent of the medical charts at the site; and is available through direct telecommunication for consultation, patient referral, or assistance with a medical emergency. Under which of the following is physician supervision adequate for purposes of delegating prescription authority at a site serving a medically underserved population? Physician supervision is adequate for purposes of delegating prescription authority at a site serving a medically underserved population only if it meets the specific requirements set out by law for such sites. Under which of the following is physician supervision adequate for purposes of delegating prescription authority at a facility-based practice site? Physician supervision is adequate for purposes of delegating prescription authority at a facility based practice site only if it meets the specific requirements set out by law for such sites. If a delegating physician will be unavailable to supervise the physician assistant as required by law, arrangements shall be made for another physician to provide that supervision on a temporary basis. With respect to the alternate or substitute physician, which of the following is not true? It is not true that the physician assistant is responsible for verifying that the alternate physician is a licensed Texas physician qualified to practice in the same or a similar specialty as the regular delegating physician. Regarding the protocol that may be used to delegate prescriptive authority to a physician assistant, as described by Medical Board rules, which of the following are true? The protocol: (1) may authorize diagnosis of the patient's condition and treatment, but cannot authorize the exercise of independent medical judgment by the physician assistant; (2) may state the types or categories of medications that may be prescribed or the types or categories of medications that may not be prescribed by the physician assistant; (3) must be documented in writing and maintained as a permanent record; (4) does not change the fact that a physician assistant remains professionally responsible for acts performed under the scope and authority of his or her own license. Regarding the protocol that may be used to delegate prescriptive authority to a physician assistant, as described by Medical Board rules, the protocol may authorize diagnosis of the patient's condition and treatment, but cannot authorize the exercise of independent medical judgment by the physician assistant; may state the types or categories of medications that may be prescribed or the types or categories of medications that may not be prescribed by the physician assistant; must be documented in writing and maintained as a permanent record; and does not change the fact that a physician assistant remains professionally responsible for acts performed under the scope and authority of his or her own license. A physician assistant shall: 57 | P a g e A physician assistant shall keep the physician assistant's license available for inspection at the physician assistant's primary place of business. A physician assistant: A physician assistant shall, when engaged in the physician assistant's professional activities, wear a name tag identifying him or her as a physician assistant. Each physician assistant and the physician assistant's supervising physician are required to ensure which of the following? (1) that the physician assistant's scope of function is identified; (2) that delegation of medical tasks is appropriate to the physician assistant's level of competence; (3) that the hours of practice of the physician assistant are posted at the practice site at least one week in advance. Each physician assistant and the physician assistant's supervising physician are required to ensure that the physician assistant's scope of function is identified and that delegation of medical tasks is appropriate to the physician assistant's level of competence. Each physician assistant and the physician assistant's supervising physician are required to ensure which of the following? (1) that the hours of practice of the physician assistant are agreed to by the physician and the physician assistant, subject to emergencies or other designated situations; (2) that the relationship between the physician assistant and the supervising physician and the access of the physician assistant to the supervising physician are defined; (3) that a process is established for evaluating the physician assistant's performance. Each physician assistant and the physician assistant's supervising physician are required to ensure that the relationship between the physician assistant and the supervising physician and the access of the physician assistant to the supervising physician are defined and that a process is established for evaluating the physician assistant's performance. A physician assistant shall report relevant information to the Physician Assistant Board related to the acts of another physician assistant in this state: A physician assistant shall report relevant information to the Physician Assistant Board related to the acts of another physician assistant in this state if, in the physician assistant's opinion, the other physician assistant poses a continuing threat to the public welfare through practice as a physician assistant. With regard to patient billing, which of the following are true? With regard to patient billing, the physician assistant may not independently bill patients for the services provided by the physician assistant except where provided by law. In relation to a physician assistant's patient care activities, which of the following is true? (1) the physician assistant is legally responsible for his or her patient care activities and the supervising 60 | P a g e Chapter 483, Health and Safety Code, or any subsequent rules; (3) represents that he or she is a physician; (4) habitually uses drugs or intoxicating liqueurs to the extent that, in the opinion of the Board, the person cannot safely perform as a physician assistant. The Physician Assistant Board may take action against a physician assistant or an applicant for a physician assistant license who violates state law if the violation is connected with practice as a physician assistant; fails to keep complete and accurate records of the purchase and disposal of drugs as required by Chapter 483, Health and Safety Code, or any subsequent rules; represents that he or she is a physician; or habitually uses drugs or intoxicating liqueurs to the extent that, in the opinion of the Board, the person cannot safely perform as a physician assistant. The Physician Assistant Board may take action against a physician assistant or an applicant for a physician assistant license