Deck 13: Care and Safety Standards, Competence, and Nurse Accountability

Question 1

An RN realizes that she inadvertently gave a patient who was NPO for surgery his otherwise normally scheduled PO medications. Which action would she take if she were exhibiting professional accountability?

A) Report the error to the charge nurse and follow up with the patient's surgeon.
B) Report the incident to the charge nurse and blame the co-worker who interrupted her medication pass.
C) Keep the incident to herself so that the patient's surgery will not be canceled.
D) Report the incident the next day that she works.

Answer 1

A
Accountability is being answerable for the actions or interventions one performs as a nurse. Accountability also means taking responsibility for one's other actions and growth. Although individuals are ultimately accountable to themselves, the RN is particularly accountable to the patient, society, and the profession. The RN should report the incident immediately to the charge nurse and surgeon, in the best interest of the patient.

Question 2

A nurse has just realized that her license is due to expire in 5 months. The nurse knows that she is responsible for maintenance of her license in order to continue practicing as a nurse. What would be the best action for her to take?

A) Put off obtaining the continuing education credits until 1 month before the expiration date.
B) Immediately begin working on obtaining the continuing education credits.
C) Email the nursing board to inquire about why she was not notified earlier.
D) Forgo obtaining the continuing education credits and hope that she does is not audited.

Answer 2

B
Personal responsibility indicates that the nurse is responsible for her own actions and for maintenance of her nursing license. The nurse should be aware of the expiration date and should plan to obtain continuing education credits accordingly.

Question 3

The medical team determines that a patient needs to be transferred to another facility to continue receiving the most appropriate and beneficial care. The transfer process has been slow and difficult, and the nurse is struggling to care for the transferring patient along with her other assigned patients. What is the best action the nurse can take to improve her situation?

A) Continue to do the best that she can do for all of her patients.
B) Inform the medical team that the transfer will have to wait for the next shift.
C) Involve management so that the nurse can focus on patient care.
D) Ask her co-workers to manage her patient assignment.

Answer 3

C
The best action the nurse can take is to involve management so that she can focus on patient care. Continuing to struggle takes away from the care she is able to provide and could be detrimental to her patients. Halting the transfer could possibly be detrimental to the patient in need of the medical transfer. Asking her co-workers to absorb her assignment could reduce the quality of care that they are able to provide as well.

Question 4

A nurse manager wants to assess quality of care over the last 6 months for her unit. How could the nurse manager best accomplish this?

A) Interview each nurse about the patients on the unit for the last 6 months.
B) Review the results of patient satisfaction surveys.
C) Obtain charts from medical records for all of the patients.
D) Ask the nurses to perform discharge phone calls on previous patients.

Question 5

A patient on a medical-surgical floor is unhappy with the care he is receiving from his physician and wants to speak to someone about it. Which action should the nurse take?

A) Contact the director of medical-surgical nursing.
B) Leave an urgent message for the patient's physician.
C) Notify the nurse's immediate supervisor.
D) Ask another nurse on the floor to talk with the patient.

Question 6

An operating room nurse has returned from a conference on the impact of never events. Recognition of which of the following would lead her to believe that a never event could occur?

A) The patient is losing an anticipated amount of blood during surgery.
B) Toward the end of a surgical procedure, the sponge count does not match up with the beginning count.
C) The procedure is taking longer than planned.
D) The surgeon was late to the procedure.

Question 7

A nurse has just received training on the Quality and Safety Education for Nurses (QSEN) Project. What should the nurse do to show that she understands the importance of the project?

A) After assessing the patient, determine a list of priorities for care and begin implementing them.
B) Collaborate with medical personnel involved in the patient's care to develop a treatment plan for the patient.
C) Develop a treatment plan with the patient and medical personnel that best fits the patient's needs and lifestyle.
D) Develop a treatment plan based on what the patient's wife says he needs.

Question 8

There are a number of characteristics that will help a novice nurse find success in a mentoring relationship. Which action represents one of these positive characteristics?

A) The novice nurse asks clear, thoughtful questions and seeks clarifications.
B) The novice nurse is patient and waits for the mentor to approach with learning opportunities.
C) The novice nurse is directive rather than open to dialogue.
D) The novice nurse stays busy, and the mentor seeks the opportunities.

Question 9

An RN has been working on a cardiac unit for 1 year and has settled comfortably into an efficient, safe, and organized routine for each shift. However, whenever an urgent issue arises, the nurse feels uncomfortable. It is most likely that this nurse is functioning at which skill level?

A) Novice
B) Proficient
C) Competent
D) Expert

Question 10

A nurse manager is reviewing an incident report submitted by the previous day's charge nurse. The incident report indicates that the wrong IV antibiotic was given to a patient. What is the best way for the nurse manager to address this incident with the nurse involved so that it may be prevented in the future?

A) Provide education to the nurse on how to assess the five rights before medication administration.
B) Punish the nurse for the error by sending her home for the day.
C) Allow the nurse one error, and educate her if the same mistake happens again.
D) Ask the charge nurse to educate the nurse because she caught the error.

Question 11

A new graduate has been working as an RN for 6 months and is no longer working with a preceptor. However, she still frequently checks with an experienced nurse to validate that she is following the rules and the policies she is still learning. The new graduate in this scenario exhibits the actions of what theoretical level of skill?

A) Expert
B) Competent
C) Proficient
D) Novice

Question 12

The nurse is working on a busy cardiac floor. While preparing medications, the nurse is interrupted by a co-worker, who has a question about another patient. After administering the medication, the nurse realizes that she gave the medication to the wrong patient. Which action by the nurse would indicate accountability?

A) Shifting blame to the co-worker who interrupted her
B) Attempting to hide the medication error to avoid getting into trouble
C) Accepting partial responsibility for her own actions
D) Taking responsibility for her own actions and interventions by immediately assessing the patient and reporting the error to a physician

Question 13

In a situation involving a medication error, the hospital policy is to use root-cause analysis to evaluate the situation fully. In the root-cause analysis process, which action would take place?

A) A committee is formed to determine the risk of litigation.
B) A committee is formed to determine the punishment for those involved.
C) A committee is formed that can reconstruct the events leading to the error.
D) A committee is formed that can correct the error and avoid damages.

Question 14

Which action would indicate that the RN is practicing at the proficient level?

A) Asks another nurse to be present while a Foley catheter is inserted
B) Becomes frazzled when two patients are unexpectedly admitted at the same time
C) Thinks critically about situations and is able to anticipate patient needs
D) Assumes the role of charge nurse while managing a tough patient assignment

Question 15

On administering a medication, the RN realizes that she gave the incorrect amount. After assessing the patient, which action would not be appropriate for the nurse to take?

A) Report the incident to the patient's physician.
B) Immediately report the incident to her manager.
C) Keep the incident to herself and continue to monitor the patient.
D) Continue to reassess the patient.

Question 16

While passing noon meds, an RN notes that one of her patients did not receive his 0600 dose of antibiotic during the prior shift. She calls the prior nurse to try to determine whether the medication was given, then fills out an occurrence or care aberrance report, and follows through as institutional policy indicates. What is the best explanation for why the RN who found the error took action?

A) Because the prior nurse needed to know she made an error
B) Because she is accountable for not contributing to the error by ignoring it
C) To keep the patient from suing the hospital
D) To keep herself out of trouble

Question 17

An RN has been practicing for 12 years in pediatrics. Peers often seek out this nurse to help them with complex problems. This experienced nurse is assigned the patients with the highest acuity, and the nurse accepts these assignments with confidence. This nurse is likely practicing at which skill level?

A) Novice
B) Competent
C) Proficient
D) Expert