Final exam study thing

Texas Board of Nursing Mission/Primary Purpose:

to protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in the State of Texas is competent to practice safely.

What resources are recommended when networking for a job? (See page 00 in your textbook.)

· Resources that are recommended when networking for a job include reaching out to alumini, family, linked in, staff at current workplace

4. The NCLEX-PN examination contains test items that evaluate what levels of learning? (See page 311 in your textbook.)

• Application and analysis level

Rule on Duty to Report

Nurses1 (in all positions and settings) have a legal and ethical obligation to report incompetent or impaired practice or unethical conduct of regulated health professionals. It is important for nurses to understand when to report, what to report and how to report, and to know what is legally and ethically required.

. What are the requirements of the Quality Improvement Organization (QIO) program? (See page 246 in your textbook.)

- Requirements of the QIO include: 1. improve quality of care for beneficiaries 2. protect intergigy of medicare trust fund protect benefieries by expeditiously addressing indiv complaints, notices, and appeals such as noncoverage

What is ethical conduct

Ethics are fundamental to nursing. All nurses should respect their patients, maintain patients' dignity and protect patients' rights. Nurses must create an environment of mutual trust and respect between patients and healthcare professionals

Historical Research

Examination of past events from the point of view of today; describes events in context of time, social structures, concurrent events, and key individuals

Compare and contrast fee-for-service and capitation as ways to finance health care services. (See page 223 in your textbook.) -

Fee-for-service: Physicans are paid a fee for each service they provide - Capitation: a monthly fee charged by the health care provider services for each member of the health care group for a specific set of services.

What is unsafe practice according to the NPA

Inability to Practice Safely--demonstration of actual or potential inability to practice nursing with reasonable skill and safety to clients by reason of illness, use of alcohol, drugs, chemicals, or any other mood-altering substances, or as a result of any mental or physical condition.

Continuing Education Requirements

LVNs are required to complete 20 contact hours every two years in their area of practice. CE content areas specified in the Texas nurse practice act include: Two contact hours related to forensic evidence collection for any LVN practicing in an emergency room setting (one-time requirement)

What are examples of misconduct

Misconduct — actions or conduct that include, but are not limited to: (D) Violating professional boundaries of the nurse/client relationship including but not limited to physical, sexual, emotional or financial exploitation of the client or the client's significant other(s)

What is Texas Occupation Code Chapter 303

Nursing peer review and qualifications of peer review

What is safe harbor peer review

Safe harbor nursing peer review (SHNPR), a process that protects a nurse from employerretaliation, suspension, termination, discipline, discrimination, and licensure sanction when anurse makes a good faith request for nursing peer review of an assignment or conduct the nurseis requested to perform and that the nurse believes could result in a violation of the NursingPractice Act (NPA) or Board rules. Safe harbor must be invoked prior to engaging in the conductor assignment for which nursing peer review is requested, and may be invoked at any timeduring the work period when the initial assignment changes.

What are the rights of Delegation

The "right" person. The "right" task. The "right" circumstances. The "right" directions and communication and. The "right" supervision and evaluation.

What is the Texas Peer Assistance Program (TPAP) for nurses

The Texas Peer Assistance Program for Nurses (TPAPN) is a non-punitive, confidential, and voluntary program for RNs and LVN's who have concerns related to substance use or mental health. ... However, TPAPN maintains a service contract with the Texas Board of Nursing and works cooperatively with the Board.

ethnonursing research

The study of human cultures, with a focus on a group's beliefs and practices relating to nursing care and related health behaviors. ØMadeline Leininger ØSpecific to culture factors that affect health and illness ØUsed to study health/illness within a specific culture

