Texas Medical Jurisprudence Exam Answers 2024, Exams of Nursing

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Answers 2024

Can a patient successfully sue a doctor if there is no physician-patient relationship? - Correct Answers ✅No If there is no prior physician-patient relationship, are you legally obliged to respond to a call from a patient for treatment? - Correct Answers ✅No Does being on call give rise to a physician-patient relationship? - Correct Answers ✅No How can one terminate a physician-patient relationship, without abandonment if there is ongoing treatment? - Correct Answers ✅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? - Correct Answers ✅Yes What is "proximate cause"? - Correct Answers ✅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? - Correct Answers ✅Cause-in-fact (but-for test) and foreseeability

Answers 2024

Does an expert witness have to be actively practicing medicine? - Correct Answers ✅Yes Does an expert witness have to know standards of care? - Correct Answers ✅Yes Does an expert witness have to have enough training to express an opinion on whether standard of care was provided? - Correct Answers ✅Yes Does an expert witness have to be board certified? - Correct Answers ✅No, board certified or eqivalent In a medical malpractice case, are expert witnesses required? - Correct Answers ✅Yes, with two exceptions In a medical malpractice setting, what 2 instances do not need expert testimony? - Correct Answers ✅Res ipsa loquitur (e.g., amputation of wrong leg) and negligence per se (a law was broken) What are "exemplary damages"? - Correct Answers ✅Damages above compensatory designed to punish the defendant and deter the behavior

Answers 2024

Is there a cap to noneconomic damages? How much? - Correct Answers ✅$250,000 for physicians, $500,000 for hospitals Does the cap on noneconomic damage depend on the number of defendants or claimants? - Correct Answers ✅No What is "proportional responsibility"? - Correct Answers ✅Percentage of liability apportioned according to percentage of fault Can the claimant have part of the proportional responsibility? - Correct Answers ✅Yes If the claimant's proportionate responsibility is more than what %, he/she may not recover damages? - Correct Answers ✅If > 50%, no damages awarded How long is the statute of limitations for adults? For minors? - Correct Answers ✅2 years; for minors 2 years after becoming 18 years of age By how much can the statute of limitations be extended and how? - Correct Answers ✅File complaint—extra 60-day, notice letter extends statute by 75 days

Answers 2024

What is the statute of limitations for wrongful death? - Correct Answers ✅2 years What is the discovery rule? Give examples. - Correct Answers ✅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? - Correct Answers ✅Yes, except gross negligence Is there immunity from civil action in volunteer care? - Correct Answers ✅Yes, except gross negligence When can a physician be charged with "assault and battery"? - Correct Answers ✅Un-consented surgery or examination or when exceeding the scope of the consent When can a physician be charged with patient abandonment? - Correct Answers ✅Unilateral cessation of treatment when continued treatment is necessary What is "strict liability"? - Correct Answers ✅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

Answers 2024

Are hospitals liable for the actions of a physician? - Correct Answers ✅No, unless the hospital employs the physician Who determines in a criminal case if the medical records of a patient should be released? - Correct Answers ✅Judge by inspection How many days do you have to release medical records to an attorney?

• Correct Answers ✅45 days Can medical records be admitted as evidence in court? What are the requirements? - Correct Answers ✅Yes, but only with affidavit What are schedule 1, 2, 3, 4, 5 drugs? - Correct Answers ✅Schedule 1—no known use (e.g., heroin); schedule 2—very addictive (morphine, cocaine); schedule 3-5—less addictive What are dangerous drugs? - Correct Answers ✅Prescription drugs other than schedule 1- How many DEA registrations do you need if you prescribe drugs? dispense drugs? - Correct Answers ✅One to prescribe; a separate registration for each location where you dispense

