TEXAS NURSING JURISPRUDENCE EXAM CHAPTER 1-4 (Q & A)

TEXAS NURSING JURISPRUDENCE EXAM CHAPTER 1-4 (Q & A) Can a patient successfully sue a doctor if there is no physician-patient relationship? - CORRECT ANSWER-No If there is no prior physician-patient relationship, are you legally obliged to respond to a call from a patient for treatment? - CORRECT ANSWER-No Does being on call give rise to a physician-patient relationship? - CORRECT ANSWERNo How can one terminate a physician-patient relationship, without abandonment if there is ongoing treatment? - CORRECT ANSWER-30 days written notice; must provide for emergency Does a physician's duty extend to the unborn child or potential victims of an ill patient? - CORRECT ANSWER-Yes What is "proximate cause"? - CORRECT ANSWER-Prove that negligence caused harm and that the cause was not too remote; what is required to hold a defendant liable in a civil lawsuit What are the two components of proximate cause? - CORRECT ANSWER-Cause-infact (but-for test) and foreseeability Does an expert witness have to be actively practicing medicine? - CORRECT ANSWER-Yes Does an expert witness have to know standards of care? - CORRECT ANSWER-Yes Does an expert witness have to have enough training to express an opinion on whether standard of care was provided? - CORRECT ANSWER-Yes Does an expert witness have to be board certified? - CORRECT ANSWER-No, board certified or eqivalent In a medical malpractice case, are expert witnesses required? - CORRECT ANSWERYes, with two exceptions In a medical malpractice setting, what 2 instances do not need expert testimony? - CORRECT ANSWER-Res ipsa loquitur (e.g., amputation of wrong leg) and negligence per se (a law was broken) What are "exemplary damages"? - CORRECT ANSWER-Damages above compensatory designed to punish the defendant and deter the behavior Is there a cap to noneconomic damages? How much? - CORRECT ANSWER-$250,000 for physicians, $500,000 for hospitals Does the cap on noneconomic damage depend on the number of defendants or claimants? - CORRECT ANSWER-No What is "proportional responsibility"? - CORRECT ANSWER-Percentage of liability apportioned according to percentage of fault Can the claimant have part of the proportional responsibility? - CORRECT ANSWERYes If the claimant's proportionate responsibility is more than what %, he/she may not recover damages? - CORRECT ANSWER-If > 50%, no damages awarded How long is the statute of limitations for adults? For minors? - CORRECT ANSWER-2 years; for minors 2 years after becoming 18 years of age By how much can the statute of limitations be extended and how? - CORRECT ANSWER-File complaint—extra 60-day, notice letter extends statute by 75 days What is the statute of limitations for wrongful death? - CORRECT ANSWER-2 years What is the discovery rule? Give examples. - CORRECT ANSWER-Statute does not begin until damage is discovered. For example, a retained sponge that is found 3 years post-op Is there immunity from civil action in emergency cases? - CORRECT ANSWER-Yes, except gross negligence Is there immunity from civil action in volunteer care? - CORRECT ANSWER-Yes, except gross negligence When can a physician be charged with "assault and battery"? - CORRECT ANSWERUn-consented surgery or examination or when exceeding the scope of the consent When can a physician be charged with patient abandonment? - CORRECT ANSWERUnilateral cessation of treatment when continued treatment is necessary What is "strict liability"? - CORRECT ANSWER-Liability that does not depend on actual negligence, but that is based on a breach of a duty to make something safe. This often applies to product liability Are hospitals liable for the actions of a physician? - CORRECT ANSWER-No, unless the hospital employs the physician Who determines in a criminal case if the medical records of a patient should be released? - CORRECT ANSWER-Judge by inspection How many days do you have to release medical records to an attorney? - CORRECT ANSWER-45 days Can medical records be admitted as evidence in court? What are the requirements? - CORRECT ANSWER-Yes, but only with affidavit What are schedule 1, 2, 3, 4, 5 drugs? - CORRECT ANSWER-Schedule 1—no known use (e.g., heroin); schedule 2—very addictive (morphine, cocaine); schedule 3-5—less addictive What are dangerous drugs? - CORRECT ANSWER-Prescription drugs other than schedule 1-5 How many DEA registrations do you need if you prescribe drugs? dispense drugs? - CORRECT ANSWER-One to prescribe; a separate registration for each location where you dispense How often do you renew your DEA license? - CORRECT ANSWER-Every 3 years Can you move your office location and then change your DEA? - CORRECT ANSWERNo, need to change BEFORE move Is a DEA registration sufficient to prescribe drugs in Texas? - CORRECT ANSWER-No, also need Department of Public Safety Bureau of Narcotics and Dangerous Drug registration How often do you renew a DPS license? - CORRECT ANSWER-Yearly Do you have to display the DEA and DPS licenses? - CORRECT ANSWER-Not required by any statute. How many days do you have to notify the DPS of any change in your information (name, address, tel., etc.)