who has or has done which of the following? (1) has a mental or physical condition that renders the person unable to safely perform as a physician assistant; (2) has committed an act of moral turpitude; (3) has failed to practice as a physician assistant in an acceptable manner consistent with public health and welfare; (4) prescribes, dispenses, or administers a drug or treatment that is nontherapeutic in nature or nontherapeutic in the manner the drug or treatment is prescribed, dispensed, or administered. The Physician Assistant Board may take action against a physician assistant or an applicant for a physician assistant license who has a mental or physical condition that renders the person unable to safely perform as a physician assistant; has committed an act of moral turpitude; has failed to practice as a physician assistant in an acceptable manner consistent with public health and welfare; or prescribes, dispenses, or administers a drug or treatment that is nontherapeutic in nature or nontherapeutic in the manner the drug or treatment is prescribed, dispensed, or administered. The Physician Assistant Board may take action against a physician assistant who meets which of the following criteria? (1) has had the person's license or other authorization to practice as a physician assistant suspended, revoked, or restricted or who has had other disciplinary action taken by another state regarding practice as a physician assistant; (2) has repeated or recurring meritorious health care liability claims that in the opinion of the board evidence professional incompetence likely to harm the public; (3) through his or her practice as a physician assistant sexually abuses or exploits another person; (4) is removed or suspended or has disciplinary action taken by his or her peers in any professional association or society, or is being disciplined by a licensed hospital or medical staff of a hospital if that action, in the opinion of the Board, was based on unprofessional conduct or professional inc The Physician Assistant Board may take action against a physician assistant who has had the person's license or other authorization to practice as a physician assistant suspended, revoked, or restricted or who has had other disciplinary action taken by another state regarding practice as a physician assistant; has repeated or recurring meritorious health care liability claims that in the opinion of the board 61 | P a g e evidence professional incompetence likely to harm the public; through his practice as a physician assistant sexually abuses or exploits another person; or is removed or suspended or has disciplinary action taken by his peers in any professional association or society, or is being disciplined by a licensed hospital or medical staff of a hospital if that action, in the opinion of the board, was based on unprofessional conduct or professional incompetence that was likely to harm the public. If a physician assistant, or an applicant for a physician assistant license, is found to have committed an act that is subject to disciplinary action, the Physician Assistant Board may take which of the following actions? (1) deny the person's application for a license or license renewal or revoke the person's license or other authorization; (2) require the person to complete additional training; (3) suspend, limit, or restrict the person's license; (4) assess an administrative penalty. Physician Assistant Board may deny the person's application for a license or license renewal or revoke the person's license or other authorization; require the person to complete additional training; suspend, limit, or restrict the person's license; and/or assess an administrative penalty. If a physician assistant, or an applicant for a physician assistant license, is found to have committed an act that is subject to disciplinary action, the Physician Assistant Board may take which of the following actions? (1) limit the practice of the physician assistant to one or more specified activities or exclude from the practice of the physician assistant one or more specified activities; (2) require the person to submit to the care, counseling, or treatment of a health care practitioner designated by the Physician Assistant Board; (3) order the person to perform public service; (4) administer a public reprimand. The Physician Assistant Board may limit the practice of the physician assistant to one or more specified activities or exclude from the practice of the physician assistant one or more specified activities; require the person to submit to the care, counseling, or treatment of a health care practitioner designated by the physician assistant board; order the person to perform public service; and/or administer a public reprimand. The Board shall provide a physician assistant who is the subject of a formal complaint with access to all information in its possession subject to certain exceptions. The Board is not required to provide which of the following? (1) any information deemed to be too sensitive to be in the public domain; (2) Board investigative reports; (3) the identity of the complainant, if they are not going to testify at the hearing. The Board is not required to provide Board investigative reports or the identity of the complainant, if they are not going to testify at the hearing. 62 | P a g e A physician assistant has a duty to report relevant information to the Board related to the acts of another physician assistant in this state in which of the following situations? A physician assistant has a duty to report relevant information to the Board related to the acts of another physician assistant in this state if, in his or her opinion, the physician assistant poses a continuing threat to the public welfare through practice as a physician assistant. Which of the following is true regarding the disciplinary actions that may be taken by the Board against a physician assistant? The disciplinary action: The disciplinary actions may, except in the special case of a temporary suspension, be taken only after an informal hearing before at least two members of the Board after due notice and with opportunity for the physician assistant to respond to the allegations. The Board may impose an administrative penalty against a physician assistant who violates the Physician Assistant Act or a Board rule adopted under the Act. The amount of the penalty: The amount of an administrative penalty may not exceed $5,000 per violation, though each day a violation continues or occurs is considered a separate violation for purposes of imposing a penalty. The Board may temporarily suspend the license of a physician assistant: The Board may temporarily suspend the license