NURSING JURISPRUDENCE AND ETHICS FOR TEXAS NURSES EXAM PRACTICE |
COMPREHENSIVE STUDY GUIDE & TESTBANK | PRACTICE QUESTIONS &
ANSWERS | LATEST UPDATE 2026/2027
TABLE OF CONTENTS
i. Texas Nursing Practice Act and Board of Nursing Authority
ii. Nurse Licensure, Scope of Practice, and Delegation
iii. Standards of Practice and Professional Accountability
iv. Documentation, Confidentiality, and Patient Rights
v. Ethical Decision-Making and Professional Boundaries
vi. Medication, Prescribing, and Advanced Practice Regulation
vii. Impairment, Mandatory Reporting, and Disciplinary Processes
viii. Telehealth, Social Media, and Emerging Professional Issues
INTRODUCTION
This practice examination reviews advanced nursing jurisprudence and ethics
concepts relevant to nurses practicing in Texas. Questions emphasize application of
the Texas Nursing Practice Act, Texas Board of Nursing rules, professional standards,
delegation, documentation, confidentiality, informed decision-making, professional
boundaries, mandatory reporting, impairment, disciplinary accountability, and
ethical practice. The questions are designed for advanced learners who must
interpret regulatory requirements and apply professional judgment to complex
clinical situations. Expect realistic scenarios involving competing ethical and legal
considerations, scope-of-practice boundaries, documentation deficiencies,
delegation decisions, patient autonomy, and professional accountability. Success
requires more than memorization: candidates should analyze facts, distinguish legal
requirements from ethical principles, identify the nurse's safest action, and
recognize circumstances requiring escalation or reporting.
QUESTION 1
A registered nurse in Texas is asked by a physician to perform a procedure that the
nurse has never performed independently. The nurse has observed the procedure
several times but has not demonstrated competency. The physician argues that the
procedure is within the general scope of registered nursing and instructs the nurse
,to proceed. Which action is most consistent with professional and regulatory
accountability?
A. Perform the procedure because the physician has authorized it.
B. Perform the procedure if another registered nurse remains available for
assistance.
C. Decline to perform the procedure until competency has been established and
appropriately validated.
D. Perform the procedure because observation of several procedures establishes
competency.
🔴 Correct Answer: C. Decline to perform the procedure until competency has
been established and appropriately validated.
🔵 Explanation: Scope of practice does not automatically establish individual
competency. A nurse remains accountable for accepting assignments that can be
performed safely and competently. Physician authorization does not eliminate the
nurse's independent professional responsibility.
QUESTION 2
A charge nurse delegates a task to an unlicensed assistive personnel (UAP). During
the shift, the patient's condition changes substantially and the delegated task now
requires clinical assessment before it can safely be performed. What is the nurse's
priority action?
A. Allow the UAP to continue because the task was originally delegated.
B. Reassess the patient and determine whether the task remains appropriate for
delegation.
C. Ask the UAP to document the patient's change in condition.
D. Transfer responsibility for the patient to the UAP until the physician arrives.
🔴 Correct Answer: B. Reassess the patient and determine whether the task
remains appropriate for delegation.
🔵 Explanation: Delegation is dynamic and depends on the patient's condition, task
complexity, and the delegatee's competency. A significant change in condition requires
nursing reassessment and may require withdrawal or modification of the delegation.
QUESTION 3
,A nurse discovers that a colleague administered a medication to the wrong patient
but immediately recognized the error and notified the charge nurse. The colleague
asks the nurse not to mention the incident because "no harm occurred." What is the
most appropriate response?
A. Agree because an error without harm does not require reporting.
B. Report the event according to applicable organizational requirements.
C. Wait to see whether the patient develops symptoms.
D. Document the event only if the patient requests disclosure.
🔴 Correct Answer: B. Report the event according to applicable organizational
requirements.
🔵 Explanation: Medication errors require appropriate reporting even when no
immediate harm occurs. Concealing an error undermines patient safety and
professional accountability. The nurse should follow applicable incident-reporting and
patient-safety procedures.
QUESTION 4
A nurse receives an assignment involving a patient whose condition is substantially
more complex than the nurse's demonstrated competency. The nurse believes
accepting the assignment could jeopardize patient safety. Which response best
reflects professional accountability?
