Texas Nursing Jurisprudence Exam (NJE) — Questions and Answers

Question 1: An incident-based peer review committee is convened to review the practice of a Registered Nurse (RN). Which of the following is a specific requirement for the composition of this committee according to the Nursing Practice Act?

At least two-thirds of the members must be Registered Nurses, and only RNs may vote. (Correct answer)
Exactly half the members must be LVNs and half must be RNs.
The majority of members must be from outside the employing facility to ensure impartiality.
The committee must be chaired by a physician.

Correct answer: At least two-thirds of the members must be Registered Nurses, and only RNs may vote.

Texas Occupations Code §303.003(c) specifies that a peer review committee reviewing the practice of professional nursing must have registered nurses as two-thirds of its members, and only registered nurses are permitted to be voting members.

Question 2: What is generally the first step in the licensing process?

Paying a registration fee
Completing an application (Correct answer)
Scheduling a meeting with a supervisor
Completing an internship

Correct answer: Completing an application

The licensing process formally begins with the submission of an application. This initial step provides the regulatory board with essential personal, educational, and experiential information about the applicant. It allows the board to verify eligibility and initiate the review process before any further requirements, such as exams or fees, are addressed.

Question 3: A licensed vocational nurse (LVN) works in a long-term care facility where the majority of residents are over the age of 65. According to Texas BON rules, what specific targeted continuing education must this nurse complete for each two-year renewal period?

A 4-contact hour course on pain management.
A 2-contact hour course on nursing jurisprudence and ethics.
A 2-contact hour course related to the care of older adults. (Correct answer)
A 2-contact hour course on forensic evidence collection.

Correct answer: A 2-contact hour course related to the care of older adults.

Texas BON Rule 216.3(h) requires nurses whose practice includes older adult or geriatric populations to complete at least 2 contact hours of CNE relating to the care of older adults for each renewal cycle.

Question 4: Which of the following might be required for license renewal?

Continuing education or training credits (Correct answer)
Volunteer hours
A background check
Proof of employment

Correct answer: Continuing education or training credits

Continuing education (CE) or training credits are a common and crucial requirement for professional license renewal. These credits ensure that professionals stay updated with the latest advancements, research, regulations, and best practices in their field. This ongoing learning demonstrates a commitment to maintaining competency and enhancing skills, which is vital for providing high-quality and safe services to the public.

Question 5: Which of the following might be required for license renewal?

Proof of employment
Continuing education or training credits (Correct answer)
A background check
Volunteer hours

Correct answer: Continuing education or training credits

Question 6: Who defines the scope of practice for licensed healthcare professionals?

Professional associations
State and federal laws (Correct answer)
The individual professional
Insurance companies

Correct answer: State and federal laws

The scope of practice for licensed healthcare professionals is primarily defined and regulated by governmental bodies through state and federal laws, as well as professional licensing boards. These legal frameworks establish the educational requirements, competencies, and boundaries for each profession to protect the public. Individual professionals or associations do not have the authority to unilaterally define these limits.

Question 7: Which of the following would be considered unprofessional conduct under Texas BON Rule 217.12 and could result in disciplinary action?

Refusing a patient assignment due to a lack of experience after notifying the supervisor.
Accepting a sealed box of chocolates from a patient's family during the holidays.
Failing to document a patient's response to a PRN pain medication. (Correct answer)
Having a disagreement with a coworker about the unit's staffing schedule.

Correct answer: Failing to document a patient's response to a PRN pain medication.

BON Rule 217.12 defines unprofessional conduct to include inaccurately or incompletely reporting and documenting, which covers failing to document a client's response to medication. While accepting some gifts can cross boundaries, a simple box of chocolates is not typically considered exploitation. Refusing an assignment appropriately is a patient safety measure, and workplace disagreements are not typically a BON matter.

Question 8: Which of the following situations would obligate a home health agency that regularly employs 12 nurses (7 RNs, 5 LVNs) to conduct an incident-based nursing peer review?

A nurse requests a schedule change due to personal reasons.
A physician disagrees with a nurse's documented assessment.
A patient provides a positive satisfaction survey about a nurse.
A nurse commits five minor incidents within a 12-month period. (Correct answer)

Correct answer: A nurse commits five minor incidents within a 12-month period.

