A Nurse Wants Help to Lobby the Texas Legislature

A nurse wants help to lobby the Texas Legislature in favor of a bill that will help staff nurses. The nurse should contact his or her nursing professional organization. A nurse who contacts a physician to clarify a medication order is A. fulfilling a duty to keep the patient safe. B. likely to detract from a collegial nurse-physician relationship. C. engaging in action that is the duty of the pharmacist. D. not fulfilling nursing tasks with other patients. When deciding what course of action to follow, the nurse has a duty to always keep the patient safe. A nurse believes that she lacks the basic knowledge and skills necessary to carry out her initial patient assignment. The nurse invokes Safe Harbor and brings her Quick Request for Safe Harbor form to her supervisor. What other action is required by the nurse when refusing an assignment?The nurse must collaborate with the supervisor in an attempt to determine an alternate assignment that will not violate the nurse's duty to the patient(s). An advanced practice registered nurse in an outpatient clinic could delegate which of the following tasks to an unlicensed clinical staff member? ANSWER A. Administering intramuscular (IM) and subcutaneous (SQ) injections other than insulin. B. Calling in prescription refills of a PRN pain medication for which no refills have been authorized. C. Reviewing routine laboratory results and calling the patient to tell the patient what the results mean. D. Cleansing and dressing a minor leg wound in accordance with step-by-step instructions. If a nurse borrows money from an elderly client to help pay personal bills, this act would be ANSWER A. physical abuse of the patient. B. a violation of professional boundaries. C. emotional abuse of the patient. D. a violation of Scope of Practice. An Incident-Based Nursing Peer Review Committee ANSWER 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. One of the ways the BON carries out its mission is by ANSWER A. starting nursing schools. B. projecting the needs for nurse aides in the state. C. approving nursing educational programs. D. regulating work settings for nurses. A nurse believes that she lacks the basic knowledge and skills necessary to carry out her initial patient assignment. The nurse invokes Safe Harbor and brings her Quick Request for Safe Harbor form to her supervisor. What other action is required by the nurse when refusing an assignment? ANSWER A. The nurse must agree to accept the assignment as there is no valid reason to ever refuse an assignment. B. The nurse must go home immediately, as her duty to any of the patient(s) starts only after taking report. C. The nurse must collaborate with the supervisor in an attempt to determine an alternate assignment that will not violate the nurse's duty to the patient(s). D. The nurse must fax the form to the BON so that the meeting can be scheduled within two weeks. According to Board Rule 213.29, Criteria and Procedure Regarding Intemperate Use and Lack of Fitness in Eligibility and Disciplinary Matters, a person desiring to obtain or retain his or her nursing license must provide a sworn certificate to the board that he or she has NOT ANSWER A. had any alcohol within the last five years. B. been under the influence of any alcohol or other illegal substance for the last five years. C. been addicted to or treated for the use of alcohol or any other drug in the last five years. D. been in the hospital for any type of surgery within the last five years. In Texas, advanced practice registered nurses (APRNs) may delegate which of the following to unlicensed assistive personnel? ANSWER A. APRNs can delegate anything a physician would delegate, as APRNs are educated to engage in some aspects of medical diagnosis and medical management. B. Medical diagnosis and nursing assessment in compliance with BON Rules 224 and 225 on RN delegation. C. Advanced practice skills that the APRN learned in his or her advanced practice nursing program of study. D. Activities of daily living, health maintenance activities, and nursing tasks in compliance with BON Rules 224 and 225 on RN Delegation. Which of the following situations is an example of a nurse MAINTAINING appropriate professional boundaries between the nurse and the client? A nurse ANSWER A. rewards a patient with a small stuffed mascot of his favorite football team for progress made in rehabilitation. B. responds less frequently to a demanding patient's call light. C. shares personal information regarding her recent bankruptcy because the patient seems genuinely interested. D. is personally attracted to a patient and calls and visits him on her days off "to check on how he is doing." An advertisement for a "licensed nurse" states the following as routine job responsibilities: "Must work independently without supervision; have expertise in developing nursing care plans, including establishing appropriate nursing diagnoses for assigned patients; and, must be able to complete comprehensive nursing assessments." Based on these responsibilities, this advertisement would require, at a minimum, the nurse to hold a valid RN When a nurse commits a crime outside of the workplace, the BON's concern relates to whether the nurse may ANSWER A. discuss the crime with his or her colleagues. B. involve other nurses in the criminal behavior. C. repeat the same misconduct against a