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Course # 31373 • The Ohio Nurse Practice Act


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  1. Identify the organization and mission of the Ohio Board of Nursing.
  2. List the components of the nursing process, as related to the practice of registered nurses and licensed practical nurses in the state of Ohio.
  3. Recognize the importance of safe nursing practice.
  4. Identify nursing violations that may result in the revocation of a license.
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1. The Ohio Board of Nursing is composed of
A) eight RNs and four LPNs.
B) four RNs, four LPNs, and one consumer member.
C) eight RNs, four LPNs, and one consumer member.
D) seven RNs, three LPNs, and one consumer member.

BOARD ORGANIZATION AND MISSION

The Ohio Board of Nursing consists of 13 members and includes eight registered nurses (at least two of which must be authorized to practice as an advanced practice registered nurse), four licensed practical nurses, and one consumer member that represents the interests of consumers of health care [2]. A president and vice-president are elected from among the members; these positions are one-year terms. Board members serve four years, commencing on the 1st day of January and ending on the 31st day of December. In addition, the Board employs a full-time Executive Director who is a registered nurse.


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2. The Board's mission is to
A) actively safeguard the health of the public through the effective regulation of nursing care.
B) act as an advocate for the licensed nurse, modifying regulations as they relate to individual nursing practice.
C) encourage nurses to acquire additional education and experience by disciplining those individuals who only fulfill minimum education requirements.
D) None of the above

BOARD ORGANIZATION AND MISSION

The Board's mission is "to actively safeguard the health of the public through the effective regulation of nursing care" [1]. The Board evaluates reported deviation from standards with relation to intent, pattern, and circumstance. After evaluating a possible violation, a nurse is adjudicated through due process action. The Board may revoke or place restrictions on the nurse's license, reprimand and levy a fine, or take no action when standards have been breached with regard to nursing process, patient safety, competent practice, or proper delegation.


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3. Which of the following are components of the nursing process for RNs?
A) Evaluation and analysis
B) Assessment and discipline
C) Planning and implementation
D) Both A and C

STANDARDS OF PRACTICE

In conjunction with his or her knowledge, the RN uses the nursing processes of assessment, analysis, planning, implementation, and evaluation to perform duties as outlined by the OAC [3]:

  • Assessment of health status involves collecting and documenting data from the patient, family members, significant others, and other members of the healthcare team. The RN may direct or delegate the performance of data collection.

  • Analysis of individual patient needs should utilize skills and reasoning, including identification, organization, assimilation, and interpretation of data to establish, accept, or modify a nursing diagnosis. The patient's health status and nursing diagnosis must be reported to other members of the healthcare team.

  • Planning for care involves the development, establishment, maintenance, or modification of the nursing plan of care consistent with current nursing science, including the nursing diagnosis, desired patient outcomes or goals, and nursing interventions. It must be communicated to other team members in a timely fashion to allow for input and modification or implementation.

  • Implementation involves executing the nursing regimen; implementing the current plan of care; providing nursing care within the RN's documented scope of education, knowledge, skills, and abilities; assisting and collaborating with other healthcare providers in the care of the patient; and delegating appropriate nursing tasks. In some cases, this also involves collaboration in the administration of care that has been ordered by a licensed practitioner.

  • Evaluation of the patient's response to nursing treatment is a critical component of nursing practice. Progress toward expected outcomes should be documented. RNs should also reassess the patient's health status and establish or modify any aspect of the nursing plan. After performing the evaluation, the RN must communicate the patient's response to others who are involved in the patient's care and seek medically prescribed modification when indicated by prudent nursing judgment.


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4. The role of the LPN in the nursing process is to
A) delegate job duties to CNAs and other unlicensed personnel.
B) communicate relevant information to other LPNs and CNAs.
C) analyze individual patient needs and relay the information to the physician.
D) contribute to the assessment, planning, implementation, and evaluation of care.

STANDARDS OF PRACTICE

Under the Nurse Practice Act, practicing as an LPN is defined as providing to individuals and groups nursing care requiring basic knowledge, judgment, and skill derived from the principles of biological, physical, behavioral, social, and nursing sciences at the direction of a licensed physician, dentist, podiatrist, optometrist, chiropractor, or registered nurse [2]. When the LPN is properly trained and supervised, this care may consist of special tasks. The practical nurse contributes to the assessment, planning, implementation, and evaluation of care while communicating information to others [3].


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5. In order to provide safe patient care, the nurse should, at all times,
A) delegate nursing tasks according to the nurse's best judgment.
B) enforce sanctions against nurses who have committed violations.
C) display the applicable title or initials to identify the nurse's relevant licensure as an RN or LPN.
D) None of the above

STANDARDS OF PRACTICE

In addition to competency, licensed nurses have the responsibility to provide safe patient care. This requires the nurse, at all times, to [4]:

  • Display applicable identification indicating licensure as a registered nurse or licensed practical nurse, including area of practice (e.g., certified nurse-midwife).

