RNSG 2221
NURSING
JURISPRUDENCE Q AND A
CONTAINS:
✓ Nursing Jurisprudence / Legal & Ethical Nursing Practice exam preparation
material
✓ Scenario-based multiple-choice questions
✓ Select-all-that-apply (SATA) questions
✓ Correct answers clearly identified
✓ Detailed legal and ethical rationales
✓ Nursing Practice Act (NPA) violations and disciplinary actions
✓ Standards of nursing practice and professional conduct
✓ Use of restraints and legal requirements
✓ Mandatory reporting and impaired nurse obligations
✓ Substance use disorder and alternative-to-discipline programs
✓ Nurse licensure and scope of practice accountability
✓ Nurse Licensure Compact (NLC) rules and residency requirements
✓ Delegation, assignment, and liability for unsafe staffing
✓ Employer vs nurse liability and negligence principles
✓ Patient consent and implied consent in emergency situations
✓ End-of-life legal and ethical issues (DNR orders)
✓ Minor consent laws and patient advocacy responsibilities
✓ Documentation requirements for legal protection
,A registered nurse is working on a medical-surgical unit and receives a shift report that includes a
patient admitted for acute alcohol withdrawal. The patient becomes agitated and threatens to harm
staff members. The nurse applies leather restraints as per facility protocol but fails to obtain a
physician's order for the restraints within the required timeframe. Which of the following violations of
the Nursing Practice Act (NPA) is the nurse most likely guilty of committing?
A) Failure to maintain patient safety
B) Failure to implement the nursing process
C) Practicing nursing without a license
D) Unprofessional conduct
Correct Answer: D) Unprofessional conduct
Explanation / Rationale:
In the context of nursing jurisprudence, specifically within the Texas Nurse Practice Act and similar
regulations, "unprofessional conduct" includes a failure to adhere to established standards of care and
legal protocols regarding patient rights. Restraints are considered a violation of patient rights and
safety risks that require strict adherence to legal standards, including a timely physician's order. While
patient safety is involved, the specific legal violation here is the deviation from the standard of care
and legal requirements (lack of order), which classifies as unprofessional conduct. Options A and B are
generic nursing issues, but the legal implication of not obtaining the order falls under disciplinary
conduct. Option C is incorrect as the nurse is licensed but acting outside the scope of acceptable
practice.
The Texas Board of Nursing (BON) receives a complaint regarding a nurse who has been diverting
controlled substances from the hospital's medication dispensing system. Upon investigation, the BON
determines that the nurse has a diagnosis of opioid use disorder. Which of the following actions is the
BON most likely to take regarding the nurse's license?
A) Automatic permanent revocation of the nursing license
B) Mandatory suspension for 5 years
C) Offer participation in the Texas Peer Assistance Program for Nurses (TPAPN) as an alternative to
disciplinary action
D) Issuance a letter of counseling with no further monitoring
,Correct Answer: C) Offer participation in the Texas Peer Assistance Program for Nurses (TPAPN)
as an alternative to disciplinary action
Explanation / Rationale:
The Texas Board of Nursing prioritizes public safety but also recognizes that substance use disorders
are illnesses that can be treated. TPAPN is a non-disciplinary monitoring program designed to support
nurses whose competency may be impaired due to substance use or mental health issues. If the nurse
agrees to participate and complies with the program requirements, the BON may choose to suspend
disciplinary proceedings. Automatic revocation is reserved for the most egregious cases where
rehabilitation is not feasible or the nurse poses an immediate, non-negotiable danger. A letter of
counseling is insufficient for a serious violation like drug diversion. Suspension without rehabilitation
does not address the root cause of the impairment.
A nurse is teaching a nursing student about the requirements for the "Good Professional Nursing
Practice" standard under the Texas Board of Nursing. Which statement by the nursing student
indicates a need for further teaching?
A) "I must provide safe, compassionate, and competent nursing care."
B) "I am expected to use critical thinking and nursing judgment in my practice."
C) "I must follow the orders of a physician even if I believe they are detrimental to the patient."
D) "I need to maintain accurate and timely documentation of patient care."
Correct Answer: C) "I must follow the orders of a physician even if I believe they are detrimental
to the patient."