patient. D. lie to his or her family about the criminal behavior. Conduct by a nurse that is subject to reporting to the BON includes all of the following EXCEPT: conduct that constitutes a single minor incident in compliance with Board Rule 217.16, Minor Incidents. Any person who wishes to report and or file a complaint against a nurse regarding possible violations of the board rules should rint a complaint form from the BON web page under the Disciplinary Action section, complete as much of the information as possible, and mail or fax the form to the BON. Halfway through her shift, a nurse is told she will be getting several patient admissions. The nurse is fearful that she cannot provide safe care for so many patients. What initial steps must the nurse take if she decides to invoke Safe Harbor? Discuss patient safety with the supervisor and invoke Safe Harbor. The BON rules, located in Title 22 of the Texas Administrative Code, help implement and reflect ANSWER A. the standards of nursing care developed by various nursing specialty and professional organizations. B. the statutes passed by the legislature relating to nursing found in Texas Occupations Code, including the NPA. C. the steps necessary to complete the NCLEX exam application. D. the process necessary to be promoted to higher positions in nursing in different practice settings. Board cases involving eligibility or disciplinary issues that are resolved through a board agreed order ANSWER 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. Which of the following factors is evaluated by the BON when determining the relevance of past criminal behavior of a nurse? The nature and seriousness of the crime. 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 a violation of professional boundaries of the nurse-client relationship. A nursing error that contributes to the death or serious harm of a patient ANSWER A. can be considered a minor incident if the nurse is accountable for his or her practice and understands his or her error. B. can be considered a minor incident if the patient had a do-not-resuscitate order. C. cannot be considered a minor incident, even if the nurse appears to have the knowledge and skills to practice safely. D. cannot be considered a minor incident unless the nurse has a previous pattern of similar nursing practice errors A nurse under investigation by the board is required to complete which of the following within 20 days of receipt of the letter of notice? ANSWER A. Enroll in a BON approved remedial education course. B. Resign from nursing employment. C. Provide a written response to the BON investigator. D. Inform employer of the BON investigation. Which of the following actions by a nurse would comply with the Standards of Nursing Practice in Board Rule 217.11? ANSWER A. Documenting the medication administration route as intramuscular (IM) (as per physician order) when the nurse accidently administered the medication intravenously (IV). B. Omitting healthcare information on a patient record at the patient's request. C. Documenting an aspect of nursing care provided to a patient after the fact by following facility policy for making a "late entry." D. Documenting a colleague's assessment findings as your own. 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: THEFT OF PROPERTY The mission of the BON supersedes ANSWER 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. Which of the following factors is evaluated by the BON when determining the relevance of past criminal behavior of a nurse? ANSWER A. The state in which the crime occurred. B. The nature and seriousness of the crime. C. The nurse's level of education and licensure (LVN vs. RN). D. His or her grade point average (GPA) in nursing school. A RN working with an unlicensed assistive person (UAP) directs the UAP to perform the task of applying a sterile dressing to a minor abrasion for a specific client. The RN is directly responsible for the nursing care given to the client. This is an example of ANSWER A. a RN training an unlicensed person to perform certain nursing tasks. B. a RN delegating nursing tasks to an unlicensed person. C. a RN supervising nursing care delivered by other licensed nurses. D. a RN providing direct care for a client. The Standards of Nursing Practice, Board Rule 217.11 state that the LVN scope of practice includes doing which of the following with regard to care plans? Only review A professional nursing association determines that a nurse cheated on a national certification exam. The association disqualifies the nurse from being eligible to seek certification, and suspends the nurse's membership privileges for the association. According to the NPA Section 301.406, Duty of Professional Associations and Organizations to Report, the professional association ANSWER A. has authority to mandate that the BON suspend the nurse's license in Texas. B. also has a duty to report the nurse to the BON. C. must publish this disciplinary action against the nurse in the yearly newsletter to its members. D. is required to make a report to local law enforcement authorities as the nurse's deliberate act of cheating may also be considered criminal conduct. 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 A. the nurse may convince the committee the errors were not her fault, and the committee can then withdraw the CNO's report to the BON. B. the IBPR Committee can decide to reverse the CNO's decision to terminate the nurse's employment. C. the IBPR Committee may decide to re-orient and re-train the nurse even though she was fired. D. 