Texas Jurisprudence Exam: Questions and Answers, Exams of Nursing

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Texas Jurisprudence Exam questions and answers Can a patient successfully sue a doctor if there is no physician-patient relationship? - No If there is no prior physician-patient relationship, are you legally obliged to respond to a call from a patient for treatment? - No Does being on call give rise to a physician-patient relationship? - No How can one terminate a physician-patient relationship, without abandonment if there is ongoing treatment? - 30 days written notice; must provide for emergency Does a physician's duty extend to the unborn child or potential victims of an ill patient? - Yes What is "proximate cause"? - Prove that negligence caused harm and that the cause was not too remote; what is required to hold a defendant liable in a civil lawsuit What are the two components of proximate cause? - Cause-in-fact (but-for test) and foreseeability Texas Jurisprudence Exam questions and answers Does an expert witness have to be actively practicing medicine? - Yes Does an expert witness have to know standards of care? - Yes Does an expert witness have to have enough training to express an opinion on whether standard of care was provided? - Yes Does an expert witness have to be board certified? - No, board certified or eqivalent In a medical malpractice case, are expert witnesses required? - Yes, with two exceptions In a medical malpractice setting, what 2 instances do not need expert testimony? - Res ipsa loquitur (e.g., amputation of wrong leg) and negligence per se (a law was broken) What are "exemplary damages"? - Damages above compensatory designed to punish the defendant and deter the behavior Texas Jurisprudence Exam questions and answers What is "strict liability"? - Liability that does not depend on actual negligence, but that is based on a breach of a duty to make something safe. This often applies to product liability Are hospitals liable for the actions of a physician? - No, unless the hospital employs the physician Who determines in a criminal case if the medical records of a patient should be released? - Judge by inspection How many days do you have to release medical records to an attorney? - 45 days Can medical records be admitted as evidence in court? What are the requirements? - Yes, but only with affidavit What are schedule 1, 2, 3, 4, 5 drugs? - Schedule 1—no known use (e.g., heroin); schedule 2—very addictive (morphine, cocaine); schedule 3-5—less addictive What are dangerous drugs? - Prescription drugs other than schedule 1-5 Texas Jurisprudence Exam questions and answers How many DEA registrations do you need if you prescribe drugs? dispense drugs? - One to prescribe; a separate registration for each location where you dispense How often do you renew your DEA license? - Every 3 years Can you move your office location and then change your DEA? - No, need to change BEFORE move Is a DEA registration sufficient to prescribe drugs in Texas? - No, also need Department of Public Safety Bureau of Narcotics and Dangerous Drug registration How often do you renew a DPS license? - Yearly Do you have to display the DEA and DPS licenses? - Not required by any statute. How many days do you have to notify the DPS of any change in your information (name, address, tel., etc.)? - 7 days Texas Jurisprudence Exam questions and answers Can you have your DPS suspended and keep your DEA or vice versa? - No, they are interconnected For schedules 2-5 drugs, can you just put the number of pills on prescription? - No, number and number spelled out Do you have to put intended use on prescription? - Yes With how many days of a schedule 2-5 drug can a patient be discharged from the hospital? - 7 days; only if the drug was already rx in the hospital What kind of prescription pad do you need for schedule 2 drugs? Can you use stickers? - Official DPS form; no stickers Can a physician prescribe schedule 2 over the phone? - Yes, for emergencies, and only for the duration of emergency How many days does the physician have to mail the schedule's emergency prescription to the pharmacy? - 7 days Texas Jurisprudence Exam questions and answers How many and what competency levels of healthcare providers do you need in all settings? - At least 2 physicians with advanced competency How many days do you have to report office-based anesthesia-related complications? - 15 days What is considered an anesthesia-related complication? - Admission to hospital within 24 hours or death within 72 hours What is considered intractable pain? - Pain where cause of pain cannot be removed and where relief or cure has not been found Can a hospital forbid a physician to give dangerous drugs or controlled substances for treatment of intractable pain? - No Can the board take disciplinary action against a physician for giving dangerous or controlled substances to a patient with intractable pain? - No Texas Jurisprudence Exam questions and answers What must the physician document prior to treatment of intractable