Nursing Jurisprudence and Ethics Texas Nurses

Questions and Answers

What is the best decision for the Incident Based Peer Review Committee to make regarding the nurse's actions?

The nurse needs remedial education in how to document the rationale for and response to PRN pain medications.

The nurse must be reported to the Texas Medical Board for signing out medications without a valid physician's order for controlled substances.

The nurse should be terminated from employment at the facility for stealing drugs.

The nurse must be reported to the BON because of the combination of practice errors with possible practice impairment due to substance use or abuse. (correct)

What type of license is required to utilize the two BON rules on delegation to unlicensed personnel?

Physician

Registered Nurse (correct)

Physician Assistant

Licensed Vocational Nurse

The BON rules in Title 22 of the Texas Administrative Code help implement and reflect?

The process necessary to be promoted to higher positions in nursing in different practice settings. (correct)

The statutes passed by the legislature relating to nursing found in Texas Occupations Code, including the NPA.

The steps necessary to complete the NCLEX exam application.

The standards of nursing care developed by various nursing specialty and professional organizations.

In the scenario where a school district contracts an RN to teach staff about blood glucose monitoring, the RN is?

Training the staff how to perform the task of monitoring blood glucose. Signup and view all the answers

To help a nurse decide if a task is within his or her individual scope of practice, a prudent nurse should?

Obtain a list of tasks a nurse may perform from the BON. Signup and view all the answers

A nurse's history of substance use disorder or mental illness is relevant to nursing licensure because it may indicate?

The nurse's current lack of fitness for duty. Signup and view all the answers

When the BON considers imposing disciplinary action, it is most concerned with the nurse consistently?

Acting in the best interest of clients. Signup and view all the answers

Rule 216 related to Continuing Competency requires nurses to complete?

20 contact hours of continuing education within two years preceding license renewal. Signup and view all the answers

Why does the Chief Nursing Officer (CNO) send a case to the Incident Based Peer Review (IBPR) Committee when a nurse is terminated for practice errors?

The IBPR Committee is required to review external factors surrounding the practice errors and to report to the facility's Patient Safety Committee as appropriate. Signup and view all the answers

While an LVN has a 'directed' scope of practice, this is NOT true for an RN. This means that the RN?

Is permitted to practice nursing independently within the RN's scope of practice. Signup and view all the answers

Which of the following activities would violate a provision of the NPA and Board Rule 217.11(2), Standards of Nursing Practice, related to the practice of nursing by an LVN?

Practicing in any setting without an appropriate practice supervisor who is at least telephonically available. Signup and view all the answers

The integrated pattern of personal, academic, and occupational behaviors indicating an individual consistently conforms to the Nursing Practice Act and the Board's rules relates to?

The BON's rule concerning good professional character. Signup and view all the answers

In the scenario where a nurse reports a physician for breaking sterile technique, which statement is accurate?

The nurse cannot be disciplined by the BON or discriminated against by the employer. Signup and view all the answers

The board's Disciplinary Sanction Policy on Sexual Misconduct explains that?

Sex-related criminal activity by a nurse is a private matter and may not need to be reported to the board. Signup and view all the answers

Knowing, recognizing, and maintaining professional boundaries of the nurse-patient relationship is a nursing standard. Which of the following is a violation of professional boundaries?

A nurse borrows money from a patient to repair the nurse's car. Signup and view all the answers

The identity of a person submitting a complaint against a nurse to the BON is kept confidential?

Throughout the entire investigation process. Signup and view all the answers

A nurse was arrested for making death threats and admitted to a psychiatric facility. The BON is likely to consider this conduct as grounds for disciplinary action due to?

Lack of fitness to practice which may impose a risk to patients. Signup and view all the answers

A person with a history of chemical dependency on controlled substances who desires to obtain or retain a license to practice nursing may be required to provide evidence of?

Current sobriety and fitness to practice. Signup and view all the answers

In Texas, advanced practice registered nurses (APRNs) may delegate which of the following to unlicensed assistive personnel?

Activities of daily living, health maintenance activities, and nursing tasks in compliance with BON Rules 224 and 225 on RN Delegation. Signup and view all the answers

According to BON Position Statement 15.24, what is required for a nurse to replace a gastrostomy tube?