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. A RN working with an unlicensed assistive person (UAP) directs the UAP to perform the task of applying a sterile dressing to a minor abrasion for a specific client. This is an example of ANSWER A. a RN delegating nursing tasks to an unlicensed person. B. a RN training an unlicensed person to perform certain nursing tasks. C. a RN supervising nursing care delivered by other licensed nurses. D. a RN providing direct care for a client. A nurse wants help to lobby the Texas Legislature in favor of a bill that will help staff nurses. The nurse should ANSWER A. contact his or her nursing professional organization. B. contact the Texas BON. C. contact the local newspaper. D. contact his or her nurse manager. 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 A. Guideline for Nurses Transitioning to a New Practice Setting. B. Statistics on the number of nurses living in each county in Texas. C. Position Statement 15.14 Duty of a Nurse in Any Setting. D. Position Statement 15.27 The Licensed Vocational Nurse Scope of Practice. Within the nurse licensure compact agreement, the party state that is the nurse's primary state of residence is called the nurse's HOME STATE Why does the BON require nurses to disclose that they have been diagnosed with, treated for, or hospitalized with certain mental illnesses? 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 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 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. According to the Standards of Nursing Practice, Board Rule 217.11, LVNs have a "directed" scope of practice. Of the following categories of providers, which of the following is an appropriate nursing practice supervisor for the LVN? PHYSICIAN 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. Which of the following activities would violate a provision of the NPA and Board Rule 217.11(2), Standards of Nursing Practice, relating to the practice of nursing by a LVN? ANSWER A. Assisting in the evaluation of a client's response to nursing interventions. B. Practicing in any setting without an appropriate practice supervisor who is at least telephonically available. C. Collaborating with the RN to revise the nursing care plans for assigned clients. D. Making assignments to other licensed nurses and to unlicensed assistive personnel when working in a supervisory position. A nurse had his license revoked by the BON in Hawaii. When the nurse moves to Texas and applies for a nursing license in Texas, the most likely result will be that ANSWER A. the nurse will be granted a nursing license until the Texas BON learns of the revocation in Hawaii. B. the nurse will have to retake the NCLEX licensure exam to be licensed in Texas since his nursing license in Hawaii was revoked. C. the nurse may not be able to get a job until employers find out why his license was revoked in Hawaii. D. the nurse may not be able to obtain licensure in Texas until he addresses the conduct that caused his license to be revoked. According to the NPA section 301.403, the Peer Review Committee must report which of the following to the board? ANSWER A. Any minor incidents the nurse makes while caring for patients. B. A description of any corrective action taken against the nurse. C. The names and addresses of the Peer Review Committee members. D. An organizational chart that reflects the reported nurse's position in the agency. A professional nursing association determines that a nurse cheated on a national certification exam. The association disqualifies the nurse from being eligible to seek certification, and suspends the nurse's membership privileges for the association. According to the NPA Section 301.406, Duty of Professional Associations and Organizations to Report, the professional association ANSWER A. has authority to mandate that the BON suspend the nurse's license in Texas. B. also has a duty to report the nurse to the BON. C. must publish this disciplinary action against the nurse in the yearly newsletter to its members. D. is required to make a report to local law enforcement authorities as the nurse's deliberate act of cheating may also be considered criminal conduct. In a nurse-patient relationship, the most vulnerable patients are those who are under anesthesia or sedation. On the board's website, the Nursing Practice section contains board Position Statements that provide guidance to help nurses practice safely. What is the board's position on the role of an LVN in the moderate sedation of patients? No amount of post-licensure continuing education can prepare the LVN to safely administer agents that produce moderate sedation, or to monitor patients receiving moderate sedation. One of the purposes of the Nurse Licensure Compact is to . facilitate the protection of the public's health and safety. According to the NPA section 301.404, a nursing educational program has the duty to report which of the following to the BON?The student exhibited signs of impairment during class and tested positive for cocaine and alcohol. . According to the NPA, Section 301.452 Grounds for Disciplinary Action, the definition of "intemperate use" includes being on-call or on duty while under the influence of alcohol or drugs. A nurse fears that administration of a medication as ordered would place a patient at risk of harm. The nurse would fulfill his duty to the patient if the nurse informs the physician of his concern and requests clarification of the order. 