pain? - Understanding between physician and patient about treatment; dose, type, frequency of medication; consultation with psychologist, psychiatrist, addictions expert Can you guarantee that a drug will work? - No Who can be part of a confidential communication? - Persons involved, furthering interest of the patient, and those participating in diagnosis or treatment, e.g., patients, doctors, translators, nurses, etc Is the billing record confidential? - No, billing record is NOT part of medical record In a criminal proceeding, is the physician-patient privilege communication confidential? - NO (except for mental health records); judicial ruling should be obtained In a criminal proceeding, are records of alcohol and drug abuse confidential? - Yes Texas Jurisprudence Exam questions and answers Does the physician confidentiality apply to court or administrative proceedings brought by the patient against a physician? - No Can the physician violate confidentiality if he/she thinks he or someone else is in danger? - Yes, must report that to law enforcement agency (NOT for mental health) What information must a release of medical records include? - Type of records, reason, and person to whom to release How many days (hospital) or business days (physician) does a hospital/physician have to provide medical records when they are requested? - Physician has 15 business days, hospital has 15 days What is "therapeutic privilege," when can it be used, who has access to the information, and what is the protocol the physician must follow? - If physician thinks that information would be harmful to the patient, it can be withheld; in writing, copy in the chart; films or tests must be released to patient representative Can the physician charge for medical records and films? For an affidavit? Does he have to give the information if the patient does not pay? What does he do if the Texas Jurisprudence Exam questions and answers Is HIV information confidential? - Yes Can you "break" confidentiality in order to tell a spouse that his/her spouse is HIV positive? - Yes Can you break confidentiality to tell a partner about notification program?. - Yes Are blood bank records confidential? - Yes If a blood bank finds a donor with an infectious disease, can they call other blood banks and tell them the name of donor and the disease?Edition. - They can tell name of donor, NOT disease If a blood bank finds that blood outbound to hospitals is HIV positive, can they call the hospitals and give name of donor? Type of disease? - They can tell name of disease, NOT donor For statistical purposes, can a blood bank give out medical records? Names? - Yes, but not names or other identifying information Texas Jurisprudence Exam questions and answers Is genetic information confidential? - Yes Can patients have access to the results of their genetic testing? - Yes What kind of crime is the unauthorized release of records? - Misdemeanor Can the Texas Medical Board (TMB) show preference to a specific school of medicine such as medicine v. osteopathy? - No What does the Medical Practice Act (MPA) regulate? - The practice of medicine Who does the MPA apply to? - Physicians (MD, DO), PAs, and acupuncturists Does the MPA apply to the armed forces and federal public health? Can they moonlight? - It does NOT apply to a federal job, they can NOT moonlight outside the federal setting Does the MPA apply to emergency assistance if there is NO charge of money? If there is money charged or billed? - NO if no charge; YES if money is charged Texas Jurisprudence Exam questions and answers Are medical students in "board-approved schools" subject to the MPA? - No Does the MPA prohibit self-care? - No Does the MPA apply to physicians in contiguous states? - NO (physicians from nearby states can only order care for patients in hospice or nursing homes) How many people are on the TMB? Who appoints them? Who must confirm them? - 19 members, appointed by the governor, confirmed by the senate Can the board subpoena people and records? Who can serve a subpoena? - YES, subpoenas can be served by board investigator or sent by certified mail How often does the Department of Public Safety (DPS; state police) check on physicians and report to the board? - Quarterly What are acceptable methods to tell the public on how to register a complaint to the TMB? In what languages? Where can a physician include this info? - By phone Texas Jurisprudence Exam questions and answers What is a temporary postgraduate training permit? - License for residents and fellows pending the physician in training permit What is a telemedicine license? Do you have to be board certified to have it? Do you have to pass the jurisprudence exam? - A license to do consulting work through internet, etc., in Texas; cannot physically see or treat patients; board certification is required; JP exam required How often do you register your license? Do you need an updated physician profile? - Every 2 years; yes How many days prior to the expiration of your license does the TMB notify you? - 30 How