What is unprofessional conduct according to the NPA

The following unprofessional conduct rules are intended to protect clients and the public from incompetent, unethical, or illegal conduct of licensees. The purpose of these rules is to identify behaviors in the practice of nursing that are likely to deceive, defraud, or injure clients or the public. Actual injury to a client need not be established. These behaviors include but are not limited to: (1) Unsafe Practice--actions or conduct including, but not limited to: (A) Carelessly failing, repeatedly failing, or exhibiting an inability to perform vocational, registered, or advanced practice nursing in conformity with the standards of minimum acceptable level of nursing practice set out in §217.11 of this chapter; (B) Failing to conform to generally accepted nursing standards in applicable practice settings; (C) Improper management of client records; (D) Delegating or assigning nursing functions or a prescribed health function when the delegation or assignment could reasonably be expected to result in unsafe or ineffective client care; (E) Accepting the assignment of nursing functions or a prescribed health function when the acceptance of the assignment could be reasonably expected to result in unsafe or ineffective client care; (F) Failing to supervise the performance of tasks by any individual working pursuant to the nurse's delegation or assignment; or (G) Failure of a clinical nursing instructor to adequately supervise or to assure adequate supervision of student experiences. (2) Failure of a chief administrative nurse to follow standards and guidelines required by federal or state law or regulation or by facility policy in providing oversight of the nursing organization and nursing services for which the nurse is administratively responsible. (3) Failure to practice within a modified scope of practice or with the required accommodations, as specified by the Board in granting an encumbered license or any stipulated agreement with the Board. (4) Conduct that may endanger a client's life, health, or safety. (5) Inability to Practice Safely--demonstration of actual or potential inability to practice nursing with reasonable skill and safety to clients by reason of illness, use of alcohol, drugs, chemicals, or any other mood-altering substances, or as a result of any mental or physical condition. (6) Misconduct--actions or conduct that include, but are not limited to: (A) Falsifying reports, client documentation, agency records or other documents; (B) Failing to cooperate with a lawful investigation conducted by the Board; (C) Causing or permitting physical, emotional or verbal abuse or injury or neglect to the client or the public, or failing to report same to the employer, appropriate legal authority and/or licensing board; (D) Violating professional boundaries of the nurse/client relationship including but not limited to physical, sexual, emotional or financial exploitation of the client or the client's significant other(s); (E) Engaging in sexual conduct with a client, touching a client in a sexual manner, requesting or offering sexual favors, or language or behavior suggestive of the same; (F) Threatening or violent behavior in the workplace; (G) Misappropriating, in connection with the practice of nursing, anything of value or benefit, including but not limited to, any property, real or personal of the client, employer, or any other person or entity, or failing to take precautions to prevent such misappropriation; (H) Providing information which was false, deceptive, or misleading in connection with the practice of nursing; (I) Failing to answer specific questions or providing false or misleading answers in a licensure or employment matter that could reasonably affect the decision to license, employ, certify or otherwise utilize a nurse; or (J) Offering, giving, soliciting, or receiving or agreeing to receive, directly or indirectly, any fee or other consideration to or from a third party for the referral of a client in connection with the performance of professional services. (7) Failure to pay child support payments as required by the Texas Family Code §232.001, et seq. (8) Drug Diversion--diversion or attempts to divert drugs or controlled substances. (9) Dismissal from a board-approved peer assistance program for noncompliance and referral by that program to the Board. (10) Other Drug Related--actions or conduct that include, but are not limited to: (A) Use of any controlled substance or any drug, prescribed or unprescribed, or device or alcoholic beverages while on duty or on call and to the extent that such use may impair the nurse's ability to safely conduct to the public the practice authorized by the nurse's license; (B) Falsification of or making incorrect, inconsistent, or unintelligible entries in any agency, client, or other record pertaining to drugs or controlled substances; (C) Failing to follow the policy and procedure in place for the wastage of medications at the facility where the nurse was employed or working at the time of the incident(s); (D) A positive drug screen for which there is no lawful prescription; or (E) Obtaining or attempting to obtain or deliver medication(s) through means of misrepresentation, fraud, forgery, deception and/or subterfuge. (11) Unlawful Practice--actions or conduct that include, but are not limited to: (A) Knowingly aiding, assisting, advising, or allowing an unlicensed person to engage in the unlawful practice of vocational, registered or advanced practice nursing; (B) Violating an order of the Board, or carelessly or repetitively violating a state or federal law relating to the practice of vocational, registered or advanced practice nursing, or violating a state or federal narcotics or controlled substance law; (C) Aiding, assisting, advising, or allowing a nurse under Board Order to violate the conditions set forth in the Order; or (D) Failing to report violations of the Nursing Practice Act and/or the Board's rules and regulations. (12) Leaving a nursing assignment, including a supervisory assignment, without notifying the appropriate personnel.