Texas Administrative Code Rule 217.16(e) specifies that in practice settings with nursing peer review, a nurse must be reported to the peer review committee if they commit five minor incidents within a 12-month period, as this may indicate a pattern of practice that poses a risk of harm.

Question 9: Which of the following is a key factor in determining scope of practice?

Amount of time in the profession
Professional experience
Educational background and training (Correct answer)
Personal interest in certain procedures

Correct answer: Educational background and training

A healthcare professional's scope of practice is fundamentally determined by their formal education, specialized training, and demonstrated competencies. These qualifications dictate what procedures they are legally authorized and prepared to perform, ensuring they have the necessary knowledge and skills. While experience is valuable, it must be within the boundaries established by their foundational education and licensure.

Question 10: A Registered Nurse (RN) in Texas is renewing their license for the third time. In addition to the standard continuing competency requirement, which of the following is a mandatory, targeted continuing nursing education (CNE) requirement they must meet for this specific renewal cycle?

2 contact hours relating to nursing jurisprudence and nursing ethics. (Correct answer)
2 contact hours related to older adult or geriatric populations.
5 contact hours in pharmacotherapeutics.
A one-time human trafficking prevention course.

Correct answer: 2 contact hours relating to nursing jurisprudence and nursing ethics.

According to the Texas Board of Nursing (BON) rules, all nurses are required to complete at least 2 contact hours of CNE relating to nursing jurisprudence and nursing ethics before the end of every third two-year licensing period.

Question 11: A registered nurse (RN) is assigned to a busy medical-surgical unit. A physician gives the RN a verbal order for a medication that the nurse is unfamiliar with. According to the Texas Board of Nursing (BON) Rules and Regulations, which of the following actions should the nurse take first?

Refuse to administer the medication because it was a verbal order.
Delegate the administration of the medication to another experienced RN.
Administer the medication as ordered and document the verbal order.
Research the medication's rationale and effects before administration. (Correct answer)

Correct answer: Research the medication's rationale and effects before administration.

BON Rule 217.11, Standards of Nursing Practice, requires nurses to know the rationale for and the effects of medications and treatments and to correctly administer them. This standard implies that before administering an unfamiliar medication, the nurse has a duty to obtain the necessary knowledge. Refusing based solely on it being a verbal order isn't the primary issue, and delegating does not absolve the primary nurse of responsibility.

Question 12: Which of the following is an acceptable alternative to completing 20 contact hours of continuing nursing education (CNE) for license renewal in Texas?

Serving as a preceptor for a nursing student for one semester.
Publishing an article in a non-peer-reviewed nursing blog.
Attending a national nursing conference without receiving official contact hours.
Achieving or maintaining a Board-approved national nursing certification in the nurse's area of practice. (Correct answer)

Correct answer: Achieving or maintaining a Board-approved national nursing certification in the nurse's area of practice.

The Texas Board of Nursing (BON) Rule 216.3 allows a nurse to satisfy their continuing competency requirement by either completing 20 CNE contact hours OR by demonstrating the achievement, maintenance, or renewal of a Board-approved national nursing certification in their practice area.

Question 13: What is the scope of practice for healthcare professionals?

The area where a professional works
The legal limits within which a professional may practice (Correct answer)
The expectations set by patients
A professional’s personal decision on what services to offer

Correct answer: The legal limits within which a professional may practice

The scope of practice defines the services, procedures, and actions that a licensed healthcare professional is legally permitted to perform. These limits are established by state and federal laws, regulations, and professional boards to ensure patient safety and quality of care. It is not based on personal decisions or patient expectations, but rather on legal and regulatory frameworks.

Question 14: A Registered Nurse on a busy unit delegates the task of ambulating a stable post-operative patient to an Unlicensed Assistive Person (UAP). The RN provides clear instructions on technique and weight-bearing status. Later, the RN observes the UAP struggling to assist the patient, who appears dizzy. According to Rule 217.11, Standards of Nursing Practice, what is the RN's most critical next action?

Document the UAP's poor performance in the patient's chart.
Report the UAP to the charge nurse at the end of the shift.
Instruct the UAP to return the patient to bed and try again later.
Immediately intervene to ensure the patient's safety. (Correct answer)

Correct answer: Immediately intervene to ensure the patient's safety.

Rule 217.11 requires the nurse to implement measures to promote a safe environment for clients. The delegating nurse retains responsibility for supervising the delegated task and for the patient's outcome. Observing an unsafe situation requires immediate intervention to protect the patient from harm, which is the nurse's primary duty and takes precedence over reporting or documentation at that moment.

