Tennessee Nursing
Practice Act
Jurisprudence Exam:
The Elite Universal
Test Bank
Table of Contents
● Part I: The Preview
● Part II: The Elite Test Bank
○ Tier 1: Foundational Syntax & Application (Questions 1–18)
○ Tier 2: Complex Application & Simulation (Questions 19–37)
○ Tier 3: Grandmaster Synthesis (Questions 38–55)
Part I: The Preview
Mastering this test bank translates directly to elite clinical and administrative performance by
fusing strict legal boundaries with advanced clinical decision-making. These 55 scenarios forge
strict adherence to the Tennessee Nursing Practice Act, ensuring invulnerability to malpractice,
board discipline, and catastrophic delegation errors.
The "Critical Axioms" Cheat Sheet
● The "Isolated Island" of Delegation: The registered nurse (RN) transfers the task but
absolutely retains total accountability for the outcome, supervision, and clinical judgment.
● LPN Intravenous (IV) Boundaries: Licensed Practical Nurses (LPNs) may only push IV
medications in peripheral lines for adults over 80 pounds, possessing proper certification.
Pediatrics, prenatal patients, and central line pushes are strictly forbidden.
● Mandatory Reporting Absolutes: Every citizen, especially healthcare providers, is a
mandatory reporter for suspected elder and child abuse (TCA 71-6-103, TCA 37-1-403).
Failure to report is a Class A misdemeanor.
● The 2-for-2 Competency Rule: RNs and LPNs must complete two recognized continued
competence activities every two years (e.g., 5 CE hours plus a satisfactory employer
evaluation). Records must be retained for four years.
● APRN Prescriptive Prohibitions: Advanced Practice Registered Nurses (APRNs) are
, strictly barred from prescribing legend drugs or controlled substances for themselves or
their immediate family, except in documented, immediate emergencies.
Professional License Scope of Practice Summary Primary Statutory Rule
RN Independent assessment, care TCA 63-7-103
plan formulation, delegation,
care evaluation.
LPN Directed scope, contributes to TCA 63-7-108
assessment, cares for stable
patients.
APRN Medical diagnosis, TCA 63-7-126
therapeutics, prescribing (with
collaborative agreement).
MA-C Administers routine oral/topical TCA 63-7-127
meds in specific facilities; no
dosage decisions.
Part II: The Elite Test Bank
Tier 1: Foundational Syntax & Application
Q1: An RN licensed in Tennessee is audited by the Board of Nursing for continued competence
compliance. Based on the principles of the Tennessee Administrative Code, what is the
MAXIMUM allowable timeframe the RN has to produce the required documentation? A) 14 days
B) 30 days C) 45 days D) 60 days
● Answer: B (30 days)
● Distractor Analysis:
○ A is incorrect: Fourteen days is an arbitrary administrative timeline used in some
facility policies, not the statutory Board requirement.
○ C is incorrect: Forty-five days is an invalid timeline for compliance auditing in this
jurisdiction.
○ D is incorrect: Sixty days represents the early renewal window for licensure, not the
audit response deadline.
The Mentor's Analysis: Licensees must retain proof of continued competence for four years and
produce it within 30 days of a written request. When facing a state audit, the immediate priority
is producing verifiable documentation promptly. By utilizing proactive record-keeping, you
bypass the common trap of disciplinary action for failure to comply. Professional Intuition:
Always retain two items of continued competence for a minimum of four years; failure to
produce them within 30 days triggers disciplinary action.
Q2: A graduate nurse (GN) is hired at a local hospital while awaiting NCLEX-RN results. Based
on the principles of the Tennessee Nursing Practice Act, which action regarding supervision is
MANDATORY? A) The GN must be supervised by an RN who is overseeing no more than three
GNs simultaneously. B) The GN must function independently if an RN is physically present in
the building. C) The GN must be supervised by an RN located in the same unit, who is
supervising no more than one GN at a time. D) The GN must practice strictly under a temporary
permit valid for one calendar year.
● Answer: C (The GN must be supervised by an RN located in the same unit, who is
supervising no more than one GN at a time.)
● Distractor Analysis:
, ○ A is incorrect: The statute limits supervision to a strict 1:1 ratio, not 1:3.
○ B is incorrect: "In the building" is insufficient; the supervising RN must be on the
same unit.
○ D is incorrect: A temporary authorization for a graduate nurse awaiting examination
is valid only until results are received, not a full year, and practice is limited to 90
days post-graduation.
The Mentor's Analysis: Graduate nurses operate in a legally vulnerable window. When facing
the integration of a new GN, the immediate priority is ensuring a 1:1 RN-to-GN ratio on the exact
same unit. By utilizing direct, localized supervision, you bypass the common trap of unlicensed,
unsupervised practice violations. Professional Intuition: A graduate nurse's legal shield relies
entirely on the direct, 1:1 physical presence of a supervising RN on the same unit.
