Nursing Safety Measures Quiz

Questions and Answers

Which of the following documents on the BON website best explains why the nurse was correct to question a physician's order?

Guideline for LVN Scope of Practice under Board Rule 217.11

Guideline for Nurses Transitioning to a New Practice Setting

Statistics on the number of nurses living in each county in Texas

Position Statement 15.14 Duty of a Nurse in Any Setting (correct)

The initial step to invoke Safe Harbor requires that a nurse:

Complete a written request to Petition for a Declaratory Order

Complete a Licensure Renewal Form, give it to the supervisor, and wait to be notified of the date and time for the peer review hearing

Notify the supervisor and submit a written Quick Request for Safe Harbor to the supervisor before accepting the assignment (correct)

Hire an attorney so that all correspondence can be sent through the nurse's legal counsel

Based on the responsibilities outlined in a licensed nurse job advertisement, what is the minimum required license?

Advanced Practice Registered Nurse license

Registered Nurse license (correct)

Vocational Nurse license

Physician Assistant license

Which of the following tasks could an advanced practice registered nurse delegate to an unlicensed clinical staff member?

Cleansing and dressing a minor leg wound in accordance with step-by-step instructions Signup and view all the answers

Which of the following actions violates professional boundaries in the nurse-patient relationship?

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

According to the NPA Section 301.406, what duty does a professional nursing association have when a nurse cheats on a certification exam?

Also has a duty to report the nurse to the BON Signup and view all the answers

Whistleblower protection would apply to a nurse who reports unsafe conditions if:

The accusations were made in good faith Signup and view all the answers

Conduct by a nurse that is subject to reporting to the BON includes all of the following EXCEPT:

Conduct that constitutes a single minor incident in compliance with Board Rule 217.16 Signup and view all the answers

What is one key difference between the BON and nursing specialty associations?

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

According to Rule 217.12(1), Unprofessional Conduct, which of the following is an example of an unsafe practice?

Manage client records properly Signup and view all the answers

Which activity falls within the LVN scope of practice according to the Standards of Nursing Practice, Board Rule 217.11?

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

In which situation has a nurse become overly involved and at risk of committing a boundary violation?

Insists on being assigned to a patient she's attracted to every shift Signup and view all the answers

Stealing valuables from a patient may involve which of the following conduct?

Theft of property Signup and view all the answers

A person with a history of chemical dependency who wants a nursing license may need to provide evidence of:

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

According to BON Position Statement 15.24, when can a nurse replace a gastrostomy tube?

If the tube has been in place for 8-12 weeks, with a physician's order and specific competency training Signup and view all the answers

In the NPA, which conduct is subject to reporting?

Conduct causing suspicion of impaired practice due to chemical dependency Signup and view all the answers

What is the policy for an applicant receiving a final conviction for first degree murder concerning their nursing license?

Will not be eligible to apply for a nursing license until five years after release from supervision Signup and view all the answers

Which situation exemplifies a nurse maintaining appropriate professional boundaries with a client?

Rewards a patient with a small stuffed mascot for progress made in rehabilitation Signup and view all the answers

Implement measures to promote a safe environment for clients and others describes

The employer's requirement for safe staffing levels Signup and view all the answers

The purpose of the Position Statements, guidelines and other documents in the Nursing Practice section of the BON webpage is to guide nurses in

Making decisions related to their patient care assignments Signup and view all the answers

Which of the following is an example of the nurse maintaining professional boundaries in the nurse-client relationship?

Sharing candy from a patient with other staff and telling them the source of the candy Signup and view all the answers

Does the nurse have protection from negative employment action for reporting the above incident to the appropriate authorities?

It depends. The nurse may be protected, but only if the nurse can prove that the client was in an unsafe situation Signup and view all the answers

A graduate vocational nurse (GVN) with current temporary authorization to practice is in a practice setting where no other licensed nurse is physically present. This situation would best be described as

An unacceptable practice due to the lack of a licensed nurse who is physically present and readily available to directly supervise the GVN Signup and view all the answers

An Incident-Based Nursing Peer Review Committee

Must adhere to due process requirements for the nurse Signup and view all the answers

A nurse may not be reported to the BON for either appropriately invoking Safe Harbor or for advising another nurse of their right to invoke Safe Harbor. These are

Protections for a nurse who requests a peer review determination Signup and view all the answers

A nurse whose license has expired may practice until the license has been renewed.