many days after a license expires are you considered to be practicing without a license? - 30 day grace period. License expired < 90 days—penalty is? - $75 License expired 91-364 days—penalty is? - $150 Texas Jurisprudence Exam questions and answers License expired > 364 days—penalty is? - Cancellation Do you have to retake JP exam if your license is canceled? - Only if the license is canceled for more than 2 years. How can you get another license if it is lost/destroyed? - Get affidavit of lost or destroyed document and pay fee to board How many category 1 CMEs yearly? - 12 How many CMEs per year? - 24 How many category 1 CMEs yearly must be in ethics? - 1 How many category 2 CMEs can be from volunteer work? - 6 How many CMEs can a license carry forward? And for how many registration periods? - 48; only once Texas Jurisprudence Exam questions and answers How many CMEs can be applied retroactively? - 24; only once How many CMEs do you need if you become "board certified" within 36 months? - 24 If you practice pain management, how many CMEs in pain management are required? - None, but they are recommended Who can initiate a complaint to the board? - Anyone What is the "health professions council"? - Council of various professionals that establishes a central telephone complaint system (800-number) Does the TMB have to notify a physician when a complaint is filed? Are there exceptions? How often do the parties get updated on proceedings? - Yes, within 30 days, except if it would interfere with the investigation; updates are quarterly When does the TMB release complaint information to the hospital? - Upon written request Texas Jurisprudence Exam questions and answers Is sexual contact between a physician and patient OK if the patient consents? - NO, the disparity of power does not allow consent Why is it unprofessional to initially prescribe drugs over the Internet? - Did not verify identity of patient, no physician coverage or follow-up guaranteed How can you terminate care to a patient? - 30 day notice, certified letter, available for emergencies during that time, give alternative physicians What prescriptions does a physician need to keep records on? Dangerous drugs? Controlled substances? Samples? - Samples and dangerous drugs as part of medical record; for schedule 3-5 records and log; for schedule 2 separate log and records; keep record for 2 years; do inventory on schedule drugs every 2 years Can the board administer monetary penalties? - Yes What happens to his/her license if a physician goes to prison? - TMB is required to suspend Texas Jurisprudence Exam questions and answers How many malpractice claims within what time period automatically open a board investigation? - 3 within 5 years How many people from the TMB are necessary to temporarily suspend a license? - President appoints a 3-member panel; can be done by phone Is self-reporting addiction a disciplinary action? Is a rehabilitation order a disciplinary order? - No; no, it is the only nondisciplinary order Is probation a disciplinary order? Who cannot be put on probation? - Yes; sex offenders, felons, prisoners, or if the physician is a threat to public Can the TMB make a physician give a refund? What is the maximum amount of refund? - Yes; cannot be more than the amount paid What is monitoring? - Continued oversight of the board for subjects on disciplinary orders Texas Jurisprudence Exam questions and answers Who is part of an informal hearing and what is it? - Members of the board, at least one of whom is a public member, physician, his/her attorney; a means to settle a case without an administrative hearing When do you go to formal hearings? What is the SOAH? Is it part of the TMB? Who holds the hearings? Who is participating? Must the TMB follow the ruling of the administrative law judge? - If no settlement reached after informal hearing; state office of administrative hearing; no; board members, physician, attorneys, and administrative law judge; NO, they do not have to follow the judge's ruling Where can a physician file an appeal? Within what time period? Can he practice in the interim? - Circuit court Travis county, within 30 days after final board decision; physician cannot practice in interim Can the TMB panel serve a subpoena to a physician? - Yes Can the physician get his file? - Yes, with written request, within 30 days Can you voluntarily surrender your license? - Yes, but board does not have to accept it Texas Jurisprudence Exam questions and answers Who can a physician delegate to? - Any qualified and properly trained person Who can the physician delegate to administer dangerous drugs? - Any qualified and trained person Can a physician delegate to a midwife? - Yes (e.g., eye prophylaxis) Is a physician liable for the actions of a NP or PA? - No, unless vicariously liable due to employment What kind of name identification do PAs need? - Name tag identifying themselves as a physician assistant What requirements exist for prescription for PAs and NPs? - No schedule 2; maximum 90 days, no refills unless