Question 15: Which of the following is a common requirement for obtaining a professional license?

Writing an essay
Attending an orientation session
Passing an exam or certification (Correct answer)
Submitting a resume

Correct answer: Passing an exam or certification

Professional licenses are granted to individuals who demonstrate a required level of competency and knowledge in their field. Passing a standardized exam or certification is the primary method used by licensing boards to assess an applicant's qualifications, ensuring they meet the necessary professional standards for safe and effective practice.

Question 16: A nurse is ordered to float to the pediatric unit but has only worked with adult patients for the past 10 years. The nurse feels unqualified and unsafe to accept the assignment. To be protected from employer retaliation and potential BON disciplinary action, the nurse should invoke which of the following?

Conscientious Objection
Patient Abandonment Protocol
Safe Harbor (Correct answer)
The Grievance Process

Correct answer: Safe Harbor

Safe Harbor, as defined in BON Rule 217.20 and the Nursing Peer Review Law, protects a nurse from employer retaliation and BON discipline when the nurse makes a good faith request for peer review of an assignment that they believe would be a violation of their duty to a patient. This is the appropriate mechanism for a nurse who believes an assignment is unsafe due to lack of competency.

Question 17: A nurse who invokes Safe Harbor in good faith when requested to accept an assignment is protected from what action by the employer?

A future assignment to the same patient or unit.
A performance review of the nurse's clinical skills.
Disciplinary action or retaliation for making the request. (Correct answer)
A requirement to complete the detailed Comprehensive Written Request form.

Correct answer: Disciplinary action or retaliation for making the request.

The primary purpose of the Safe Harbor provision in the Nursing Practice Act is to protect a nurse from employer retaliation, suspension, termination, discipline, or discrimination for making a good faith request for a peer review of an assignment or conduct. While the nurse is still required to complete the necessary paperwork and may be subject to normal performance reviews or future assignments, they cannot be punished simply for invoking the Safe Harbor process.

Question 18: In Texas, reports of suspected child abuse or neglect by a nurse should be made to:

Texas Board of Nursing
Texas Medical Board
Texas Department of Family and Protective Services (DFPS) (Correct answer)
Local hospital administration only

Correct answer: Texas Department of Family and Protective Services (DFPS)

The Texas Department of Family and Protective Services (DFPS) is the designated agency to receive all reports of suspected child abuse or neglect in Texas.

Question 19: A nurse manager on a long-term care unit needs to delegate the task of obtaining vital signs for a stable resident to an Unlicensed Assistive Personnel (UAP). Which of the following is NOT a requirement for the RN before delegating this task according to BON Rules?

The task must not require the UAP to exercise professional nursing judgment.
The RN must provide adequate supervision after the task has been delegated.
The RN must ensure the UAP has demonstrated competency in performing the task.
The RN must personally perform the first set of vital signs for the shift. (Correct answer)

Correct answer: The RN must personally perform the first set of vital signs for the shift.

BON Rules 224 and 225, regarding delegation, require the RN to assess the client's needs, ensure the task is appropriate for delegation, verify the UAP's competency, and provide supervision. There is no specific rule stating the RN must take the first set of vitals themselves before delegating, as long as the resident is stable and the delegation is deemed safe and appropriate by the RN's assessment.

Question 20: A registered nurse (RN) in a home health setting is caring for a client with a stable, predictable condition. According to Texas BON Rule 225, which of the following tasks is strictly prohibited from being delegated to an Unlicensed Assistive Person (UAP)?

Reinforcement of health teaching that was previously provided by the RN.
Assisting the client with self-administered medications.
Performing a physical assessment to determine a change in the client's condition. (Correct answer)
Assisting with tube feedings through a permanently placed gastrostomy tube.

Correct answer: Performing a physical assessment to determine a change in the client's condition.

According to Texas Board of Nursing (BON) Rule 225.13, nursing tasks that require professional nursing judgment, such as physical assessment, formulation of a nursing care plan, and evaluation of the client's response, are prohibited from delegation. Assisting with self-administered medications, reinforcing teaching, and assisting with feedings via a permanent tube are generally delegable under specific conditions for a stable client.

