N5350 Roles Final Study Guide Exam
Questions & Answers (Grade A+)
1. What are the 4 settings for prescriptive authority? Describe the
requirements in each setting for physician supervision, # of NPs,
chart review, and any other special requirements in that site. -
correct answer ✅1. Medically Underserved
2. Physician Primary Site
3. Physician Alternate Site
4. Facility Based Practice Site.
* General requirements per TBON rule 222.5: regular visits, chart
review as determined by APRN & physician, periodic face to face
meeting of APRN & physician to discuss pt care & improvement.
1a) Medically Underserved -
correct answer ✅*site must be official, physician must be
reachable by phone & must be provided with daily status report of
any major problems outside of the protocol.
*must have protocols.
1b) Physician Primary Practice Site -
correct answer ✅* Must have protocols.
*Sign drug orders only for pts whom the MD has/will establish a
relationship.
*alternate MD may delegate.
,N5350 Roles Final Study Guide Exam
Questions & Answers (Grade A+)
*MD may delegate to no more than 7 APNS or PAs.
*Physician on-site visits should be 50% of the time according to
BME.
1c) Facility Based Practice -
correct answer ✅*Must be physically present in facility (hospital
or long term facility).
*Physician must give prior consent.
*Delegation only at > one hospital or > 2 long term care facilities -
now it is 7 FTEs.
*Long term care-only 4 APNs (APRNs) or 4 PAs or their FTE
equivalent - now it is 7 FTE & approved by Chief Physician of
Facility.
*Protocol signed by the Chief Physician.
1d) Physician Alternate Site -
correct answer ✅*No longer in effect.
2. The FOUR Approved Categories of APN in TX? -
correct answer ✅*CRNA, NP, CNS, and CNM
,N5350 Roles Final Study Guide Exam
Questions & Answers (Grade A+)
3. NP requirements by BON for approval of license/ AP recognition
each biennium. -
correct answer ✅*Current valid RN licensure.
*400 hours of current clinical practice.
*20 hours of CEs.
*8 hours of continuing education in pharmacotherapeutics.
*Current board certification.
*Separate application for dual roles.
4. New NP graduate requirements when applying for the board? -
correct answer ✅*Must take and pass national certification exam.
5. What is the NP's scope of practice based on? -
correct answer ✅*Nurse practice acts define legal scope of
practice for licensed practitioners.
*Includes privileges for diagnosis, treatment, prescriptive authority
and reimbursement.
11. What are clinical privileges and how are they obtained? -
correct answer ✅*autonomy to perform expanded role functions
based on the individuals licensure, educational preparation, clinical
experience, and credentials.
, N5350 Roles Final Study Guide Exam
Questions & Answers (Grade A+)
*Via contractual agreement with hospitals or long term care
facilities.
12. Define Malpractice -
correct answer ✅*Any professional misconduct, unreasonable lack
of skill, or infidelity in professional or fiduciary duties, or illegal or
immoral conduct.
*Negligence is the failure of an individual to do something that a
reasonable person would do, that results in injury to another.
*The alleged failure on the part of a professional to render services
with the degree of care, diligence, and precaution that another
member of the same profession in similar circumstances would
render to prevent injury to some one else.
13. FOUR Elements of Malpractice -
correct answer ✅1. Duty: provide some level of care, had some
contact.
2. Dereliction: reasonable, ordinary care, skill and diligence as NP's
in good standing in similar practice.
3. Damage: Must have an injury or no malpractice even if violated
standard of care; cap "pain and suffering" $250,000 to $500, 000.
4. Causation of Injury: For malpractice to have occurred, a breach of
the standard of care must have caused an injury to the patient.
Questions & Answers (Grade A+)
1. What are the 4 settings for prescriptive authority? Describe the
requirements in each setting for physician supervision, # of NPs,
chart review, and any other special requirements in that site. -
correct answer ✅1. Medically Underserved
2. Physician Primary Site
3. Physician Alternate Site
4. Facility Based Practice Site.
* General requirements per TBON rule 222.5: regular visits, chart
review as determined by APRN & physician, periodic face to face
meeting of APRN & physician to discuss pt care & improvement.
1a) Medically Underserved -
correct answer ✅*site must be official, physician must be
reachable by phone & must be provided with daily status report of
any major problems outside of the protocol.
*must have protocols.
1b) Physician Primary Practice Site -
correct answer ✅* Must have protocols.
*Sign drug orders only for pts whom the MD has/will establish a
relationship.
*alternate MD may delegate.
,N5350 Roles Final Study Guide Exam
Questions & Answers (Grade A+)
*MD may delegate to no more than 7 APNS or PAs.
*Physician on-site visits should be 50% of the time according to
BME.
1c) Facility Based Practice -
correct answer ✅*Must be physically present in facility (hospital
or long term facility).
*Physician must give prior consent.
*Delegation only at > one hospital or > 2 long term care facilities -
now it is 7 FTEs.
*Long term care-only 4 APNs (APRNs) or 4 PAs or their FTE
equivalent - now it is 7 FTE & approved by Chief Physician of
Facility.
*Protocol signed by the Chief Physician.
1d) Physician Alternate Site -
correct answer ✅*No longer in effect.
2. The FOUR Approved Categories of APN in TX? -
correct answer ✅*CRNA, NP, CNS, and CNM
,N5350 Roles Final Study Guide Exam
Questions & Answers (Grade A+)
3. NP requirements by BON for approval of license/ AP recognition
each biennium. -
correct answer ✅*Current valid RN licensure.
*400 hours of current clinical practice.
*20 hours of CEs.
*8 hours of continuing education in pharmacotherapeutics.
*Current board certification.
*Separate application for dual roles.
4. New NP graduate requirements when applying for the board? -
correct answer ✅*Must take and pass national certification exam.
5. What is the NP's scope of practice based on? -
correct answer ✅*Nurse practice acts define legal scope of
practice for licensed practitioners.
*Includes privileges for diagnosis, treatment, prescriptive authority
and reimbursement.
11. What are clinical privileges and how are they obtained? -
correct answer ✅*autonomy to perform expanded role functions
based on the individuals licensure, educational preparation, clinical
experience, and credentials.
, N5350 Roles Final Study Guide Exam
Questions & Answers (Grade A+)
*Via contractual agreement with hospitals or long term care
facilities.
12. Define Malpractice -
correct answer ✅*Any professional misconduct, unreasonable lack
of skill, or infidelity in professional or fiduciary duties, or illegal or
immoral conduct.
*Negligence is the failure of an individual to do something that a
reasonable person would do, that results in injury to another.
*The alleged failure on the part of a professional to render services
with the degree of care, diligence, and precaution that another
member of the same profession in similar circumstances would
render to prevent injury to some one else.
13. FOUR Elements of Malpractice -
correct answer ✅1. Duty: provide some level of care, had some
contact.
2. Dereliction: reasonable, ordinary care, skill and diligence as NP's
in good standing in similar practice.
3. Damage: Must have an injury or no malpractice even if violated
standard of care; cap "pain and suffering" $250,000 to $500, 000.
4. Causation of Injury: For malpractice to have occurred, a breach of
the standard of care must have caused an injury to the patient.