Rule 217.11 Standards of Nursing Practice

The standards of practice establish a minimum acceptable level of nursing practice in any setting for each level of nursing licensure or advanced practice authorization. Failure to meet these standards may result in action against the nurse's license even if no actual patient injury resulted. (1) Standards Applicable to All Nurses. All vocational nurses, registered nurses and registered nurses with advanced practice authorization shall: (A) Know and conform to the Texas Nursing Practice Act and the board's rules and regulations as well as all federal, state, or local laws, rules or regulations affecting the nurse's current area of nursing practice; (B) Implement measures to promote a safe environment for clients and others; (C) Know the rationale for and the effects of medications and treatments and shall correctly administer the same; (D) Accurately and completely report and document: (i) the client's status including signs and symptoms; (ii) nursing care rendered; (iii) physician, dentist or podiatrist orders; (iv) administration of medications and treatments; (v) client response(s); and (vi) contacts with other health care team members concerning significant events regarding client's status; (E) Respect the client's right to privacy by protecting confidential information unless required or allowed by law to disclose the information; (F) Promote and participate in education and counseling to a client(s) and, where applicable, the family/significant other(s) based on health needs; (G) Obtain instruction and supervision as necessary when implementing nursing procedures or practices; (H) Make a reasonable effort to obtain orientation/training for competency when encountering new equipment and technology or unfamiliar care situations; (I) Notify the appropriate supervisor when leaving a nursing assignment; (J) Know, recognize, and maintain professional boundaries of the nurse-client relationship; (K) Comply with mandatory reporting requirements of Texas Occupations Code Chapter 301 (Nursing Practice Act), Subchapter I, which include reporting a nurse: (i) who violates the Nursing Practice Act or a board rule and contributed to the death or serious injury of a patient; (ii) whose conduct causes a person to suspect that the nurse's practice is impaired by chemical dependency or drug or alcohol abuse; (iii) whose actions constitute abuse, exploitation, fraud, or a violation of professional boundaries; or (iv) whose actions indicate that the nurse lacks knowledge, skill, judgment, or conscientiousness to such an extent that the nurse's continued practice of nursing could reasonably be expected to pose a risk of harm to a patient or another person, regardless of whether the conduct consists of a single incident or a pattern of behavior. (v) except for minor incidents (Texas Occupations Code §§301.401(2), 301.419, 22 TAC §217.16), peer review (Texas Occupations Code §§301.403, 303.007, 22 TAC §217.19), or peer assistance if no practice violation (Texas Occupations Code §301.410) as stated in the Nursing Practice Act and Board rules (22 TAC Chapter 217). (L) Provide, without discrimination, nursing services regardless of the age, disability, economic status, gender, national origin, race, religion, health problems, or sexual orientation of the client served; (M) Institute appropriate nursing interventions that might be required to stabilize a client's condition and/or prevent complications; (N) Clarify any order or treatment regimen that the nurse has reason to believe is inaccurate, non-efficacious or contraindicated by consulting with the appropriate licensed practitioner and notifying the ordering practitioner when the nurse makes the decision not to administer the medication or treatment; (O) Implement measures to prevent exposure to infectious pathogens and communicable conditions; (P) Collaborate with the client, members of the health care team and, when appropriate, the client's significant other(s) in the interest of the client's health care; (Q) Consult with, utilize, and make referrals to appropriate community agencies and health care resources to provide continuity of care; (R) Be responsible for one's own continuing competence in nursing practice and individual professional growth; (S) Make assignments to others that take into consideration client safety and that are commensurate with the educational preparation, experience, knowledge, and physical and emotional ability of the person to whom the assignments are made; (T) Accept only those nursing assignments that take into consideration client safety and that are commensurate with the nurse's educational preparation, experience, knowledge, and physical and emotional ability; (U) Supervise nursing care provided by others for whom the nurse is professionally responsible; and (V) Ensure the verification of current Texas licensure or other Compact State licensure privilege and credentials of personnel for whom the nurse is administratively responsible, when acting in the role of nurse administrator. (2) Standards Specific to Vocational Nurses. The licensed vocational nurse practice is a directed scope of nursing practice under the supervision of a registered nurse, advanced practice registered nurse, physician's assistant, physician, podiatrist, or dentist. Supervision is the process of directing, guiding, and influencing the outcome of an individual's performance of an activity. The licensed vocational nurse shall assist in the determination of predictable healthcare needs of clients within healthcare settings and: (A) Shall utilize a systematic approach to provide individualized, goal-directed nursing care by: (i) collecting data and performing focused nursing assessments; (ii) participating in the planning of nursing care needs for clients; (iii) participating in the development and modification of the comprehensive nursing care plan for assigned clients; (iv) implementing appropriate aspects of care within the LVN's scope of practice; and (v) assisting in the evaluation of the client's responses to nursing interventions and the identification of client needs; (B) Shall assign specific tasks, activities and functions to unlicensed personnel commensurate with the educational preparation, experience, knowledge, and physical and emotional ability of the person to whom the assignments are made and shall maintain appropriate supervision of unlicensed personnel. (C) May perform other acts that require education and training as prescribed by board rules and policies, commensurate with the licensed vocational nurse's experience, continuing education, and demonstrated licensed vocational nurse competencies. (3) Standards Specific to Registered Nurses. The registered nurse shall assist in the determination of healthcare needs of clients and shall: (A) Utilize a systematic approach to provide individualized, goal-directed, nursing care by: (i) performing comprehensive nursing assessments regarding the health status of the client; (ii) making nursing diagnoses that serve as the basis for the strategy of care; (iii) developing a plan of care based on the assessment and nursing diagnosis; (iv) implementing nursing care; and (v) evaluating the client's responses to nursing interventions; (B) Delegate tasks to unlicensed personnel in compliance with Chapter 224 of this title, relating to clients with acute conditions or in acute are environments, and Chapter 225 of this title, relating to independent living environments for clients with stable and predictable conditions. (4) Standards Specific to Registered Nurses with Advanced Practice Authorization. Standards for a specific role and specialty of advanced practice nurse supersede standards for registered nurses where conflict between the standards, if any, exist. In addition to paragraphs (1) and (3) of this subsection, a registered nurse who holds authorization to practice as an advanced practice nurse (APN) shall: (A) Practice in an advanced nursing practice role and specialty in accordance with authorization granted under Board Rule Chapter 221 of this title (relating to practicing in an APN role; 22 TAC Chapter 221) and standards set out in that chapter. (B) Prescribe medications in accordance with prescriptive authority granted under Board Rule Chapter 222 of this title (relating to APNs prescribing; 22 TAC Chapter 222) and standards set out in that chapter and in compliance with state and federal laws and regulations relating to prescription of dangerous drugs and controlled substances.

Define the alliance system of health care, and explain its advantages. (See page 229 in your textbook.) -

They are partnerships formed among clincs, labs, health care systems, and physicians—networking allows coordination of delivery of care and containing costs. By doing this pt records are easily avaible . called seamless sysmtes.

During the application process for the NCLEX-PN examination, why is it important to have an authorization to test document? (See page 313 in your textbook.)

Valid from 60 days to 365 days. allows u to test

Explain the fee structure for the NCLEX-PN examination. (See page 00 in your textbook.)