of a physician assistant immediately, if a disciplinary panel appointed by the presiding officer of the Board finds that the physician assistant would, by his or her continuation in practice, constitute a continuing threat to the public welfare. In addition to or in place of an administrative penalty imposed by the Board against a physician assistant who violates the Physician Assistant Act or a Board rule adopted under the Act, the Board may: The Board may order the physician assistant to pay a refund to a patient in an amount not to exceed the amount the patient paid for the service provided. A person working in a physician's office may be called a physician assistant only if: A person working in a physician's office may be called a physician assistant only if he or she holds a physician assistant license issued by the Physician Assistant Board. If a person holds himself or herself out as a physician assistant, acts as a physician assistant or uses some combination or abbreviation of the term "physician assistant" without meeting the legal requirements for the use of that term, which of the following are true? The person: (1) may be subject to discipline by the Board of Nurse Examiners if he or she has a nursing license; (2) commits a misdemeanor punishable by a fine; (3) commits a felony of the third degree. If a person holds himself or herself out as a physician assistant, acts as a physician assistant or uses some combination or abbreviation of the term "physician assistant" without meeting the legal requirements for the use of that term, may be subject to discipline by the Board of Nurse Examiners if he or she has a nursing license and commits a felony of the third degree. 65 | P a g e Which of the following persons may not consent to medical treatment of a child when the person having the right to consent as provided by law cannot be contacted? A minor brother or sister of the child may not consent to medical treatment of a child when the person having the right to consent as provided by law cannot be contacted. Which of the following persons may consent to medical treatment of a child when the person having the right to consent as provided by law cannot be contacted? (1) an adult first cousin of the child; (2) a peace officer who has lawfully taken custody of the child, if the peace officer has reasonable grounds to believe the child is in need of immediate medical treatment; (3) an adult aunt or uncle of the child; (4) an adult who has actual care, control, and possession of the child and has written authorization to consent from a person having the right to consent. When the person having the right to consent as provided by law cannot be contacted, a peace officer who has lawfully taken custody of the child, if the peace officer has reasonable grounds to believe the child is in need of immediate medical treatment; an adult aunt or uncle of the child; or an adult who has actual care, control, and possession of the child and has written authorization to consent from a person having the right to consent may consent to medical treatment of a child. "Neglect" of a child, as defined by law, includes which of the following? (1) the failure to seek, obtain, or follow through with medical care for a child, with the failure resulting in or presenting a substantial risk of death, disfigurement, or bodily injury or with the failure resulting in an observable and material impairment to the growth, development, or functioning of the child; (2) the failure to provide a child with food, clothing, or shelter necessary to enable the child to participate in school and other functions and activities at a level equal to the average of other children in the lowest economic quartile; (3) the failure to provide a child with food, clothing, or shelter necessary to sustain the life or health of the child, excluding failure caused primarily by financial inability unless relief services had been offered and refused "Neglect" of a child, as defined by law, includes the failure to seek, obtain, or follow through with medical care for a child, with the failure resulting in or presenting a substantial risk of death, disfigurement, or bodily injury or with the failure resulting in an observable and material impairment to the growth, development, or functioning of the child and the failure to provide a child with food, clothing, or shelter necessary to sustain the life or health of the child, excluding failure caused primarily by financial inability unless relief services had been offered and refused. If a person has cause to believe that an elderly person (65 years of age or older) or a disabled person is in a state of abuse, neglect, or exploitation, which of the following is true? If a person has cause to believe that an elderly person (65 years of age or older) or a disabled person is in a state of abuse, neglect, or exploitation, the person has a duty to report to the Texas Department of Family and Protective Services, without regard to any professional or medical training 66 | P a g e Given that a communication between a physician and a patient, relative to or in connection with any professional services as a physician to the patient, is confidential and privileged and may not be disclosed except in certain circumstances, which of the following is true regarding a record of the identity, diagnosis, evaluation, or treatment of a patient by a physician that is created or maintained by a physician? The record: : A record of the identity, diagnosis, evaluation, or treatment of a patient by a physician that is created or maintained by a physician is confidential and privileged by law, and may not be disclosed by a physician assistant except to the extent that disclosure is consistent with the authorized purposes for which the information was obtained. HIPAA is the acronym for a federal act relating to limitations on the use and disclosure of a patient's health information. HIPAA stands for: HIPAA stands for Health Insurance Portability and Accountability Act. Under HIPAA, or HIPPA, which of the following is true? A patient's protected health information cannot be disclosed: A patient's protected health information cannot be disclosed without the patient's authorization, with limited exceptions for treatment, payment, and health care operations. If an adult patient in a hospital or nursing home is comatose, incapacitated, or otherwise mentally or physically incapable of communication, certain adults may act as a surrogate for the patient in order to give consent to medical treatment. Under state law, who of the following has the first priority for consenting to medical treatment, if available? If an adult patient in a hospital or nursing