Q3: A certified medication aide (MA-C) is employed in a licensed assisted care living facility.
Based on the principles of medication administration delegation, which action is PROHIBITED
for the MA-C? A) Administering a scheduled oral antihypertensive. B) Applying a topical barrier
cream to intact skin. C) Administering an initial dose of a PRN oral analgesic without prior RN
assessment. D) Documenting the administration of a routine vitamin supplement in the MAR.
● Answer: C (Administering an initial dose of a PRN oral analgesic without prior RN
assessment.)
● Distractor Analysis:
○ A is incorrect: MA-Cs are specifically authorized to administer routine oral
medications.
○ B is incorrect: Applying topical medications to intact skin falls within the MA-C
scope.
○ D is incorrect: Proper documentation in the Medication Administration Record
(MAR) is a required competency.
The Mentor's Analysis: MA-Cs perform task-based medication delivery, not clinical evaluation.
When facing PRN medication requests, the immediate priority is an RN assessment to
determine clinical necessity. By utilizing the RN for PRN evaluation, you bypass the common
trap of allowing unlicensed personnel to make clinical dosage decisions. Professional Intuition:
An MA-C may never make a dosage decision or administer medication requiring
independent clinical judgment.
Q4: An LPN working in an acute care setting is instructed to administer an IV push medication.
Based on the principles of LPN scope of practice in Tennessee, what is the MINIMUM patient
weight required for this intervention? A) 50 pounds B) 65 pounds C) 80 pounds D) 100 pounds
● Answer: C (80 pounds)
● Distractor Analysis:
○ A is incorrect: Fifty pounds aligns with pediatric populations, which are strictly
excluded from LPN IV push authorization.
○ B is incorrect: Sixty-five pounds is a legacy metric not supported by current
Tennessee Board of Nursing (TBON) rules.
○ D is incorrect: One hundred pounds is overly restrictive and exceeds the statutory
baseline.
The Mentor's Analysis: The Board explicitly restricts LPN IV push capabilities to protect
vulnerable demographics. When facing a delegated IV push, the immediate priority is verifying
the patient is an adult weighing over 80 pounds. By utilizing this strict metric, you bypass the
common trap of operating outside the directed scope of practice. Professional Intuition: LPNs
pushing IV medications must memorize the absolute exclusions: no pediatrics, no
prenatal patients, and no one under 80 pounds.
Practice Act
Jurisprudence Exam:
The Elite Universal
Test Bank
Table of Contents
● Part I: The Preview
● Part II: The Elite Test Bank
○ Tier 1: Foundational Syntax & Application (Questions 1–18)
○ Tier 2: Complex Application & Simulation (Questions 19–37)
○ Tier 3: Grandmaster Synthesis (Questions 38–55)
Part I: The Preview
Mastering this test bank translates directly to elite clinical and administrative performance by
fusing strict legal boundaries with advanced clinical decision-making. These 55 scenarios forge
strict adherence to the Tennessee Nursing Practice Act, ensuring invulnerability to malpractice,
board discipline, and catastrophic delegation errors.
The "Critical Axioms" Cheat Sheet
● The "Isolated Island" of Delegation: The registered nurse (RN) transfers the task but
absolutely retains total accountability for the outcome, supervision, and clinical judgment.
● LPN Intravenous (IV) Boundaries: Licensed Practical Nurses (LPNs) may only push IV
medications in peripheral lines for adults over 80 pounds, possessing proper certification.
Pediatrics, prenatal patients, and central line pushes are strictly forbidden.
● Mandatory Reporting Absolutes: Every citizen, especially healthcare providers, is a
mandatory reporter for suspected elder and child abuse (TCA 71-6-103, TCA 37-1-403).
Failure to report is a Class A misdemeanor.
● The 2-for-2 Competency Rule: RNs and LPNs must complete two recognized continued
competence activities every two years (e.g., 5 CE hours plus a satisfactory employer
evaluation). Records must be retained for four years.
● APRN Prescriptive Prohibitions: Advanced Practice Registered Nurses (APRNs) are
, strictly barred from prescribing legend drugs or controlled substances for themselves or
their immediate family, except in documented, immediate emergencies.
Professional License Scope of Practice Summary Primary Statutory Rule
RN Independent assessment, care TCA 63-7-103
plan formulation, delegation,
care evaluation.
LPN Directed scope, contributes to TCA 63-7-108
assessment, cares for stable
patients.
APRN Medical diagnosis, TCA 63-7-126
therapeutics, prescribing (with
collaborative agreement).
MA-C Administers routine oral/topical TCA 63-7-127
meds in specific facilities; no
dosage decisions.