The tube has been in place for 8-12 weeks and the nurse has a physician's order and completed competency training. Signup and view all the answers

How does the BON differ from nursing and healthcare specialty associations?

Protects and promotes the welfare of the people of Texas. Signup and view all the answers

What does Board Rule 217.11 state regarding LVN scope of practice in care plans?

Participate in the modification and development of the nursing care plan. Signup and view all the answers

If a nurse contacts a physician to clarify a medication order, what is the nurse fulfilling?

A duty to keep the patient safe. Signup and view all the answers

What specific portion of Board Rule 217.12 concerns job abandonment?

Paragraph (12) Signup and view all the answers

Which situation exemplifies a nurse maintaining appropriate professional boundaries?

Rewards a patient with a small stuffed mascot for progress. Signup and view all the answers

Which nursing license is required based on advertised job responsibilities?

Registered Nurse license. Signup and view all the answers

What is required by the NPA when a nurse is caught stealing narcotics and admits to chemical dependency?

The Peer Review Committee to monitor the nurse's practice. Signup and view all the answers

When a nurse is reported for multiple practice errors, what may the BON determine?

Indicates continued practice poses a risk of harm. Signup and view all the answers

To maintain nursing license eligibility, what must a person provide according to Board Rule 213.29?

Been under the influence of illegal substances for the last five years. Signup and view all the answers

After a nurse refuses a float assignment and invokes Safe Harbor, what is required?

Collaborate with the supervisor to determine a safe assignment. Signup and view all the answers

What happens when an applicant for a nursing license has a final conviction for first degree murder?

Not eligible to apply until five years after community supervision. Signup and view all the answers

What evidence might a person with a substance use disorder need to provide?

Attendance at Alcoholics Anonymous meetings. Signup and view all the answers

A nursing error that contributes to patient harm cannot be considered minor if:

The nurse appears to have the knowledge and skills. Signup and view all the answers

If a nurse is terminated from jobs for stealing, what may this indicate?

The nurse will repeat similar conduct toward patients. Signup and view all the answers

What occurs if a BON investigator cannot notify a nurse of formal charges?

The case proceeds and charges are deemed true. Signup and view all the answers

What do the functions of the BON include?

Regulating the education, licensure, and practice of nurses in Texas. Signup and view all the answers

What should a nurse do if they commit a minor incident?

Report only if it created significant risk of harm. Signup and view all the answers

Which statement correctly reflects Board Rule 217.20 regarding Safe Harbor Peer Review?

Safe Harbor must be invoked prior to the assignment or if changes are made. Signup and view all the answers

Why was the nurse correct to question a medication order?

Position Statement 15.14 Duty of a Nurse in Any Setting. Signup and view all the answers

What identification must each nurse wear while interacting with the public?

A registered nurse or licensed vocational nurse badge. Signup and view all the answers

Which patients are the most vulnerable in a nurse-patient relationship?

Patients under anesthesia or sedation. Signup and view all the answers

What constitutes 'conduct subject to reporting' in the NPA?

Conduct causing suspicion of the nurse's chemical dependency. Signup and view all the answers

Which resource would help a nurse determine their scope of practice?

The continuing competency information sheet. Signup and view all the answers

What must a nurse do if they suspect a medication order is inaccurate?

Give the medication as ordered and document concerns. Signup and view all the answers

When assigning nursing tasks to other LVNs and RNs, which factor is NOT considered?

The physical and emotional ability of each nurse. Signup and view all the answers

What must a person do to legally practice nursing in Texas?

Hold a license as required by the NPA. Signup and view all the answers

What constitutes 'patient abandonment' according to the BON?

Quitting at the end of a shift is NOT considered abandonment. Signup and view all the answers

What eligibility question must nurses answer for licensure renewal?

