Texas BON study guide, BON Quiz, Jurisprudence Questions with correct Answers

A nurse who contacts a physician to clarify a medication order is - Answer- fulfilling a duty to keep the patient safe. A BON investigator in the enforcement division collected evidence that supports the BON's formal charges against a nurse regarding violations of the NPA and board rules. Attempts to notify the nurse via standard and certified mail at the nurse's last address of record have been returned to the BON office as being "undeliverable or not at this address." Since the investigator has been unable to communicate with the nurse about the BON's formal charges, Board Rule 213.16(i) on Practice and Procedure requires that - Answer- the case proceed and the board's charges be deemed to be true. When the BON considers imposing disciplinary action, it is most concerned with the nurse consistently - Answer- acting in the best interest of clients A nurse quits his job, and submits a written notice at the end of his shift, telling his supervisor that he will not be back at work the following morning. The supervisor tells the nurse he has to complete the entire month's schedule or he will be committing "patient abandonment," and will be reported to the BON. This is - Answer- false. Quitting a job at the end of a shift is not considered "patient abandonment" by the BON and is not grounds for reporting to, or action by, the BON. Which of the following would indicate that an applicant for licensure is likely to possess the good professional character necessary to hold a nursing license in Texas? - Answer- the applicant provides satisfactory evidence that he/she has not committed a violation of the Nursing Practice Act or a Board rule Which of the following statements correctly reflects Board Rule 217.20 regarding the Safe Harbor Peer Review? - Answer- Safe Harbor must be invoked prior to engaging in the assignment or at any time the assignment changes as long as the nurse believes it places patients at risk of harm The identity of a person submitting a complaint against a nurse to the BON is kept confidential - Answer- throughout the entire investigation process A nurse assesses a patient, makes a medical diagnosis of "hypertension," and determines which specific anti-hypertensive medication (including dose, route, and frequency) is appropriate for this patient. The nurse then writes a prescription for an anti-hypertensive medication and instructs the patient to have it filled at a pharmacy of her choice. - Answer- the nurse must be authorized by the BON as an advanced practice registered nurse with prescriptive authority in a role and population focus appropriate for the patients being treated Revisions to the NPA can only occur through - Answer- bills passed by the Texas Legislature The Position Statement 15.27 The Licensed Vocational Nurse Scope of Practice on the board's website outlines that LVNs have a "directed" scope of practice "under supervision." This means that - Answer- the LVN must have a registered nurse present at all times while they are providing direct patient care A nurse providing nursing services to a young child in a home setting asks the parent to bring the child to the nurse's home for nursing care. The nurse asks the parent to keep this arrangement confidential. This could be considered - Answer- a violation of professional boundaries of the nurse-client relationship A nurse is counseled for questioning a physician's order that made the physician mad. Which of the following documents on the BON web site best explains why the nurse was correct to question a physician's order that the nurse believed could be harmful to a patient? - Answer- Position Statement 15.14 Duty of a Nurse in Any Setting Chart audits find the following practice errors committed by a nurse with observed impaired behavior at work: NO physician orders for narcotics signed out by the nurse, and NO documentation that the nurse either administered or wasted the narcotics. The best decision for the Incident Based Peer Review Committee to make is that - Answer- 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 A nurse would be fulfilling his or her duty to safeguard patients from harm if the nurse - Answer- recognizes that a patient's condition is deteriorating, acts to stabilize the patient, and reports the patient's status to the physician 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 - Answer- current sobriety and fitness to practice A nurse may not be reported to the BON, may not have his or her license sanctioned by the BON, and may not be suspended or terminated from his or her employment for either appropriately invoking Safe Harbor or for advising another nurse of their right to invoke Safe Harbor. These are - Answer- protections for a nurse who requests a peer review determination One way the board carries out its mission to protect the public is by - Answer- ensuring that each nurse is competent to practice safely Which of the following situations is an example of a nurse MAINTAINING appropriate professional boundaries between the nurse and the client? A nurse - Answer- rewards a patient with a small stuffed mascot of his favorite football team for progress made in rehabilitation According to BON Position Statement 15.24 Nurses Engaging in Reinsertion of Permanently Placed Feeding Tubes, it would be within the scope of practice for a nurse to replace a gastrostomy tube provided that - Answer- the tube has been in place for 8-12 weeks, the nurse has a physician's order to replace the tube, and the nurse has completed specific competency training to safely replace the tube Which of the following is an example of the nurse maintaining professional boundaries of the nurse-client relationship? - Answer- Sharing candy from a patient with other staff and telling them the source of the candy Why does the BON require nurses to disclose that