Nurse Practice Act

Question 1

Who authored the NC-NPA

Answer 1

The North Carolina General Assembly

Question 2

Who is the NC Board of Nursing

Answer 2

Elected and appointed individuals who are charged with enforcing the Nc nurse practice act

Question 3

Who comprises the BON

Answer 3

14 members: 8 RN’s of which 3 are educators, 3 LPNs and 3 members at large

Question 4

What is the charge from the NPA to the BON?

Answer 4

To interpret and enforce the NPA to keep the citizens of NC safe (regulatory).

Question 5

What is the relationship of the NPA to the BON?

Answer 5

Interdependent or symbiotic. One depends on the other.

Question 6

What is the NPA?

Answer 6

A law

Question 7

Where in the NPA is RN practice defined?

Answer 7

Within the 10 points of RN practice…this is the SCOPE and boundaries of practice.

Question 8

What is the first component of the definition of RN practice?

Answer 8

Assessment!Assess the patient’s physical and mental health including the patient’s reaction to illness and treatment regimens.

Question 9

What does the NPA say about RN practice in regards to patient safety?

Answer 9

Providing for the maintenance of safe and effective nursing care, whether rendered directly or indirectly is one of the 10 components of the scope of RN practice.

Question 10

What does the NPA say about RN practice in regards to delegation?

Answer 10

It is within the scope of the RN to delegate those activities that are appropriate for safe nursing care. The RN is ultimately responsible for the delegation and evaluation of the tasks delegated to another RN, LPN or nursing assistant.
* Search for the delegation tree on the BON website for the specifics of delegation.

Question 11

What can be delegated to a nursing assistant?

Answer 11

Tasks that are:

1. Routine
2. Repetitive
3. Have no impact on patient outcome
4. Are stable patients as deemed by the RN assessment
5. Requires no critical judgement

Question 12

What is the primary purpose of the NPA?

Answer 12

To regulate the practice of nursing keep the citizens of NC safe from incompetent nurses

Question 13

What was the first state to ever regulate nursing?

Answer 13

North Carolina in 1903.

Many states have modeled their practice act after NC.

Question 14

What is the organization that is responsible for guiding the standards for nursing regulation and setting and authoring the content of the NCLEX exam?

Answer 14

The National Council of State Boards of Nursing

Question 15

Is nursing practice regulated at the federal or the state level?

Answer 15

State.

Each state has their own practice act.

Question 16

What is the style of language used to write the NPA

Answer 16

Legal or “ legalese”

Question 17

Why is legalese style of language used?

Answer 17

To allow interpretation and debate in a court of law

Question 18

What are 2 critical ways the RN practice differs from the LPN practice

Answer 18

1. RN is responsible for the patient assessment while the LPN can only PARTICIPATE in a component if the assessment.
2. RN creates the nursing plan of care and LPN participates in carrying out PART of that plan.
3. RN creates the patient teaching plan, LPN can only teach PARTS of the plan delegated to LPN by the RN.
4. In a delegated situation RN is responsible for the care and evaluation of what is delegated to the LPN. LPN is responsible for the care they complete.

Question 19

What does the NPA say about medication administration by the RN?

Answer 19

It is one of the 10 points on RN practice if the medication has been prescribed by a licensed person i. The state (MD,DO, NP, CRNA, CNM, dentist).

Question 20

How much does it cost the first tine you apply for license in NC?

Answer 20

$75

Question 21

In NC how often must RN’s renew their license?

Answer 21

Every 2 years by the last day of their birth month.

Question 22

How much does it cost to renew an RN license?

Answer 22

$100 if mailed in

Question 23

What requirements must be met for a new graduate to obtain an RN license the first tine in NC?

Answer 23

1. Graduate from a BON approved school.
2. Pay all fees.
3. Pass the background check
4. Pass NCLEX, cost $200 to sit the exam through PearsonVUE
5. Submit all BON documents + $75
6. Be certified as mentally and physically competent

Question 24

What does the NPA say about mental and physical fitness?

Answer 24

The Act states that a nurse must be certified as mentally and physically competent (done by program director and faculty at DUKE) and able to safely render care to patients or populations.

Question 25

What is the responsibility of a licensed RN who believes a colleague is impaired?

Answer 25

The RN is legally bound to take steps to report the colleague to the board of nursing. The first step in this process is to take the alleged complaint to the supervisor. That said, the RN must not stop till corrective action and an investigation into the alleged complaint has been completed.

Failure to report can be just cause to revoke the reporting RN’s license.

Question 26

What could happen to an RN who is CONVICTED of a DUI?

Answer 26

Must report the CONVICTION within 30 days to the BON.

May lose or have their license suspended.

May be required by BON to submit to a BON treatment plan and complete that treatment and provide proof of successful completion before reinstatement of the license can occur.

Question 27

Why can a student at DUSON practice without a license?

Answer 27

Because they are enrolled in a NC BON approved school.

Question 28

Does the student practice “on” the license of another RN?

Answer 28

Absolutely not! Only one person who holds that license can practice on that license. The student practices as an unlicensed provider enrolled in a program of study from a BON approved school.

Question 29

What is the responsibility of the student when providing patient care?

Answer 29

To uphold the same standard of care as a licensed RN.

Question 30

What is the legal definition of a standard of care?

Answer 30

“What any reasonably prudent nurse would do in similar circumstances.”

Question 31

What is the responsibility of the CI in regards to student practice?

Answer 31

To ensure the student meets the same standard of care as the licensed RN.

Question 32

Can an employer restrict a nurses scope of practice to less points than is outlined in the NPA?

Answer 32

Yes if that nurse is an employee or a contractual employee accepting compensation for services.

Example: a hospital has an IV team do RN’s on the unit are not allowed to start IV’s even though venipunctures are within the scope of an RN as outlined in the 10 points of the scope of practice of an RN.

Question 33

Can an employer expand an RN’s scope if practice?

Answer 33

No. Not beyond what is outlined in the NPA.

Example: hospital wants OR nurses to learn to suture all surgical closings in the OR so surgeons can move on to another case. This is beyond the skills and knowledge of an RN. So the nurse must refuse this task on the grounds of “beyond my scope of practice.”