consultation with physician Which drug schedules can PAs and NPs prescribe? How many days? Can they give refills? Can they treat children? What ages? - Schedules 3-5, 90 days, refill after consultation with physician; Yes, but children less than 2 years only after consultation with physician Texas Jurisprudence Exam questions and answers How many PA and NP equivalent FTEs can a physician supervise at maximum? - 3 FTEs Can CRNAs give all anesthetic drugs? Are they restricted to a particular MD? - Yes; no, any MD What authority do pharmacists have? Can they give immunizations? Where does the supervising physician have to be located geographically? - Getting histories, ordering drug therapy-related tests, procedures, modifying drug therapy; yes; physician has to be able to be physically present daily What can optometrists prescribe? - Eye ointments Can anybody be a surgical assistant? Do they need a license? - Yes; yes, if they identify themselves as licensed, otherwise, no Can a physician delegate the taking of X-rays to noncertified technicians? - Yes Texas Jurisprudence Exam questions and answers Can they do bone density? Nuclear tests? CT? Skull X-ray? - Bone density, skull, spine, extremities, abdomen, chest; NOT CT, nuclear test, etc Do they need to be licensed or registered by the boards? - Yes, they need registration What is the difference between a partnership and a limited liability partnership? - The limited liability partnership can limit individual liability white partner A is liable for the acts of partner B Who can incorporate in Texas? Can physicians practice through corporations? - Dentists, PT but NOT MD; MD cannot practice through corporation Are there any corporations that can employ physicians? - Yes, Certified Nonprofit Healthcare Corporation Who can grant a title of Certified Nonprofit Healthcare Corporation? - TMB What are 5 important characteristics of Certified Nonprofit Healthcare Corporations? - Must conduct scientific research, support education, improve Texas Jurisprudence Exam questions and answers Does Texas prohibit remuneration in exchange for referral volume? - Yes, prohibition on the solicitation of patients What kind of crime is it to tamper with Texas Medical Board documents? - Class A Misdemeanor Barratry—what is it? Is it illegal? - Contacting prospective patients in attempts to solicit them; it is illegal Who can be part of a medical peer review committee? - Physicians, health care workers, anybody in the hospital Does physician competency include membership in societies, participation in education, participation in group plans? - No Who makes rules (by laws) for hospitals? - The governing body Can a hospital reject an orthopedist because he is a DO and not an MD? - No Texas Jurisprudence Exam questions and answers Can a hospital deny you privileges because you don't accept HMOs? Participate in other hospitals? - No Who makes the final decision in a hospital to grant or deny privileges to a physician? - Governing body Does the hospital have to get a report from the NPDB about physicians prior to granting privileges? - Yes, initially and every 2 years; if they don't, they are liable How many days does the board have to give data to a hospital requesting it? - 15 days How often must a physician update his core credentials? How many days does he have to provide corrections? - Yearly; corrections within 30 days Prior to the "first release" of his information, how many days does a physician have to review it? - 15 business days If a physician's privileges will be suspended, does he/she have the right to due process? - Yes Texas Jurisprudence Exam questions and answers How many days prior to hearing of due process must the hospital give the physician notification? - 30 days Do hospitals have to accept NPs and PAs? - No If accepting NPs and PAs, what are the hospital's responsibilities? - Due process, fairness, appeal Is the peer review file confidential? - Yes, EXCEPT for possible civil rights violation and possible anti-trust violation When must a hospital's medical peer review report actions taken against physicians to the TMB? to the HCQIA? to the NPDB? - If action affects privileges for longer than 30 days or if physician surrenders privileges or if it affects membership; never, the TMB reports to NPDB How much time does the committee have to report to the TMB? - 15 days Texas Jurisprudence Exam questions and answers What happens if a physician does not review a child's immunization record? - Nothing Do you need to consent to inform the authorities if you suspect child abuse or neglect? - No In what instance can a child give consent? - If on active duty, when restrictions of minor removed, for communicable disease, if pregnant for counseling, and addiction treatment Does the Consent to Medical Treatment Act apply to "incapacitated" individuals? Does it apply to psychiatry patients? - Yes; yes, but not for patients in FREE- STANDING psychiatric hospitals Who can be a surrogate decision maker? What are the requirements? - Spouse, adult child, majority