they have been diagnosed with, treated for, or hospitalized with certain mental illnesses? - Answer- Nurses diagnosed with these disorders may lack fitness to practice nursing safely and may require a period of monitored practice by the BON A nurse whose license has expired - Answer- may not practice until the license has been renewed In a nurse-patient relationship, the most vulnerable patients are those who are - Answer- under anesthesia or sedation. Action by a nurse that would constitute unprofessional conduct according to Board Rule 217.12 Unprofessional Conduct describes which of the following? - Answer- Failing to repay a guaranteed student loan A nurse injects a medication by IV (intravenous) Push instead of IM (intramuscular) as ordered by the physician. The patient goes into cardiac arrest and dies as a result of this medication error. The nurse has worked at the facility for 15 years and this is his first error. A correct determination by the Peer Review Committee would be that - Answer- the error is subject to reporting because it contributed to the death of a patient While interacting with the public in a nursing role, each nurse must wear a clearly legible insignia (such as a name badge) that identifies the nurse as - Answer- a registered nurse or a licensed vocational nurse When deciding what course of action to follow, the nurse - Answer- has a duty to always keep the patient safe A LVN learns that a facility licensing law requires that a registered nurse always perform a specific task related to admission of new patients. The LVN understands that this means he or she - Answer- may not perform the task, as the RN level of licensure is necessary to perform the task Which of the following resources on the BON web page would assist a nurse in determining his or her scope of nursing practice? - Answer- The continuing competency info sheet In the NPA, "conduct subject to reporting" includes - Answer- conduct that causes a person to suspect that the nurse's practice is impaired by chemical dependency or drug or alcohol abuse The best method of notifying the BON about reportable violations by a nurse of the NPA and board rules is to - Answer- complete the reporting form on the BON website though you may remain anonymous and not provide a signature To help a nurse decide if a task is within his or her individual scope of practice, a prudent nurse should - Answer- obtain a list of tasks a nurse may perform from the BON A nurse is terminated and reported to the BON for committing repeated practice errors. As required in the NPA, the CNO also sends the case to the Incident Based Peer Review (IBPR) Committee because: - Answer- 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 According to the Standards of Nursing Practice, Board Rule 217.11, a comprehensive nursing assessment - Answer- can be completed only by a registered nurse The board has adopted Disciplinary Sanction Policies regarding all of the following EXCEPT - Answer- Guaranteed student loan According to Board Rule 217.3(a), Temporary Authorization to Practice, a new graduate, either a graduate vocational nurse (GVN) or a graduate professional nurse (GN), is required to avoid - Answer- being placed in a supervisory or charge position, and working in any independent practice setting Which of the following would NOT be required to establish a nursing peer review committee to conduct nursing peer review according to Section 303.0015 of the Nursing Peer Review Law? - Answer- Independent school district employing 7 nurses (4 RNs and 3 LVNs) Rule 216 related to Continuing Competency requires nurses to complete - Answer- 20 contact hours of continuing education within two years preceding license renewal Within the nurse licensure compact agreement, the party state that is the nurse's primary state of residence is called the nurse's - Answer- home state When a nurse steals valuables (such as medications, money, jewelry, or credit cards) from a patient, this may be considered criminal as well as unprofessional conduct involving - Answer- theft of property Which of the following actions by a nurse would comply with the Standards of Nursing Practice in Board Rule 217.11? - Answer- Documenting an aspect of nursing care provided to a patient after the fact by following facility policy for making a "late entry. The BON differs from nursing and healthcare specialty associations since the BON - Answer- protects and promotes the welfare of the people of Texas Implement measures to promote a safe environment for clients and others describes A. The nurse's ability to invoke Safe Harbor. B. The employer's requirement for safe staffing levels. C. The nurse's duty to the patient. D. The employer's requirement to ensure the workplace meets OSHA safety standards. - Answer- B. The employer's requirement for safe staffing levels. The purpose of the Position Statements, guidelines and other documents in the Nursing Practice section of the BON webpage is to guide nurses in A. presenting a professional demeanor in a work setting. B. making decisions related to their patient care assignments. C. obtaining specialty certification. D. preparing for the NCLEX exam. - Answer- B. making decisions related to their patient care assignments. Which of the following is an example of the nurse maintaining professional boundaries of the nurse-client relationship? A. Accepting a $100 gift from the family of a hospitalized patient. B. Inviting the patient to come to dinner at her home after the patient is discharged. C. Sharing candy from a patient with other staff and telling them the source of the candy. D. Providing her personal cell phone number to the patient. - Answer- C. Sharing candy from a patient with other staff and telling them the source of the candy. A nurse finds an elderly woman helpless and alone after the unlicensed caretaker quit without notifying the agency. The nurse is then fired for reporting the caretaker for possible abuse and neglect. Does the nurse have protection from negative employment action for reporting the above incident to the appropriate authorities? A. No, the nurse is not protected in this example. The nurse must always follow any directive from his or her boss. B. No, the nurse is not protected in this example as the employer can terminate the nurse for any reason at any time. C. It depends. The nurse may be protected, but only if the nurse can prove that the client was in an unsafe situation. D. Yes, the nurse is protected from negative employment action for reporting a situation that exposed the client to substantial risk of harm. This is known as "whistleblower protections." - Answer- C. It depends. The nurse may be protected, but only if the nurse can prove that the client was in an unsafe situation. 