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 A. Home health agency employing 20 nurses (10 RNs and 10 LVNs) B. Hospital with 400 staff nurses (325 RNs and 75 LVNs) C. Independent school district employing 7 nurses (4 RNs and 3 LVNs) Halfway through her shift, a nurse is told she will be getting several patient admissions. The nurse is fearful that she cannot provide safe care for so many patients. What initial steps must the nurse take if she decides to invoke Safe Harbor? ANSWER A. Tell the supervisor making the assignment that the nurse will keep her current patient assignments but refuses any new admissions. B. Confer with her colleagues to determine their opinion. If there is not agreement, work through the shift as scheduled. C. Discuss patient safety with the supervisor and invoke Safe Harbor. Two employees are suspended for three days for a fight that violated the Human Resource policies of the facility. This behavior would be ANSWER A. board-reportable because the nurse was suspended for three days. B. an employment issue only as it did not involve patient safety and was a violation of a facility policy regarding staff conduct. C. conduct that should be reviewed by the Nursing Incident-Based Peer Review Committee. D. up to the nurse manager to determine whether or not to report the nurse to the BON for alleged violations of the NPA and board rules. A nurse is attracted to a patient and insists on being assigned to care for this patient every shift she works. As a result there are reports of the nurse not completing other assignments. In this example the nurse ANSWER A. is merely demonstrating caring behaviors. B. is ensuring continuity of care. C. has become overly involved and is at risk of committing a boundary violation. D. is acting appropriately in maintaining a therapeutic nurse-patient relationship. 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 A. the nurse must have completed a bachelor of science in nursing program (BSN). B. 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. C. the nurse can have any level of licensure; however, if the nurse is an LVN, the LVN can only engage in the conduct described in the example if the LVN practices under a physician's delegation. D. th Rule 216 related to Continuing Competency requires nurses to complete ANSWER A. 20 contact hours of continuing education within two years preceding license renewal. 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 B. being placed in a supervisory or charge position, and working in any independent practice setting. One purpose of the BON's Position Statements and Guidelines is to provide 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. Nurses often ask the Board about what it means to abandon their patients. Though the Board does not use this term in the rules, what specific portion of Board Rule 217.12, Unprofessional Conduct, provides directions for the nurse regarding job abandonment and conduct that may also be Board-reportable? ANSWER A. Paragraph (5). B. Paragraph (7). C. Paragraph (12). D. Paragraph (8). 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 A. violence against a person. B. theft of property. C. illicit drug use. D. lying and falsification. According to Rule 217.12(1), Unprofessional Conduct, one example of an unsafe practice includes failing to ANSWER C. arrive at work on time twice during the last month. A temporary permit to practice nursing issued to a graduate of a board-approved nursing educational program ANSWER A. is only necessary if the nurse does NOT plan to seek employment in nursing until licensed. B. is required only for candidates for a vocational nursing license. C. allows a GN or GVN to practice independently with no other licensed nurse present in the practice setting. D. may be denied based on a licensure candidate's criminal history. When the BON considers imposing disciplinary action, it is most concerned with the nurse consistently ANSWER A. acting in the best interest of clients. B. following medical directives for patient care. C. following the policies and procedures in the employing agency. D. acting in the best interest of the physician. A nurse would be fulfilling his or her duty to safeguard patients from harm if the nurse: recognizes that a patient's condition is deteriorating, acts to stabilize the patient, and reports the patient's status to the physician. A nurse who commits an error that is a minor incident ANSWER A. must be reported immediately to the Incident-Based Peer Review Committee or to the BON if there is no peer review at the nurse's place of employment. B. should not under any circumstances be reported to the BON based on just one minor incident. C. must immediately resign from his or her place of employment so that there is no chance of the employer alleging a "pattern of nursing practice errors." D. need not be reported to the BON unless the nurse's conduct created a significant risk of physical, emotional, or financial harm to the client. A nurse would be fulfilling his or her duty to safeguard patients from harm if the nurse ANSWER A. recognizes that a patient's condition is deteriorating, acts to stabilize the patient, and reports the patient's status to the physician. B. always implements all physicians' orders completely, quickly, and without question. C. performs only those nursing tasks that specifically relate to a physician's order for a medication or treatment. D. seeks supervisor clarification before performing any procedure. 