of children, parents, or a person identified by patient before becoming incapacitated Texas Jurisprudence Exam questions and answers Can surrogate decision maker consent to voluntary inpatient psych treatment? ECT treatment? Appoint another surrogate decision maker? - Not psych treatment, not ECT, cannot appoint another decision maker What are 3 examples of "advanced directive"? - Directive to physician, out-of- hospital DNR, medical power of attorney How many witnesses do you need, and what are the witness requirements for advanced directives? - 2 witnesses, one cannot be related, beneficiary, attending physician or hospital employee Can a directive to a physician be oral or must it be in writing? - Can be verbal and must be documented in chart with names of witnesses Does an advanced directive have to be notarized? - No How many witnesses for an oral directive? - 2 How long is a directive good for? - No limit, until revoked Texas Jurisprudence Exam questions and answers What are the 3 ways to revoke an advance directive? - Written, oral, or VOID across the pages When a directive is orally revoked, what should the physician do with it? - Destroy or write note on verbal revocation or write VOID across pages What happens if a physician disagrees with the directive given to him? - Does not have to follow; can request ethics or medical committee with 48-hour notification for all parties What is the transfer registry? - Directory of physicians or hospitals willing to accept patients in transfer who have advanced directives Is "mercy killing" allowed in Texas? - No Who must sign an "out-of-hospital DNR"? Can it be verbal? Are witnesses needed? - Attending physician, patient, and two witnesses; yes/no; yes/no What is the effect of an "out-of-hospital DNR"? - Legally binding; patient's wishes written as a physician order Texas Jurisprudence Exam questions and answers Does a mental health directive have an expiration date? - Yes, 3 years or until revoked What happens if on the expiration date of a mental health directive, the patient is incapacitated? - It continues until competent When can you use restraints? When can you use behavioral measures? - If there is danger of harm to self or others and other measures have failed; never Does the donor have rights of a parent in artificial insemination? Does the husband? - Donor NO, husband YES What prenatal maternal tests must a physician check? - HIV, hepB, syphilis How many times must a physician check prenatal maternal tests? - Twice; upon first examination and on admission for delivery Are prenatal maternal tests confidential and anonymous? - Confidential; anonymous upon request Texas Jurisprudence Exam questions and answers Does the physician have to tell the mother that he/she will do prenatal maternal tests? What if she wants anonymous testing? - Yes, must inform but not specifically consent; if anonymous is wanted must refer patient to anonymous testing center; patient can refuse If prenatal maternal tests are positive, what must the physician do? - Refer for treatment, provide counseling, and provide information about diseases How long does a physician have to keep prenatal maternal test results? - For 9 months What institutions do not need licensing for birthing centers? - Licensed hospitals, nursing homes, and ambulatory surgery centers What does the federal case Roe v. Wade say about abortion? - Abortions are legal Under what circumstance can you perform a third trimester abortion in Texas? - In emergency to save mother's life or if fetus has severe irreversible abnormality Texas Jurisprudence Exam questions and answers After third-trimester abortion, how many days does the physician have to notify the Department of Health? - 30 days What is the cut-off gestational age to do an abortion in the office? - 16 weeks What specific health risk must you inform the patient about during consent for abortion (4 categories)? - Infection, hemorrhage, infertility, breast cancer What specific economic-related issues must you talk about during consent for abortion? Do you need to document in writing that you talked about these issues? - Medical assistance, father's liability for support; yes How long before the abortion must you tell patients about risks and economic issues? - 24 hours When can you perform an abortion on a minor? Can you do it without calling the parents? - To save mother's life, court order, consent of parents; yes, only court ordered Texas Jurisprudence Exam questions and answers Who must review immunization history? - Every physician Until when must insurance pay for immunizations? - Up to age 6 Who must submit the birth certificate? - Physician, midwife, or person attending birth How many days do you have to submit the birth certificate? - 5 days What kind of crime is it if you don't submit a birth certificate? - Misdemeanor What kind of crime is it if you submit false data on a birth certificate? - Felony 3rd degree How old or young must a baby be in order for a care provider to be able to take possession of an abandoned baby? - 