Part II: The Elite Test Bank
Tier 1: Foundational Syntax & Application
Q1: An RN licensed in Tennessee is audited by the Board of Nursing for continued competence
compliance. Based on the principles of the Tennessee Administrative Code, what is the
MAXIMUM allowable timeframe the RN has to produce the required documentation? A) 14 days
B) 30 days C) 45 days D) 60 days
● Answer: B (30 days)
● Distractor Analysis:
○ A is incorrect: Fourteen days is an arbitrary administrative timeline used in some
facility policies, not the statutory Board requirement.
○ C is incorrect: Forty-five days is an invalid timeline for compliance auditing in this
jurisdiction.
○ D is incorrect: Sixty days represents the early renewal window for licensure, not the
audit response deadline.
The Mentor's Analysis: Licensees must retain proof of continued competence for four years and
produce it within 30 days of a written request. When facing a state audit, the immediate priority
is producing verifiable documentation promptly. By utilizing proactive record-keeping, you
bypass the common trap of disciplinary action for failure to comply. Professional Intuition:
Always retain two items of continued competence for a minimum of four years; failure to
produce them within 30 days triggers disciplinary action.
Q2: A graduate nurse (GN) is hired at a local hospital while awaiting NCLEX-RN results. Based
on the principles of the Tennessee Nursing Practice Act, which action regarding supervision is
MANDATORY? A) The GN must be supervised by an RN who is overseeing no more than three
GNs simultaneously. B) The GN must function independently if an RN is physically present in
the building. C) The GN must be supervised by an RN located in the same unit, who is
supervising no more than one GN at a time. D) The GN must practice strictly under a temporary
permit valid for one calendar year.
● Answer: C (The GN must be supervised by an RN located in the same unit, who is
supervising no more than one GN at a time.)
● Distractor Analysis:
, ○ A is incorrect: The statute limits supervision to a strict 1:1 ratio, not 1:3.
○ B is incorrect: "In the building" is insufficient; the supervising RN must be on the
same unit.
○ D is incorrect: A temporary authorization for a graduate nurse awaiting examination
is valid only until results are received, not a full year, and practice is limited to 90
days post-graduation.
The Mentor's Analysis: Graduate nurses operate in a legally vulnerable window. When facing
the integration of a new GN, the immediate priority is ensuring a 1:1 RN-to-GN ratio on the exact
same unit. By utilizing direct, localized supervision, you bypass the common trap of unlicensed,
unsupervised practice violations. Professional Intuition: A graduate nurse's legal shield relies
entirely on the direct, 1:1 physical presence of a supervising RN on the same unit.
Q3: A certified medication aide (MA-C) is employed in a licensed assisted care living facility.
Based on the principles of medication administration delegation, which action is PROHIBITED
for the MA-C? A) Administering a scheduled oral antihypertensive. B) Applying a topical barrier
cream to intact skin. C) Administering an initial dose of a PRN oral analgesic without prior RN
assessment. D) Documenting the administration of a routine vitamin supplement in the MAR.
● Answer: C (Administering an initial dose of a PRN oral analgesic without prior RN
assessment.)
● Distractor Analysis:
○ A is incorrect: MA-Cs are specifically authorized to administer routine oral
medications.
○ B is incorrect: Applying topical medications to intact skin falls within the MA-C
scope.
○ D is incorrect: Proper documentation in the Medication Administration Record
(MAR) is a required competency.
The Mentor's Analysis: MA-Cs perform task-based medication delivery, not clinical evaluation.
When facing PRN medication requests, the immediate priority is an RN assessment to
determine clinical necessity. By utilizing the RN for PRN evaluation, you bypass the common
trap of allowing unlicensed personnel to make clinical dosage decisions. Professional Intuition:
An MA-C may never make a dosage decision or administer medication requiring
independent clinical judgment.
Q4: An LPN working in an acute care setting is instructed to administer an IV push medication.
Based on the principles of LPN scope of practice in Tennessee, what is the MINIMUM patient
weight required for this intervention? A) 50 pounds B) 65 pounds C) 80 pounds D) 100 pounds
● Answer: C (80 pounds)
● Distractor Analysis:
○ A is incorrect: Fifty pounds aligns with pediatric populations, which are strictly
excluded from LPN IV push authorization.
○ B is incorrect: Sixty-five pounds is a legacy metric not supported by current
Tennessee Board of Nursing (TBON) rules.
○ D is incorrect: One hundred pounds is overly restrictive and exceeds the statutory
baseline.
The Mentor's Analysis: The Board explicitly restricts LPN IV push capabilities to protect
vulnerable demographics. When facing a delegated IV push, the immediate priority is verifying
the patient is an adult weighing over 80 pounds. By utilizing this strict metric, you bypass the
common trap of operating outside the directed scope of practice. Professional Intuition: LPNs
pushing IV medications must memorize the absolute exclusions: no pediatrics, no
prenatal patients, and no one under 80 pounds.
