NURSING JURISPRUDENCE TEXAS EXAM UPDATED 2023 ,VERIFIED ANSWERS

Jurisprudence - correct answer The science or philosophy of law Sources of Law - correct answer- Constitutional Law Federal State - Statutory Law Federal State - Common Law - Administrative Law Criminal Law - correct answer Federal or state government is attempting to deprive an individual of life or liberty for something the law considers an offense against society in general. Civil Law - correct answer Seeks to resolve disputes between private parties, which often results in the payment of money. Different Burden of Proof - correct answer Beyond a reasonable doubt A preponderance of the evidence Tort Law - correct answer A civil wrong that causes someone else to suffer loss or harm resulting in legal liability for the person who commits the tortious act. Types of Torts - correct answer- Negligence - Intentional Torts Assault Battery False Imprisonment - Quasi-Intentional Torts Defamaiton Libel Slander Malpractice - correct answer Negligence committed by a person in his or her professional capacity is malpractice. Also known as professional negligence. Medical and nursing malpractice occur when a doctor or nurse fails to do that which a reasonable, prudent doctor or nurse would do under the same or similar circumstances, or does that which a reasonable or prudent doctor or nurse would not do under the same or similar circumstances. Elements of a Nursing Malpractice Lawsuit - correct answer Duty - the existence of a duty, owed by the nurse to a patient, to conform to a recognized standard of care Breach - a failure to conform to the required standard of care Harm - an actual injury Cause - there must be proof that the injury was caused by the nurse's act or omission Intentional Tort: Assault - correct answer Intentionally placing another in apprehension or fear that they will suffer harmful or offensive contact. Intentional Tort: Battery - correct answer Intentional contact that is harmful or offensive, or creating the apprehension that such contact is imminent. Intentional Tort: False Imprisonment - correct answer Willful detention without consent and without authority of law. Quasi-Intentional Tort: Defamation - correct answer A communication that tends to hold the plaintiff up to hatred, contempt or ridicule, or to cause him to be shunned or avoided. Tarnishing the reputation of someone. Quasi-Intentional Tort: Defamation Types - correct answer Types: Libel - printed or broadcast Slander - spoken Nurse Practice Act - correct answer The practice of nursing is a right granted by a state to protect those who need nursing care. The guidelines of the NPA and its rules provide safe parameters within which to work, as well as protect patients from unprofessional and unsafe nursing practice. The act is a dynamic document that evolves and is updated or amended as changes in scope of practice occur. All states and territories have enacted a NPA Generally, NPAs include: Authority, power and composition of a board of nursing Education program standards Standards and scope of nursing practice Types of titles and licenses Requirements for licensure Grounds for disciplinary action, other violations and possible remedies Rules & Regulations - correct answer The NPA itself is insufficient to provide the necessary guidance for the nursing profession, therefore, each NPA establishes a board of nursing (BON) that has the authority to develop administrative rules or regulations to clarify or make the law more specific. Rules and regulations must be consistent with the NPA and cannot go beyond it. These rules and regulations undergo a process of public review before enactment. Once enacted, rules and regulations have the full force and effect of law. IT IS A NURSE'S RESPONSIBILITY TO KNOW NPA/RULES AND REGULATIONS - correct answer As a nurse in Texas, you have a responsibility to know and follow the Nursing Practice Act and all applicable BON Rules and Regulations relating to your nursing practice. All current BON Rules and Regulations and the Nursing Practice Act can be downloaded from the BON's web site at Standards of Nursing Practice - correct answer Standards Applicable to All Nurses. All vocational nurses, registered nurses and registered nurses with advanced practice authorization shall: (A) Know and conform to the Texas Nursing Practice Act and the board's rules and regulations as well as all federal, state, or local laws, rules or regulations affecting the nurse's current area of nursing practice. The standards of practice establish a minimum acceptable level of nursing practice in any setting for each level of nursing licensure or advanced practice authorization. Failure to meet these standards may result in action against the nurse's license even if no actual patient injury resulted. Laws & Regulations Regarding Nursing - correct answer- Texas Nurse Practice Act (NPA) - Texas Board of Nursing (BON) Rules & Regulations - BON Position Statements Don't have the force of law, but the Board strongly encourages nurses to choose those position statements applicable to their practice setting and incorporate them into their daily practice to assure patient safety The Texas Board of Nursing (BON) - correct answer Established by passage of the NPA BON empowered by NPA with the responsibility and legal authority for ensuring competent practitioners of nursing. Grants authority to the BON to make the rules and regulations to carry out the act. The Board: - correct answer protects the public from unsafe nursing practice, provides approval for more than 200 nursing education programs, issues licenses to more than 27,000 nurses per year by examination to new graduates and by endorsement to licensees from other states seeking a Texas license, as well as providing nursing practice and education guidance to more than 350,000 currently licensed nurses practicing in the State of Texas. BON Responsibilities & Services - correct answer Licensing