You must repay the fee if your ATT expires or if you forfit registration There is no refunds

What is nursing ethics

a branch of applied ethics that concerns itself with activities in the field of nursing. Nursing ethics shares many principles with medical ethics, such as beneficence, non-maleficence and respect for autonomy.

Know the Texas BON Rule 217.11

https://www.bon.texas.gov/rr_current/217-11.asp

What is nursing jurisprudence

knowing the laws that affect the nurse/nurse duty/nurse practice/laws/rules/regulations

What is the primary resource for state law for nursing

state practice act

boundary viol

term professional boundaries is defined as: the appropriate limits which should be established by the nurse in the nurse/client relationship due to the nurse's power and the patient's vulnerability. Professional boundaries refers to the provision of nursing services within the limits of the nurse/client relationship which promote the client's dignity, independence and best interests and refrain from inappropriate involvement in the client's personal relationships and/or the obtainment of the nurse's personal gain at the client's expense [22 TAC §217.1(29)].

Describe the four personality types identified by Hippocrates. (See page 00 in your textbook.)

· Analytical—detail orientated · Driver—blunt and objective focused · Amiable---wants to be liked and easy going; not a big risk taker · Expressive—natural salesperson and storytellder

Texas Board of Nursing Responsibilities

*-Licensing*: The BON issues licenses to graduates of approved nursing education programs seeking licensure by exam and to nurses licensed in other states seeking Texas licensure by endorsement. All nurses are required to renew their licenses on a biennial basis with evidence of required continuing nursing education. The BON licenses qualified registered nurses to enter practice as advanced practice registered nurses (APRNs), including nurse anesthetists, nurse practitioners, clinical nurse specialists, and nurse midwives. *-School Approval*: The Texas Board of Nursing (BON) approves schools of nursing which prepare nurses for initial entry into nursing practice. *-Enforcement*: The BON enforces the Nursing Practice Act and Rules and Regulations by setting minimum standards for nursing practice and nursing education, conducting investigations of complaints against nurses, and adjudicating complaints. *-Information*: The BON provides a variety of information to customers including verbal, written and electronic information. The BON's website contains information including the Nursing Practice Act, BON Rules and Guidelines, BON Position Statements, the agency's physical location, disciplinary, and licensure information. Publications and the Texas Board of Nursing Bulletin (Newsletters) of the BON are available upon request for a minimal fee.

Explain the difference between a nursing assistant and unlicensed assistive personnel. (See page 205 in your textbook.)

- A nursing assistance is trained with courses that are up to 75 hours of clinical practices and in a program up to 12 weeks. The nursing assistants are then tested on these skills and given certification. Nursing assistances can be even trained to perform skills that an LVN would perform (but in some states only). The UAP learns selected skills thorough some clinical teaching.

6. What is the basic hint for successful problem solving? (See page 241 in your textbook.)

- Basic hint = "identify the real issue and solve it"

. Because registered nurses assign routine care and the care of stable patients to assistive personnel, this allows RNs to complete what specific tasks? (See page 201 in your textbook.)

- Because routine care is assigned to the AP, the RN is able to complete the pt's POC, coordinate all of the pt care and care activities, provide more complicated care, educate pt and their families and other health care members, act as a pt advocate.

When documenting unacceptable behavior, give examples of objective information that should be included in the evaluation. (See page 242 in your textbook.)

- Dates and time it occurred (or when late as in example) - Date of oral warning - Seriousness of the situation - Consequences

. Describe the characteristics of the democratic style of leadership. (See page 237 in your textbook.)

- the leader shares responsibility and authority with employees. - Focuses on the task and the employees - Involves encouraging supervised AP's to discuss resident care, make decisions, and problem solve. - Useful for daily nursing care situations, unit meetings, and review of pt care plans.

Know the Texas BON Scope of Practice Decision Making Model (DMM): https://www.bon.texas.gov/pdfs/publication_pdfs/Scope%20of%20Practice%20Decision-Making%20Model%20-%20DMM.pdf

1. Is the activity or intervention prohibited by the Texas NPA; Board rules, guidelines, or position statements; or any law, rule, or regulation from any agency? 2. Is the activity or intervention authorized by a valid order? 3. Is the activity or intervention consistent with current policies & procedures in your employing organization or facility? 4. Is performing the activity or intervention consistent with current A) evidence‐based practice findings and/or guidelines or B) scope of practice/position statements from national nursing organizations? 5. Is there documented evidence of your current competence (education, knowledge, skills, abilities, experience, and judgements) to perform the activity or intervention safely & effectively, in accordance the accepted nursing "standard of care"? 6. Would a reasonable & prudent nurse perform the activity or intervention in a similar circumstance? 7. Are you prepared to accept accountability for the provision of safe care & the outcome of the care rendered? 8. If you are an LVN, will adequate supervision be available? (Skip if you are an RN.) IF ALL YES: You may proceed with performance of the activity or intervention in accordance with prevailing standards of safe nursing care. IF ANY NO: STOP

8. To be a leader in long-term care, it is necessary to develop what specific skills? (See page 244 in your textbook.)

1. Occupational (clinical) skills-----knowledge/skills of nursing 2. Organizational skills----- skills necessary to function in the health care organization 3. Human relationship skills-----ability to get along with/relate to people

6. List the four Client Needs categories that are divisions of the NCLEXpracture -PN examination. (See page 312 in your textbook.)