Question 21: A registered nurse (RN) in a busy ICU is assigned a patient who requires a complex dressing change that the RN has not been trained on. The charge nurse insists the RN perform the procedure due to staffing shortages. According to the Texas Nursing Practice Act, what is the most appropriate initial action for the RN to take?

Invoke Safe Harbor to initiate a peer review of the assignment's safety before accepting or rejecting it. (Correct answer)
Refuse the assignment and document the refusal in the patient's chart.
Delegate the dressing change to a licensed vocational nurse (LVN) who claims to have experience.
Attempt the procedure using the hospital's online policy and procedure manual as a guide.

Correct answer: Invoke Safe Harbor to initiate a peer review of the assignment's safety before accepting or rejecting it.

The Texas Nursing Practice Act provides for 'Safe Harbor,' a process that protects a nurse from employer retaliation when they make a good faith request for peer review of an assignment they believe could violate their duty to a patient. Invoking Safe Harbor must be done before accepting the assignment and allows a committee of peers to determine the assignment's safety without jeopardizing the nurse's license. Attempting the procedure without competency, simply refusing without invoking protections, or improperly delegating are not the appropriate first steps.

Question 22: A nurse arrives for their shift appearing intoxicated and with slurred speech. The charge nurse removes the nurse from patient care duties. According to the Nursing Practice Act, this nurse's behavior is grounds for disciplinary action due to:

Failure to complete continuing education requirements.
Lack of fitness to practice due to a physical health condition.
Violation of hospital policy regarding employee conduct.
Intemperate use of alcohol or drugs that could endanger a patient. (Correct answer)

Correct answer: Intemperate use of alcohol or drugs that could endanger a patient.

The Texas Occupations Code §301.452(b)(9) specifies that 'intemperate use of alcohol or drugs that the board determines endangers or could endanger a patient' is grounds for disciplinary action. The definition of 'intemperate use' includes being on duty or on call while under the influence.

Question 23: A Texas nurse is convicted of a misdemeanor involving moral turpitude. Within how many days must the nurse self-report this conviction to the Texas BON?

60 days
30 days (Correct answer)
90 days
10 days

Correct answer: 30 days

Texas Occupations Code requires nurses to self-report criminal convictions to the BON within 30 days of the conviction.

Question 24: How often are professional licenses typically renewed?

Every 5 years
Every 1 to 2 years (Correct answer)
They do not require renewal
Every 10 years

Correct answer: Every 1 to 2 years

Professional licenses are typically renewed every 1 to 2 years to ensure practitioners remain current with evolving standards, regulations, and best practices in their field. This regular renewal cycle allows licensing boards to verify ongoing competency, compliance, and commitment to professional development, thereby protecting public safety and maintaining professional integrity.

Question 25: According to the Texas BON Rules, how many contact hours of continuing nursing education (CNE) are required for a nurse to renew their license every two years, and what is one of the mandatory topics that must be completed every third renewal cycle?

30 contact hours, with no specific mandatory topics.
20 contact hours, with 2 hours on nursing jurisprudence and ethics. (Correct answer)
25 contact hours, with 3 hours on Texas nursing law.
15 contact hours, with 1 hour on workplace violence.

Correct answer: 20 contact hours, with 2 hours on nursing jurisprudence and ethics.

Texas Board of Nursing Rule 216.3 requires nurses to complete 20 contact hours of CNE in their area of practice every two years for licensure renewal. Additionally, the rule mandates that every nurse must complete at least 2 contact hours of CNE related to nursing jurisprudence and nursing ethics before the end of every third two-year licensing period.

Question 26: A peer review committee in Texas determines that a nurse's conduct was potentially unsafe but does not report it to the BON. Which statement best describes this situation?

Peer review findings are always confidential and never reportable
The committee may be in violation of mandatory reporting requirements under Texas law (Correct answer)
Only the BON can initiate investigations without peer review committee referral
Peer review committees have absolute discretion over whether to report to the BON

Correct answer: The committee may be in violation of mandatory reporting requirements under Texas law

Texas law establishes specific circumstances where peer review committees are required to report unsafe nurse conduct to the BON, and failure to do so may violate mandatory reporting obligations.

Question 27: Which of the following behaviors, observed in a colleague, would most clearly constitute unprofessional conduct under Texas BON Rule 217.12 and require reporting?