home is comatose, in capacitated, or otherwise mentally or physically incapable of communication, the patient's spouse has the first priority for consenting to medical treatment. Consent for emergency care of an individual is not required under which of the following situations? (1) the individual is unable to communicate because of an injury, accident, or illness or is unconscious, and is suffering from what reasonably appears to be a life-threatening injury or illness; (2) a court of record orders the treatment of an individual who is in an imminent emergency to prevent the individual's serious bodily injury or loss of life; (3) the individual is a minor who is suffering from what reasonably appears to be a life-threatening injury or illness and whose parents, managing or possessory conservator, or guardian is not present. Consent for emergency care of an individual is not required if the individual is unable to communicate because of an injury, accident, or illness or is unconscious, and is suffering from what reasonably appears to be a life-threatening injury or illness; if a court of record orders the treatment of an individual who is in an imminent emergency to prevent the individual's serious bodily injury or loss of life; of if the individual is a minor who is suffering from what reasonably appears to be a life-threatening injury or illness and whose parents, managing or possessory conservator, or guardian is not present. "Neglect" of an elderly person (age 65 and older) or a disabled person, as defined by law, includes which of the following? 67 | P a g e (1) failure of a caretaker to provide to the elderly or disabled person the goods or services, including medical services, that are necessary to avoid physical or emotional harm or pain; (2) failure of the elderly or disabled person to provide for him- or herself the goods or services, including medical services, that are necessary to avoid physical or emotional harm or pain; (3) failure of a caretaker to provide to the elderly or disabled person the goods or services, excluding medical services, that are necessary to avoid physical or emotional harm or pain. "Neglect" of an elderly person (age 65 and older) or a disabled person, as defined by law, includes the failure of a caretaker to provide to the elderly or disabled person the goods or services, including medical services, that are necessary to avoid physical or emotional harm or pain and the failure of the elderly or disabled person to provide for him- or herself the goods or services, including medical services, that are necessary to avoid physical or emotional harm or pain. Using the resources of an elderly person (age 65 and older) or disabled person, as defined by law, for monetary or personal benefit, profit, or gain constitutes "exploitation" if which of the following are true? (1) if the person using the resources of the elderly or disabled person has received benefits, profits or gains that are more than "insignificant" as determined by a court of law; (2) if the person using the resources of the elderly or disabled person is the natural heir of the elderly or disabled person; (3) if the person using the resources of the elderly or disabled person is a caretaker, family member or other individual who has an ongoing relationship with the elderly or disabled person; (4) if the person using the resources did not obtain the informed consent of the elderly or disabled person. Using the resources of an elderly person (age 65 and older) or disabled person, as defined by law, for monetary or personal benefit, profit, or gain constitutes "exploitation" if if the person using the resources of the elderly or disabled person is a caretaker, family member or other individual who has an ongoing relationship with the elderly or disabled person or if the person using the resources did not obtain the informed consent of the elderly or disabled person. "Abuse" of an elderly person (age 65 and older) or a disabled person, as defined by law, includes which of the following? (1) injury, unreasonable confinement, intimidation or cruel punishment inflicted on the elderly or disabled person by the person's caretaker; (2) injury, unreasonable confinement, intimidation or cruel punishment inflicted on the elderly or disabled person by a family member or other individual who has an ongoing relationship with the person; (3) sexual abuse of the elderly or disabled person, including any involuntary or nonconsensual sexual conduct, committed by the person's caretaker; (4) sexual abuse of the elderly or disabled person, including any involuntary or nonconsensual sexual conduct, committed by a family member or other individual who has an ongoing relationship with the person. 70 | P a g e Podiatric Medicine license until after successful completion and graduation from the GPME program and after providing to the department proof of such completion and graduation How long can a temporary residency license be extended? 3 months How many times can a temporary residency license extension be granted? maximum of 2 times What additional information can be required from an applicant for permanent licensure if the applicant has been out of practice for 2 years? -additional education -examinations -training How long is a doctor of Podiatric medicine license valid? 2 years What qualifications must a sponsor for an applicant's provisional license hold? -5 years of good standing under the act -ensure the applicant is working within the same office as the licensee under direct supervision How long is a provisional license valid for? -180 days How many times can a provisional license be renewed? -3 times When can GPME requirements be waived for provisional license? if the applicant has been practicing for at least 5 years in another state under license of that state with acceptable record from the state in which the applicant was licensed When did Texas begin the National boards Part III/PM Lexis requirement for licensure come into effect? 1/29/1992 How many hours of CME are required every 24 months? 50 hours How many of the 50 hours of CME is required to be ethics related? 2 hours How many hours of CME are required to be completed regarding approved procedures of prescribing and monitoring controlled substances? 