Whether they have a criminal background to reveal. Signup and view all the answers

Chart audits find the following errors committed by a nurse with observed __________ behavior at work.

impaired Signup and view all the answers

Study Notes

Nursing Procedures and Responsibilities

A nurse can replace a gastrostomy tube after 8-12 weeks if they have a physician's order and completed specific competency training.
The Board of Nursing (BON) protects the welfare of Texas residents and differs from associations that may lobby for nursing legislation.
Licensed Vocational Nurses (LVNs) may participate in the modification and development of nursing care plans but cannot initiate them independently.
Contacting a physician to clarify medication orders is part of a nurse's duty to ensure patient safety.
Job abandonment is addressed under Board Rule 217.12, specifically in Paragraph (12).

Professional Boundaries and Ethics

A nurse maintains appropriate professional boundaries by rewarding progress in rehabilitation rather than personalizing the relationship.
For certain responsibilities, a nurse requires a Registered Nurse license, signifying the minimum competencies needed.
Upon admitting to substance dependence, the nurse must be monitored by a Peer Review Committee, according to the NPA.

Safety and Patient Care

Continuous practice errors reported to the BON may indicate risk to patient safety.
A nurse with a first-degree murder conviction must wait five years post-release from supervision to apply for a nursing license.
A report to the BON isn’t required for minor incidents unless they pose significant risks to patients.

Licensing and Reporting

Nurses must be aware of the implications of questioning a physician's orders, supported by the Position Statement 15.14 highlighting their duty to patient safety.
Practicing nursing in Texas necessitates holding a valid nursing license; an applicant must comply with specific education and licensing criteria.
Quitting a job at the end of a shift is not considered patient abandonment, countering potential misconceptions.

Continuing Education and Competence

Nurses must answer questions about any criminal background during the licensure renewal process, impacting their eligibility.
The BON's rules advocate for accountability regarding narcotic management, requiring action if practices indicate impairment or substance use issues.

Scope of Practice

Registered Nurses (RNs) are necessary for delegating tasks to unlicensed personnel, ensuring that patient care standards are maintained.
The BON enforces statutes from the Texas Occupations Code, shaping the nursing profession's operational standards and practice laws.

Instructional Roles in Nursing

An RN is contracted to teach staff how to monitor blood glucose levels, demonstrating the application of nursing expertise outside direct patient care contexts.### Nurse Delegation and Scope of Practice
RN is responsible for training staff to monitor blood glucose effectively.
A prudent nurse evaluates tasks against the Scope of Practice Decision-Making Model.
The Board of Nursing (BON) provides a list of tasks specific to nursing practice.

Substance Use and Nursing Licensure

A nurse's history of substance use disorder is crucial for evaluating fitness for duty.
Disciplinary actions from BON focus on the nurse's ability to serve clients' best interests.

Continuing Competency and Education Requirements

Rule 216 mandates RNs to complete 20 contact hours of continuing education biennially.

Incident Based Peer Review (IBPR)

CNO must report practice errors to the IBPR Committee, which evaluates external factors impacting care.

RN Practice Autonomy

Unlike LVNs, RNs can practice independently within their designated scope.

Violations of Nursing Practice

Practicing without a qualified supervisor is a violation of nursing standards for LVNs.

Professional Character and Ethical Standards

Adherence to the Nursing Practice Act reflects on an individual’s professional character.

Reporting Ethical Violations

Nurses are protected from discipline for reporting ethical breaches, such as observing a physician violating sterile technique.

Sexual Misconduct Policy

Sexual misconduct is a critical concern; it questions the nurse's ability to provide safe care.

Professional Boundaries

Nurses borrowing money from patients significantly breach professional boundaries.

Confidentiality in Complaints

The identity of individuals filing complaints against nurses remains confidential throughout the investigation.

Mental Health and Fitness for Practice

Conduct raising concerns regarding fitness to practice, such as making threats, may trigger disciplinary actions.

Chemical Dependency and Licensing

Individuals with chemical dependency histories must demonstrate current sobriety and fitness to practice for licensure.

APRN Delegation Authority

In Texas, APRNs can delegate daily activities and health maintenance tasks to unlicensed assistive personnel according to BON rules.

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Description

Test your knowledge on the legal and ethical guidelines relevant to nursing practice in Texas. This quiz focuses on key position statements and scope of practice as defined by the Board of Nursing. Prepare to engage with complex scenarios involving nursing ethics and jurisprudence.