Deck 2: Clinical Safety: The Core of Leading, managing, and Following

Question 1

To achieve Nurse-Sensitive Care Standards developed by the NQF,you advocate for which of the following in your health facility?

A) Evidence-based practice to reduce the prevalence of pressure sores
B) Implementation of informatics at the bedside
C) Staff-manager conferences to review reporting of adverse medical events
D) Patient councils to review food, recreation, and nurse-patient relations

Answer 1

Evidence-based practice to reduce the prevalence of pressure sores

Question 2

Pleasant Valley Hospital has amended its safety practices and policies.What has the hospital elected to emphasize accordance with changes by The Joint Commission (TJC)?

A) Safety goals specific to Pleasant Valley
B) Decision-making processes
C) Sufficient staffing for safe care
D) Increased numbers of baccalaureate-prepared RNs

Answer 2

Safety goals specific to Pleasant Valley

Question 3

What would managers and staff review annually in order to ensure compliance with The Joint Commission (TJC)to improve patient safety?

A) Appropriateness of charting terms and abbreviations
B) Nursing hours per patient
C) Acuity of patient admissions
D) Wait times for care

Answer 3

Appropriateness of charting terms and abbreviations

Question 4

The Rehabilitation Unit at Pleasant Valley Hospital has a high number of falls.What interventions might assist to reduce the number of falls on the unit?

A) Determining who is responsible for the falls
B) Strengthening unit policies to avoid inappropriate admissions
C) Encouraging involvement of nurses in education related to falls and safety
D) Ensuring that patients are appropriately restrained if they are at risk for falls

Question 5

During review of back injuries,it is determined that a large number of injuries are occurring in spite of mechanical lifts being used.Furthermore,it is determined that some lifts are outdated.In addressing this concern,the unit manager:

A) meets individually with nurses who are observed to be using the lifts incorrectly to review the correct procedure.
B) after consultation with the staff about the review, orders new lifts to replace older ones that are malfunctioning.
C) blames the system for inadequate funding for resources.
D) reviews the system of reporting incidents to ensure that appropriate reporting is occurring.

Question 6

In an effort to control costs and maximize revenues,the Rehabilitation Unit at Cross Hospital reduced the number of its managers and increased the number of units for which each manager was responsible.Within a year,the number of adverse events on the units had doubled.How do the increase in adverse events relate to decreased managers?

A) The overload of staff nurse duties
B) Resistance to change by staff
C) A change in reporting system for everyone
D) Fewer clinical leaders facilitate best practice

Question 7

As a manager in a new nursing home,where might you consult for guidance and evidence to support the development of safe patient practices?

A) Hospitals
B) Business
C) Industry
D) Outpatient clinics

Question 8

What does the SBAR approach to patient safety encourage?

A) Consistency in assessment and practices
B) Continuing education
C) Multidisciplinary approaches
D) Patient feedback

Question 9

After consulting with practice environments about quality and safety concerns in health care,a dean in a health care program implements what to improve quality and safety in health care?

A) A nursing program that emphasizes the development of a strong disciplinary identity.
B) Programming that stresses discipline-based research.
C) Partnerships with health care to develop software for the reporting of adverse events.
D) An interdisciplinary program for nurses, pharmacists, and medical practitioners that emphasizes collaborative learning teams.

Question 10

A nurse manager is implementing strategies to support the steps in the AHRQ document "Five Steps to Safer Health Care." What does the manager include in the implementation?

A) Patients are actively encouraged to make decisions related to care.
B) Rules and decisions are made through centralized processes.
C) You monitor the performance of each staff member closely.
D) Preference is given to increasing staff numbers rather than staff credentials.

Question 11

How would the nurse executive begin to increase safety in patient care areas of the Valley Hospital?

A) Asking the community what the safety issues are
B) Consulting with a management expert about staffing schedules
C) Ensuring that the senior nursing officer attends the board meetings
D) Instituting improved practices to reduce needlestick injuries

Question 12

As a nurse manager on the West Surgery Unit,you are interested in increasing patient safety and reducing morbidity and mortality on your unit.What recommendations would be consistent with the IOM The Future of Nursing report?

A) Careful screening of nursing staff for substance use and abuse
B) Increased RN staffing on the unit
C) Salary and benefits that reflect nursing accountabilities
D) Increase in the percentage of baccalaureate-prepared nurses to 80%

Question 13

What would be the primary emphasis in designing and implementing a quality,safe healthcare environment?

A) Evidence-based practice
B) Informatics
C) Staffing
D) The patient

Question 14

What did the IOM Health Professions Education report highlight as a concern for patient safety?