A. Accept the assignment and rely on coworkers for all clinical decisions.
B. Refuse the assignment without notifying anyone.
C. Communicate the competency concern promptly through the appropriate chain
of command.
D. Accept the assignment because staffing shortages eliminate individual
accountability.
🔴 Correct Answer: C. Communicate the competency concern promptly through
the appropriate chain of command.
🔵 Explanation: Nurses have a professional responsibility to recognize limitations and
advocate for safe care. The appropriate response is to communicate the concern, seek
assistance or reassignment when warranted, and follow applicable organizational
procedures rather than abandoning the assignment.
, QUESTION 5
A nurse documents in the medical record that a patient "refused all treatment."
Later, the nurse recalls that the patient actually refused only one proposed
intervention but accepted other treatments. What is the most appropriate
documentation response?
A. Delete the original entry and replace it without explanation.
B. Leave the inaccurate entry unchanged because the shift has ended.
C. Correct the record using the organization's approved correction procedure.
D. Ask another nurse to rewrite the original documentation.
🔴 Correct Answer: C. Correct the record using the organization's approved
correction procedure.
🔵 Explanation: Clinical documentation must accurately reflect the patient's care and
decisions. An inaccurate entry should be corrected according to approved record-
correction procedures, preserving the integrity and traceability of the original
documentation.
QUESTION 6
A nurse posts on a private social-media account that a "difficult patient" on the
nurse's unit is receiving treatment for a rare condition. The nurse does not use the
patient's name but includes the hospital unit and details that make the patient
readily identifiable to coworkers. Which concern is most significant?
A. The nurse has violated professional confidentiality expectations.
B. The nurse is protected because the account is private.
C. The nurse may disclose information as long as the patient's name is omitted.
D. The nurse has committed no violation if no photograph was posted.
🔴 Correct Answer: A. The nurse has violated professional confidentiality
expectations.
🔵 Explanation: Patient confidentiality extends beyond names and photographs.
Information that permits identification through context or combination of details may
constitute an inappropriate disclosure. A private social-media account does not
eliminate professional confidentiality obligations.
QUESTION 7
COMPREHENSIVE STUDY GUIDE & TESTBANK | PRACTICE QUESTIONS &
ANSWERS | LATEST UPDATE 2026/2027
TABLE OF CONTENTS
i. Texas Nursing Practice Act and Board of Nursing Authority
ii. Nurse Licensure, Scope of Practice, and Delegation
iii. Standards of Practice and Professional Accountability
iv. Documentation, Confidentiality, and Patient Rights
v. Ethical Decision-Making and Professional Boundaries
vi. Medication, Prescribing, and Advanced Practice Regulation
vii. Impairment, Mandatory Reporting, and Disciplinary Processes
viii. Telehealth, Social Media, and Emerging Professional Issues
INTRODUCTION
This practice examination reviews advanced nursing jurisprudence and ethics
concepts relevant to nurses practicing in Texas. Questions emphasize application of
the Texas Nursing Practice Act, Texas Board of Nursing rules, professional standards,
delegation, documentation, confidentiality, informed decision-making, professional
boundaries, mandatory reporting, impairment, disciplinary accountability, and
ethical practice. The questions are designed for advanced learners who must
interpret regulatory requirements and apply professional judgment to complex
clinical situations. Expect realistic scenarios involving competing ethical and legal
considerations, scope-of-practice boundaries, documentation deficiencies,
delegation decisions, patient autonomy, and professional accountability. Success
requires more than memorization: candidates should analyze facts, distinguish legal
requirements from ethical principles, identify the nurse's safest action, and
recognize circumstances requiring escalation or reporting.
QUESTION 1
A registered nurse in Texas is asked by a physician to perform a procedure that the
nurse has never performed independently. The nurse has observed the procedure
several times but has not demonstrated competency. The physician argues that the
procedure is within the general scope of registered nursing and instructs the nurse
,to proceed. Which action is most consistent with professional and regulatory
accountability?
A. Perform the procedure because the physician has authorized it.
B. Perform the procedure if another registered nurse remains available for
assistance.
C. Decline to perform the procedure until competency has been established and
appropriately validated.