  • Identify to each patient or healthcare professional the nurse's title or initials when engaged in nursing practice through telecommunications.

  • Delegate a nursing task only in accordance with Board rules.

  • Report and document nursing assessments or observations in a complete, accurate, and timely manner. This includes care provided by the nurse for the patient, and the patient's response to that care.

  • Report to the appropriate practitioner errors in or deviations from the current valid order.


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6. Licensed nurses should not engage in behavior that causes or may cause
A) mental abuse.
B) physical abuse.
C) emotional abuse.
D) All of the above

STANDARDS OF PRACTICE

The OAC 4723-4-06 states that all licensed nurses must take measures to promote a safe environment for each patient. Specifically, this includes delineating, establishing, and maintaining professional boundaries with each patient. When providing direct nursing care to a patient, licensed nurses should treat each patient with courtesy, respect, and with full recognition of dignity and individuality. During examination or treatment and in the care of personal or bodily needs, privacy should be respected and given. Licensed nurses should not engage in behavior that causes or may cause physical, verbal, mental, or emotional abuse to a patient [5].


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7. Patients are always presumed
A) guilty in cases of accused sexual harassment.
B) capable of giving consent to sexual activity with the nurse.
C) incapable of giving consent to sexual activity with the nurse.
D) None of the above

STANDARDS OF PRACTICE

Patients are always presumed incapable of giving free, full, or informed consent to sexual activity with the nurse.


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8. A complete list of violations that may result in disciplinary action is available at
A) OAC 4723-01.
B) ORC 4732.13.
C) ORC 4723.28.
D) OAC 4237-23.

DISCIPLINARY ACTIONS

A nurse who commits fraud through misrepresentation or deception when applying for renewal of a nursing license may have his or her license revoked by the Board. The Board may also deny, revoke, suspend, or place restrictions on any nursing license; reprimand or otherwise discipline a holder of a nursing license; or impose a fine of not more than $500 per violation for a multitude of reasons. Violations can be grouped into general areas; the following is not meant to be an inclusive account of every type of infringement [6]. (Please refer to Section 4723.28 of the Ohio Revised Code for a complete list of violations.)


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9. Which of the following violations may result in the revocation or suspension of a nursing license?
A) Pleading guilty to a misdemeanor
B) Failing to establish and maintain professional boundaries
C) Self-administering dangerous drugs without a prescription
D) All of the above

DISCIPLINARY ACTIONS

Engaging in criminal activity, either in the course of practice or outside of a practice setting, may be grounds for disciplinary action. Criminal activity is defined as being convicted of or pleading guilty to a misdemeanor or felony. In the case of a misdemeanor committed in the course of practice, there may be a finding of "eligibility for a pretrial diversion or similar program or for intervention in lieu of conviction" [6]. The Board may impose sanctions for being convicted of a felony in relation to gross immorality or moral turpitude, the illegal sale of drugs or therapeutic devices, or committing a crime outside of the jurisdiction of the state that would constitute a felony or misdemeanor in the state of Ohio [6].

Any action that causes impairment is also grounds for sanction by the Board. This includes self-administering dangerous drugs without a prescription and habitual indulgence of habit-forming drugs, alcohol, or other chemical substances. A physical or mental disability may also impair the nurse's ability to practice according to acceptable and prevailing standards of safe nursing. If a nurse's license has been revoked due to mental illness or incompetence, the Board may reinstate the license upon proof of competence through adjudication of a probate court [6].

Other violations include assaulting or causing harm to a patient, depriving a patient of the means to summon assistance, and using intentional misrepresentation or material deception to obtain money and/or anything of value in the course of practice. The nurse who fails to establish and maintain professional boundaries with a patient or engages in sexually inappropriate behavior, physically or verbally, is also eligible for disciplinary action [6].


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10. Which of the following constitutes the violation of a safety precaution?
A) An RN delegating a task to an unlicensed assistive person
B) Failing to complete the continuing education requirement
C) Engaging in activities that exceed the practice of the licensee
D) All of the above

DISCIPLINARY ACTIONS

Disciplinary action may also result from violating safety precautions. Safety violations include the failure to use universal blood and body fluid precautions and the failure to practice in accordance with acceptable and prevailing standards of safe nursing care. Engaging in activities that exceed the scope of practice of the licensee is deemed unsafe. In addition, aiding and abetting the practice of nursing by a person who does not hold a license is grounds for sanction by the Board [6]. Effective December 2020, APRNs who are clinical nurse specialists, certified nurse-midwives, or certified nurse practitioners who fail to comply with the terms of a consult agreement entered into with a pharmacist may be sanctioned [6].


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