A) A normal risk in professional practice
B) A result of disciplinary silos
C) A reflection of frontline staff
D) Related to systems errors

Question 15

The nurse is educating older adult patients on staying safe in the healthcare system.What information does the nurse include in the teaching?

A) The need to understand and record all medications being taken.
B) Bringing their own linens and other personal items to the hospital.
C) Washing hands frequently while in a healthcare environment and using a hand sanitizer.
D) Following closely the directions and orders of healthcare providers.

Question 16

On the West Surgery unit,you want to institute a new system for checking armbands that evidence suggests may increase safety in medication administration.The system involves technology.What strategy may assist with rapid adoption of the technology and system?

A) Employ a centralized decision-making approach.
B) Use simulators for initial practice to build confidence.
C) Bring in a nurse consultant who is familiar with the technology.
D) Use early adopters among the staff as leaders and role models in implementation.

Question 17

How would a nurse manager and the staff prepare for redesignation as a Magnet Hospital?

A) Commit staff resources over a 6-month period to updating procedure manuals.
B) Educate staff through meetings and training sessions regarding appropriate answers to questions.
C) Prepare a manual that outlines orientation procedures and ensure that all safety issues are addressed.
D) Ensure that there are empirical data to support review of patient outcomes, actions taken, and results of actions.

Question 18

The NQF provides a model for advancement of healthcare quality that could be used in healthcare organizations.What does the use of this model by the Centers for Medicare and Medicaid Services specificity link with adverse patient events for healthcare facilities?

A) Staffing
B) Funding
C) Composition of executive councils
D) Composition of consumer-based councils

Question 19

You notice that Sally,a student on your unit,is giving information to an anxious young teen who seems very uncertain about preparation for an upper GI series.After Sally leaves the room,you ask her how she thought her conversation with the patient.What is the appropriate response for you to give Sally?

A) Encourage her to ask the patient if he has questions or concerns about the procedure.
B) Advise her to consider providing the patient with more information.
C) Suggest that she leave some brochures on the procedure with the patient.
D) Suggest that she also provide teaching to the adolescent's parents.

Question 20

Sarah is a second-year nursing student.The clinical instructor overhears Sarah telling a patient that she "always" checks patients' bracelets before giving medication and she is not sure how the nurses on the unit "get away with" not making more errors than they do.The clinical instructor pulls Sarah aside and explores with her how her communication might affect the patient and what it reflects about her beliefs related to the team.What competency does this action outline?

A) QSEN
B) IHI
C) DNV/NIAHO
D) AHRQ

Question 21

A client requires an appendectomy.The surgeon explains the procedure and asks the client to sign the consent.The patient speaks very little English and looks worried.What is the appropriate action by the nurse?

A) Suggest that an interpreter explain the procedure to the client and answer any questions.
B) Ask the client if he has any questions.
C) Draw a picture to show the incision.
D) Not intervene.

Question 22

As the manager on an acute care medical unit,you note that the incidence of medication errors has increased since the implementation of staffing changes.What is an important stratagem to reduce errors?

A) Revisit reporting standards for medication errors in your organization.
B) Ensure that medication errors are consistently reported.
C) Provide staff with additional education related to safe practice in medication administration.
D) Involve RN staff in determining reasons for errors and practice solutions to increase the safety of medication administration.

Question 23

Mary,an 85-year-old patient with cognitive impairment and gross instability,wanders continuously.Lately,she has fallen twice,and the family demands that she be restrained.As the unit manager,you have initiated a least restraint practice.What is an appropriate action in this situation?

A) Setting up a nursing team meeting to review practices
B) Calling the family to inform them of the practice
C) Initiating a multidisciplinary and family meeting to focus on Mary's needs
D) Restraining Mary to satisfy the family's wishes

Question 24

What patients would be considered "at risk" consumers during a healthcare visit?

A) Clyde requires an anticoagulant. He tells the nurse about his medications. He does not include an herbal supplement.
B) George is very shy and withdrawn. He asks the nurse to leave him alone.
C) Sarah is a new parent who finds that nurses on the children's unit are very helpful. She is eager to accept all suggestions, including those that she does not yet understand.
D) Claude is booked for bowel surgery. His doctor explains about the colostomy. Later, Claude tells his wife that he really doesn't know what the doctor meant by colostomy.

Question 25

What facilitate the development of decision-making skills related to safe patient care for a nurse manager?

A) Regular reflection on decisions
B) A culture of perfectionism
C) Recognition of who should be held responsible for individual errors
D) A culture of trust between the staff and you