TX NJE - Texas Nursing Jurisprudence BON Rules and Regulations Questions and Answers — Questions and Answers
Question 1: 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?
- Administer the medication as ordered and document the verbal order.
- Refuse to administer the medication because it was a verbal order.
- Research the medication's rationale and effects before administration. (Correct answer)
- Delegate the administration of the medication to another experienced RN.
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 2: 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?
- 15 contact hours, with 1 hour on workplace violence.
- 25 contact hours, with 3 hours on Texas nursing law.
- 30 contact hours, with no specific mandatory topics.
- 20 contact hours, with 2 hours on nursing jurisprudence and ethics. (Correct answer)
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 3: 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 RN must ensure the UAP has demonstrated competency in performing the task.
- The task must not require the UAP to exercise professional nursing judgment.
- The RN must personally perform the first set of vital signs for the shift. (Correct answer)
- The RN must provide adequate supervision after the task has been delegated.
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 4: 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.
- 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.
- Accepting a sealed box of chocolates from a patient's family during the holidays.
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 5: 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?
- Patient Abandonment Protocol
- The Grievance Process
- Safe Harbor (Correct answer)
- Conscientious Objection
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 6: Under the standards of nursing practice in Texas (Rule 217.11), a nurse's responsibility to a client includes which of the following?
- Ensuring the client has the best possible insurance coverage for their care.
- Making all healthcare decisions on behalf of an indecisive client.
- Implementing measures to promote a safe environment for the client. (Correct answer)
- Providing personal contact information for follow-up questions after discharge.
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.
TX NJE - Texas Nursing Jurisprudence BON Rules and Regulations Questions and Answers
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?