TEXAS BOARD OF NURSING
Texas Nursing Jurisprudence Exam
2026/2027
Official Practice Exam — 2026/2027 Edition
QUESTIONS MINUTES PASSING SCORE RECERTIFICATION
100 90 80% Required
TABLE OF CONTENTS
Section: Texas Nursing Practice Act — Questions 1–25 (25 questions)
Section: Board of Nursing Rules and Regulations — Questions 26–50 (25 questions)
Section: Delegation and Supervision — Questions 51–70 (20 questions)
Section: Professional Boundaries and Disciplinary Actions — Questions 71–85 (15 questions)
Section: Licensure, Peer Review, and Advocacy — Questions 86–100 (15 questions)
Instructions
This practice exam contains 100 multiple-choice questions divided across 5 sections covering Texas nursing
jurisprudence. You have 90 minutes to complete the entire exam. Select the single best answer for each question. A
score of 80% or higher (80 correct answers out of 100) is required to pass. Each question includes a rationale
explaining the correct answer and why the top distractor is incorrect. Review all rationales carefully to reinforce key
legal and regulatory concepts. Do not use outside resources during the exam. Good luck on your preparation for the
2026/2027 Texas Nursing Jurisprudence Exam.
Disclaimer: This practice exam is an independent study resource and is not affiliated with, endorsed by, or connected to the Texas Board of
Nursing or any official testing organization. Content is designed for educational preparation only.
TX Nursing Jurisprudence — 2026/2027 | Passing Score: 80% | Page 0
,Section 1: Texas Nursing Practice Act — 2026/2027
Q1 Question 1 of 100
A 34-year-old registered nurse working in a Houston hospital is asked by a physician to perform a
procedure that the nurse believes is outside the scope of practice for an RN in Texas. The nurse
consults the Texas Nursing Practice Act to determine the legality of the request. Under the NPA,
which statement best describes the scope of practice for an RN in Texas?
A. The RN performs acts requiring substantial specialized judgment and skill based on knowledge and
application of nursing principles
B. The RN may perform any procedure that a physician delegates regardless of training
C. The RN scope of practice is limited to tasks explicitly listed in the Nursing Practice Act statute
D. The RN may perform any procedure that a physician is authorized to perform
Correct Answer: A
Rationale:
The Texas NPA defines RN scope of practice as performing acts requiring substantial specialized judgment
and skill based on nursing knowledge. The NPA does not limit RNs to an explicit list of tasks, nor does it allow
RNs to perform any physician-delegated procedure without proper training and scope alignment.
Q2 Question 2 of 100
A 28-year-old licensed vocational nurse (LVN) in a Dallas clinic is assigned to assess a newly
admitted patient with complex comorbidities. The LVN questions whether this assignment is within
the LVN scope of practice. According to the Texas Nursing Practice Act, the LVN scope of practice
is best described as which of the following?
A. Performing independent comprehensive assessments and developing nursing care plans
B. Providing directed, focused assessments and participating in planning under the direction of an RN
or other authorized provider
C. Performing the same scope of practice as an RN under direct physician supervision
D. Performing only those tasks that are explicitly enumerated in the Nursing Practice Act
Correct Answer: B
Rationale:
Under the Texas NPA, the LVN provides directed, focused assessments and participates in care planning
under the direction of an RN or authorized provider. LVNs do not perform independent comprehensive
assessments, which is an RN function. The LVN scope is not equivalent to the RN scope even under
physician supervision.
TX Nursing Jurisprudence — 2026/2027 | Passing Score: 80% | Page 1
,Section 1: Texas Nursing Practice Act — 2026/2027
Q3 Question 3 of 100
A 42-year-old RN working in an Austin emergency department refuses to carry out a physician order
that the nurse believes would cause patient harm. The nurse documents the refusal and notifies the
charge nurse. Under the Texas NPA, this action by the nurse is considered which of the following?
A. Professional insubordination subject to disciplinary action by the Board
B. A voluntary action that exceeds the minimum requirements of the NPA
C. A duty required by the NPA to protect patient safety and avoid negligent practice
D. A violation of the nurse's obligation to follow physician orders without exception
Correct Answer: C
Rationale:
The Texas NPA requires nurses to act in the best interest of patient safety, which includes refusing to carry
out orders that would cause harm. This is a duty, not merely voluntary. The NPA does not require blind
obedience to physician orders, and the nurse would not be disciplined for protecting patient safety.
Q4 Question 4 of 100
A 36-year-old advanced practice registered nurse (APRN) in San Antonio is questioned by a
colleague about the APRN's prescriptive authority under the Texas NPA. The APRN explains that
prescriptive authority requires which of the following?