71 | P a g e 2 hours How often does a licensed podiatrist who prescribed opioids have to attend a course covering best practices, alternative treatment options, and multi-modal approaches to pain management per CME period? How long does each session have to be? 2 times, once annually 1 hour course What qualifies as appropriate CME crediting events? -hospital Podiatric medical grand rounds -APMA/APMA affiliated organizations -TPMA -state -county or regional Podiatric medical association -university sponsored pod medical meetings -hospital Podiatric medical meetings How many hours of home study and self-study programs will be accepted for CME credit hours? up to 20 hrs How many credits of CME is CPR training worth? How many CME hours is ACLS worth? Can you get credit for both? 1) 3 hours 2) 6 hours 3) no How many CME credit hours can a practitioner receive for a published article? 1 hr How many hours can carry over to the next CME period if there is an excess of 50 hours completed biannually? 10 credit hours When do CME hours need to be sent to the department for review? if audited How does the audit process look like? 1) random selection of sample license holders 2) if selected, the license holder shall submit copies of certificates, transcripts, or other documentation satisfactory to the department, verifying the license holder's attendance and participation and completion of the continuing education 72 | P a g e 3) failure to timely furnish this information w/in 30 days or providing false info can be grounds for disciplinary action 4) if selected for continued education during renewal period, license holder may submit renewal fees at that time for permanent licensure Can CME required for disciplinary action be counted towards biannual CME requirements? No what was the Texas legislature that allowed authority to establish a 1 or 2 year license term for licensees? Texas Legislature 85 in chapter 202 When can CME be exempted? -hardships for the practitioner which the executive director can clear How much time does a provider have to complete delinquent hours? 3 years Which agency published the recommendations for HBOT care? Undersea and Hyperbaric medical society (UHMS) Where can HBOT be done? In a hospital setting What is the document that determines the scope of HBOT practice of a podiatrist? Podiatric Medical Practice Act How long is the HBOT certificate active and what is the cost for the certificate? 1) $25 2) 1 year How long do certificate holders have to inform the department of any address change or change of hospital setting no later than ___ days? 10 days Define Conscious sedation? the production, by pharmacological or non-pharmalogical methods, or a combination thereof, of an altered level of consciousness in a patient What are the requirements of the didactic and clinical course which includes aspects of monitoring patients and the hands-on use of the gas machine? 75 | P a g e Does a pod medical rad tech need to be registered? YES How long is a Podiatric medical radiological technician license valid? When are the licenses renewed? 1 year Sept 1 2020 How long do radiological records of Podiatric care need to be retained? 5 years after treatement How long does a practitioner have to send records of imaging once medical records are requested? w/in 30 days Can the practitioner hold onto requested information until payment is received? Yes In the event that the payment for imaging is not routed with request for records within ___ days after receiving request, the practitioner will notify the requesting party in WRITING of the need for payment and may withhold information until payment is complete 10 days Can a practitioner give notification given before to discontinue treatment to a patient to give the patient reasonable time to secure the services of another practitioner or all Podiatric medical services actually begun have been completed and there is no contract or agreement to provide further treatment? Yes What constitutes sexual impropriety? behavior, gestures, or expressions that are seductive, sexually suggestive, or sexually demeaning to a patient/staff (ex examination of genitals without gloves) What is sexual exploitation? breakdown of professionalism in the physical/patient/staff relationship constituting sexual abuse (ex coercive power) What are the responsibile steps need to be taken prior to prescribing controlled substances to patients? 1) review Texas Prescription Monitoring Program (PMP) database 2) pt's identifiers match 3) initial H&P performed and documented 4) schedule II prescription copies must be placed in records and charts 76 | P a g e 5) alternative therapies are noted as discussed and prescribed When does PMP not need to be evaluated prior to prescribing meds? hospice care, cancer pts What is true about schedule 1 drugs in USA? not prescribed because of concern for addiction When can a podiatrist prescribe an opioid-antagonist? a podiatrist may prescribe an opioid antagonist to a person at risk of experiencing an opioid-related drug overdose or to a family member, friend, or other person in a position to assist the person who is at risk of experiencing an opioid-related drug overdose Define acute pain normal, predicted, physiological response to stimulus such as trauma, disease, and operative procedures What are conditions not considered acute pain? -chronic pain -cancer treatment -hospice care -palliative care How many days worth of opioids can a podiatrist prescribe for acute pain? 10 days worth Since what date have controlled substances been requested to be ordered electronically? 1//1/21 Under what circumstances can you prescribe controlled substances outside of electronic means? 1) emergency 2) if medication is filled out of state 3) if the prescriber and dispenser are in the SAME location under the SAME license 4) for a drug that the FDA requires more information that can be submitted online 5) for a non-patient-specific prescription pursuant of standing order, approved protocol for drug therapy, collaborative drug mngmt, comprehensive medication mngmt, or in response to public health emergency 6) drug for research protocol 77 | P a g e 7) practitioner with a waiver 8) if it is impractical for patient to obtain meds if prescribed electronically If a practitioner has a waiver to prescribe meds outside of electronic means, how long does waiver last? When can renewal be started? 