qualified practitioners Enforcement - investigating violations of the NPA and initiating appropriate legal action when necessary Establishing minimum standards for educational programs in nursing BON Mission Statement - correct answer To protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in the State of Texas is competent to practice safely. BON Mission Fulfilled Through - correct answer The regulation of the practice of nursing, and The approval of nursing education programs. Licensure Required - correct answer A person may not practice or offer to practice professional nursing or vocational nursing in this state unless the person is licensed [NPA § 301.251] This section of the NPA establishes the NPA as a practice control act for RNs and LVNs Use of Titles - correct answer Must hold a license to use the title: Registered Nurse or RN Professional Nurse Licensed Vocational Nurse or LVN Any designation that implies that the person is a licensed registered or vocational nurse Clearly Legible Insignia - correct answer When interacting with the public in a nursing role, RNs and LVNs must wear an insignia identifying them as RNs or LVNs [NPA § 301.351] APRNs practicing in an advance practice role must identify themselves with their APRN title BON Rule 217.10(b) requires the nurse's first or last name and licensure level Although the board does not require the inclusion of any other designations, with the exception of the specific authorization of advanced practice nurses, the insignia may not contain information other than: - correct answer(A) the registered nurse or licensed vocational nurse designation; (B) the nurse's name, certifications, academic degrees, or practice position; (C) the name of the employing facility or agency, or other employer; or (D) a picture of the nurse. No More Paper Licenses - correct answer The BON discontinued issuing wallet-sized paper licenses for nurses renewing their licenses beginning September 1, 2008 Paper license certificates are issued for: Graduate nurses who pass the NCLEX® exam and obtain their initial license in Texas; Nurses who hold licenses in other states and are obtaining a Texas license for the first time; and Nurses who receive full licensure as APRNs Licensure Verification - correct answer Employers may verify the licensure status of all nurses seeking employment online or by phone. Renewal of Licensure - correct answer60 days prior to license expiration, the BON will mail a postcard reminder to renew online. This is one of the reasons it is important to keep your contact information up to date! Continuing Competency (TAC Chapter 216) - correct answer Purpose: to ensure nurses stay abreast of current industry practices, enhance their professional competence, learn about new technology and treatment regimens, and update their clinical skills. [TAC § 216.2] All nurses are required to demonstrate continuing competency for renewal of licensure. Methods: Complete 20 hours of continuing education, or Attain, maintain, or renew an approved national nursing certification in the area of practice Nursing Jurisprudence & Ethics - 2 hours [Rule 216.3 (g)] Older Adult or Geriatric Care - 2 hours [Rule 216.3 (h)] Nurse Licensure Compact - correct answer The Nurse Licensure Compact (NLC) allows RNs and LVNs to have one multistate license, with the ability to practice in both their home state and other NLC states. The APRN Compact allows an advanced practice registered nurse to hold one multistate license with a privilege to practice in other compact states. Agreement among states to mutually recognize each others' licenses Texas among first to adopt Premise: current licensure requirements essentially the same from state to state Does not interfere with each state defining scope of practice Only defines requirements to hold license Nurse Licensure Compact - Definitions - correct answer Party states - states who have adopted the compact Home state license - where you permanently reside Remote state - where you practice using multistate privilege (must be a party state) Nurse Licensure Compact - Requirements - correct answer Maintain home state license Adhere to state practice laws of state in which patient is located at the time care is provided Use multistate privilege only in party states Hold home state license in only one party state at a time. Practice in a Non-Party State - correct answer To practice in a state that is not part of the Compact, the nurse must obtain license from the non-party state May concurrently hold a home state license and a license to practice in a non-party state If you live in a non-party state, you must obtain a non-resident Texas license in order to practice in Texas Ethical Conduct - correct answer Year after year, Nursing is recognized as one of the most trusted professions. It is important to maintain that trust, so we can practice efficiently. ...what is good and bad and with moral duty and obligation... Good Professional Character - correct answer Integrated pattern of personal, academic and occupational behaviors which, in the judgment of the Board, indicates that an individual is able to consistently conform his or her conduct to the requirements of the Nursing Practice Act, the Board's rules and regulations, and generally accepted standards of nursing practice including, but not limited to, behaviors indicating honesty, accountability, trustworthiness, reliability, and integrity [TAC § 213.27(a)]. Factors Indicating Good Professional Character - correct answer Distinguish right from wrong; Think and act rationally; Keep promises and honor obligations; Accountable for own behavior; Able to practice nursing in an autonomous role with patients/clients, their families, significant others, and members of the public who are or who may become physically, emotionally, or financially vulnerable; Recognize and honor the interpersonal boundaries appropriate to any therapeutic relationship or health care setting; and