D. Perform the procedure because observation of several procedures establishes
competency.
🔴 Correct Answer: C. Decline to perform the procedure until competency has
been established and appropriately validated.
🔵 Explanation: Scope of practice does not automatically establish individual
competency. A nurse remains accountable for accepting assignments that can be
performed safely and competently. Physician authorization does not eliminate the
nurse's independent professional responsibility.
QUESTION 2
A charge nurse delegates a task to an unlicensed assistive personnel (UAP). During
the shift, the patient's condition changes substantially and the delegated task now
requires clinical assessment before it can safely be performed. What is the nurse's
priority action?
A. Allow the UAP to continue because the task was originally delegated.
B. Reassess the patient and determine whether the task remains appropriate for
delegation.
C. Ask the UAP to document the patient's change in condition.
D. Transfer responsibility for the patient to the UAP until the physician arrives.
🔴 Correct Answer: B. Reassess the patient and determine whether the task
remains appropriate for delegation.
🔵 Explanation: Delegation is dynamic and depends on the patient's condition, task
complexity, and the delegatee's competency. A significant change in condition requires
nursing reassessment and may require withdrawal or modification of the delegation.
QUESTION 3
,A nurse discovers that a colleague administered a medication to the wrong patient
but immediately recognized the error and notified the charge nurse. The colleague
asks the nurse not to mention the incident because "no harm occurred." What is the
most appropriate response?
A. Agree because an error without harm does not require reporting.
B. Report the event according to applicable organizational requirements.
C. Wait to see whether the patient develops symptoms.
D. Document the event only if the patient requests disclosure.
🔴 Correct Answer: B. Report the event according to applicable organizational
requirements.
🔵 Explanation: Medication errors require appropriate reporting even when no
immediate harm occurs. Concealing an error undermines patient safety and
professional accountability. The nurse should follow applicable incident-reporting and
patient-safety procedures.
QUESTION 4
A nurse receives an assignment involving a patient whose condition is substantially
more complex than the nurse's demonstrated competency. The nurse believes
accepting the assignment could jeopardize patient safety. Which response best
reflects professional accountability?
A. Accept the assignment and rely on coworkers for all clinical decisions.
B. Refuse the assignment without notifying anyone.
C. Communicate the competency concern promptly through the appropriate chain
of command.
D. Accept the assignment because staffing shortages eliminate individual
accountability.
🔴 Correct Answer: C. Communicate the competency concern promptly through
the appropriate chain of command.
🔵 Explanation: Nurses have a professional responsibility to recognize limitations and
advocate for safe care. The appropriate response is to communicate the concern, seek
assistance or reassignment when warranted, and follow applicable organizational
procedures rather than abandoning the assignment.
, QUESTION 5
A nurse documents in the medical record that a patient "refused all treatment."
Later, the nurse recalls that the patient actually refused only one proposed
intervention but accepted other treatments. What is the most appropriate
documentation response?
A. Delete the original entry and replace it without explanation.
B. Leave the inaccurate entry unchanged because the shift has ended.
C. Correct the record using the organization's approved correction procedure.
D. Ask another nurse to rewrite the original documentation.
🔴 Correct Answer: C. Correct the record using the organization's approved
correction procedure.
🔵 Explanation: Clinical documentation must accurately reflect the patient's care and
decisions. An inaccurate entry should be corrected according to approved record-
correction procedures, preserving the integrity and traceability of the original
documentation.
QUESTION 6
A nurse posts on a private social-media account that a "difficult patient" on the
nurse's unit is receiving treatment for a rare condition. The nurse does not use the
patient's name but includes the hospital unit and details that make the patient
readily identifiable to coworkers. Which concern is most significant?
A. The nurse has violated professional confidentiality expectations.
B. The nurse is protected because the account is private.
C. The nurse may disclose information as long as the patient's name is omitted.
D. The nurse has committed no violation if no photograph was posted.
🔴 Correct Answer: A. The nurse has violated professional confidentiality
expectations.
🔵 Explanation: Patient confidentiality extends beyond names and photographs.
Information that permits identification through context or combination of details may
constitute an inappropriate disclosure. A private social-media account does not
eliminate professional confidentiality obligations.
QUESTION 7