Answers 2024

How often do you renew your DEA license? - Correct Answers ✅Every 3 years Can you move your office location and then change your DEA? - Correct Answers ✅No, need to change BEFORE move Is a DEA registration sufficient to prescribe drugs in Texas? - Correct Answers ✅No, also need Department of Public Safety Bureau of Narcotics and Dangerous Drug registration How often do you renew a DPS license? - Correct Answers ✅Yearly Do you have to display the DEA and DPS licenses? - Correct Answers ✅Not required by any statute. How many days do you have to notify the DPS of any change in your information (name, address, tel., etc.)? - Correct Answers ✅7 days Can you have your DPS suspended and keep your DEA or vice versa? - Correct Answers ✅No, they are interconnected

Answers 2024

For schedules 2-5 drugs, can you just put the number of pills on prescription? - Correct Answers ✅No, number and number spelled out Do you have to put intended use on prescription? - Correct Answers ✅Yes With how many days of a schedule 2-5 drug can a patient be discharged from the hospital? - Correct Answers ✅7 days; only if the drug was already rx in the hospital What kind of prescription pad do you need for schedule 2 drugs? Can you use stickers? - Correct Answers ✅Official DPS form; no stickers Can a physician prescribe schedule 2 over the phone? - Correct Answers ✅Yes, for emergencies, and only for the duration of emergency How many days does the physician have to mail the schedule's emergency prescription to the pharmacy? - Correct Answers ✅ 7 days How many days does the patient have to fill schedule 2 prescriptions? - Correct Answers ✅7 days

Answers 2024

Can you refill a schedule 2 prescription? How about schedule 3-5? - Correct Answers ✅No for schedule 2. Max 5 refills for schedules 3-

Who can call in prescription from a physician's office? - Correct Answers ✅Any qualified DESIGNATED person Can they call in schedule 2? - Correct Answers ✅Only physician in emergencies Can a physician prohibit substitutions for generics? - Correct Answers ✅Yes From whom and how do you order schedule 2? Schedules 3-5? - Correct Answers ✅Schedule 2 on triplicate order form from distributor; schedules 3-5 regular form from wholesaler What drugs do you need to keep records on? How are the records kept? How often do you need to do inventory? Do you need to submit the records? How long do you have to keep the last inventory list? - Correct Answers ✅If dispensed in office, then all dangerous drugs, schedule drugs and samples; separate records for schedule 1+2; inventory every 2 years; records are not submitted; keep records for 2 years

Answers 2024

Who can inspect your drugs? - Correct Answers ✅TMB, DPS, attorney general for the DEA What is the method of ordering and accounting for drug samples? - Correct Answers ✅Written and signed request by physician; must keep inventory and drug logs Can you repackage samples? - Correct Answers ✅No Do you need to keep records on samples? - Correct Answers ✅Yes, just like other meds Can a physician buy and rebottle? Any exceptions? - Correct Answers ✅No, except for rural areas (less than 5000 population of town or 2500 of municipality, closest pharmacy > 15 miles) To give anesthesia, how often do you have to register with the board? - Correct Answers ✅Every 2 years What life support competency do surgeons and anesthesiologists need?

• Correct Answers ✅ACLS, PALS, or board-approved course

Answers 2024

How many and what competency levels of healthcare providers do you need in all settings? - Correct Answers ✅At least 2 physicians with advanced competency How many days do you have to report office-based anesthesia-related complications? - Correct Answers ✅15 days What is considered an anesthesia-related complication? - Correct Answers ✅Admission to hospital within 24 hours or death within 72 hours What is considered intractable pain? - Correct Answers ✅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? - Correct Answers ✅No Can the board take disciplinary action against a physician for giving dangerous or controlled substances to a patient with intractable pain? - Correct Answers ✅No

Answers 2024

What must the physician document prior to treatment of intractable pain? - Correct Answers ✅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? - Correct Answers ✅No Who can be part of a confidential communication? - Correct Answers ✅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? - Correct Answers ✅No, billing record is NOT part of medical record In a criminal proceeding, is the physician-patient privilege communication confidential? - Correct Answers ✅NO (except for mental health records); judicial ruling should be obtained In a criminal proceeding, are records of alcohol and drug abuse confidential? - Correct Answers ✅Yes