Discussing a desire to change specialties to a less stressful environment.
Frequently volunteering to administer narcotic medications for other nurses' patients. (Correct answer)
Having a single glass of wine during an off-duty lunch break, several hours before their shift begins.
Complaining about fatigue due to working frequent overtime shifts.

Correct answer: Frequently volunteering to administer narcotic medications for other nurses' patients.

Rule 217.12 defines unprofessional conduct to include diverting or attempting to divert drugs. Frequently offering to administer narcotics for others, especially when not assigned, is a significant red flag for drug diversion. While the other options are not in themselves unprofessional conduct, the pattern of seeking access to narcotics is highly suspicious and reportable to protect patient safety.

Question 28: An RN working in an acute care hospital delegates the task of obtaining a routine blood glucose level on a stable diabetic patient to a UAP. The RN has already verified the UAP's competency. After the UAP performs the task, who retains ultimate accountability for the patient's overall outcome related to this task?

The delegating RN, who is accountable for the delegation process and the client's response. (Correct answer)
The UAP, because they accepted the task and performed it.
The physician who ordered the blood glucose check.
The hospital administration, as they are the employer.

Correct answer: The delegating RN, who is accountable for the delegation process and the client's response.

Texas BON Rules 224.5 and 225.5 state that the RN is responsible and accountable for the safe and appropriate delegation of nursing tasks. While the UAP is responsible for performing the task correctly, the delegating RN retains accountability for the entire process, including the decision to delegate, supervision, and the patient's overall outcome.

Question 29: A hospital that regularly employs 30 nurses, including 20 RNs and 10 LVNs, establishes a nursing peer review committee. According to the Texas Occupations Code, what is the primary purpose of this committee?

To mediate workplace disputes between nurses and other healthcare professionals.
To evaluate nursing services and determine if a nurse's conduct requires reporting to the Board of Nursing. (Correct answer)
To approve and oversee continuing nursing education (CNE) for the facility's staff.
To determine the nurse's employment status and issue disciplinary action.

Correct answer: To evaluate nursing services and determine if a nurse's conduct requires reporting to the Board of Nursing.

The Texas Occupations Code §303.001(5) defines peer review as the evaluation of nursing services, the qualifications of a nurse, the quality of patient care, and the merits of a complaint, ultimately to determine or recommend whether a report to the Board of Nursing is warranted. The committee does not make employment decisions, though the employer may use its findings to inform their own decisions.

Question 30: A Texas nurse who reports a peer's suspected impairment to the BON in good faith later learns the suspicion was unfounded. The nurse faces:

A mandatory ethics hearing before the BON
Automatic license suspension for making a false report
Potential civil liability to the reported nurse
No legal liability, as good faith reporting provides immunity (Correct answer)

Correct answer: No legal liability, as good faith reporting provides immunity

Texas law protects good faith reporters from civil liability even if the report ultimately proves unfounded, as long as the report was made honestly and without malice.

Question 31: What should a manager do after delegating a task?

Forget about the task
Delegate the task to multiple people
Provide clear deadlines and check-ins (Correct answer)
Micro-manage the process

Correct answer: Provide clear deadlines and check-ins

After delegating a task, a manager should establish clear expectations regarding deadlines and implement a system for periodic check-ins or progress reports. This ensures accountability, allows for timely support or adjustments if needed, and helps the manager monitor the task's progression without micromanaging. It's about providing oversight and support, not forgetting the task or constantly hovering, to ensure successful completion.

Question 32: A Texas nurse discovers that a coworker has been falsifying patient medication records. The nurse's legal obligation is to:

Document personal observations but take no formal action
Report the falsification to the employing facility and potentially to the BON (Correct answer)
Notify the patient's family immediately before reporting to anyone else
Confront the coworker privately and give them a chance to correct the records

Correct answer: Report the falsification to the employing facility and potentially to the BON

Falsifying medical records is unsafe practice that must be reported internally to the facility, and to the BON if the facility does not address it.

Question 33: A registered nurse is randomly selected for a continuing competency audit by the Texas Board of Nursing. Which of the following is the most appropriate documentation to submit as proof of completing a CNE contact hour course?

A certificate of completion that includes the provider's name, date, course title, and number of contact hours awarded. (Correct answer)
The registration receipt showing payment for the CNE course.
A copy of the PowerPoint slides from the educational presentation.
A signed letter from a colleague who also attended the course.

