Washington PA Jurisprudence Exam Coverage Summary
Scope of Practice & Supervision: PA role requires physician supervision;
supervision defined; delegation of tasks; limitations on independent practice;
prohibited procedures.
Prescriptive Authority: Requirements for prescribing (DEA, physician delegation);
formulary limitations; prescribing controlled substances (Schedules II-V); medication
dispensing and labeling.
Licensure & Regulation: Role of the Washington State Board of Physician
Assistants; licensure requirements; renewal (biennial); continuing education (CME)
requirements; reporting changes.
Professional Conduct & Ethics: Unprofessional conduct definitions; patient
confidentiality/HIPAA; boundaries; conflict of interest; record-keeping requirements;
impaired colleague reporting.
Medical Records: Content requirements; retention period (7 years for adults); patient
access and release of information; electronic records.
Mandatory Reporting: Child abuse/neglect; vulnerable adult abuse; communicable
diseases; duty to warn; reporting to law enforcement and relevant state agencies.
Prescription Monitoring Program (PMP): Utilizing the Washington PMP;
requirements for checking before prescribing controlled substances; documentation.
Supervision of Others: Physician delegation for PA supervision; PA supervision of
other healthcare personnel (e.g., medical assistants, students).
Liability & Risk Management: Informed consent; patient rights; professional
liability insurance; handling adverse events and errors.
Legal Definitions: Definitions of a patient; standard of care; scope of practice.
Washington PA Jurisprudence Exam 250 Questions
1. A PA has been practicing in Washington for several years. If they move to a new
practice and their supervising physician changes, what is the PA's primary legal
obligation to the Board of Physician Assistants?
A. Notify the Board of the new supervising physician and practice location within 30 days.
B. Wait for the new supervising physician to inform the Board.
C. The PA is not required to update the Board as long as their license is active.
D. Only notify the Board if the change affects their prescriptive authority.
,Answer: A
Rationale: The PA must notify the Board of any changes in supervising physician or practice
location to ensure accurate supervision records are maintained.
2. A PA receives a request from a patient's lawyer for a complete copy of the medical
record. The patient has not signed a release. What is the most appropriate first step for
the PA?
A. Provide the record to the lawyer immediately, as they are acting on the patient's behalf.
B. Refuse the request and inform the lawyer to get a subpoena.
C. Verify that the patient has signed a valid HIPAA-compliant authorization form.
D. Release only a summary of the record, not the full chart.
Answer: C
Rationale: Patient confidentiality is paramount. A valid authorization signed by the patient is
required before releasing any protected health information to a third party.
3. A PA in a family medicine clinic is asked by their supervising physician to perform an
osteopathic manipulation technique (OMT) on a patient with back pain. The PA has
never performed this procedure before but watched a video on it. What should the PA
do?
A. Perform the procedure, as it is delegated by the supervising physician.
B. Politely refuse and explain that they lack the required training and competency.
C. Perform the procedure under direct supervision of the physician.
D. Delegate the procedure to a certified medical assistant.
Answer: B
Rationale: A PA must only perform tasks they are competent and trained to perform.
Accepting a delegation without the proper skills can lead to liability and is unprofessional
conduct.
4. The Washington State Board of Physician Assistants has received a complaint about
a PA's standard of care. What is the Board's primary purpose in investigating such
complaints?
A. To immediately revoke the PA's license to protect the public.
B. To punish the PA for past mistakes.
C. To protect the public by ensuring PAs practice competently and safely.
D. To collect evidence for a potential criminal case.
,Answer: C
Rationale: The Board's primary mandate is consumer protection. They investigate complaints
to assess the competence and safety of a PA's practice, taking disciplinary action when
necessary to protect the public.
5. A PA in a dermatology clinic is asked to prescribe an oral antibiotic for a patient's
skin infection. The patient is a friend of the PA. Under Washington law, is this
permissible?
A. Yes, as long as the PA uses their own clinical judgment.
B. No, it is considered unprofessional conduct to prescribe for family members or friends
except in emergencies.
C. Yes, but only if the friend pays for the visit.
D. No, PAs cannot prescribe antibiotics without a physician's co-signature.
Answer: B
Rationale: While not an absolute prohibition, prescribing for friends or family outside a
formal provider-patient relationship with appropriate documentation is strongly discouraged
and considered unprofessional conduct due to a lack of objective medical judgment.
6. A PA working in a cardiac surgery unit is involved in a case where a patient suffers a
stroke post-operatively. The PA discovers that a medication reconciliation error was the
cause. What is the PA's legal and ethical obligation?