1. Safe, effective care environment. 2. Health promotion and mantinence 3. Psychosocial integrity 4. Physiological intergity

What is the Nursing Peer Review Law and how does it affect nursing

(a) In evaluating a nurse's conduct, the nursing peer review committee shall review the evidence to determine the extent to which a deficiency in care by the nurse was the result of deficiencies in the nurse's judgment, knowledge, training, or skill rather than other factors beyond the nurse's control.

What is the minimum due process rules

(d) Minimum Due Process. (1) A licensed nurse subject to incident-based nursing peer review is entitled to minimum due process under TOC §303.002(e) (NPR Law). Any person or entity that conducts incident-based nursing peer review must comply with the due process requirements of this section even if the person or entity does not utilize the number of nurses described by subsection (c) of this section. (2) A facility conducting incident-based nursing peer review shall have written policies and procedures that, at a minimum, address: (A) the level of participation of nurse or nurse's representative at an incident-based nursing peer review hearing beyond that required by this subsection; (B) confidentiality and safeguards to prevent impermissible disclosures including written agreement by all parties to abide by TOC §§303.006, 303.007, 303.0075 (NPR Law) and subsection (h) of this section; (C) handling of cases involving nurses who are impaired or suspected of being impaired by chemical dependency, drug or alcohol abuse, substance abuse/misuse, "intemperate use," mental illness, or diminished mental capacity in accordance with the TOC §301.410, and subsection (g) of this section; (D) reporting of nurses to the Board by incident-based nursing peer review committee in accordance with the TOC §301.403, and subsection (i) of this section; and (E) effective date of changes to the policies which in no event shall apply to incident-based nursing peer review proceedings initiated before the change was adopted unless agreed to in writing by the nurse being reviewed. (3) In order to meet the minimum due process required by TOC Chapter 303 (NPR Law), the nursing peer review committee must: (A) comply with the membership and voting requirements as set forth in TOC §303.003 (NPR Law); (B) exclude from the committee, including attendance at the nursing peer review hearing, any person or persons with administrative authority for personnel decisions directly relating to the nurse. This requirement does not exclude a person who is administratively responsible over the nurse being reviewed from appearing before the committee to speak as a fact witness; (C) provide written notice to the nurse in person or by certified mail at the last known address the nurse has on file with the facility that: (i) the nurse's practice is being evaluated; (ii) the incident-based nursing peer review committee will meet on a specified date not sooner than 21 calendar days and not more than 45 calendar days from date of notice, unless: (I) the incident-based nursing peer review committee determines an extended time period (extending the 45 days by no more than an additional 45 days) is necessary in order to consult with a patient safety committee; or (II) otherwise agreed upon by the nurse and incident-based nursing peer review committee; and (iii) includes the information required by subparagraph (D) of this paragraph. (D) Include in the notice required by subparagraph (C) of this paragraph: (i) a description of the event(s) to be evaluated in sufficient detail to inform the nurse of the incident, circumstances and conduct (error or omission), including date(s), time(s), location(s), and individual(s) involved. The patient/client shall be identified by initials or number to the extent possible to protect confidentiality but the nurse shall be provided the name of the patient/client; (ii) the name, address, telephone number of contact person to receive the nurse's response; and (iii) a copy of this rule (§217.19 of this title) and a copy of the facility's incident-based nursing peer review plan, policies and procedures. (E) provide the nurse the opportunity to review, in person or by attorney, the documents concerning the event under review, at least 15 calendar days prior to appearing before the committee; (F) provide the nurse the opportunity to: (i) submit a written statement regarding the event under review; (ii) call witnesses, question witnesses, and be present when testimony or evidence is being presented; (iii) be provided copies of the witness list and written testimony or evidence at least 48 hours in advance of proceeding; (iv) make an opening statement to the committee; (v) ask questions of the committee and respond to questions of the committee; and n

What is incident peer review

Incident-based nursing peer review (IBNPR), which focuses on determining if a nurse's action,be it a single event or multiple events (such as in reviewing up to five (5) minor incidents by thesame nurse within a year's period of time) should be reported to the Board, or if the nurse'sconduct does not require reporting because the conduct constitutes a minor incident that canbe remediated. The review includes whether external factors beyond the nurse's control mayhave contributed to any deficiency in care by the nurse, and to report such findings to a patientsafety committee as applicable; or

Identify the types of test item formats found in the NCLEX-PN examination. (See pages 311, 312 in your textbook.)

Muliple choice and alternate item format Alternate item format includes: o Fill in the blank o Multiple response o Prioritizing o Figure/illustration o Chart/exhibit questions

Tasks Prohibited from Delegation

Nursing Tasks Prohibited from Delegation By way of example, and not in limitation, the following are nursing tasks that are not within the scope of sound professional nursing judgment to delegate: (1) physical, psychological, and social assessment which requires professional nursing judgment, intervention, referral, or follow-up; (2) formulation of the nursing care plan and evaluation of the client's response to the care rendered; (3) specific tasks involved in the implementation of the care plan which require professional nursing judgment or intervention; (4) the responsibility and accountability for client health teaching and health counseling which promotes client education and involves the client's significant others in accomplishing health goals; and (5) administration of medications, including intravenous fluids, except by medication aides as permitted under §224.9 of this title (relating to The Medication Aide Permit Holder)