1 year 30 days or less from expiration of waiver A practitioner's waiver of electronic prescribing request form must contain sufficient evidence of one or more of the following that, in the judgment of the executive director, justify the issuance of a waiver: 1) economic hardship 2) technological limitations 3) ISSUANCE OF FIFTY OR LESS PRESCRIPTIONS FOR CONTROLLED SUBSTANCES IN THE YEAR IMMEDIATELY PRIOR TO REQUEST FOR WAIVER 4) exceptional circumstance that is shown by the practitioner What is the cost to extend the temporary license? $50 How much does doctor of Podiatric medicine initial license? $750 How much does renewal of the Podiatric medicine license cost? $700 How much does it cost to duplicate license/replacement license? $25 How soon after a complaint or claim must information be provided and what information needs to be sent in addition? within 30 days, copy of claim letter or petition If a license suspension is probated, the commission or executive director may require the licensee to: (1) report regularly to the department on matters that are the basis of the probation; (2) limit practice to the areas prescribed by the commission or executive director; or 80 | P a g e 1) civil violations 2) product liability claims 3) antitrust alligations 4) allegations regarding improper peer review activities 5) business disputes 6) allegations of liability of injuries occurring on Podiatric physician's property, but not involving breach of duty in the podiatric physician-patient relationship T/F a licensed veterinary technician must be at least 18 years old T how long is a temporary vet license for disaster relief good for? 120 days T/F for disaster relief, the SBE and licensure fee are waived T- still must register with DPS T/F any dues/fees paid go toward unpaid balances first T how long do you have to renew your license? 90 days after 1st day following birth month T/F if you go into default on your student loan, you cannot practice T- won't renew T/F your license can be revoked for failure to pay child support T T/F castration is a surgical procedure and therefore reserved for veterinarians F- applies to food animals only T/F A rancher can castrate his/her own dogs F- only food animals T/F Branding requires veterinary oversight F T/F AI requires veterinary oversight 81 | P a g e F T/F farriers require veterinary oversight F T/F Debeaking can be done without veterinary oversight T T/ Dehorning cattle does not require veterinary oversight T T/F Shelter employees (non-veterinarian) can perform euthanasia T- Provided training is complete how many members on state board? 9 who appoints members? governor describe the makeup of the state board 3 public members, 1 vet tech, 1 vet with 3 yr tx large animal practice, 1 shelter med What is the maximum # of board members who are in academia? 1 how many years do you need to have practiced in TX prior to eligibility to serve on state board? 6 T/F members of the public from healthcare fields are preferred for state vet board members F- prohibited- nor someone whose spouse is low long is a TX state vet board term? 6 yr T/F missing more than half of the board meetings can cause a tx state vet board member to lose their position T T/F board members may not participate in full until completely trained T T/F within the TBVME there is a ladder-style of career advancement and regular performance evals 82 | P a g e T What are the 4 purposes of TBVME rules? 1. Protect the public 2. ensure alternate therapies and delegated work are performed under vet supervision 3. ensure equine dentistry is only done by vets or equine dentists 4. provide for licensing of vet techs, equine dentists, vets What is the procedure for making an exception to board rules? Notice and hearing T/F The board may regulate advertising or competitive bidding at its discretion F- Only to prohibit false, misleading, or deceptive practices. This includes restrictions on content, duration, name, etc. Where do funds for board members salaries come from? May only come from fees What three things as the board required to maintain a registry of on veterinary licenses? Name, residence, business address How long do you have to notify the board of a change in business address on your license? 60 days T/F The board may order a veterinarian subject to disciplinary action for chemical dependency or mental illness to submit to care, counseling, or treatment through peer assistance program T In what court do legal actions involving the board take place? Primarily Travis County but can be anywhere T/F The board is required to file an annual report with each legislative house T T/F The board may conduct a risk-based inspection of a veterinarian's practice based on information obtained from any source of information regarding controlled substances T Describe the process that a complaint undergoes when coming before the board 1. Complaint received, categorized, prioritized if medical expertise required: 2. Preliminary reviewer determines dismissal or referral of complaint 85 | P a g e A rural vet clinic would like to partner with the local ER to triage HBC cases as the vet lives over an hour away. Can they do this? No 573.6 T/F It is illegal to have a client sign a waiver waiving their right to file a board complaint T 573.7c The head of the TAMU veterinary school accepts a commission to endorse dubious pet products on TV. Can he lose his license? Yes 573.7a A disgruntled client threatens to submit a board complaint. The veterinarian offers free nail trims for a year if the client will not submit a complaint. Is the veterinarian's license in jeopardy for this act? Yes 573.7 b T/F Any loss or revocation of license, certification, or registration must be reported to the board within 15 days F 30 days 573.8 A veterinarian may serve as a consultant in Texas even if he or she does not live there, provided that he/she does not maintain a routine consult schedule T 573.9- but must be under supervision of TX vet Which of the following may NOT be delegated to non-vets? equine dentistry, Chiropractic, dental cleaning Dental cleaning Which of the following may not be delegated to a veterinary technician under direct supervision? Induction of anesthesia, suturing, dental extractions Dental extractions, unless the teeth are so loose they can be removed by hand T/F Veterinary technicians may extract loose teeth in rabbits F The loose teeth clause applies only to dogs and cats, horses T/F Direct veterinary supervision is required for technicians to draw blood or take other samples F General Veterinary supervision is sufficient T/F A veterinary assistant (non-technician) may suture and induce anesthesia under immediate veterinary supervision True T/F An unlicensed veterinary employee may extract teeth if they are loose enough to be removed by hand 86 | P a g e F Only technicians Which of the following may an unlicensed employee perform with veterinary supervision? Suture, induce anesthesia, draw blood, take samples, all the above All the above T/F Only a veterinarian may perform euthanasia F- Anyone under the supervision of a veterinarian T/F Only a veterinarian may administer a rabies vaccine F- anyone under direct veterinary supervision provided the vet has valid VCPR T/F It is illegal for anyone to use a veterinarian's signature stamp or electronic signature pad except the veterinarian F- Employees Allowed under veterinary supervision (clinic) 4 actions expressly reserved for