Explanation / Rationale:
A nurse has a legal and ethical duty to act as a patient advocate. Following a physician's order that a
nurse knows or should know is detrimental to the patient constitutes a failure to exercise the duty to
the patient and is a violation of the standard of care. The "Good Professional Nursing Practice"
standard requires nurses to use critical thinking and judgment. Nurses have the right and
responsibility to question and refuse to carry out orders that are not in the best interest of the patient
or are contraindicated. Options A, B, and D all accurately describe components of safe and
professional nursing practice.
, A nurse is employed by a staffing agency and is assigned to various hospitals on a per-diem basis. The
nurse realizes that one of the assignment facilities requires a nurse-to-patient ratio of 1:5, but the
agency contract says the nurse can take up to 6 patients. If the nurse accepts 6 patients and a patient
is harmed due to the lack of timely surveillance, who bears the primary liability for the negligence?
A) The staffing agency, because they set the contract terms
B) The hospital, because they accepted the nurse and assigned the patients
C) The nurse, because the nurse is ultimately responsible for their own practice and accepting the
assignment
D) The physician, because they oversee the patient's plan of care
Correct Answer: C) The nurse, because the nurse is ultimately responsible for their own practice
and accepting the assignment
Explanation / Rationale:
While employers (agencies and hospitals) can be held vicariously liable, the Nursing Practice Act holds
the individual nurse responsible for their own practice. A nurse has a duty to accept only those
assignments that they are competent to perform and that do not compromise patient safety. If the
nurse knows the ratio is unsafe or violates the facility's safety standards (which often reflect standard
of care) and accepts the patient assignment anyway, the nurse is accountable for the resulting
negligence. The nurse should refuse the unsafe assignment. The agency and hospital may share
liability, but the primary liability for the decision to provide care in an unsafe manner rests with the
licensed professional.
Which of the following situations constitutes a violation of the "Nurse Licensure Compact" (NLC) if the
nurse holds a primary residence in a Compact state?
A) The nurse holds a multi-state license but practices nursing physically located in a non-Compact state
using only the multi-state license.
B) The nurse changes their primary residence to a Non-Compact state and continues to practice using
the original multi-state license for more than 60 days.
C) The nurse practices telehealth from their primary residence in a Compact state to a patient located in
another Compact state.
D) The nurse is licensed in Texas (Compact state) and works across the border in New Mexico (Compact
state) without obtaining a New Mexico license.
NURSING
JURISPRUDENCE Q AND A
CONTAINS:
✓ Nursing Jurisprudence / Legal & Ethical Nursing Practice exam preparation
material
✓ Scenario-based multiple-choice questions
✓ Select-all-that-apply (SATA) questions
✓ Correct answers clearly identified
✓ Detailed legal and ethical rationales
✓ Nursing Practice Act (NPA) violations and disciplinary actions
✓ Standards of nursing practice and professional conduct
✓ Use of restraints and legal requirements
✓ Mandatory reporting and impaired nurse obligations
✓ Substance use disorder and alternative-to-discipline programs
✓ Nurse licensure and scope of practice accountability
✓ Nurse Licensure Compact (NLC) rules and residency requirements
✓ Delegation, assignment, and liability for unsafe staffing
✓ Employer vs nurse liability and negligence principles
✓ Patient consent and implied consent in emergency situations
✓ End-of-life legal and ethical issues (DNR orders)
✓ Minor consent laws and patient advocacy responsibilities
✓ Documentation requirements for legal protection
,A registered nurse is working on a medical-surgical unit and receives a shift report that includes a
patient admitted for acute alcohol withdrawal. The patient becomes agitated and threatens to harm
staff members. The nurse applies leather restraints as per facility protocol but fails to obtain a
physician's order for the restraints within the required timeframe. Which of the following violations of
the Nursing Practice Act (NPA) is the nurse most likely guilty of committing?
A) Failure to maintain patient safety
B) Failure to implement the nursing process
C) Practicing nursing without a license
D) Unprofessional conduct
Correct Answer: D) Unprofessional conduct
Explanation / Rationale:
In the context of nursing jurisprudence, specifically within the Texas Nurse Practice Act and similar
regulations, "unprofessional conduct" includes a failure to adhere to established standards of care and
legal protocols regarding patient rights. Restraints are considered a violation of patient rights and
safety risks that require strict adherence to legal standards, including a timely physician's order. While
patient safety is involved, the specific legal violation here is the deviation from the standard of care
and legal requirements (lack of order), which classifies as unprofessional conduct. Options A and B are
generic nursing issues, but the legal implication of not obtaining the order falls under disciplinary
conduct. Option C is incorrect as the nurse is licensed but acting outside the scope of acceptable
practice.