A. No additional requirements beyond the APRN license itself
B. Completion of a 40-hour pharmacology course approved by the medical board
C. Direct physical presence of the collaborating physician for every prescription written
D. A delegation agreement with a collaborating physician and compliance with prescriptive authority
rules
Correct Answer: D
Rationale:
Under the Texas NPA, APRNs must have a delegation agreement with a collaborating physician to exercise
prescriptive authority. The license alone does not grant prescriptive authority, and there is no requirement for
direct physician presence for each prescription. Pharmacology education is part of preparation but does not
alone confer prescriptive authority.
TX Nursing Jurisprudence — 2026/2027 | Passing Score: 80% | Page 2
, Section 1: Texas Nursing Practice Act — 2026/2027
Q5 Question 5 of 100
A 30-year-old RN working in a Fort Worth hospital is asked by a patient's family member to provide
a copy of the patient's medical record. The patient is conscious and has not authorized release of
records. Under the Texas NPA and related law, the nurse should take which action?
A. Deny the request and explain that patient authorization is required for release of records
B. Provide the records because family members have a legal right to access
C. Provide a summary of the records without disclosing specific details
D. Consult the hospital attorney before responding to any family request
Correct Answer: A
Rationale:
Under Texas law, patient medical records are confidential and cannot be released without patient
authorization. Family members do not have an automatic right to access records of a competent adult.
Providing even a summary without authorization violates confidentiality. While consulting an attorney is an
option, the nurse should first follow the legal requirement to deny unauthorized release.
Q6 Question 6 of 100
A 45-year-old RN working in a rural Texas clinic is the only nurse on duty when a patient presents
with an emergency condition. The physician is unavailable by phone. The nurse initiates life-saving
measures. Under the Texas NPA, the nurse's actions are justified under which principle?
A. Good Samaritan doctrine that shields all healthcare providers from liability
B. Emergency doctrine allowing nurses to act beyond normal scope in life-threatening situations when
a provider is not available
C. Standing orders that authorize nurses to practice medicine in emergencies
D. Informed consent waiver that applies in all emergency situations
Correct Answer: B
Rationale:
The Texas NPA includes an emergency doctrine that permits nurses to act beyond their usual scope in
life-threatening situations when no authorized provider is available. The Good Samaritan doctrine applies to
voluntary assistance outside employment. Standing orders do not authorize practicing medicine, and informed
consent is a separate legal concept.
TX Nursing Jurisprudence — 2026/2027 | Passing Score: 80% | Page 3
Texas Nursing Jurisprudence Exam
2026/2027
Official Practice Exam — 2026/2027 Edition
QUESTIONS MINUTES PASSING SCORE RECERTIFICATION
100 90 80% Required
TABLE OF CONTENTS
Section: Texas Nursing Practice Act — Questions 1–25 (25 questions)
Section: Board of Nursing Rules and Regulations — Questions 26–50 (25 questions)
Section: Delegation and Supervision — Questions 51–70 (20 questions)
Section: Professional Boundaries and Disciplinary Actions — Questions 71–85 (15 questions)
Section: Licensure, Peer Review, and Advocacy — Questions 86–100 (15 questions)
Instructions
This practice exam contains 100 multiple-choice questions divided across 5 sections covering Texas nursing
jurisprudence. You have 90 minutes to complete the entire exam. Select the single best answer for each question. A
score of 80% or higher (80 correct answers out of 100) is required to pass. Each question includes a rationale
explaining the correct answer and why the top distractor is incorrect. Review all rationales carefully to reinforce key
legal and regulatory concepts. Do not use outside resources during the exam. Good luck on your preparation for the
2026/2027 Texas Nursing Jurisprudence Exam.
Disclaimer: This practice exam is an independent study resource and is not affiliated with, endorsed by, or connected to the Texas Board of
Nursing or any official testing organization. Content is designed for educational preparation only.
TX Nursing Jurisprudence — 2026/2027 | Passing Score: 80% | Page 0
,Section 1: Texas Nursing Practice Act — 2026/2027
Q1 Question 1 of 100
A 34-year-old registered nurse working in a Houston hospital is asked by a physician to perform a
procedure that the nurse believes is outside the scope of practice for an RN in Texas. The nurse
consults the Texas Nursing Practice Act to determine the legality of the request. Under the NPA,
which statement best describes the scope of practice for an RN in Texas?
A. The RN performs acts requiring substantial specialized judgment and skill based on knowledge and
application of nursing principles
B. The RN may perform any procedure that a physician delegates regardless of training
C. The RN scope of practice is limited to tasks explicitly listed in the Nursing Practice Act statute
D. The RN may perform any procedure that a physician is authorized to perform
Correct Answer: A
Rationale:
The Texas NPA defines RN scope of practice as performing acts requiring substantial specialized judgment
and skill based on nursing knowledge. The NPA does not limit RNs to an explicit list of tasks, nor does it allow
RNs to perform any physician-delegated procedure without proper training and scope alignment.