Answers 2024

Does the physician confidentiality apply to court or administrative proceedings brought by the patient against a physician? - Correct Answers ✅No Can the physician violate confidentiality if he/she thinks he or someone else is in danger? - Correct Answers ✅Yes, must report that to law enforcement agency (NOT for mental health) What information must a release of medical records include? - Correct Answers ✅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? - Correct Answers ✅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? - Correct Answers ✅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? - Correct Answers

Answers 2024

✅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? - Correct Answers ✅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? - Correct Answers ✅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? - Correct Answers ✅No Can you relate information without patient consent for treatment? Billing? To report abuse? To law enforcement? For funeral directions? For worker's comp? - Correct Answers ✅Yes, all of the above What is the "minimum necessary standard" for a medical release? - Correct Answers ✅It protects health care information unless it is required to be released (investigation, law enforcement, authorized release, participating care providers, HIPAA compliant release)

Answers 2024

Does a patient have the right to see his/her own record? Can he/she ask for amendments to the records? - Correct Answers ✅Yes; yes, they can request amendments What is the Texas medical record privacy act? Is it like HIPAA? - Correct Answers ✅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? - Correct Answers ✅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? - Correct Answers ✅Yes; no Are substance abuse records admissible during criminal proceedings? - Correct Answers ✅No, unless the crime is EXTREMELY serious Is HIV information confidential? - Correct Answers ✅Yes Can you "break" confidentiality in order to tell a spouse that his/her spouse is HIV positive? - Correct Answers ✅Yes

Answers 2024

Can you break confidentiality to tell a partner about notification program?. - Correct Answers ✅Yes Are blood bank records confidential? - Correct Answers ✅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. - Correct Answers ✅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? - Correct Answers ✅They can tell name of disease, NOT donor For statistical purposes, can a blood bank give out medical records? Names? - Correct Answers ✅Yes, but not names or other identifying information Is genetic information confidential? - Correct Answers ✅Yes Can patients have access to the results of their genetic testing? - Correct Answers ✅Yes

Answers 2024

What kind of crime is the unauthorized release of records? - Correct Answers ✅Misdemeanor Can the Texas Medical Board (TMB) show preference to a specific school of medicine such as medicine v. osteopathy? - Correct Answers ✅No What does the Medical Practice Act (MPA) regulate? - Correct Answers ✅The practice of medicine Who does the MPA apply to? - Correct Answers ✅Physicians (MD, DO), PAs, and acupuncturists Does the MPA apply to the armed forces and federal public health? Can they moonlight? - Correct Answers ✅It does NOT apply to a federal job, they can NOT moonlight outside the federal setting Does the MPA apply to emergency assistance if there is NO charge of money? If there is money charged or billed? - Correct Answers ✅NO if no charge; YES if money is charged Are medical students in "board-approved schools" subject to the MPA?

• Correct Answers ✅No

Answers 2024

Does the MPA prohibit self-care? - Correct Answers ✅No Does the MPA apply to physicians in contiguous states? - Correct Answers ✅NO (physicians from nearby states can only order care for patients in hospice or nursing homes) How many people are on the TMB? Who appoints them? Who must confirm them? - Correct Answers ✅19 members, appointed by the governor, confirmed by the senate Can the board subpoena people and records? Who can serve a subpoena? - Correct Answers ✅YES, subpoenas can be served by board investigator or sent by certified mail How often does the Department of Public Safety (DPS; state police) check on physicians and report to the board? - Correct Answers ✅Quarterly What are acceptable methods to tell the public on how to register a complaint to the TMB? In what languages? Where can a physician include this info? - Correct Answers ✅By phone (direct number and 1-800 number) or by mail; posted sign, on registration forms or bill; in English and Spanish

Answers 2024

How often must the TMB disseminate updated information? What info is included? - Correct Answers ✅2 times per year; info includes disciplinary action, board activities and functions, changes to the MPA and attorney general opinions Are disciplinary orders private or public? - Correct Answers ✅Public Are the following included in the physician profile?