Graduates Temporary Authorization to Practice

(1) In order to receive temporary authorization to practice as a GN or GVN and obtain a Permit, the new graduate must: (A) file a completed application, including verification of completion of graduation requirements and the non-refundable application processing fee (see §217.2(a)(1)-(2) of this title relating to Licensure by Examination for Graduates of Basic Nursing Education Programs Within the United States, its Territories or Possessions); (B) have no outstanding eligibility issues (see §213.30 of this title (relating to Declaratory Order of Eligibility for Licensure), and Texas Occupations Code §301.257); (C) have never taken the NCLEX-PN or NCLEX-RN. Temporary authorization to practice as a GN will not be issued to any applicant who has previously failed the licensing examination; and (D) have registered to take the NCLEX-PN or NCLEX-RN with the examination administration service. (2) The temporary authorization to practice as a GN or GVN, which is not renewable, is valid for 75 days from the date of eligibility, receipt of permanent license, or upon receipt of a notice of failing the examination from the Board, whichever date is the earliest. The GN or GVN must immediately inform employers of receipt of notification of failing the examination and cease nursing practice. (3) The new graduate who has been authorized to practice nursing as a GN or GVN pending the results of the licensing examination must work under the direct supervision of either a licensed vocational or a registered professional nurse if a GVN or a registered professional nurse only if a GN, who is physically present in the facility or practice setting and who is readily available to the GN or GVN for consultation and assistance. If the facility is organized into multiple units that are geographically distanced from each other, then the supervising nurse must be working on the same unit to which the GN or GVN is assigned. The GN or GVN shall not be placed in supervisory or charge positions and shall not work in independent practice settings. (4) The nurse administrator of facilities that employ Graduate Nurses or Graduate Vocational Nurses must ensure that the GN or GVN has a valid temporary authorization to practice as a GN or GVN pending the results of the licensing examination, has scheduled a date to take the NCLEX-PN or NCLEX-RN , and does not continue to practice after expiration of the 75 days of eligibility or receipt of a notice of failing the examination from the Board, whichever date is earlier. (b) A nurse who has not practiced nursing for four or more years may be issued a temporary permit for the limited purpose of completing a refresher course, extensive orientation to the practice of professional or vocational nursing, whichever is applicable, or academic course. The permit is valid for six months and is nonrenewable. (c) A nurse whose license has been suspended, revoked, or surrendered through action by the board, may be issued a temporary permit for the limited purpose of meeting any requirement(s) imposed by the board in order for the nurse's license to be reissued. The permit is valid for six months and is nonrenewable.

10. As a practical/vocational charge nurse, what are your responsibilities when evaluating nursing assistants? (See page 249 in your textbook.)

- observing skill performances/attitudes of nursing assistants - providing daily oral/written feedback---include suggestions for improvement - documenting observations - presenting a final eval form

What is the Texas Occupation Code Chapter 301?

- Defines LVN/LPN: "Vocational nursing" means a directed scope of nursing practice, including the performance of an act that requires specialized judgment and skill, the proper performance of which is based on knowledge and application of the principles of biological, physical, and social science as acquired by a completed course in an approved school of vocational nursing. The term does not include acts of medical diagnosis or the prescription of therapeutic or corrective measures. Vocational nursing involves: (A) collecting data and performing focused nursing assessments of the health status of an individual; (B) participating in the planning of the nursing care needs of an individual; (C) participating in the development and modification of the nursing care plan; (D) participating in health teaching and counseling to promote, attain, and maintain the optimum health level of an individual; (E) assisting in the evaluation of an individual's response to a nursing intervention and the identification of an individual's needs; and (F) engaging in other acts that require education and training, as prescribed by board rules and policies, commensurate with the nurse's experience, continuing education, and demonstrated competency.

What role do you, as an LPN/LVN, have in containing costs in the health care setting? (See page 229 in your textbook.)

- Documenting all pt care provided so facility can be reimbursed, efficient and effective in delivering pt care (do it right the first time), avoid unnecessary waste, provide pt centered care.,

1. The various health care services in the United States can be grouped into what general categories? (See page 211 in your textbook.)

- Health care services can be group in Public health care agenecies and Private health care agencies. - Public Health services can be further divided into official and voluntary agencies.

5. According to Howlett's hierarchy, what are the five levels of work motivators? (See page 240 in your textbook.)

- Howlett Hierarchy: levels of work motivators: - 5 levels: - Level 1: salary, benefits, working conditions, supervision, agency policy - Level 2: safety in the workplace and job security - Level 3: affiliation, interpersonal relationships - Level 4: Recognition, growth, responsibility, nature of the job - Level 5: achievement, advancement

2. How does management differ from leadership? (See pages 235, 236 in your textbook.)

- Management: organization of all care required of patients in a health care setting for a specific period. - Leadership: how a person empowers and develops a team to meet and exceed patient and institutional outcomes

Explain the difference between Medicare's Part A and Part B insurance programs. (See page 225 in your textbook.)

- Medicare part A: hospital insurance; covers inpatient hospital stays, SNF care, hospice, and some home health care. - Medicare part B: medical insurance; covers doctor services, outpatient care, medical supplies, and preventive services.

4. Identify five core areas of knowledge and skills that are necessary for the practical/vocational charge nurse to be an effective leader. (See page 238 in your textbook.)

