Question 1

A nurse is assisting with the delivery of twins. The first infant is placed on the scale to be weighed. The physician requests an instrument stat. The nurse turns to hand the instrument to the physician, and the infant falls off the scale. When evaluating the incident, the nurse and her manager list contributory factors such as the need for two nurses when multiple births are known, and the location of the scale so far from the delivery field. These nurses are performing a(n):

Accepted Answer

A)  standardization of care. 
B)  root cause analysis. 
C)  process variation. 
D)  analysis of a deployment flowchart.

Question 2

A group of nurses is presenting the importance of high-quality care during a system-wide meeting of medical-surgical nurses. They point out a finding of the Quality Chasm that:

Accepted Answer

A)  being insured has little effect on a person's longevity and the quality of care received. 
B)  lobbyists for the drug companies are able to gain permission for the use of new drugs within 1 year of their discovery. 
C)  although a greater number of lawsuits stem from medication errors, more people actually die from human immunodeficiency virus (HIV) and acquired immunodeficiency disease syndrome (AIDS). 
D)  medication-related errors place a tremendous financial burden on the U.S. health care system.

Question 3

Quality is defined by the ____________.

Accepted Answer

The answer of Quality is defined by the ____________....

Question 4

Which of the following occurrences would be classified as a sentinel event?

Accepted Answer

A)  A postpartum patient who elects to breastfeed only twice daily develops mastitis. 
B)  A newly diagnosed diabetic patient self-injects insulin in the abdominal area rather than the upper thigh as instructed by the patient educator. 
C)  A nurse assisting with the delivery of twins places the "Twin 1" name tag on the second-born twin, causing the first-born twin to undergo surgery that was scheduled for the other twin. 
D)  A nurse administers 3 units of regular insulin rather than 3 units of NPH insulin subcutaneously, resulting in a drop in the patient's serum glucose from 160 to 100 mg.

Question 5

A patient with complicated diabetes is scheduled for a below the knee amputation at 7 AM. The surgical team adheres to the 2012 National Patient Safety Goals by implementing which protocols? (select all that apply)

Accepted Answer

A)  The surgical team asks the patient to verify his or her name, type of surgery, and limb to be removed. 
B)  Ask each member of the surgical team to provide a copy of licensure and, if applicable, certification to patient and family. 
C)  The surgical team uses the chart number and name/hospital number to ensure they have the correct patient. 
D)  Mark the procedure site with "X" and again ask the patient to verify correct site. 
E)  After arrival in the operating room, perform a "time-out" for final identification of patient and operative site along with agreement of what procedure is scheduled.

Question 6

According to the Quality Chasm report:

Accepted Answer

A)  health care providers should be proactive rather than reactive to patient needs. 
B)  common needs rather than individual preferences should be the priority. 
C)  medical information should be confined to the primary care provider. 
D)  specialized providers or case managers should control health care decisions.

Question 7

Each month data on admission assessments that are based on the following standard are entered: "All patients will be assessed by an RN within 2 hours of admission." The target goal for this standard is 97% compliance. Data are displayed on a graph that shows number and time of admission assessments and compliance variation limits. This pictorial representation is:

Accepted Answer

A)  Pareto chart. 
B)  control chart. 
C)  deployment chart. 
D)  top-down flowchart.

Question 8

A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency?

Accepted Answer

A)  Safety 
B)  Timely 
C)  Equitable 
D)  Patient-centered care

Exam 22: Quality Improvement and Patient Safety