Correct answer: A certificate of completion that includes the provider's name, date, course title, and number of contact hours awarded.

According to BON Rule 216.4, the appropriate proof of CNE completion is a certificate that contains specific information: the nurse's name, course title, date, number of contact hours, provider name, and accreditation information. Other items like colleague letters or payment receipts are not sufficient proof.

Question 34: A nurse serves on a nursing peer review committee and participates in the evaluation of a colleague's practice. The committee proceedings are conducted in good faith. What protection is this nurse afforded under the Texas Occupations Code?

Complete anonymity, where their identity is never revealed to the nurse being reviewed.
Immunity from civil liability for any act or recommendation made without malice during the peer review process. (Correct answer)
Guaranteed promotion within the facility for their service.
The authority to independently report the nurse to the BON, regardless of the committee's findings.

Correct answer: Immunity from civil liability for any act or recommendation made without malice during the peer review process.

Texas Occupations Code §303.006 grants immunity from civil liability to members of a nursing peer review committee for any act, statement, determination, or recommendation made in the course of peer review, provided it is done in good faith and without malice.

Question 35: A newly graduated nurse passes the NCLEX-RN in July and is issued their initial Texas license on August 1st. Their first license renewal is due two years later. Regarding continuing competency requirements for this very first renewal, which statement is correct?

The nurse must complete 10 contact hours, which is half the standard requirement.
The nurse is only required to complete the 2-hour Jurisprudence and Ethics course.
The nurse is exempt from all continuing competency requirements. (Correct answer)
The nurse must complete the full 20 contact hours, including any targeted requirements.

Correct answer: The nurse is exempt from all continuing competency requirements.

According to Texas BON Rule 216.8 and other BON publications, a nurse is exempt from the continuing competency requirement for the first license renewal after initial licensure by examination. The requirement to complete 20 contact hours begins with the second renewal.

Question 36: A nurse who reports unsafe nursing practice to the Texas BON and is subsequently terminated by the employer may be protected under:

HIPAA privacy regulations
Federal OSHA standards only
The Texas Whistleblower Act and Occupations Code anti-retaliation provisions (Correct answer)
The Americans with Disabilities Act (ADA)

Correct answer: The Texas Whistleblower Act and Occupations Code anti-retaliation provisions

Texas law, including the Occupations Code anti-retaliation provisions, protects nurses who report violations from retaliation such as termination by their employer.

Question 37: Which of the following events MUST a Texas nurse report to the BON as a mandatory self-reporting obligation?

Receiving a verbal warning from a supervisor
Failing to complete optional hospital training on time
Being named as a witness in a civil lawsuit
Having a nursing license suspended in another state (Correct answer)

Correct answer: Having a nursing license suspended in another state

Texas requires nurses to self-report any disciplinary action taken against their license by another state's board, including suspensions.

Question 38: According to the Texas Board of Nursing, the "Five Rights of Delegation" are critical for ensuring patient safety. Which of the following is NOT one of these five rights?

Right Circumstance
Right Task
Right Person
Right Documentation (Correct answer)

Correct answer: Right Documentation

The Five Rights of Delegation are Right Task, Right Circumstance, Right Person, Right Direction/Communication, and Right Supervision/Evaluation. While proper documentation of the delegated task is a crucial part of the nursing process, "Right Documentation" is not one of the official Five Rights of Delegation.

Question 39: Under Texas Board of Nursing Rule 217.11, Standards of Nursing Practice, a nurse has a mandatory duty to report another nurse to the Board of Nursing (BON) or a peer review committee under which of the following circumstances?

The nurse is frequently rude to coworkers but provides clinically excellent patient care.
The nurse's conduct leads to a reasonable suspicion that their practice is impaired by substance abuse. (Correct answer)
The nurse consistently clocks in five minutes late for their shift, creating a brief report delay.
The nurse has a personal, non-violent misdemeanor conviction unrelated to nursing practice.

Correct answer: The nurse's conduct leads to a reasonable suspicion that their practice is impaired by substance abuse.

The Texas Nursing Practice Act and Board Rules mandate reporting when a nurse has reasonable cause to suspect that another nurse's practice is impaired by chemical dependency or substance abuse. While rudeness and tardiness are unprofessional, they do not typically meet the threshold for mandatory reporting unless they directly impact patient safety in a reportable way. Similarly, a misdemeanor unrelated to nursing may not require reporting, whereas impairment from substance abuse poses a direct threat to patient safety and is explicitly defined as conduct subject to reporting.