60 days Can any money transaction be done during an adoption? - Yes; only to cover expenses Texas Jurisprudence Exam questions and answers When is a person considered dead? - Cardiac and respiratory functions cease to exist When is a ventilated person considered dead? - Irreversible cessation of brain function What is the time of death for ventilated people? - At time of determined brain death For your ventilated person, do you pronounce death before or after you turn off ventilator? - Before Who can pronounce somebody dead? - MD, PA, NP, RN Who must file the death certificate? - Person in charge of interment How many days does the physician have to fill it out once it is given to him/her? - 5 days for MD to fill out medical portion, 10 days to send in death certificate Texas Jurisprudence Exam questions and answers Do fetuses require death certificates? - If 350 grams or more or 20 weeks or older Sudden infant death syndrome (SIDS) applies to children ages or younger - 1 year In SIDS, is an autopsy required? - Yes To whom and how fast must you report SIDS? - To a justice of the peace, medical examiner, or other proper official immediately Who pays for autopsy in SIDS? - State If at the time of death the physician knows that the patient had a communicable disease, what must be done to the body? - Report to TDSHS and tag body to indicate caution required due to communicable disease The death of a child under ____ years must be reported. - 6 years Whom do you report it to? - Medical examiner or justice of the peace Texas Jurisprudence Exam questions and answers At what age and how can a mentally retarded person donate a kidney? - Age 12, by petitioning the district court Can a blood bank pay for blood? How? After how many days? - Yes, by mailed check, 15 days after donation What is the duty of a medical professional when treating an adult with family violence? What languages to use? - Duty to treat and provide information (and document that information was provided) in English and Spanish; no need to report Does the physician have to call the police in cases of adult family violence? - No, just inform victim of options What is the difference between a professional and a medical professional? - Medical professional = MD; professional = anybody else, e.g., teacher Reporting of child abuse? By whom? How fast? Can it be delayed? To whom (3 entities)? - Report immediately but MUST be within 48 hours, cannot be delegated; to Texas Department of Protective and Regulatory Services, any law enforcement, Texas Youth Commission Texas Jurisprudence Exam questions and answers Will the TDPRS act on anonymous calls regarding child abuse? Does it satisfy a professional duty to report? - Yes, they will be acted upon but DO NOT satisfy duty to report How much time do professionals and medical professionals have to report the death of a child secondary to suspected abuse? - 48 hours What kind of crime is lying in a report on child abuse? Not submitting a report? - State jail felony, misdemeanor class B Who must report nursing home abuse? - Any person Is the report of nursing home abuse verbal or written? - Immediately verbally, written within 5 days What kind of offense is it NOT to report nursing home abuse? - Misdemeanor class A Texas Jurisprudence Exam questions and answers Can the institution retaliate against a whistle-blower in cases of nursing home abuse? - No When and within what time limit must nursing homes report resident deaths? - Within 10 working days Within what time period must nursing home deaths be reported if the resident just transferred to hospital within 24 hours and died? - 10 working days Who is considered a child, elderly, or disabled person when talking about a criminal offense for injury of the above? - 14 year or younger, 65 or older or disabled older than 14 Who is considered "elderly" when living at home? - 65 or older What kind of offense is it if you do not report elderly abuse? - Misdemeanor class A; false information class B Can a volunteer report abuse in a hospital, etc.? - Yes Texas Jurisprudence Exam questions and answers What sort of situations must be reported? - Documented or suspected infection, exotic diseases, outbreaks Can an employee in the office do the reporting? - Yes, if designated by physician If a physician reports a communicable disease, does the hospital also have to report it? - Yes, both If you treat a patient with a communicable disease that dies, what are your 2 responsibilities and within what time frame? - Report death immediately and put toe tag on What kind of crime is nonreporting communicable disease? - Class B misdemeanor If you are a police officer, firefighter, etc., can you make somebody have an HIV test if you think you might have been exposed? Who do you call? - Yes, request TDH Is the police officer, etc., required to be tested himself/herself? - No Texas Jurisprudence Exam questions and answers If an employee is exposed, can the hospital check if the person is harboring an infective agent? - Yes, to HepB, C, HIV What diseases must