- Nurses need to be knowledgeable in 1. Team motivation to accomplish goals 2. Communicating assertively 3. Effective problem solving 4. Building a team of cooperative workers 5. Manage stress effectively

10. Summarize patient-centered care as a method of delivering care. (See page 207 in your textbook.)

- Patient-centered care is care that is respectful and responsive to indiv pt preferences, needs, values, and ensure that the client's values guide all clinical deciosns. So a large emphasis of autonomy and respecting pt customs/needs/preferences.

4. When do RNs function in an interdependent role? (See page 201 in your textbook.)

- RNs function in an interdependent role when they are carrying out the orders of the physician, PA, NP, or other members on the pt's health care team.

9. What is the major characteristic of the primary care method? (See page 206, 207 in your textbook.)

- The major characteristic of the primary care method is that the RN is responsible for the total care of their clients and is even the client's bedside nurse in addition to her other roles.

1. What is the primary goal of health care, and how is it accomplished? (See page 199 in your textbook.)

- The primary goal of healthcare is restore optimal physical, emotional, and spiritual health to patients. This means getting the pt to their best and highest functioning selves.

Differentiate between victims, survivors, and navigators of change. (See page 230 in your textbook.)

- Victims look at change negativiely - Survivors resist change but go along with the ride - Navigators feel in control and believe they have some control over the change rather than being controlled by the change

2. According to Virginia Henderson, how do you define nursing? (See page 200 in your textbook.)

- Virgina Henderson defines nursing as: "...assist the individual sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform if he had the necessary strength, will, or knowledge." - So to help the pt with all functions until they are healthy to do them or if dying, help them achieve a peaceful death.

2. What are some ways the Affordable Care Act affects private health insurance? (See pages 223, 224 in your textbook.)

- before the ACA people who were likely to have high medical bills were denied coverage. Under the ACA it is illegal to deny care for those pt who have existing medical cojndtiosn pr heath status. It also prhohibts insurances and plans from placing lifetime limits on the dollar value of coverage denying covraged based on cost of care

Standards of Nursing Practice position statements: 15.27, 15.28, 15.2, 15.3, 15.6, 15.7, 15.9, 15.11, 15.12, 15.13, 15.14, 15.15, 15.17, 15.18, 15.19, 15.24, 15.25, 15.29, and 15.30. https://www.bon.texas.gov/practice_bon_position_statements_content.asp#15.2

15.2 : a LVN may not accept an order that would require the LVN to "pronounce death," or to complete the state-required "medical certification" of a death that occurs without medical attendance. !5.27: LVN SCOPE OF PRACTICE 15.28: RN SCOPE OF PRACTICE 15.3: WORKPLACE VIOLENCE; NO BULLYING BEHAVIOR; ASSIGNMETS APPROPIRATE FOR SCOPE; NO HARM TO PT; BEHAVIORS HANDELED APPRIOPRIATE; REPORT THREATS AND VIOLENCE 15.6; PT ABANDOMENT (sleeping/walking off job midshift/faslsfiying records/not reporting to management;) AND QAULIFERIES; EMPLOYEMENT ISSUE VS NURSE ABADONDMOENT 15.7 LVN can provide basic nursing care to patients with epidural or intrathecal catheters; RN can manage and admin medications but must be licesned for the mangement. 15.8; sedation should be managemed by crna but can be managed by rn if trained 15.9 lvn/rn can perform laser treatments 15.11 carrying out delegated medical acts; need to be supervised by provider 15.12 dsms dx must be done by CNS/APRN 15.13; school health care is a rn speciality; lvn should be under supervision. 15.14 rn/lvn is required to uphold standards of nurse care in all settings. 15.15 title of nurse should be used by the lvn/rn only 15.17 medicaqtion safety 15.18 can accept orders from aprn but question order if fishy looking 15.19. orders from pharmacist 15.24 j-tube/gtube resinsertion; OK only if cont education and training; use judgement dont accept assignment if no order or training 15.25: lvn scope and stuff 15.29 professsional boundaries and social media use/hippa violation 15.30 workplace violence

What is a Texas minor incident rule

A "minor incident" is defined as: "conduct by a nurse that may be a violation of the Texas Nursing Practice Act or a Board rule but does not indicate the nurse's continued practice poses a risk of harm to a patient or another person." 22 TAC § 217.16(a)