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. appropriate if the nurse seeks supervisor approval. B. a violation of professional boundaries of the nurse-client relationship. C. an example of a nurse providing patient-centered care. D. an act of beneficence when family members are not willing to care for the child. The board's Disciplinary Sanction Policy on Sexual Misconduct explains that ANSWER A. suggestive language between the nurse and patient are acceptable only in a therapeutic nursepatient relationship. B. sexual misconduct towards patients or in the workplace raises questions regarding the nurse's ability to provide safe, competent care. C. sex-related criminal activity by a nurse is a private matter and may not need to be reported to the board. D. sex between a nurse and a patient is acceptable if the patient consents. A nurse who accepts fees from a home health agency for each client he or she refers to the agency would be ANSWER A. engaging in unprofessional conduct that should be reported to the BON. B. capitalizing on an opportunity to supplement his income, with no violation of BON statutes or rules. C. in violation only if his activities become known to the other home health agencies. D. possibly violating his employer's policy, but not violating any part of the NPA or board rules. According to the BON rules, a person must hold the following level of nursing license in order to delegate tasks to unlicensed staff in Texas: ANSWER A. Licensed Vocational Nurse. B. Registered Nurse. C. Certified Nurse Aide. D. Certified Medication Aide. According to the BON rules, a person must hold the following level of nursing license in order to delegate tasks to unlicensed staff in Texas: ANSWER A. Licensed Vocational Nurse. B. Registered Nurse. C. Certified Nurse Aide. D. Certified Medication Aide. A nurse whose license has expired ANSWER 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. The board's Disciplinary Sanction Policy on Sexual Misconduct explains that ANSWER B. sexual misconduct towards patients or in the workplace raises questions regarding the nurse's ability to provide safe, competent care. A nurse witnesses another nurse slap a long-term care facility resident for refusing to take his medications. There is no Peer Review Committee in this practice setting, so the correct action to be taken by the nurse who saw the abuse is to ANSWER B. report it to the Director of Nursing and leave further action to the discretion of the DON. Which of the following situations is an example of a nurse MAINTAINING appropriate professional boundaries between the nurse and the client? A nurse ANSWER A. rewards a patient with a small stuffed mascot of his favorite football team for progress made in rehabilitation. B. responds less frequently to a demanding patient's call light. C. shares personal information regarding her recent bankruptcy because the patient seems genuinely interested. D. is personally attracted to a patient and calls and visits him on her days off "to check on how he is doing." According to the NPA section 301.403, the Peer Review Committee must report which of the following to the board? ANSWER A. Any minor incidents the nurse makes while caring for patients. B. A description of any corrective action taken against the nurse. C. The names and addresses of the Peer Review Committee members. D. An organizational chart that reflects the reported nurse's position in the agency. A professional nursing association determines that a nurse cheated on a national certification exam. The association disqualifies the nurse from being eligible to seek certification, and suspends the nurse's membership privileges for the association. According to the NPA Section 301.406, Duty of Professional Associations and Organizations to Report, the professional association ANSWER B. also has a duty to report the nurse to the BON. Board Rule 217.11, Standards of Nursing Practice, requires the nurse to "Implement measures to prevent exposure to infectious pathogens and communicable conditions." This is a standard that ANSWER A. applies to nurses working with patients with infectious diseases. B. is the basis for use of personal protective equipment. C. applies to all licensed nurses in Texas. D. can be waived in home health settings. The best method of notifying the BON about reportable violations by a nurse of the NPA and board rules is to ANSWER B. complete the reporting form on the BON website though you may remain anonymous and not provide a signature. According to Nursing Practice Frequently Asked Questions (FAQs) on the BON web page, a LVN whose duties include being on-call to triage patient concerns telephonically would be ANSWER A. exceeding his or her scope of practice because it requires the LVN to perform comprehensive (RN-level) nursing assessments on patients potentially experiencing unpredictable and unstable conditions. B. practicing within his or her scope of practice provided the LVN completed a ten-hour postlicensure course on comprehensive telephonic nursing assessments. C. practicing within his or her scope of practice if an ER physician trains the LVN to make independent medical judgment and how to perform medical screening exams. D. exceeding his or her scope of practice UNLESS a registered nurse is on-call and telephonically available to "back up" the LVN, and the RN is ultimately responsible for the decisions made by the LVN. Pending the results of the licensing examination, the GN or GVN must ANSWER A. wait 2 weeks before accepting a charge nurse role. B. accept an assignment of four patients or less. C. work under the direct supervision of a licensed LVN or RN. D. complete a nurse residency program with 80 clinical hours. 