False Signup and view all the answers

A nurse is assisting a physician when she witnesses the physician break sterile technique and use a contaminated instrument to finish the procedure. The nurse reports the physician to the Texas Medical Board. Which of the following statements is accurate in relation to this scenario?

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

Board cases involving eligibility or disciplinary issues that are resolved through a board agreed order

Are public records and accessible on the BON's web page Signup and view all the answers

One purpose of the BON's Position Statements and Guidelines is to provide

Guidance to help the nurse apply the NPA and board rules Signup and view all the answers

In a nurse-patient relationship, the most vulnerable patients are those who are

Under anesthesia or sedation Signup and view all the answers

The mission of the BON supersedes

The interests of individuals, the profession, or special interest groups Signup and view all the answers

According to the Standards of Nursing Practice, Board Rule 217.11, a comprehensive nursing assessment

Can be completed only by a registered nurse Signup and view all the answers

Why does the BON require nurses to disclose that they have been diagnosed with certain mental illnesses?

Nurses diagnosed may lack fitness to practice nursing safely Signup and view all the answers

Which of the following actions by a nurse would comply with the Standards of Nursing Practice in Board Rule 217.11?

Documenting an aspect of nursing care provided to a patient after the fact Signup and view all the answers

The integrated pattern of personal, academic, and occupational behaviors that indicate an individual conforms to the requirements of 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

A nurse fears that administration of a medication as ordered would place a patient at risk. The nurse would fulfill his duty to the patient if the nurse

Informs the physician of his concern and requests clarification of the order Signup and view all the answers

A temporary permit to practice nursing issued to a graduate of a board-approved nursing educational program

May be denied based on a licensure candidate's criminal history Signup and view all the answers

Revisions to the NPA can only occur through

Bills passed by the Texas Legislature Signup and view all the answers

Within the nurse licensure compact agreement, the party state that is the nurse's primary state of residence is called the nurse's

Home state Signup and view all the answers

One way the board carries out its mission to protect the public is by

Ensuring that each nurse is competent to practice safely Signup and view all the answers

A nurse was terminated from three different jobs because he or she was stealing from staff members. Though this activity does not involve patients, it may indicate that

The nurse will repeat similar conduct and exploit patients 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

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 Signup and view all the answers

A person with a history of a substance use disorder who desires to obtain or retain a license to practice nursing may be required to provide evidence that includes all of the following EXCEPT:

Attendance at Alcoholics Anonymous meetings Signup and view all the answers

The Position Statement 15.27 The Licensed Vocational Nurse Scope of Practice outlines that LVNs have a "directed" scope of practice under supervision. This means that

The LVN must have a registered nurse present at all times Signup and view all the answers

According to the NPA, Section 301.452 Grounds for Disciplinary Action, the definition of "intemperate use" includes

Being on-call or on duty while under the influence Signup and view all the answers

According to the NPA section 301.403, the Peer Review Committee must report which of the following to the board?

A description of any corrective action taken against the nurse Signup and view all the answers

A nurse is terminated and reported to the BON for committing repeated practice errors. The CNO also sends the case to the Incident-Based Peer Review Committee because:

The IBPR Committee is required to review external factors surrounding the practice errors Signup and view all the answers

Study Notes

Safe Environment and Nurse Responsibilities

The employer is required to ensure safe staffing levels to promote a safe environment for clients and others.
Nurses must make decisions related to patient care assignments based on guidelines provided by the BON.

Professional Boundaries in Nurse-Client Relationships

Sharing candy from a patient with staff while disclosing its source exemplifies maintaining professional boundaries.
Accepting gifts or inviting former patients to personal events breaches professional behavior norms.

