Texas BON Position Statements 2023 Study

Which of the following statements is false? A. LVNs may provide nursing care to patients with epidural or intrathecal catheters B. LVNs are responsible for catheter management, including the administration of drugs via these routes. C. Epidural & Intrathecal catheter management are within the RN's scope of practice D. The sky is blue (I can't think of another answer choice)

B. LVNs are responsible for catheter management, including administration of drugs via these routes. 15.7 LVNs may provide nursing care to patients with epidural or intrathecal catheters, but should not be responsible for catheter management, including adminstration of drugs via these routes.Epidural & Intrathecal catheter management may be within the RN's scope of practice if the RN has current comptency in both the knowledge and skills required, with certain limitations recommended in the obstetrical setting. Appropriate Nursing policies and procedures must also be in place.

Which of the following statements is false? A. LVNs must initiate CPR in the absence of a clear do-not-resuscitate (DNR) order. B. LVNs cannot pronounce death. C. LVNs may accept a physician's order regarding post-mortem care D. LVNs can accept a verbal order to pronounce death.

D. LVNs can accept a verbal order to pronounce death. 15.2 LVNs must initiate CPR in the absence of a clear do-not-resuscitate (DNR) order. Laws regarding the pronouncement of death are not in the NPA or Board Rules. LVNs cannot pronounce death. The LVN may accept a physician's order regarding post-mortem care, but cannot accept a verbal order to pronounce death.

In a school setting, the LVNs directed scope of practice is under supervision of all EXCEPT: A. Parents B. Registered Nurse (RN) C. Physician Assistant (PA) D. Dentists

A. Parents 15.13 The licensed vocational nurse (LVN) has a directed scope of practice under supervision of a registered nurse, advanced practice registered nurse, physician, physician assistant, podiatrist, or dentist. 1 The provision of nursing care when provided by an LVN in a school setting should be under the supervision of an RN. The RN, in compliance with the BON's Standards of Nursing Practice [22 TAC §217.11], assigns those aspects of care and activities to the LVN that are within the LVN's educational preparation and demonstrated competency to provide.

True or False? LVNs and RNs can determine medical diagnoses.

False 15.12 LVNs and RNs cannot determine medical diagnoses. Use of these multi-disciplinary psychiatric diagnoses is permitted by advanced practice nurses designated as Clinical Nurse Specialists (CNS) or Nurse Practitioners (NP's) whose population focus area is psych/mental health. Patient problems beyond the scope of training and education of the psychiatric mental health CNS/NP are to be referred to an appropriate psychiatric mental health or medical provider.

True or False? If a RN or LVN functions in a role other than current level of licensure, the nurse is NOT held to the level of education and competency of the nurse's highest licensure.

False 15.15 If a RN or LVN functions in a role other than current level of licensure, or in another area with an overlapping scope of practice, the nurse is still held to the level of education and competency of the nurse's highest licensure. Also restricts use of the titles LVN or RN or any designation implying nursing licensure by non-nurses (NPA Section 301.351 and NPA Section 301.004(a) (5)and Rule 217.10).

True or False? Reinsertion of a feeding tube is beyond the scope of practice of an LVN.

False 15.24 LVNs & RNs should receive post-licensure training and demonstrate competency in reinsertion of a displaced permanently placed feeding tube prior to engaging in this activity. Verification of correct placement is essential to prevent life-threatening complications. Reinsertion by a nurse is not recommended prior to 8-12 weeks post-initial insertion; specific physician orders must be obtained regarding reinsertion by a nurse.

True or False? LVNs can administer medications and treatments as ordered by a physician, podiatrist, dentist or any practitioner EXCEPT when ordered by physician assistants and advanced practice registered nurses

False 15.25 LVNs are educationally prepared to administer medications and treatments as ordered by a physician, podiatrist, dentist or any practitioner legally authorized to prescribe the ordered medication. LVNs may administer medications and treatments ordered by physician assistants (PS 15.1) and advanced practice registered nurses (PS 15.18). Also see NPA 301.002(5), the definition of vocational nursing.

True or False? LVNs can insert/remove IV/Venipunctures AND PICC lines

False 15.3 The LVN must complete post-licensure training to engage in IV Therapy/Venipuncture (not typically included in LVN curriculum). Insertion and removal of PICC lines is beyond the scope of practice for LVN.

True or False? Education regarding mobility is the a RNs and PTs responsibility and LVNs are not required to.

False 15.5 Nurses may initiate physician's standing medical orders or standing delegation orders by selecting specific tasks or functions for patient management. The nurse is accountable to assure his/her actions are in accordance with the NPA and Board Rules, including that the standing orders do not require the nurse to engage in independent medical judgment.NOTE: RN's who lack Advanced Practice licensure and LVNs may not utilize "protocols" intended for use by APRN's or PA's (see definitions of protocols from the Texas Medical Board in this position statement).

True or False? When carrying out orders for a Physician Assistant (PA), a nurse is responsible for clarifying orders.

True 15.1 Nurses may carry out physician orders relayed by a physician assistant (PA) when the PA is compliant with laws regulating the practice of the PA. The nurse is expected to clarify any order the nurse questions by communicating with the PA or the physician.

True or False? LVNs can give education related to mobility

True 15.4 The Board supports educational mobility for nurse's prepared at LVN, Diploma, ADN, and BSN levels without needless repetition of clinical experiences or time penalties. The Board also supports educational mobility for military personnel and veterans.

True or False? LVNs cannot administer pharmacologic agents for the purpose of achieving moderate sedation to or monitor patients receiving moderate sedation.

True 15.8 LVNs cannot administer pharmacologic agents for the purpose of achieving moderate sedation to or monitor patients receiving moderate sedation.The administration of drugs and monitoring of patients for moderate sedation may be within the RN's scope of practice. If an RN elects to engage in administration of pharmacologic agents classified as "anesthetic" agents to induce moderate sedation, the RN should either be skilled in, or have immediate availability of other practitioners skilled in advanced airway management along with appropriate equipment that might be necessary to rescue a patient from unintended deep sedation. The facility or physician's office needs to have policies and procedures to guide the RN. See evidence-based practice standards of professional anesthesia association guidelines listed in the position statement.