they test for? - Hep B, C, HIV Do they need the patient's consent? - No Who must report occupational exposure? Does that include labs? - Physicians, labs, health care workers; labs must report abnormal lead levels What occupational exposure must be reported? - Asbestosis, silicosis Do you have to report birth defects? - Yes Which diseases have to be reported immediately? - Diphtheria, measles, anthrax, pertussis, hemophilus, plague, rabies, SARS, smallpox, yellow fever, etc Texas Jurisprudence Exam questions and answers Which diseases must microbiology labs report immediately? - Vancomycin- resistant staph, VRE, HIV, neisseria meningitis Can you make somebody have HIV test? What are the 4 exceptions? - No, unless during pregnancy, criminal proceedings, accidental exposure, consented What kind of crime is it if you force somebody to take an HIV test? - Misdemeanor A Does HIV testing consent have to be written? - No Do you have to sign an HIV consent if you have signed a consent for treatment? - No Do you need consent for lab testing after accidental exposure? - No Does a physician have to contact the partner notification program if a patient is HIV positive and the physician suspects sexual activity? - Yes Texas Jurisprudence Exam questions and answers When you are admitted involuntarily, when can a patient be forced to take psychoactive mediations (3 cases)? - (1) a medication-related emergency, (2) under a court order, (3) patient is a ward and guardian consents Do you need a separate court order to give psychoactive medications in addition to the court order for involuntary admission? - Yes, you need 2 separate court orders Do you need a physician order to put patient in restraints? - Yes When should you consider prescribing psychoactive medications? - Medication emergency—threat to self or others ECT may not be used in people less than ___ years of age. Any exceptions? - 16, no Can anyone, including courts, force somebody to have ECT without their written consent? - No, ECT cannot be court ordered How often do you need consent for ECT? - Before each treatment Texas Jurisprudence Exam questions and answers How about people > 65 years of age, who must sign for ECT? - Patient and 2 physicians Can psychiatry hospitals employees' pay be based on # of admissions, length of stay, calls to referring sources? - No Can psychiatry hospitals "guarantee" a cure on advertising? - No Can psychiatry hospitals solicit information about patients' confidential records to solicit them for services? - No Can a physician send a patient directly to psychiatry hospital? Do they have to first get insurance approval? - Yes; no How long is a mental health directive valid for? - 3 years or earlier if revoked Does a mental health directive suffice to allow ECT treatment? - Yes, it is considered a prior consent Texas Jurisprudence Exam questions and answers Does Texas have "duty to warn" for mentally-ill patients? Is this breach of confidentiality - Texas does NOT have duty to warn, it IS a breach of confidentiality Can patient refuse mental health treatment after admission? - If they are voluntarily admitted, yes; if involuntarily, no, with court order Who does EMTALA apply to? - Hospitals participating in Medicare What is considered "campus"? - 250 yards from ER What 4 places constitute "coming" to the ER? - In hospital-owned ambulance or air transport, or patient is in ER or in hospital requesting ER consultation If an ambulance despite being told that the hospital is on diversion comes to the ER, can you send them away? - No, patient HAS TO BE SEEN Is pregnancy a medical emergency? - No, except for complications and labor Texas Jurisprudence Exam questions and answers What are the 3 penalties for hospitals and physicians for violation of EMTALA? What is the maximum damage? - Civil money penalties, termination of provider agreement, civil action. Up to $50,000 per violation ($25,000 for < 100 beds) Can a patient initiate his/her own transfer? - Yes How many people on the Texas Medical board? - 19 How many MDs on the TMB? - 12 How many layperson on the TMB? - 7 How often does the police run a check on physicians? - Monthly How often does the TMB put out reports on physicians? - Every 6 months How many years of postgraduate training to apply for full license? - 1 Texas Jurisprudence Exam questions and answers If a resident does not show up to begin his training, how many days does the program director have to report that to the board? - 30 Institutional permit: how many months for initial license? How many renewals? How many months for each renewal? - 14 months; 7; 12 months Physician-in-training permit: how many months for initial license? How many renewals? How many months for each renewal? - 18 months; 6; 18 months How often do you register your license with the TMB? - Every 2 years How many days prior to expiration of your license does the board notify you? - 30 How many days after expiration are you considered practicing without a license? - 30 How many days after expiration is license canceled? - 365 How