veterinarians Surgery, diagnosis, prescriptions, initiation of treatment (except in emergencies) T/F A veterinarian may issue treatment instructions to owners at home over the telephone in case of emergency T- Only to prevent death or alleviate extreme suffering An unlicensed kennel staff member gives the wrong medication to a boarding dog overnight. Who is responsible- the veterinarian, or the veterinary technician on the shift with them at the time? The technician On a busy surgery day, the veterinary technician is taking dental x-ray and notices and incisor with severe bone loss that would be easy to take out with slight elevation. The technician decides to quickly remove the tooth and save the veterinary and the hassle. Who may be disciplined by the board? The veterinarian and the technician (if tech breaks rules and vet allows it, both are subject to discipline) T/F: A frustrating client who brought their dog and for a health certificate walked out refusing to pay after the exam was complete. The veterinarian may refuse to provide the health certificate until payment is rendered. F- No official health documents may be withheld regardless if compensation is furnished or not T/F The issuance of pre-signed or prestamped official health documents is prohibited T T/F A nonlicensed employee under veterinary technical or veterinary direct supervision may collect blood samples for official health tests T 87 | P a g e Who may perform animal chiropractic services? Veterinarian, non-veterinarian under veterinary supervision, T/F A rancher with his/her own ultrasound may moonlight and sell "puppy checks' with his machine F-Diagnosis via ultrasound is considered the practice of veterinary medicine T/F Human acupuncturists may perform animal acupuncture provided they are under direct veterinary supervision F- Only veterinarians allowed to perform acupuncture 573.16b T/F A signed statement acknowledging that acupuncture is an alternative therapy is required prior to any acupuncture treatment T 573.16c T/F Only a veterinarian may practice holistic medicine or homeopathy, And a signed client form acknowledging the holistic medicine is an alternative therapy is required prior to treatment T 573.17 b,c T/F Awake scaling by groomers is illegal T, but brushing, flossing, or swabbing is not T 573.19 T/F Licensed equine dentists may extract teeth if loose or wolf teeth T 573.19e T/F A VCPR may be established with premises visits for dogs or cats F- only applies to herd animals T/F when veterinary care is delegated to another vet, the owner must be informed T- ex. case take-overs T/F Once a veterinarian establishes a VCPR and prescribed medications, another veterinarian at the same clinic may refill that prescription without having seen the patient T 573.2e T/F Corporate veterinary practices can dictate a clinician's treatment and handling of the case F- Veterinarians are expressly prohibited from submitting to medical interference 573.21 T/F Board-certified specialists are held to a higher standard of care than general practitioners T 573.22 T/F Board complaints involving specialists will be addressed in consultation with practitioners of the same specialty, whether inside or outside Texas 90 | P a g e F All 3 must occur T/F a veterinarian muse notify clients of license revocation or surrender within 30 days by letter T/F both- same as for closing T/F a veterinarian must close and swiftly lock the controlled drug cabinet after each use T- no leaving it open! T/F a veterinarian must maintain a written list of all persons that have access to the controlled substances area T T/F a veterinarian must permit a board representative to inspect the premises, equipment, and records at any time F during business hours What are the CE requirements for a TX license? 17 hours annually T/F residents are exempt from CE requirements T which of the following is not a valid CE option in TX? conferences, correspondence courses that require a test, live/active webinar, self study, all the above are acceptable all the above how many hours may be claimed for online webinars? 10 T/F a minimum of 10 hours attendance in person are required for CE F 7 T/F CE certifications must be maintained for 4 years in case of an audit T Where must CE records be maintained at the place of practice T/F for in-person CE the licensee must mark on the schedule with a pen the courses attended T T/F For proof of self study, you must have a date, article, and hours registry T 91 | P a g e T/F any animal from a rescue or HS must be altered and microchipped or tattooed T- specific symbol on inner thigh T/F a veterinarian in default on student loans or child support payments may be subject to disciplinary action T When to report child abuse / neglect? Within 48 hours When to report birth certificate? 5 days When to report death certificate? 10 days Reporting most communicable diseases? 7 days (1 day for TB and pertussis) When supplying medical records by? 15 days How many people compose the texas medical board? how many MDs? DOs? laypersons? how long is the term? 12 are physicians (9 MD, 3 DO). 7 are laypersons. All are appointed by the governor for 6-year terms. Who does the Texas Medical Practice Act apply to? Only texas licensed doctors practicing in texas. All laws covered by the MPA only apply to Texas-licensed physicians while practicing in Texas (or outside state providers providing telemedicine services to patients in Texas). All other healthcare providers (nurses, medical students, and other "doctors" such as dentists/podiatrist/optometrists) are not included. What criteria is needed for licensure? - Complete college (60 credit hours) - Have an MD or DO - Pass the USMLE Steps 1-3 (within the past 7 years) and the Texas JP exam - Complete your intern (PGY1) year So, any US-trained grad finished with the Step exams can apply for their full Texas medical license after completing their internship. Ben White. The Texas Medical Jurisprudence Exam - A Concise Review (Kindle Locations 77-81). Kindle Edition. What is the renewal schedule for your texas medical license? Overdue fines? Expiration? 92 | P a g e For starters, you renew it every two years (after the initial licensing period, which ranges from 12 to 24 months). If you're late: - No fine if expired < 30 days - $75 if expired < 90 days - $145 if expired < 365 days *- Canceled entirely after 1 year. Must reapply and fork over entire processing fee etc. (ouch!)* - If you wait longer than 2 years, then you not only have to apply for a new license from scratch but must also retake the JP exam If you continue practicing with an expired license after 30 days, you are now practicing medicine without a license, which is a third degree felony. Ben White. The Texas Medical Jurisprudence Exam - A Concise Review (Kindle Locations 87-96). Kindle Edition. How much Continuing medical education CME must you have to renew your license? 