Question 40: An RN determines the need to delegate a task and provides clear, concise instructions to a UAP, including the expected results and when to report back. This action by the RN fulfills which of the Five Rights of Delegation?

Right Task
Right Direction/Communication (Correct answer)
Right Supervision/Evaluation
Right Circumstance

Correct answer: Right Direction/Communication

Providing clear, concise, and complete instructions about the task, including objectives, limits, and expectations, directly relates to the Right Direction/Communication. This ensures the UAP understands exactly what to do, how to do it, and what to report, minimizing the chance of error.

Question 41: If a professional license is suspended, what is generally required to reinstate it?

Paying a reinstatement fee
Reapplying for the license from the beginning
Meeting certain conditions or corrective actions (Correct answer)
Nothing, it automatically reinstates

Correct answer: Meeting certain conditions or corrective actions

When a professional license is suspended, reinstatement is not automatic and usually requires the licensee to address the specific issues that led to the suspension. This often involves fulfilling certain conditions, completing corrective actions, or demonstrating rehabilitation as mandated by the licensing board. These steps ensure that the underlying problems are resolved before the individual can safely resume practice.

Question 42: Which of the following is a critical element for successful delegation?

Giving vague instructions
Trusting the delegate to complete the task (Correct answer)
Supervising every step
Only assigning trivial tasks

Correct answer: Trusting the delegate to complete the task

Successful delegation requires the delegator to trust the delegate's competence and commitment to complete the assigned task. While clear instructions and appropriate supervision are important, an underlying trust empowers the delegate and fosters a sense of ownership, which is crucial for effective task completion and professional development. Without trust, delegation often devolves into micromanagement, undermining its benefits.

Question 43: What could happen if a healthcare provider works outside their scope of practice?

Their patient outcomes improve
They gain more experience
They may receive extra pay
They could face legal and disciplinary actions (Correct answer)

Correct answer: They could face legal and disciplinary actions

Practicing outside one's defined scope of practice is a serious professional offense. Healthcare providers who exceed their legal limits can face severe consequences, including license suspension or revocation, fines, civil lawsuits for malpractice, and even criminal charges depending on the nature of the transgression. Adhering to the scope of practice is essential for patient safety and legal compliance, protecting both the provider and the public.

Question 44: A nurse is audited by the Texas Board of Nursing for continuing competency. For how long is the nurse required to keep records of their CNE activities?

For one renewal period (2 years).
Indefinitely.
For three consecutive renewal periods (6 years). (Correct answer)
For two renewal periods (4 years).

Correct answer: For three consecutive renewal periods (6 years).

According to Texas Board of Nursing Rule 216.7, nurses are responsible for keeping a record of all CNE activities for a minimum of three consecutive renewal periods, which equates to six years.

Question 45: Under Texas BON Rule 217.11, Standards of Nursing Practice, a nurse's duty to a client includes clarifying any order or treatment the nurse has reason to believe is inaccurate or contraindicated. What is the primary purpose of this standard?

To act as a patient advocate and prevent harm. (Correct answer)
To protect the nurse from liability.
To challenge the physician's authority.
To ensure accurate billing for procedures.

Correct answer: To act as a patient advocate and prevent harm.

Rule 217.11(1)(N) requires nurses to clarify any order or treatment regimen they believe to be inaccurate, non-efficacious, or contraindicated. This standard is fundamentally based on the nurse's role as a patient advocate whose primary commitment is to the patient's safety and well-being. By questioning potentially harmful orders, the nurse acts as a critical safety check in the healthcare system to prevent errors and adverse events.

Question 46: To maintain licensure, all nurses in Texas are required to complete 20 hours of continuing education every two years. Which of the following is also a mandatory continuing education requirement for every third license renewal cycle?

Two contact hours related to forensic evidence collection.
A minimum of four hours on Texas-specific communicable diseases.
Two contact hours related to nursing jurisprudence and nursing ethics. (Correct answer)
A course on the latest advancements in pharmacology.

Correct answer: Two contact hours related to nursing jurisprudence and nursing ethics.

The Texas Board of Nursing requires all nurses to complete 2 contact hours of continuing education on nursing jurisprudence and ethics before the end of every third two-year licensing period. While other specific requirements exist (like forensic evidence for ER nurses or geriatrics for those working with older adults), the jurisprudence and ethics course is a recurring requirement for all nurses every six years (every third renewal).