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 A. the employer terminate the nurse's employment. B. the error is subject to reporting because it contributed to the death of a patient. C. this is the nurse's first practice error and a nurse can have up to five minor incidents in a year before peer review is required. D. the nurse is remorseful and has completed remediation in the work setting, so it may be considered a minor incident. A person may not practice or offer to practice professional or vocational nursing in Texas unless the person ANSWER A. graduates from a board-approved nursing educational program in Texas. B. completes at least 500 hours of clinical practice in his or her nursing educational program. C. demonstrates basic nursing skills on the Nursing Competency Skills List. D. holds a license as required by the NPA. 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 A. the nurse needs remedial education in how to document the rationale for and response to PRN pain medications. Which of the following resources on the BON web page would assist a nurse in determining his or her scope of nursing practice? ANSWER D. Scope of Practice Decision-Making Model. A nurse was terminated from three different jobs because he or she was stealing from staff members. The nurse has no pending criminal issues and no criminal history. Though this activity does not involve patients, it may indicate that ANSWER A. the nurse will repeat similar conduct and exploit patients who trust the nurse to act in their best interest. According to the Standards of Nursing Practice, Board Rule 217.11, a comprehensive nursing assessment ANSWER D. can be completed only by a registered nurse. A school district contracts with a registered nurse (RN) to teach the staff how to monitor a student's blood glucose. The RN then observes each person perform this task correctly. The RN does not work for the school district and will not have any further contact with the staff. In this example, the RN is ANSWER A. training the staff how to perform the task of monitoring blood glucose. When a staff nurse attempts to invoke Safe Harbor, more nurses are floated to the unit to provide adequate staffing. The supervisor then tells the nurse "You must withdraw your request for Safe Harbor. It is no longer valid because we fixed the problem." Does this statement accurately reflect the Safe Harbor rule? ANSWER A. Yes. If the issue that caused the nurse to request Safe Harbor is resolved, the nurse cannot ask the Peer Review Committee to review it. B. Yes. The supervisor is correct and the nurse can be reported to the board if he or she refuses to withdraw the request for Safe Harbor. C. No. Resolving the immediate issue does not invalidate the request. It is the nurse's choice whether or not to continue with the request for a Peer Review Committee decision. 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? ANSWER 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. A nurse's history of substance use disorder or mental illness is relevant to nursing licensure as it may indicate ANSWER A. the nurse's current lack of fitness for duty. 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 A. true. The nurse must work the entire currently posted work schedule before he can quit his present job. B. true. It would be "patient abandonment" if the nurse does not complete the current schedule. The nurse could be reported to the BON. C. 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. D. false. The nurse only has to work for two more weeks of the schedule before he can quit. An Incident-Based Peer Review Committee ANSWER D. may make a determination as to whether or not a nurse should be terminated from employment for practice-related nursing errors. NO SE SI ESTA BIEN !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! A nurse was reported to the BON by two different employers regarding multiple practice errors. The BON may determine that the nurse's conduct demonstrates a pattern of practice that ANSWER A. complies with the standard to provide nursing services without discrimination of the client served. B. violates professional boundary regulations because the nurse has two employers. C. results in immediate disciplinary action because the second complaint validates the first. D. indicates the nurse’s continued practice poses a risk of harm and may endanger a client's life, health, or safety. QUESTION The functions of the BON include ANSWER A. regulating the education, licensure, and practice of nurses in Texas to ensure the safety of the public. B. lobbying members of the Texas Legislature to pass bills that are favorable to nurses. C. evaluating student D. advising currently licensed nurses about potential employment opportunities throughout the state. While a LVN has a "directed" scope of practice, this is NOT true for a RN. This means that the RN ANSWER D. is permitted to practice nursing independently within the RN's scope of practice. 