What are minor incidents evaluated; what is the criteria for evaluating

The first step in determining whether an error is a minor incident is to evaluate the nurse's conduct to determine whether deficit(s) in knowledge, judgment, skills, professional responsibility, or patient advocacy contributed to the incident. If it is determined that the nurse's practice has no deficit(s) in knowledge, judgment, skills, professional responsibility, or patient advocacy, the incident may not even reach the level of a minor incident. If it is determined that the nurse's practice deficit(s) in knowledge, judgment, skills, professional responsibility, or patient advocacy contributed to the error, then a determination of whether remediation will address any identified deficit(s) is required. If remediation will address the deficit(s), a remediation plan must be developed to address the deficit(s). If remediation will not address the deficit(s), then the error cannot be considered a minor incident and the nurse must be reported to the nursing peer review committee or, in practice settings with no nursing peer review, to the Board. (If the determination is that the nurse could be remediated but the nurse does not complete the required remediation, then the nurse must be reported to a nursing peer review committee or the Board.) After evaluating the nurse's conduct (acts or omissions), the presence of factors beyond the nurse's control (sometimes called 'systems factors') must also be evaluated for contribution to the incident. If such factors are found, a report must be made to the patient safety committee, or if the facility does not have a patient safety committee, to the chief nursing officer. In situations involving a nursing practice breakdown with contribution by factors beyond the nurse's control, the relationship between the nurse's contribution to the incident and the factors beyond the nurse's control must be evaluated as well. If factors beyond the nurse's control are identified, the incident should be evaluated to determine if the error would still have occurred even if such factors were absent or did not exist. If the error would not have occurred but for the factors beyond the nurse's control, the incident may not even reach the level of a minor incident. Please be aware, the Minor Incident Rule is clear that the presence of factors beyond the nurse's control does NOT automatically exclude the possibility that the nurse's conduct also contributed to the error. Any identified deficits by the nurse must be addressed and remediated, even if factors beyond the nurse's control are also identified. If remediation will not address the deficit(s), then the error cannot be considered a minor incident and must be reported to the nursing peer review committee or to the Board if there is not a nursing peer review in the practice setting. **Intentionally mis-classifying an error/incident to avoid reporting may result in a violation of the mandatory reporting law.

What are criminal behaviors related to nursing

lying, falsification, or deceptive conduct, the Board is mindful that similar misconduct may be repeated in nursing settings, thereby placing patients, healthcare employers, and the public at risk.

Texas Board of Nursing Functions

unctions. The board shall perform the following functions as outlined in Texas Occupations Code chapters 301, 303, and 304. (1) Establish standards of nursing practice and regulate the practice of professional and vocational nursing. (2) Interpret the Nursing Practice Act and the Rules and Regulations Relating to Nurse Education, Licensure and Practice to nurses, employers, and the public to ensure informed professionals, allied health professionals, and consumers. (3) Receive complaints and investigate possible violations of the Nursing Practice Act and rules and regulations. (4) Discipline violators through appropriate legal action to enforce the Nursing Practice Act and rules and regulations. (5) Provide a mechanism for public comment with regard to the rules and regulations and the Nursing Practice Act and review and modify the rules and regulations when necessary and appropriate. (6) Examine and license qualified applicants to practice professional and vocational nursing and recognize qualified applicants to practice advanced practice nursing in the state of Texas in a manner that ensures that applicable standards are maintained and that practitioners are minimally competent. (7) Grant licensure by endorsement to vocational and registered nurses and grant recognition of advanced practice nurses from other states to ensure standards are maintained and applicable practices are consistent. (8) Recommend to legislature appropriate changes in the Nursing Practice Act to ensure that the act is current and applicable to changing needs and practices. (9) Establish standards for nursing education and accredit or deny accreditation to schools of nursing and educational programs which fail to meet or maintain the prescribed course of study or other applicable standards to ensure that high levels of education are achieved. (10) Monitor the examination results of licensure applicants to determine variances in the level of educational effectiveness. (11) Provide consultation and guidance to nurse education institutions to facilitate self-study, evaluation, and the development of effective nurse education programs. (12) Provide advice and counsel to the faculty of educational programs, to staff of health agencies utilizing nursing services, and to practitioners of nursing to continually improve professional service delivery. (13) Implement and manage all other programs and responsibilities as authorized and mandated from time to time by the Texas Legislature.

3. What are some tips for using social media when networking? (See page 00 in your textbook.)

· Do not add coworkers/supervisor · Do not add unless you know who they are · Never let anyone post for you · Never post opionins about employers · Do not post nonmainstream/problematic beliefs, hobbies, recreational activitesi · Never announce intention to leave employment; may lead to rapid termination · Be vareful about extra cost

5. Because 75% to 85% of all available jobs are not advertised, what are some examples of sources of the hidden job market? (See page 00 in your textbook.)

· Family/friends · Employer and staff recommendations · School social amlumni network · State/federal websites · Contact nurse union to find poteional hires · In person/virtual job fairs

When attending a professional conference, why would it be important to behave as if it were an interview? (See page 00 in your textbook.)

· Poteional employers everywhere; you may come in mind to someone you had a conversation with if an employment oppurtiunity pops up

9. Summarize the time restrictions when taking the NCLEX-PN examination. (See page 313 in your textbook.)

• 5 hours total with up to 2 breaks

10. Explain how you receive the results to the NCLEX-PN examination. (See page 315 in your textbook.)

• Available 1 month after testing • Do not call BON/NCLEX-PN/Pearson Center/NCSBN for results • Result sent by mail or email from state BON • Google "my license" to check if license has been issued • States BON notifies you of results

Name the four phases of the nursing process that are integrated into all areas of the NCLEX-PN examination. (See page 311 in your textbook.)

• Data collection—assessment • Planning • Implementation • Evaluation

. What is the NCLEX-PN examination, and what is its purpose? (See page 311 in your textbook.) (CHAPTER 19)

• It is a licensure test and is designed to test minimum knowledge, skills, and abilities needed to safety and effectively practice as a new entry-level LVN

2. In what countries is the NCLEX-PN examination administered? (See page 314 in your textbook.)

• US and territories include American Somoa, Guam, Northern Mariana islands, the virgin islands. • Canada