NURSING JURISPRUDENCE CORE REVIEWS
ANSWERS AND QUESTIONS SET A+
✔✔Standards of Nursing Practice (cont) - ✔✔Know and conform to the Texas Nursing
Practice Act and the board's rules and regulations
Promote a safe environment for clients and others
Know the rationale for and the effects of medications and treatments and correctly
administer
Accurately and completely report and document
Respect the client's right to privacy by protecting confidential information
Promote and participate in education and counseling
Notify the appropriate supervisor when leaving a nursing assignment
Know, recognize, and maintain professional boundaries of the nurse-client relationship
✔✔Role of LVN - ✔✔Directed scope of practice that must be supervised
Educated to care for clients with stable and predictable conditions
Educated to do hands-on assessments using their senses
✔✔Role of RN - ✔✔Works in both structured and unstructured healthcare environments
Responsible for well-being of all patients
Functions within the scope of the NPA and Board rules
✔✔Professional Nursing Only - ✔✔Practice independently within NPA and board rules
Make nursing diagnosis
Develop a nursing care plan
Perform comprehensive assessment
Evaluate patient response to nursing care
✔✔Vocational Nursing - ✔✔Practice in Planning of Nursing Care
Assisting in evaluating patient response to nursing care
Perform focused assessment
✔✔LVN Supervision - ✔✔The practice of vocational nursing must be performed under
the supervision of a registered nurse, physician, physician assistant, podiatrist, or
dentist.
, ✔✔Duty of a Nurse in any Practice Setting - ✔✔Establishes, through the NPA and
Board Rules, that a nurse has a responsibility and duty to a client/patient to provide and
coordinate the delivery of safe, effective nursing care.
This duty supersedes any facility policy or physician order.
Duty to the patient
Lunsford v. Board of Nurse Examiners, 648 S.W. 2d 391 (Tex. App.--Austin, 1983)
The court in affirming the disciplinary action of the Board, held that a nurse has a duty to
the patient which cannot be superseded by hospital policy or physician's order.
This landmark case involved a gentleman who arrived to a rural hospital via private
vehicle. The gentleman was experiencing severe chest pain, nausea, and sweating—all
hallmark symptoms of myocardial infarction (heart attack). Nurse Lunsford was
summoned to the ER waiting room by this gentleman's friend. Upon seeing the acute
distress the man was experiencing and hearing his symptoms, she instructed his friend
to drive the man to the nearest facility equipped to handle heart attack victims. This
facility was 24 miles away. The man succumbed to the heart attack 5 miles away from
the small hospital.
When the Board sought to sanction the nurse's license, the nurse maintained that the
ER physician (who never saw the man) told her the man needed to be transported to
the larger facility. The facility policy was also to transfer patients experiencing heart
attacks (via ambulance) to the larger facility that was equipped to provide the broad
range of therapies that might be needed.
The court sided with the BON and agreed that the nurse had the knowledge, skills and
abilities to recognize the life-threatening nature of the man's symptoms. Because of this
knowledge, the court maintained that it was the nurse's duty to act in the best interest of
the client by assessing the man, taking measures to stabilize him and to
✔✔Graduate Nurse - ✔✔Supervision for a period of six months, or lesser time, if agreed
upon by the newly licensed nurse and the supervising nurse
Competence to perform independently should be mutually determined by the new
graduate and the supervising nurse and demonstrated and supported by documentation
✔✔Nurses transitioning back to practice or to new primary practice area - ✔✔Should
not act as charge nurse for at least six months, unless a lesser time period is agreed
upon by the nurse and his/her supervisor, based on the competency of the nurse
✔✔Six-Step Decision-Making Model - ✔✔Tool developed by the BON to assist nurses
in making good professional judgments about the nursing tasks or procedures they
choose to undertake.
ANSWERS AND QUESTIONS SET A+
✔✔Standards of Nursing Practice (cont) - ✔✔Know and conform to the Texas Nursing
Practice Act and the board's rules and regulations
Promote a safe environment for clients and others
Know the rationale for and the effects of medications and treatments and correctly
administer
Accurately and completely report and document
Respect the client's right to privacy by protecting confidential information
Promote and participate in education and counseling
Notify the appropriate supervisor when leaving a nursing assignment
Know, recognize, and maintain professional boundaries of the nurse-client relationship
✔✔Role of LVN - ✔✔Directed scope of practice that must be supervised
Educated to care for clients with stable and predictable conditions
Educated to do hands-on assessments using their senses
✔✔Role of RN - ✔✔Works in both structured and unstructured healthcare environments
Responsible for well-being of all patients
Functions within the scope of the NPA and Board rules
✔✔Professional Nursing Only - ✔✔Practice independently within NPA and board rules
Make nursing diagnosis
Develop a nursing care plan
Perform comprehensive assessment
Evaluate patient response to nursing care
✔✔Vocational Nursing - ✔✔Practice in Planning of Nursing Care
Assisting in evaluating patient response to nursing care
Perform focused assessment
✔✔LVN Supervision - ✔✔The practice of vocational nursing must be performed under
the supervision of a registered nurse, physician, physician assistant, podiatrist, or
dentist.
, ✔✔Duty of a Nurse in any Practice Setting - ✔✔Establishes, through the NPA and
Board Rules, that a nurse has a responsibility and duty to a client/patient to provide and
coordinate the delivery of safe, effective nursing care.
This duty supersedes any facility policy or physician order.
Duty to the patient
Lunsford v. Board of Nurse Examiners, 648 S.W. 2d 391 (Tex. App.--Austin, 1983)
The court in affirming the disciplinary action of the Board, held that a nurse has a duty to
the patient which cannot be superseded by hospital policy or physician's order.
This landmark case involved a gentleman who arrived to a rural hospital via private
vehicle. The gentleman was experiencing severe chest pain, nausea, and sweating—all
hallmark symptoms of myocardial infarction (heart attack). Nurse Lunsford was
summoned to the ER waiting room by this gentleman's friend. Upon seeing the acute
distress the man was experiencing and hearing his symptoms, she instructed his friend
to drive the man to the nearest facility equipped to handle heart attack victims. This
facility was 24 miles away. The man succumbed to the heart attack 5 miles away from
the small hospital.
When the Board sought to sanction the nurse's license, the nurse maintained that the
ER physician (who never saw the man) told her the man needed to be transported to
the larger facility. The facility policy was also to transfer patients experiencing heart
attacks (via ambulance) to the larger facility that was equipped to provide the broad
range of therapies that might be needed.
The court sided with the BON and agreed that the nurse had the knowledge, skills and
abilities to recognize the life-threatening nature of the man's symptoms. Because of this
knowledge, the court maintained that it was the nurse's duty to act in the best interest of
the client by assessing the man, taking measures to stabilize him and to
✔✔Graduate Nurse - ✔✔Supervision for a period of six months, or lesser time, if agreed
upon by the newly licensed nurse and the supervising nurse
Competence to perform independently should be mutually determined by the new
graduate and the supervising nurse and demonstrated and supported by documentation
✔✔Nurses transitioning back to practice or to new primary practice area - ✔✔Should
not act as charge nurse for at least six months, unless a lesser time period is agreed
upon by the nurse and his/her supervisor, based on the competency of the nurse
✔✔Six-Step Decision-Making Model - ✔✔Tool developed by the BON to assist nurses
in making good professional judgments about the nursing tasks or procedures they
choose to undertake.