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 A. the LVN must have a supervisor, as outlined in Rule 217.11, accessible at least telephonically or by some other similar means. In the NPA, "conduct subject to reporting" includes ANSWER A. conduct that causes a person to suspect that the nurse's practice is impaired by chemical dependency or drug or alcohol abuse. The integrated pattern of personal, academic, and occupational behaviors that indicate an individual is able to consistently conform his/her conduct to the requirements of the Nursing Practice Act and the Board’s rules relates to ANSWER D. the BON's rule concerning good professional character. The BON rules regarding licensure renewal require the nurse to answer eligibility questions concerning which of the following with regard to the previous two-year licensure cycle ANSWER C. whether the nurse has any criminal background that must be revealed. Action by a nurse that would constitute unprofessional conduct according to Board Rule 217.12 Unprofessional Conduct describes which of the following? ANSWER A. Implementing measures to promote a safe environment for clients and others. B. Obtaining instruction and supervision as needed when implementing nursing procedures or practices. C. Respecting the clients right to privacy by protecting confidential information. D. Failing to repay a guaranteed student loan. ………………………………………… A nurse is reported to the BON for cashing checks from a patient's checking account in excess of $70,000. According to the NPA and board rules, the nurse's conduct will likely be viewed by the BON as evidence that the nurse ANSWER A. provided care that complied with the NPA and board rules in any practice setting. B. caused harm to the patient and the patient's family by violating the professional boundaries of the nurse-patient relationship. C. caused harm to the patient by providing nursing services when he or she lacked fitness to practice due to impairment by drugs or alcohol. D. provided care that allowed an elderly patient to live in her own home until her natural death. 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 A. the case proceed and the board's charges be deemed to be true. What type of license is required to utilize the two BON rules on delegation to unlicensed personnel? ANSWER A. Registered Nurse. The BON rules relating to unprofessional conduct is intended to ANSWER D. protect clients from unethical or illegal conduct. The BON differs from nursing and healthcare specialty associations since the BON ANSWER D. protects and promotes the welfare of the people of Texas. 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 A. 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. When making nursing assignments to other LVNs and RNs, the Board Rule 217.11 Standards of Nursing Practice, requires the nurse in a supervisory position to take into consideration all of the following EXCEPT: ANSWER C. the state where the nurse was licensed. Which of the following statements correctly reflects Board Rule 217.20 regarding the Safe Harbor Peer Review? ANSWER B. 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. 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 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. 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? ANSWERA 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 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." The Scope of Practice Decision-Making Model does NOT require a nurse to consider ANSWER D. familiarity of the patient and family with the procedure being implemented. In order for a nurse to appropriately carry out his or her "duty to the patient," the nurse must ANSWER A. demonstrate strict adherence to professional dress code requirements. B. follow facility policies, whether they are congruent with what the nurse learned in school or not. C. consistently act in the best interest of every patient under the nurse's care. IDK THO LOLZ D. achieve a score of 70 percent or better on his or her annual employment performance evaluation. Which of the following activities would violate a provision of the NPA and Board Rule 217.11(2), Standards of Nursing Practice, relating to the practice of nursing by a LVN? ANSWER B. Practicing in any setting without an appropriate practice supervisor who is at least telephonically available. The purpose of the Position Statements, guidelines and other documents in the Nursing Practice section of the BON webpage is to guide nurses in ANSWER B. making decisions related to their patient care assignments. According to Board Rule 213.27, Good Professional Character, which of the following actions by a nurse demonstrates that the nurse possesses good professional character? ANSWER B. The nurse realizes that he or she has given a medication to the wrong patient and immediately notifies the physician and documents the medication in the patient's chart. When an applicant for a nursing license receives a final conviction for first degree murder, the NPA mandates that the applicant ANSWER C. will not be eligible to apply for an initial nursing license until five years after being released from community supervision or parole.