The Texas Board of Nursing (BON) receives a complaint regarding a nurse who has been diverting
controlled substances from the hospital's medication dispensing system. Upon investigation, the BON
determines that the nurse has a diagnosis of opioid use disorder. Which of the following actions is the
BON most likely to take regarding the nurse's license?
A) Automatic permanent revocation of the nursing license
B) Mandatory suspension for 5 years
C) Offer participation in the Texas Peer Assistance Program for Nurses (TPAPN) as an alternative to
disciplinary action
D) Issuance a letter of counseling with no further monitoring
,Correct Answer: C) Offer participation in the Texas Peer Assistance Program for Nurses (TPAPN)
as an alternative to disciplinary action
Explanation / Rationale:
The Texas Board of Nursing prioritizes public safety but also recognizes that substance use disorders
are illnesses that can be treated. TPAPN is a non-disciplinary monitoring program designed to support
nurses whose competency may be impaired due to substance use or mental health issues. If the nurse
agrees to participate and complies with the program requirements, the BON may choose to suspend
disciplinary proceedings. Automatic revocation is reserved for the most egregious cases where
rehabilitation is not feasible or the nurse poses an immediate, non-negotiable danger. A letter of
counseling is insufficient for a serious violation like drug diversion. Suspension without rehabilitation
does not address the root cause of the impairment.
A nurse is teaching a nursing student about the requirements for the "Good Professional Nursing
Practice" standard under the Texas Board of Nursing. Which statement by the nursing student
indicates a need for further teaching?
A) "I must provide safe, compassionate, and competent nursing care."
B) "I am expected to use critical thinking and nursing judgment in my practice."
C) "I must follow the orders of a physician even if I believe they are detrimental to the patient."
D) "I need to maintain accurate and timely documentation of patient care."
Correct Answer: C) "I must follow the orders of a physician even if I believe they are detrimental
to the patient."
Explanation / Rationale:
A nurse has a legal and ethical duty to act as a patient advocate. Following a physician's order that a
nurse knows or should know is detrimental to the patient constitutes a failure to exercise the duty to
the patient and is a violation of the standard of care. The "Good Professional Nursing Practice"
standard requires nurses to use critical thinking and judgment. Nurses have the right and
responsibility to question and refuse to carry out orders that are not in the best interest of the patient
or are contraindicated. Options A, B, and D all accurately describe components of safe and
professional nursing practice.
, A nurse is employed by a staffing agency and is assigned to various hospitals on a per-diem basis. The
nurse realizes that one of the assignment facilities requires a nurse-to-patient ratio of 1:5, but the
agency contract says the nurse can take up to 6 patients. If the nurse accepts 6 patients and a patient
is harmed due to the lack of timely surveillance, who bears the primary liability for the negligence?
A) The staffing agency, because they set the contract terms
B) The hospital, because they accepted the nurse and assigned the patients
C) The nurse, because the nurse is ultimately responsible for their own practice and accepting the
assignment
D) The physician, because they oversee the patient's plan of care
Correct Answer: C) The nurse, because the nurse is ultimately responsible for their own practice
and accepting the assignment
Explanation / Rationale:
While employers (agencies and hospitals) can be held vicariously liable, the Nursing Practice Act holds
the individual nurse responsible for their own practice. A nurse has a duty to accept only those
assignments that they are competent to perform and that do not compromise patient safety. If the
nurse knows the ratio is unsafe or violates the facility's safety standards (which often reflect standard
of care) and accepts the patient assignment anyway, the nurse is accountable for the resulting
negligence. The nurse should refuse the unsafe assignment. The agency and hospital may share
liability, but the primary liability for the decision to provide care in an unsafe manner rests with the
licensed professional.
Which of the following situations constitutes a violation of the "Nurse Licensure Compact" (NLC) if the
nurse holds a primary residence in a Compact state?
A) The nurse holds a multi-state license but practices nursing physically located in a non-Compact state
using only the multi-state license.
B) The nurse changes their primary residence to a Non-Compact state and continues to practice using
the original multi-state license for more than 60 days.
C) The nurse practices telehealth from their primary residence in a Compact state to a patient located in
another Compact state.
D) The nurse is licensed in Texas (Compact state) and works across the border in New Mexico (Compact
state) without obtaining a New Mexico license.