Question 47: Under the standards of nursing practice in Texas (Rule 217.11), a nurse's responsibility to a client includes which of the following?

Providing personal contact information for follow-up questions after discharge.
Ensuring the client has the best possible insurance coverage for their care.
Implementing measures to promote a safe environment for the client. (Correct answer)
Making all healthcare decisions on behalf of an indecisive client.

Correct answer: Implementing measures to promote a safe environment for the client.

BON Rule 217.11, Standards of Nursing Practice, explicitly states that all nurses shall 'implement measures to promote a safe environment for clients and others.' The other options are outside the nurse's scope of practice or professional boundaries. Financial matters are not a nursing responsibility, making decisions for a client violates their autonomy, and providing personal information is a boundary violation.

Question 48: A nurse successfully obtains an initial national certification in a nursing specialty from a certifying body approved by the Texas BON. How does this achievement apply to their Texas CNE requirement for the renewal period in which it was earned?

It fulfills the entire 20-contact-hour CNE requirement for that renewal period. (Correct answer)
It does not count towards CNE unless the certification exam was taken in Texas.
It fulfills the mandatory 2 hours of Jurisprudence and Ethics CNE, but not the other 18 hours.
It provides 10 of the required 20 contact hours.

Correct answer: It fulfills the entire 20-contact-hour CNE requirement for that renewal period.

Texas BON Rule 216.3 allows a nurse to meet the entire 20-contact-hour requirement by obtaining, maintaining, or renewing a national nursing certification in their area of practice from a BON-approved certifying body.

Question 49: A nurse discovers a coworker diverting controlled substances from the medication cart. The nurse's FIRST legal obligation is to:

Report directly to the DEA
Confront the coworker and document the conversation
Secure the medication cart and report to the charge nurse or supervisor (Correct answer)
Contact the patient whose medications were diverted

Correct answer: Secure the medication cart and report to the charge nurse or supervisor

The immediate priority is patient safety and internal reporting to a supervisor, who will initiate proper procedures including notification of appropriate authorities.

Question 50: Under Texas mandatory reporting laws, which statement best describes the nurse's duty to report known patient abuse in a healthcare facility?

Reporting is required only for nurses in supervisory positions
Reporting is the physician's responsibility, not the nurse's
All nurses are mandatory reporters and must report known or suspected patient abuse (Correct answer)
Reporting is optional if the nurse believes the patient is not seriously harmed

Correct answer: All nurses are mandatory reporters and must report known or suspected patient abuse

Under Texas Health and Safety Code, all nurses are mandatory reporters and are legally obligated to report known or suspected patient abuse regardless of their role.

Question 51: A nurse believes an assignment from a supervisor would violate their duty to a patient and could potentially violate the Nursing Practice Act. To be protected from employer retaliation, the nurse invokes Safe Harbor. When must the nurse invoke this protection?

Prior to engaging in the conduct or assignment for which peer review is requested. (Correct answer)
After discussing the concern with the patient's family.
Within 24 hours after completing the assignment.
At any point during the nurse's employment at the facility.

Correct answer: Prior to engaging in the conduct or assignment for which peer review is requested.

According to BON Rule 217.20, Safe Harbor must be invoked *prior* to engaging in the conduct or assignment. It can be invoked when the assignment is made or at any time during the work period if the initial assignment changes in a way that the nurse believes could cause patient harm.

Texas Nursing Jurisprudence Exam (NJE)

The Texas Nursing Jurisprudence Exam (NJE) is required by the Texas Board of Nursing for all nursing licensure applicants, testing knowledge of the Texas Nursing Practice Act, BON rules, and related legal standards.

Questions

120 min

Time Limit

75%

To Pass

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Exam Rules

You can skip questions and return to them later
Flag questions for review before submitting
No feedback shown until you submit the entire exam
Unanswered questions count as wrong — answer everything
10 pretest questions are mixed in and don't affect your score
Timer auto-submits when time runs out
Your progress is auto-saved every 30 seconds

These practice questions were written with AI tools. They are not real exam questions. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy

Sources & references

Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy

bon.texas.gov — Eligibility, fees, test delivery, exam format, retake policy, score release, time limit · verified Oct 2026