A. Only inform the supervising physician.
B. Document the incident in the patient's chart and inform the patient or their family.
C. Do nothing, as this is a system error, not an individual one.
D. Quit their job to avoid legal repercussions.
Answer: B
Rationale: PAs have an ethical and legal obligation to be transparent about medical errors.
This includes informing the patient and accurately documenting the event.
7. A supervising physician asks a PA to cover their practice for a week while the
physician is on vacation. The physician gives the PA a signed, detailed delegation of
services agreement. What is the PA's responsibility regarding this delegation?
A. The PA can practice entirely independently during that week, as the agreement is in place.
B. The PA must ensure the delegated tasks are within the physician's own scope of practice
and within the PA's scope of competence.
, C. The PA can delegate any of the physician's duties to other medical staff.
D. The PA must have the physician's consent for every single prescription written.
Answer: B
Rationale: The PA can only perform delegated tasks that are within their own training and
competence and also fall within the supervising physician's scope of practice.
8. A patient refuses a standard-of-care treatment recommended by the PA. The patient
has been informed of the risks and benefits. What should the PA document in the
medical record?
A. Nothing, the conversation was verbal.
B. Only the patient's refusal.
C. The diagnosis, recommendations, the patient's questions, and their final refusal with the
patient's signature on a refusal form if possible.
D. A note to contact the patient's family to convince the patient.
Answer: C
Rationale: Thorough documentation is critical. It should include the informed consent
discussion, the patient's questions, and their decision to refuse treatment to protect the PA
from liability.
9. For a PA to prescribe Schedule II controlled substances in Washington, what specific
authorization is required in addition to a DEA registration and a supervising
physician's approval?
A. A special endorsement from the Washington Medical Commission.
B. A certificate from the Board of Pharmacy.
C. The specific delegation agreement must authorize the prescribing of Schedule II drugs.
D. No additional authorization is needed beyond a standard DEA license.
Answer: C
Rationale: The delegation agreement between the PA and physician must specifically
authorize the prescribing of Schedule II drugs for it to be legal.
10. A PA in a rural emergency department is faced with a patient in respiratory
distress. The supervising physician is 30 minutes away. The PA needs to intubate the
patient. What should the PA do?
A. Attempt the intubation on their own, it's an emergency.
B. Wait for the physician to arrive before taking any action.
Scope of Practice & Supervision: PA role requires physician supervision;
supervision defined; delegation of tasks; limitations on independent practice;
prohibited procedures.
Prescriptive Authority: Requirements for prescribing (DEA, physician delegation);
formulary limitations; prescribing controlled substances (Schedules II-V); medication
dispensing and labeling.
Licensure & Regulation: Role of the Washington State Board of Physician
Assistants; licensure requirements; renewal (biennial); continuing education (CME)
requirements; reporting changes.
Professional Conduct & Ethics: Unprofessional conduct definitions; patient
confidentiality/HIPAA; boundaries; conflict of interest; record-keeping requirements;
impaired colleague reporting.
Medical Records: Content requirements; retention period (7 years for adults); patient
access and release of information; electronic records.
Mandatory Reporting: Child abuse/neglect; vulnerable adult abuse; communicable
diseases; duty to warn; reporting to law enforcement and relevant state agencies.
Prescription Monitoring Program (PMP): Utilizing the Washington PMP;
requirements for checking before prescribing controlled substances; documentation.
Supervision of Others: Physician delegation for PA supervision; PA supervision of
other healthcare personnel (e.g., medical assistants, students).
Liability & Risk Management: Informed consent; patient rights; professional
liability insurance; handling adverse events and errors.
Legal Definitions: Definitions of a patient; standard of care; scope of practice.
Washington PA Jurisprudence Exam 250 Questions
1. A PA has been practicing in Washington for several years. If they move to a new
practice and their supervising physician changes, what is the PA's primary legal
obligation to the Board of Physician Assistants?
A. Notify the Board of the new supervising physician and practice location within 30 days.
B. Wait for the new supervising physician to inform the Board.
C. The PA is not required to update the Board as long as their license is active.
D. Only notify the Board if the change affects their prescriptive authority.
,Answer: A
Rationale: The PA must notify the Board of any changes in supervising physician or practice
location to ensure accurate supervision records are maintained.
2. A PA receives a request from a patient's lawyer for a complete copy of the medical
record. The patient has not signed a release. What is the most appropriate first step for
the PA?