Reporting Concerns and Whistleblower Protections

Nurses may face negative employment actions after reporting unsafe situations, but can be protected under whistleblower laws if they prove significant risk existed.
Accurate reporting of misconduct, such as a physician compromising sterile technique, shields nurses from potential disciplinary actions by the BON.

Nursing Licensure and Practice Requirements

Nurses cannot practice without a current and renewed license; expired licenses prohibit practice.
Graduate vocational nurses must be supervised by a licensed nurse physically present in the practice setting.

Governance and Oversight

Nursing peer review committees must uphold due process for nurses facing employment termination.
Board agreed orders related to disciplinary actions are public records accessible online.

Ability to Practice Safely

The BON requires nurses to disclose mental health diagnoses to ensure fitness for safe practice.
The comprehensive nursing assessment per nursing standards must be completed only by a registered nurse.

Delegation and Scope of Practice

Advanced practice registered nurses (APRNs) can delegate specific nursing tasks in compliance with BON rules.
Due to substance abuse history, individuals may need to show evidence of sobriety and additional qualifications to be licensed.

Disciplinary Actions and Ethical Responsibilities

A nurse with a history of theft, even if not related to patients, raises concerns about potential exploitation of vulnerable patients.
Documentation of nursing care should follow facility policy, especially for late entries.

Safe Harbor Procedures

Nurses invoking Safe Harbor must notify supervisors before accepting assignments they deem unsafe.
Guidelines affirm the nurse's duty to question potentially harmful physician orders, emphasizing patient safety.

Heart of Nursing Practice Standards

Nurses must consistently act in the best interest of patients, adhering to the Nursing Practice Act (NPA).
The home state is defined as the primary residence of the nurse within the Nurse Licensure Compact agreement.

Legal and Legislative Framework

Amendments to the Nursing Practice Act (NPA) occur only through bills passed by the Texas Legislature.
Peer review committees are responsible for reporting corrective actions to the BON concerning nurses' practice issues.### Delegation of Tasks
Advanced practice registered nurses can delegate tasks to unlicensed staff in outpatient settings.
Cleansing and dressing a minor leg wound can be delegated if following step-by-step instructions.

Professional Boundaries

Maintaining professional boundaries is crucial in nurse-patient relationships.
Borrowing money from a patient is a clear violation of these boundaries.

Reporting Obligations

Professional nursing associations are required to report unethical behavior to the Board of Nursing (BON).
Disqualification from certification can result from cheating on exams.

Whistleblower Protection

Whistleblower protection applies to nurses reporting unsafe conditions if made in good faith.

Conduct Subject to Reporting

Not all conduct is subject to reporting; minor incidents compliant with Board rules are exceptions.
Serious violations include abuse, fraud, or actions leading to patient harm.

BON Responsibilities

The BON's primary obligation is to protect the welfare of the public.
Unlike nursing associations, BON does not lobby for legislation or offer liability insurance.

Unsafe Nursing Practices

Failing to manage client records properly is an example of unsafe nursing practice.

Care Plan Participation

Licensed Vocational Nurses (LVNs) may participate in modifying and developing nursing care plans.

Boundary Violations

A nurse excessively involved with a patient risks violating professional boundaries.

Theft as Unprofessional Conduct

Stealing from patients, including valuables, constitutes theft and unprofessional conduct.

Evidence of Sobriety

Individuals with a history of substance abuse must provide evidence of current sobriety to obtain or retain a nursing license.

Replacement of Feeding Tubes

Nurses can replace gastrostomy tubes only if certain conditions are met, including competency training and physician's orders.

Reporting Impaired Practice

Conduct indicating potential impairment due to substance abuse must be reported.

Eligibility for Nursing License

Applicants with serious convictions, such as first-degree murder, must wait five years post-release from supervision to apply for a nursing license.

Maintaining Professional Boundaries

Appropriate actions include rewarding patients for progress, while sharing personal issues or visiting patients outside work violates boundaries.

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Description

Test your knowledge on the implementation of safety measures within nursing practice. This quiz covers essential concepts including safe staffing levels and the employer's responsibilities in maintaining a safe environment. Perfect for nursing students and professionals alike.