? - CORRECT ANSWER-7 days Can you have your DPS suspended and keep your DEA or vice versa? - CORRECT ANSWER-No, they are interconnected For schedules 2-5 drugs, can you just put the number of pills on prescription? - CORRECT ANSWER-No, number and number spelled out Do you have to put intended use on prescription? - CORRECT ANSWER-Yes With how many days of a schedule 2-5 drug can a patient be discharged from the hospital? - CORRECT ANSWER-7 days; only if the drug was already rx in the hospital What kind of prescription pad do you need for schedule 2 drugs? Can you use stickers? - CORRECT ANSWER-Official DPS form; no stickers Can a physician prescribe schedule 2 over the phone? - CORRECT ANSWER-Yes, for emergencies, and only for the duration of emergency How many days does the physician have to mail the schedule's emergency prescription to the pharmacy? - CORRECT ANSWER-7 days How many days does the patient have to fill schedule 2 prescriptions? - CORRECT ANSWER-7 days Can you refill a schedule 2 prescription? How about schedule 3-5? - CORRECT ANSWER-No for schedule 2. Max 5 refills for schedules 3-5. Who can call in prescription from a physician's office? - CORRECT ANSWER-Any qualified DESIGNATED person Can they call in schedule 2? - CORRECT ANSWER-Only physician in emergencies Can a physician prohibit substitutions for generics? - CORRECT ANSWER-Yes From whom and how do you order schedule 2? Schedules 3-5? - CORRECT ANSWERSchedule 2 on triplicate order form from distributor; schedules 3-5 regular form from wholesaler What drugs do you need to keep records on? How are the records kept? How often do you need to do inventory? Do you need to submit the records? How long do you have to keep the last inventory list? - CORRECT ANSWER-If dispensed in office, then all dangerous drugs, schedule drugs and samples; separate records for schedule 1+2; inventory every 2 years; records are not submitted; keep records for 2 years Who can inspect your drugs? - CORRECT ANSWER-TMB, DPS, attorney general for the DEA What is the method of ordering and accounting for drug samples? - CORRECT ANSWER-Written and signed request by physician; must keep inventory and drug logs Can you repackage samples? - CORRECT ANSWER-No Do you need to keep records on samples? - CORRECT ANSWER-Yes, just like other meds Can a physician buy and rebottle? Any exceptions? - CORRECT ANSWER-No, except for rural areas (less than 5000 population of town or 2500 of municipality, closest pharmacy > 15 miles) To give anesthesia, how often do you have to register with the board? - CORRECT ANSWER-Every 2 years What life support competency do surgeons and anesthesiologists need? - CORRECT ANSWER-ACLS, PALS, or board-approved course How many and what competency levels of healthcare providers do you need in all settings? - CORRECT ANSWER-At least 2 physicians with advanced competency How many days do you have to report office-based anesthesia-related complications? - CORRECT ANSWER-15 days What is considered an anesthesia-related complication? - CORRECT ANSWERAdmission to hospital within 24 hours or death within 72 hours What is considered intractable pain? - CORRECT ANSWER-Pain where cause of pain cannot be removed and where relief or cure has not been found Can a hospital forbid a physician to give dangerous drugs or controlled substances for treatment of intractable pain? - CORRECT ANSWER-No Can the board take disciplinary action against a physician for giving dangerous or controlled substances to a patient with intractable pain? - CORRECT ANSWER-No What must the physician document prior to treatment of intractable pain? - CORRECT ANSWER-Understanding between physician and patient about treatment; dose, type, frequency of medication; consultation with psychologist, psychiatrist, addictions expert Can you guarantee that a drug will work? - CORRECT ANSWER-No Who can be part of a confidential communication? - CORRECT ANSWER-Persons involved, furthering interest of the patient, and those participating in diagnosis or treatment, e.g., patients, doctors, translators, nurses, etc Is the billing record confidential? - CORRECT ANSWER-No, billing record is NOT part of medical record