Promptly and fully self-disclose facts, circumstances, events, errors, and omissions when such disclosure could enhance the health status of patients/clients or the public or could protect patients/clients or the public from unnecessary risk of harm [ Rule 213.27(b)(2)(A-G)]. Any conviction for a felony or for a misdemeanor involving moral turpitude or order of probation with or without an adjudication of guilt for an offense that would be a felony or misdemeanor involving moral turpitude if guilt were adjudicated [Rule 213.27 (b)(3)]. Any revocation, suspension, or denial of, or any other adverse action relating to, the person's license or privilege to practice nursing in another jurisdiction [Rule 213.27 (b)(4)]. Criminal Behavior Disclosure - correct answer Requirement for criminal history for applicants for a license [NPA § 301.2511]. Requirement for criminal history for renewal of license [NPA § 301.3011]. Disclose: Convictions Deferred adjudications Probated sentences Domestic offenses Professional Boundaries - correct answer The appropriate limits which should be established by the nurse in the nurse/client relationship due to the nurse's power and the patient's vulnerability. Refers to the provision of nursing services within the limits of the nurse/client relationship which promote the client's dignity, independence and best interests and refrain from inappropriate involvement in the client's personal relationships and/or the obtainment of the nurse's personal gain at the client's expense. A zone of patient-centered care is in the center of the professional behavior continuum. This is where the patient interactions should occur for effectiveness and patient safety. Over-involvement with a patient is on the right side of the continuum; this includes boundary crossings, boundary violations and professional sexual misconduct. Under-involvement lies on the left side; this includes distancing, disinterest and neglect, and can be detrimental to the patient and the nurse. Rule 217.11. Standards of Nursing Practice - correct answer Know, recognize, and maintain professional boundaries of the nurse-client relationship Rule 217.12. Unprofessional Conduct - correct answer Misconduct — actions or conduct that include, but are not limited to: (D) Violating professional boundaries of the nurse/client relationship including but not limited to physical, sexual, emotional or financial exploitation of the client or the client's significant other(s) Unprofessional Conduct - correct answer Using fraud or deceit in procuring a license Improperly using a nursing license Impersonating another person in examination Aiding and abetting someone in unlawful practice Failing to cooperate with a lawful investigation Behaving in a threatening or violent manner in the workplace Offering, giving, soliciting, or receiving or agreeing to receive, directly or indirectly, any fee or other consideration to or from a third party for the referral of a client in connection with the performance of professional services. Rule 217.12. Standards of Nursing Practice - correct answer This rule covers standards of nursing practice that apply to all nurses, including RNs, LVNs, and APRNs. This is one rule to know well! Standards of Nursing Practice (cont) - correct answer 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 - correct answer 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 - correct answer 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 - correct answer 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 - correct answer Practice in Planning of Nursing Care Assisting in evaluating patient response to nursing care Perform focused assessment LVN Supervision - correct answer 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 - correct answer 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 t Graduate Nurse - correct answer 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 - correct answer 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 - correct answer Tool developed by the BON to assist nurses in making good professional judgments about the nursing tasks or procedures they choose to undertake. Goal is making sure that he/she only accepts those assignments for which the nurse has the education, training, and skill competency 1. Is the activity consistent with the Nursing Practice Act (NPA), Board Rules, and Board Position Statements and or/Guideline? Yes: continue. No: stop. 2. Is the activity appropriately authorized by valid order/protocol and in accordance with established policies and behaviors? Yes: continue. No: stop. 3. Is the act supported by either research reported in nursing and health-related literature or in scope of practice statements by national nursing organizations? Yes: continue. No: stop. 4. Do you possess the required knowledge and have you demonstrated the competency required to carry out this activity safely? "" 5. Would a reasonable and prudent nurse perform this activity in this setting? 6. Are you prepared to assume accountability for the provision of safe care and the outcome of the care rendered? Yes: Perform the activity. No: stop. Delegation - correct answer Authorizing an unlicensed person to provide nursing services while retaining accountability for how the unlicensed person performs the task. It does not include situations in which an unlicensed person is directly assisting a RN by carrying out nursing tasks in the presence of a RN [Rule 224.4 (3)]. RNs may delegate LVNs may supervise The RN is responsible for the evaluation of the delegated task to ensure it was completed and completed correctly [Rule 224.3]. According to the BON website, many find delegation to be a perplexing concept with multiple nuances. The BON created the Delegation Resource Packet to afford RNs clearer direction for delegation in a variety of settings thereby improving the delegation process Criteria for Delegation - correct answer RNs may delegate LVNs may supervise