A. Provide the record to the lawyer immediately, as they are acting on the patient's behalf.
B. Refuse the request and inform the lawyer to get a subpoena.
C. Verify that the patient has signed a valid HIPAA-compliant authorization form.
D. Release only a summary of the record, not the full chart.
Answer: C
Rationale: Patient confidentiality is paramount. A valid authorization signed by the patient is
required before releasing any protected health information to a third party.
3. A PA in a family medicine clinic is asked by their supervising physician to perform an
osteopathic manipulation technique (OMT) on a patient with back pain. The PA has
never performed this procedure before but watched a video on it. What should the PA
do?
A. Perform the procedure, as it is delegated by the supervising physician.
B. Politely refuse and explain that they lack the required training and competency.
C. Perform the procedure under direct supervision of the physician.
D. Delegate the procedure to a certified medical assistant.
Answer: B
Rationale: A PA must only perform tasks they are competent and trained to perform.
Accepting a delegation without the proper skills can lead to liability and is unprofessional
conduct.
4. The Washington State Board of Physician Assistants has received a complaint about
a PA's standard of care. What is the Board's primary purpose in investigating such
complaints?
A. To immediately revoke the PA's license to protect the public.
B. To punish the PA for past mistakes.
C. To protect the public by ensuring PAs practice competently and safely.
D. To collect evidence for a potential criminal case.
,Answer: C
Rationale: The Board's primary mandate is consumer protection. They investigate complaints
to assess the competence and safety of a PA's practice, taking disciplinary action when
necessary to protect the public.
5. A PA in a dermatology clinic is asked to prescribe an oral antibiotic for a patient's
skin infection. The patient is a friend of the PA. Under Washington law, is this
permissible?
A. Yes, as long as the PA uses their own clinical judgment.
B. No, it is considered unprofessional conduct to prescribe for family members or friends
except in emergencies.
C. Yes, but only if the friend pays for the visit.
D. No, PAs cannot prescribe antibiotics without a physician's co-signature.
Answer: B
Rationale: While not an absolute prohibition, prescribing for friends or family outside a
formal provider-patient relationship with appropriate documentation is strongly discouraged
and considered unprofessional conduct due to a lack of objective medical judgment.
6. A PA working in a cardiac surgery unit is involved in a case where a patient suffers a
stroke post-operatively. The PA discovers that a medication reconciliation error was the
cause. What is the PA's legal and ethical obligation?
A. Only inform the supervising physician.
B. Document the incident in the patient's chart and inform the patient or their family.
C. Do nothing, as this is a system error, not an individual one.
D. Quit their job to avoid legal repercussions.
Answer: B
Rationale: PAs have an ethical and legal obligation to be transparent about medical errors.
This includes informing the patient and accurately documenting the event.
7. A supervising physician asks a PA to cover their practice for a week while the
physician is on vacation. The physician gives the PA a signed, detailed delegation of
services agreement. What is the PA's responsibility regarding this delegation?
A. The PA can practice entirely independently during that week, as the agreement is in place.
B. The PA must ensure the delegated tasks are within the physician's own scope of practice
and within the PA's scope of competence.
, C. The PA can delegate any of the physician's duties to other medical staff.
D. The PA must have the physician's consent for every single prescription written.
Answer: B
Rationale: The PA can only perform delegated tasks that are within their own training and
competence and also fall within the supervising physician's scope of practice.
8. A patient refuses a standard-of-care treatment recommended by the PA. The patient
has been informed of the risks and benefits. What should the PA document in the
medical record?
A. Nothing, the conversation was verbal.
B. Only the patient's refusal.
C. The diagnosis, recommendations, the patient's questions, and their final refusal with the
patient's signature on a refusal form if possible.
D. A note to contact the patient's family to convince the patient.
Answer: C
Rationale: Thorough documentation is critical. It should include the informed consent
discussion, the patient's questions, and their decision to refuse treatment to protect the PA
from liability.
9. For a PA to prescribe Schedule II controlled substances in Washington, what specific
authorization is required in addition to a DEA registration and a supervising
physician's approval?
A. A special endorsement from the Washington Medical Commission.
B. A certificate from the Board of Pharmacy.
C. The specific delegation agreement must authorize the prescribing of Schedule II drugs.
D. No additional authorization is needed beyond a standard DEA license.
Answer: C
Rationale: The delegation agreement between the PA and physician must specifically
authorize the prescribing of Schedule II drugs for it to be legal.
10. A PA in a rural emergency department is faced with a patient in respiratory
distress. The supervising physician is 30 minutes away. The PA needs to intubate the
patient. What should the PA do?
A. Attempt the intubation on their own, it's an emergency.
B. Wait for the physician to arrive before taking any action.