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 A. an acceptable practice due to the nursing shortage and the recent school experience of the GVN. B. an acceptable practice if a supervising nurse is telephonically available to supervise and advise the GVN. C. an unacceptable practice due to the lack of a licensed nurse who is physically present and readily available to directly supervise the GVN. D. an unacceptable practice because there must be a physician present in the practice setting to supervise the GVN. - Answer- C. an unacceptable practice due to the lack of a licensed nurse who is physically present and readily available to directly supervise the GVN. An Incident-Based Nursing Peer Review Committee A. must make decisions about whether or not a nurse's employment should be terminated, and whether or not the nurse will be paid for accrued vacation time. B. may include the nurse's supervisor, charge nurse, and other management-level nurses who have administrative authority over the nurse. C. can prohibit the nurse from calling witnesses or asking questions during the hearing. D. must adhere to due process requirements for the nurse, unless the nurse has already been reported to the board and the committee is only reviewing the possible impact of external factors on the error. - Answer- D. must adhere to due process requirements for the nurse, unless the nurse has already been reported to the board and the committee is only reviewing the possible impact of external factors on the error. A nurse may not be reported to the BON, may not have his or her license sanctioned by the BON, and may not be suspended or terminated from his or her employment for either appropriately invoking Safe Harbor or for advising another nurse of their right to invoke Safe Harbor. These are A. criteria for determining a minor incident. B. rules that apply to RNs and not LVNs. C. criteria for determining safe staffing. D. protections for a nurse who requests a peer review determination. - Answer- D. protections for a nurse who requests a peer review determination. A nurse whose license has expired A. may not practice until the license has been renewed. B. has a 14-day grace period in which to renew. C. may practice if documentation is cosigned by another nurse. D. will have his or her license revoked by the BON. - Answer- A. may not practice until the license has been renewed. 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? A. The nurse cannot be disciplined by the BON or discriminated against by the employer. B. The nurse has no recourse if the physician gets angry and terminates her employment. C. If the facility terminates the nurse's employment, the BON can provide the nurse with legal advice. D. The nurse must inform the physician of any reports the nurse files. - Answer- A. The nurse cannot be disciplined by the BON or discriminated against by the employer. Board cases involving eligibility or disciplinary issues that are resolved through a board agreed order A. are public records and accessible on the BON's web page. B. are not subject to open records requests or accessible to the public. C. do not have to be sent to the nurse's last known employer or to the nurse. D. do not follow the nurse if the nurse decides to move to another state. - Answer- A. are public records and accessible on the BON's web page. One purpose of the BON's Position Statements and Guidelines is to provide A. step-by-step instructions to help the nurse complete complex tasks in the nurse's specialty area of nursing practice. B. guidance to help the nurse apply the NPA and board rules to a given situation so that the nurse can make appropriate decisions that promote safe nursing practice. C. information on employment opportunities, advanced training, and malpractice insurance discounts available through various professional nursing organizations. D. a specific list of tasks that a nurse can or cannot perform based on federal government guidelines. - Answer- B. guidance to help the nurse apply the NPA and board rules to a given situation so that the nurse can make appropriate decisions that promote safe nursing practice. In a nurse-patient relationship, the most vulnerable patients are those who are A. under anesthesia or sedation. B. wearing a patient or exam gown. C. undergoing chemotherapy. D. using an interpreter. - Answer- A. under anesthesia or sedation. The mission of the BON supersedes A. the licensing rules for acute care hospitals. B. the regulations for federal agencies. C. the interests of individuals, the profession, or special interest groups. D. the state laws that apply to medical supply services, medical facilities, and physicians. - Answer- C. the interests of individuals, the profession, or special interest groups. According to the Standards of Nursing Practice, Board Rule 217.11, a comprehensive nursing assessment A. focuses only on one aspect of the patient's status and nursing care needs. B. requires the nurse to make a medical diagnosis. C. can be initiated by a licensed vocati