1. ethnic origin
2. CME
3. years in practice
4. Medicaid participation
5. misdemeanors
6. felonies
7. malpractice claims
8. tax ID or social security numbers - Correct Answers ✅Everything except for tax ID/soc. security Which malpractice claims should be included? - Correct Answers ✅Any jury awards, liabilities—NOT settlements

Answers 2024

What happens if you don't give this info? - Correct Answers ✅License is not renewed How many years of postgraduate training do you need to be eligible for licensure? - Correct Answers ✅One Who can get a limited license? - Correct Answers ✅Applicant who is recommended by dean, president, or chief administrator from Texas medical school Do you need the jurisprudence exam for a limited license? - Correct Answers ✅Yes Who is not eligible for licensure? - Correct Answers ✅If applicant is under prosecution, investigation, or has restrictions on license in another state How many days does the program director have to tell the board that somebody with a physician-in-training license did not show up, was suspended, etc.? - Correct Answers ✅30 days What is a temporary postgraduate training permit? - Correct Answers ✅License for residents and fellows pending the physician in training permit

Answers 2024

What is a telemedicine license? Do you have to be board certified to have it? Do you have to pass the jurisprudence exam? - Correct Answers ✅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? - Correct Answers ✅Every 2 years; yes How many days prior to the expiration of your license does the TMB notify you? - Correct Answers ✅ 30 How many days after a license expires are you considered to be practicing without a license? - Correct Answers ✅30 day grace period. License expired < 90 days—penalty is? - Correct Answers ✅$ License expired 91-364 days—penalty is? - Correct Answers ✅$ License expired > 364 days—penalty is? - Correct Answers ✅Cancellation

Answers 2024

Do you have to retake JP exam if your license is canceled? - Correct Answers ✅Only if the license is canceled for more than 2 years. How can you get another license if it is lost/destroyed? - Correct Answers ✅Get affidavit of lost or destroyed document and pay fee to board How many category 1 CMEs yearly? - Correct Answers ✅ 12 How many CMEs per year? - Correct Answers ✅ 24 How many category 1 CMEs yearly must be in ethics? - Correct Answers ✅ 1 How many category 2 CMEs can be from volunteer work? - Correct Answers ✅ 6 How many CMEs can a license carry forward? And for how many registration periods? - Correct Answers ✅48; only once How many CMEs can be applied retroactively? - Correct Answers ✅24; only once

Answers 2024

How many CMEs do you need if you become "board certified" within 36 months? - Correct Answers ✅ 24 If you practice pain management, how many CMEs in pain management are required? - Correct Answers ✅None, but they are recommended Who can initiate a complaint to the board? - Correct Answers ✅Anyone What is the "health professions council"? - Correct Answers ✅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? - Correct Answers ✅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? - Correct Answers ✅Upon written request

Answers 2024

Who investigates issues of "medical competency"? - Correct Answers ✅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? - Correct Answers ✅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? - Correct Answers ✅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? - Correct Answers ✅2 times per year. Restrictive action by the TMB: Must the board report crimes found during investigations? - Correct Answers ✅Yes, to the law enforcement.

Answers 2024

Restrictive action by the TMB: Within how many days must the board report to the NPDB? - Correct Answers ✅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? - Correct Answers ✅30 days. Are TMB reports confidential? - Correct Answers ✅Yes Who can the NPDB give info to? How about to patients? How about statistical data? - Correct Answers ✅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? - Correct Answers ✅To prevent mother's death, if unborn has severe irreversible brain damage When is it not illegal to perform an abortion on a minor? - Correct Answers ✅In emergency and with court order Is sexual contact between a physician and patient OK if the patient consents? - Correct Answers ✅NO, the disparity of power does not allow consent

Answers 2024

Why is it unprofessional to initially prescribe drugs over the Internet? - Correct Answers ✅Did not verify identity of patient, no physician coverage or follow-up guaranteed How can you terminate care to a patient? - Correct Answers ✅ 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? - Correct Answers ✅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? - Correct Answers ✅Yes What happens to his/her license if a physician goes to prison? - Correct Answers ✅TMB is required to suspend How many malpractice claims within what time period automatically open a board investigation? - Correct Answers ✅3 within 5 years