many category 1 CMEs per year? - 12 Texas Jurisprudence Exam questions and answers How many ethics CME credits? - 1 yearly How many CME credits can be from volunteering? - 6 How many CMEs can you carry forward? - 48 How often must the board give update to all participants in a complaint? - Every 3 months (quarterly) How much time do insurances have to report malpractice to the board? - 30 days If disciplinary action is taken by the board, how much time to report to the hospital verbally? In writing? To the NPDB? - Verbally immediately to hospitals on first working day; in writing to all hospitals and agencies within 30 days. How much time to report court reports to the board? - 30 days Texas Jurisprudence Exam questions and answers A suspension in the hospital must be reported if it lasts for how long? Within what time must it be reported? - More than 30 days; 15 days. Until what age is one considered a minor? - 18 years How many witnesses do you need for advanced directive? For verbal directive to physician? For out-of-hospital DNR? - 2; 2; 2 How many witnesses for a mental health directive? - 2 How long until mental health directive expires? How long until medical directives expire? - 3 years; no limit. How many days does a physician have to give records to patient? Hospital? Attorney? - 15 business days; 15 business days; 45 days. How many days does patient have to pay fees for requested records? - 10 days. Texas Jurisprudence Exam questions and answers What are the fees for copied records? Postage or not? - $25 for first 20 pages, then 15¢ per page plus postage. How many years must a physician keep records for adults? For minors? From what age? - 7 years; 7 years or age 21. How many years must hospitals keep records for adults? For minors? From what age? - 10 years; 10 years or 20th birthday. How many days does a hospital have to send itemized bill if requested? - 30 business days. What is the economic cap on noneconomic damages in Texas per defendant/claimant? - $250,000 How long is the statute of limitations for adults? Minors? - 2 years; 2 years from age 18. When must a claimant send a letter, and by how long can he/she extend the statute of limitations? - Within 60 days; extends by 75 days. Texas Jurisprudence Exam questions and answers How many yards from ER is considered campus? - 250 yards. How many years must you keep records of transferred patients? - 5 years. What is the maximum monetary penalty for a hospital violating EMTALA? - $50,000, $25,000 if < 100 beds. How long do physicians have to keep screening test records from the first visit of a pregnant woman? - 9 months. How many days does a physician have to notify the DPS of a third trimester abortion? - 30 days. What is the cut-off gestational age for office-based abortions? - 16 weeks. How long prior to abortion must you give the woman information on abortion (verbal/written)? - 24 hours. Texas Jurisprudence Exam questions and answers If a patient dies within how many hours of admission must an inquest be ordered? - 24 hours. A mentally retarded person of what age can donate a kidney if the guardian petitions the court? - 12 years. After how many days can a blood bank pay for blood donation? - 15 days. A person older than what age can voluntarily commit self to psychiatry? - 16 years How often do private psychiatry hospitals file reports? - Yearly. What age do you have to be to get ECT? - 16 How often do you renew DEA license? DPS license? - Every 3 years; yearly. How many days to you have to inform the DPS of change in information? - 7. Texas Jurisprudence Exam questions and answers How many days of pills can a patient get of schedule 2-5 when discharged from the hospital? - 7. How many days to send written prescription to pharmacy of schedule 2 drug? - 7. How long is a schedule 2 script valid? How many refills? Schedule 3-5 valid? Refills? Dangerous drugs valid? Refills? - 7 days; no refills; 6 months; 5 refills; unlimited; unlimited. How often do you need to do inventory on your drugs? - Every 2 years. How often do you have to register with the board and pay a fee to administer anesthesia? - Every 2 years. How many days do you have to report an office-based anesthesia complication? - 15 days. How much time do you have to report a death from communicable disease? - Immediately. Texas Jurisprudence Exam questions and answers How much time to report a gunshot wound? - Immediately. What is the monetary penalty for violation of anti-kickback laws for physicians? Hospitals? - $25,000-$250,000 / $50,000-$500,000. How much time does a physician have to report child abuse? - Immediately; 48 hours in writing. How much time does a professional (not medical professional) have to report child abuse? - 48 hours. How much time do professionals/physicians have to report death of a child secondary to abuse? - 48 hours. How much time do you have to report nursing home abuse verbally? In writing? - Immediately; 5 days. If a nursing home resident dies after transfer to a hospital, within what time frame must be reported? - 24 hours.