48 hours of CME. 1/2 formal 1/2 informal (self reported, volunteering, peer review and 2 hours of medical ethics/professional responsibility When must you inform the TMB of any name / practice address changes? 30 days. You do not need to notify texas about changing medical malpractice insurance. When do you have to notify the TMB when you recieve a lawsuit? insurance will do it for you, but if you don't have insurance you have to tell the TMB in 30 days. When must the TMB be notified if a hospital takes disciplinary action against a physician (affecting privileges)? If the restriction lasts more than 30 days. What do you need to practice telemedicine in Texas? A special texas telemedicine license (required JP exam). A full medical license in good standing in another state. Board certified in speciality. NOT practicing medicine PHYSICALLY in texas. What states are contiguous with Texas? and what can these doctors order? OK, AR, LA, NM Oklahoma, Arkansas, Louisiana, New Mexico 95 | P a g e License is suspended. If convicted, it is revoked. 3rd degree felony to practice medicine without a license. Violating the medical practice act is what degree felony/class misdemeanor violation? Class A misdemeanor A List of things that violates the MPA - Lying - Drug/alcohol abuse - Felony convictions - Mental incompetence (including psychiatric illness that impairs judgment/ability to practice medicine) - False advertising - Malpractice - Dangerous prescribing (typically of controlled substances) - "Unprofessional or dishonorable" conduct (not specifically defined) - Violating the MPA TMB can punish you for mistakes made in other states / during military What is deferred adjudication? Equivalent of pleading guilty / being found guilty. you still have to report the crime to the TMB even if the crime is eventually waived. You can then petition to have your misdemeanor removed from the TMB website if successfully adjudicated. What does the TMB website post about you? usual demographic information (who you are, what school you went to, what state(s) you have a medical license in, etc), but they'll also post felony and most misdemeanor convictions (from any state), ditto analogous charges with deferred adjudication (until you fulfill the requirements and petition), malpractice claims, formal complaints, and disciplinary action from the medical board (from any state). When does TMB remove records of formal complaints and malpractice investigations? They will remove it after 5 years as long as it didn't amount to anything and no action was taken against the physician. What problem can you self-report and keep confidential? Forced rehab for self-reported drug/alcohol problems or physical/mental illness is confidential/not public (assuming you haven't hurt anyone yet through your impaired practice). This is to incentivize physicians to seek help for substance use and mental health issues. TMB can also privately reprimand you for a mistake which is also completely confidential and not in 96 | P a g e your TMB file. Internal peer review is confidential, but any practice restriction longer than 30 days must be reported to the TMB. When do you need to let the TMB know about conviction for felonies, drug violations, Medicare/Medicaid fraud, or misdemeanors that involve moral turpitude ("moral turpitude" is counter to the standards of decency/conduct/etc.). 30 days When do you need to let the TMB know about misdemeanors? Regular misdemeanors, including those eligible for deferred adjudication, should be reported during the scheduled renewal process. It doesn't matter if the crime happened in another state, the TMB still wants to know. How many lawsuits triggers a review of your license? 3 lawsuits in 5 years. Do you need to report colleagues who are impaired? You have a duty to report colleagues who you think are a "continuing threat to public welfare" to the TMB. There is no precise definition of what a "continuing threat" is, leaving you the physician with some wiggle room. There is no punishment for sounding the alarm for claims made in good faith ("immune from civil liability"). When will the TMB tell your hospital you've been restricted or suspended? Day 1 What are your rights when investigated / suspended? - May be temporarily suspended without notice or hearing if there is concern for a continuing danger to public welfare (though must then be notified immediately, with a formal hearing to follow within 10 days) - Due process (under the law) - 5th amendment protected (you never have to incriminate yourself) - 30 days to appeal Concept/Definition: What are infractions? Misdemeanors? Felonies? Jail v. Prison? Infractions are what everyone gets, tickets: jaywalking, speeding, illegal parking, etc. These involve small fines, no jail time, and have no effect on your ability to practice medicine. Misdemeanors are smallish crimes (e.g. shoplifting, pimping, marijuana possession, DUI without injury) with relatively small fines, less than 1 year of jail time, and no effect on your civil liberties (can still vote, buy a gun, run for public office, etc.). 97 | P a g e Severity is A > B > C. Felonies are more serious (aggravated assault, murder, etc.) with jail time greater than 1 year and complete loss of civil liberties. Severity is 1st > 2nd > 3rd. Though people often talk colloquially about "jail time," jails are generally places run by the county sheriff's department where people go to await trial or to serve short sentences. Prison (either state or federal) is where most convicted criminals serve their sentences. Lastly, a State Jail Felony is essentially the lowest form of felony offense in Texas. Think of it as a fourth- degree felony that is served in a state jail instead of a prison (a common state jail felony is the possession of small amounts of cocaine or meth). Confinement: 180 days-2 years, 2-10 years if with a deadly weapon or prior felony conviction. What degree felony / class misdemeanor are the following crimes: Practicing medicine without a license? 3rd degree felony What degree felony / class misdemeanor are the following crimes: Selling child? 3rd degree felony What degree felony / class misdemeanor are the following crimes: Sexual abuse of nursing home or mental institution patient? 2nd deg felony What degree felony / class misdemeanor are the following crimes: Failure to report elder abuse (outside or inside of a nursing home) Class A misdemeanor What degree felony / class misdemeanor are the following crimes: Failure to report child abuse?