Q2 Question 2 of 100
A 28-year-old licensed vocational nurse (LVN) in a Dallas clinic is assigned to assess a newly
admitted patient with complex comorbidities. The LVN questions whether this assignment is within
the LVN scope of practice. According to the Texas Nursing Practice Act, the LVN scope of practice
is best described as which of the following?
A. Performing independent comprehensive assessments and developing nursing care plans
B. Providing directed, focused assessments and participating in planning under the direction of an RN
or other authorized provider
C. Performing the same scope of practice as an RN under direct physician supervision
D. Performing only those tasks that are explicitly enumerated in the Nursing Practice Act
Correct Answer: B
Rationale:
Under the Texas NPA, the LVN provides directed, focused assessments and participates in care planning
under the direction of an RN or authorized provider. LVNs do not perform independent comprehensive
assessments, which is an RN function. The LVN scope is not equivalent to the RN scope even under
physician supervision.
TX Nursing Jurisprudence — 2026/2027 | Passing Score: 80% | Page 1
,Section 1: Texas Nursing Practice Act — 2026/2027
Q3 Question 3 of 100
A 42-year-old RN working in an Austin emergency department refuses to carry out a physician order
that the nurse believes would cause patient harm. The nurse documents the refusal and notifies the
charge nurse. Under the Texas NPA, this action by the nurse is considered which of the following?
A. Professional insubordination subject to disciplinary action by the Board
B. A voluntary action that exceeds the minimum requirements of the NPA
C. A duty required by the NPA to protect patient safety and avoid negligent practice
D. A violation of the nurse's obligation to follow physician orders without exception
Correct Answer: C
Rationale:
The Texas NPA requires nurses to act in the best interest of patient safety, which includes refusing to carry
out orders that would cause harm. This is a duty, not merely voluntary. The NPA does not require blind
obedience to physician orders, and the nurse would not be disciplined for protecting patient safety.
Q4 Question 4 of 100
A 36-year-old advanced practice registered nurse (APRN) in San Antonio is questioned by a
colleague about the APRN's prescriptive authority under the Texas NPA. The APRN explains that
prescriptive authority requires which of the following?
A. No additional requirements beyond the APRN license itself
B. Completion of a 40-hour pharmacology course approved by the medical board
C. Direct physical presence of the collaborating physician for every prescription written
D. A delegation agreement with a collaborating physician and compliance with prescriptive authority
rules
Correct Answer: D
Rationale:
Under the Texas NPA, APRNs must have a delegation agreement with a collaborating physician to exercise
prescriptive authority. The license alone does not grant prescriptive authority, and there is no requirement for
direct physician presence for each prescription. Pharmacology education is part of preparation but does not
alone confer prescriptive authority.
TX Nursing Jurisprudence — 2026/2027 | Passing Score: 80% | Page 2
, Section 1: Texas Nursing Practice Act — 2026/2027
Q5 Question 5 of 100
A 30-year-old RN working in a Fort Worth hospital is asked by a patient's family member to provide
a copy of the patient's medical record. The patient is conscious and has not authorized release of
records. Under the Texas NPA and related law, the nurse should take which action?
A. Deny the request and explain that patient authorization is required for release of records
B. Provide the records because family members have a legal right to access
C. Provide a summary of the records without disclosing specific details
D. Consult the hospital attorney before responding to any family request
Correct Answer: A
Rationale:
Under Texas law, patient medical records are confidential and cannot be released without patient
authorization. Family members do not have an automatic right to access records of a competent adult.
Providing even a summary without authorization violates confidentiality. While consulting an attorney is an
option, the nurse should first follow the legal requirement to deny unauthorized release.
Q6 Question 6 of 100
A 45-year-old RN working in a rural Texas clinic is the only nurse on duty when a patient presents
with an emergency condition. The physician is unavailable by phone. The nurse initiates life-saving
measures. Under the Texas NPA, the nurse's actions are justified under which principle?
A. Good Samaritan doctrine that shields all healthcare providers from liability
B. Emergency doctrine allowing nurses to act beyond normal scope in life-threatening situations when
a provider is not available
C. Standing orders that authorize nurses to practice medicine in emergencies
D. Informed consent waiver that applies in all emergency situations
Correct Answer: B
Rationale:
The Texas NPA includes an emergency doctrine that permits nurses to act beyond their usual scope in
life-threatening situations when no authorized provider is available. The Good Samaritan doctrine applies to
voluntary assistance outside employment. Standing orders do not authorize practicing medicine, and informed
consent is a separate legal concept.
TX Nursing Jurisprudence — 2026/2027 | Passing Score: 80% | Page 3
