Question 1

An agency has not created a continuous quality improvement program. Which of the following actions should the agency take to help ensure quality care within the institution?

Accepted Answer

A)  Ensure appropriate policies and procedures are followed.
B)  Employ highly recommended and credentialed professionals to give care.
C)  Use administrative action to ensure that quality care is given to clients.
D)  Write quality care plans for the most typical problems of clients. A

Question 2

What is the primary goal of total quality management?

Accepted Answer

A)  To confirm the high standards desired in patient care
B)  To discover and correct errors in task completion
C)  To eliminate problems before negative outcomes occur
D)  To enable organizations to publicize their quality approach to patient care C

Question 3

In which of the following ways does licensing differ from accreditation? (Select all that apply.)

Accepted Answer

A)  Licensing applies to the individual, whereas accreditation applies to a program.
B)  Licensing is required to practice, whereas accreditation is by choice.
C)  Licensing is required by state law, whereas accreditation is required by federal law.
D)  Licensing is required for all professions, whereas accreditation is only available for some. A, B

Question 4

A nurse has identified a need to increase the quality assurance efforts within the home care agency. Which of the following has most likely occurred?

Accepted Answer

A)  Increased number of client complaints and injuries
B)  Increased costs of providing care
C)  Reduced number of incident reports
D)  Reduced government reimbursement (Medicare and Medicaid)

Question 5

The staff was informed that a PRO (Professional Review Organization) would be making an unannounced visit in a few hours. Which of the following would the hospital nurse expect the PRO team to examine?

Accepted Answer

A)  Records of hospital admissions and scheduled procedures
B)  Nursing care plans of patients with unexpected problems (infections, falls) 
C)  Discharge paperwork of patients discharged in the past 30 days
D)  Documentation of adherence to nursing standards of care

Question 6

A home health care agency has major problems but does not want consumers to know about these problems while the agency decides what should be done to improve them. Employees are not told to lie, but they are advised not to share information. Which of the following is the most likely outcome of this situation?

Accepted Answer

A)  As long as employees do not share what they know, the community will be uninformed.
B)  By law, comparative information will be available to the public via the Internet.
C)  Only a few informed persons will know about the problems.
D)  Secrecy will prevail unless the local newspaper does an investigative report.

Question 7

The quality improvement team reviews the records of clients on a monthly basis to determine whether protocols for pain assessment were followed. Which of the following best describes the major drawback to the team's approach?

Accepted Answer

A)  The client is no longer under the agency's care.
B)  It is difficult to compare documentation of care to standards of care.
C)  Records can be inaccurate or incomplete.
D)  Team members may disagree on whether the standards of care were met.

Question 8

Which of the following information can be gathered by reviewing a community health report card?

Accepted Answer

A)  Utilization of health care services in the community
B)  Demographic information of the community
C)  Leading causes of morbidity in a community
D)  Frequency of malpractice claims within a community

Question 9

How does continuous quality improvement (CQI) differ from quality assurance?

Accepted Answer

A)  Quality assurance focuses on client care, whereas CQI focuses on system issues.
B)  Quality assurance focuses on system issues, whereas CQI focuses on individual client care.
C)  Quality assurance measures care at one point in time, whereas CQI is an ongoing issue.
D)  Quality assurance focuses on families, whereas CQI focuses on agency issues.

Question 10

An agency is beginning to implement a general approach for quality improvement. Which of the following activities would the agency most likely implement?

Accepted Answer

A)  Customer satisfaction is assessed through the use of surveys provided to the client after each appointment.
B)  The health maintenance organization (HMO)  provides incentives to personnel who complete in-house programs on customer service.
C)  The institution has received accreditation through The Joint Commission.
D)  The total quality improvement (TQI)  team meets to examine how to make the registration process more efficient.

Question 11

The quality improvement team reviews the records of clients on a monthly basis to determine whether protocols for pain assessment were followed. Which of the following best describes this activity?

Accepted Answer

A)  Accreditation review
B)  Concurrent audit
C)  Retrospective audit
D)  Utilization review

Question 12

A wealthy factory owner says, "I don't care about the poor. I just want the best care available for me and my family. Why should I care whether other people get health care or not?" Which of the following would be the most appropriate response by the nurse?

Accepted Answer

A)  "If your employees are ill, who will do the work in your factory?"
B)  "You might catch a contagious disease from one of your employees."
C)  "You have a moral obligation to help those less fortunate."
D)  "Your personal insurance and tax costs will go up if your employees have to use community resources when they're ill."

Question 13

Which of the following is accomplished through the use of traditional quality assurance?

Accepted Answer

A)  Implementation of new techniques to improve outcomes
B)  Implementation of appropriate interventions for diagnosed problems
C)  Implementation of change when measured performance does not meet standards
D)  Implementation of research findings to ensure appropriate clinical treatment

Question 14

A nurse is invited to join the utilization review team to help the agency avoid giving unnecessary care. Which of the following difficulties would the nurse most likely confront as client records are reviewed?

Accepted Answer

A)  Alternative care options rather than agency care are often encouraged.
B)  Not all clients fit the pattern and need more care than guidelines suggest.
C)  The nurse suggests the agency provide guidelines to professionals giving care.
D)  The agency is now accountable to its clients and their families.

Question 15

The pharmacist sent up the wrong medication for the patient. The nurse filled out an incident report when the error was discovered. Which of the following best describes the likely outcome when the quality improvement team reviews the incident report?

Accepted Answer

A)  The nurse will receive a commendation for recognition of the error.
B)  The pharmacist will be disciplined.
C)  The pharmacist will be reported to the state pharmacy board.
D)  The CQI team will try to determine how the error occurred.

Question 16

A home care nurse is encouraging the administration of the agency to increase their quality assurance efforts. Which of the following best describes a negative outcome from this activity?

Accepted Answer

A)  An agency deficiency may become visible.
B)  An individual may be found at fault and then become fearful of being involved.
C)  Some agency processes may be questioned.
D)  Employees at the agency will have to commit extra time to complete this process.

Question 17

The management team of the Central County Community Health Agency wants to analyze the cost of homebound client services. Which of the following records are most likely to provide useful data?

Accepted Answer

A)  Clinical records
B)  Financial records
C)  Morbidity and mortality records
D)  Provider service records

Question 18

Which of the following best explains why evaluation of client outcomes resulting from nursing intervention is so difficult?

Accepted Answer

A)  Client records may not include appropriate data.
B)  Few tools exist to measure client outcomes.
C)  Many other factors can also affect client outcomes.
D)  Measuring client outcomes is extremely time consuming.

Question 19

Which of the following led to the development of the National Health Quality Improvement Act?

Accepted Answer

A)  A very famous movie and television star died as the result of a medical error.
B)  The number of malpractice claims had increased.
C)  Media such as films highlighted the reality of current medical care.
D)  Publicity about a few unfortunate cases caused consumers to become concerned.

Question 20

A nursing committee is responsible for evaluating the process of health care agency in their quality assurance efforts. Which of the following techniques would most likely be used by the committee members? (Select all that apply.)

Accepted Answer

A)  Client satisfaction survey data
B)  Confirmation of credentials of all health care providers employed
C)  Patient discharge data over the past one year
D)  Peer review committee audit

Exam 17: Managing Quality and Safety