Question 1

Patient perceptions are useful in:

Accepted Answer

A)   Determining disciplinary actions in QI.
B)   Establishing the competitive advantage of QI decisions.
C)   Assisting to establish priorities among possible changes to care identified in QI.
D)   Establishing blame for poor-quality care. C

Question 2

The chief executive officer asks the nurse manager of the telemetry unit to justify the disproportionately high number of registered nurses on the telemetry unit.The nurse manager explains that nursing research has validated which statement about a low nurse-to-patient ratio? It:

Accepted Answer

A)   Promotes teamwork among healthcare providers.
B)   Increases adverse events.
C)   Improves outcomes.
D)   Contributes to duplication of services. C

Question 3

In determining the relationship between injury-producing falls and proposed preventive measures as part of the QI process,a QI team might turn to which of the following for confirmatory evidence?

Accepted Answer

A)   NDNQI
B)   NANDA
C)   NIOSH
D)   AHRQ A

Question 4

Healthcare organization X is committed to improving patient outcomes and,as part of the QI process,examines its executive structure and organizational design.This approach recognizes which model of QI?

Accepted Answer

A)   Donabedian
B)   Continuous quality improvement
C)   Employee involvement
D)   QSEN

Question 5

With the rise in workplace violence in the emergency department,the nurse manager decides that she should work with the risk manager in violence prevention.The nurse manager should:

Accepted Answer

A)   Request all staff to accept new risk management practices.
B)   Hold staff accountable for safe practices.
C)   Document inappropriate behavior.
D)   Hire more police security.

Question 6

A nursing-led classification system that has led to greater reliability and standardization in data utilized for QI processes is:

Accepted Answer

A)   NANDA.
B)   AHRQ.
C)   NIOSH.
D)   Nursing process.

Question 7

Hospital ABCD is a Magnet™ hospital.This designation has been applied to Hospital ABCD because it:

Accepted Answer

A)   Facilitates active staff participation in decision making related to quality nursing care.
B)   Has implemented a graduate nurse orientation program.
C)   Espouses commitment to excellence in patient care.
D)   Is establishing career ladders for nurses.

Question 8

A healthcare organization is committed to improving patient outcomes as part of the quality improvement (QI)process and examines its executive structure and organizational design.This approach recognizes which model of QI?

Accepted Answer

A)   Donabedian
B)   Benchmarking
C)   Employee involvement and innovation
D)   QSEN

Question 9

Examples of sentinel events include

Accepted Answer

A)   Forceps left in an abdominal cavity.
B)   Patient fall, with injury.
C)   Short staffing.
D)   Administration of morphine overdose.
E)   Death of patient related to postpartum hemorrhage.

Question 10

Your institution has identified a recent rise in postsurgical infection rates.As part of your QI analysis,you are interested in determining how your infection rates compare with those of institutions of similar size and patient demographics.This is known as:

Accepted Answer

A)   Quality assurance.
B)   Sentinel data.
C)   Benchmarking.
D)   Statistical analysis.

Question 11

An example of an effective patient outcome statement is:

Accepted Answer

A)   Eighty percent of all patients admitted to the Emergency Department will be seen by a nurse. Practitioner within 3 hours of presentation in the Emergency Department.
B)   Patients with cardiac diagnoses will be referred to cardiac rehabilitation programs.
C)   The hospital will reduce costs by 3% through the annual budget process.
D)   Quality is a desired element in patient transactions.

Question 12

A nursing unit is interested in refining its self-medication processes.In beginning this process,the team is interested in how frequently errors occur with different patients.To assist with visualizing this question,which organizational tool is most appropriate?

Accepted Answer

A)   Histogram
B)   Flowchart
C)   Fishbone diagram
D)   Pareto chart

Question 13

At Hospital Ajax,staff members are reluctant to admit to medication errors because of previous litigation and a culture that seeks to assign blame.This culture demonstrates:

Accepted Answer

A)   QM principles that emphasize customer safety.
B)   A deep concern with improvement of quality and processes.
C)   Effective employee orientation and development in relation to QM.
D)   Goals that are inconsistent with QM.

Question 14

The nurse manager is concerned about the negative ratings her unit has received on patient satisfaction surveys.The first step in addressing this issue from the point of view of quality improvement is to:

Accepted Answer

A)   Assemble a team.
B)   Establish a benchmark.
C)   Identify a clinical activity for review.
D)   Establish outcomes.

Question 15

A method commonly used in Quality Assurance to monitor adherence to established standards is:

Accepted Answer

A)   A Pareto chart.
B)   Brainstorming.
C)   Patient interviews.
D)   Chart audit.

Question 16

Hospital Magnet™ decides against creating a separate department to lead and monitor quality activities because:

Accepted Answer

A)   Total organizational involvement is critical to QI.
B)   Data generated by a single, separate department are generally flawed.
C)   Monitoring and commitment to QI can come only from senior level managers.
D)   Staff resent suggestions for improvement that originate outside of their unit.

Question 17

The outcome statement "Patients will experience a ten percent reduction in urinary tract infections as a result of enhanced staff training related to catheterization and prompted voiding" is:

Accepted Answer

A)   Physician-sensitive and nonmeasurable.
B)   Measurable and nursing-sensitive.
C)   Precise, measurable, and physician-sensitive.
D)   Patient care-centered and nonmeasurable.

Question 18

A nurse manager wants to decrease the number of medication errors that occur in her department.The manager arranges a meeting with the staff to discuss the issue.The manager conveys a total quality management philosophy by:

Accepted Answer

A)   Explaining to the staff that disciplinary action will be taken in cases of additional errors.
B)   Recommending that a multidisciplinary team should assess the root cause of errors in medication.
C)   Suggesting that the pharmacy department should explore its role in the problem.
D)   Changing the unit policy to allow a certain number of medication errors per year without penalty.

Question 19

The nurse educator of the pediatric unit determines that vital signs are frequently not being documented when children return from surgery.According to quality improvement (QI),to correct the problem,the educator,in consultation with the patient care manager,would initially do which of the following?

Accepted Answer

A)   Talk to the staff individually to determine why this is occurring.
B)   Call a meeting of all staff to discuss this issue.
C)   Have a group of staff nurses review the established standards of care for postoperative patients.
D)   Document which staff members are not recording vital signs, and write them up.

Question 20

A new graduate is asked to serve on the hospital's quality improvement (QI)committee.The nurse understands that the first step in quality improvement is to:

Accepted Answer

A)   Collect data to determine whether standards are being met.
B)   Implement a plan to correct the problem.
C)   Identify the standard.
D)   Determine whether the findings warrant correction.

Exam 20: Managing Quality and Risk