Fundamentals Chapter 2-The Nurse's Role in Healthcare Quality and Pati

The nurse is teaching an unlicensed assistive personnel (UAP) about fire safety. Which UAP statement demonstrates that teaching has been effective?

"I will rescue clients from harm before doing anything else."

A nurse mistakenly documented a client's vital signs and assessment findings in the health record of a client who has since been discharged. The nurse tells a colleague, "I'm wary of filing an incident report because I don't know what the consequences will be." What should the colleague tell the nurse?

"It sounds like it was an honest mistake, and maybe a report will lead to improvements"

A neonate was born by vaginal birth and initial assessment revealed no distress. However, the infant soon developed dyspnea and then apnea. The care team in the room attempted to manage the infant's distress independently and neglected to call an emergency code, which was later determined to be necessary. Root cause analysis of this event should begin by asking what question?

"Why did no one in the room choose to call a code?"

The community health nurse is talking with four clients. Who does the nurse identify that would most benefit from teaching about alcohol and drug use?

19-year-old male college student majoring in physics

Practices surrounding the maintenance of intravenous lines on a unit are being reviewed to ensure that they are consistent with the Quality and Safety Education for Nurses (QSEN) competency of evidence-based practice (EBP). Which main factors will be integrated into the revised practices? Select all that apply. 1. practices at other similar care sites in the immediate region 2. the most recent peer-reviewed nursing literature 3. experienced nurses' clinical expertise around intravenous management 4. clients' preferences for the care of their intravenous systems 5. the costs of different intravenous pumps and tubing

2, 3, 4

A Medicare client who was being treated in the hospital for major depression attempted suicide by hanging and suffered brain damage due to hypoxia. The Centers for Medicare & Medicaid Services (CMS) has classified this as a "never event." The nurse should recognize what consequence of this classification? A.The hospital will have to bear the cost of treating the client's brain injury. B. The hospital will no longer be reimbursed for the care of Medicare and Medicaid clients.

A

An experienced nurse on a unit has shown a recent nursing graduate how to override the maximum flow rate settings on a client's intravenous pump in order to administer a scheduled medication more quickly. The recent graduate should A. report this safety violation to the hospital's health and safety board B. avoid doing this if the resulting flow rate exceeds the ordered rate

A

A nurse is a member of a hospital's quality improvement committee, which has reaffirmed the hospital's commitment to eliminating "never events." Which of these clinical events would the committee address?

A client with vascular dementia exited the hospital unnoticed and suffered a fall

The nurse is providing safety teaching to the family of an older adult client. Which finding in the client's home will the nurse teach the family to address? A.No extension cords are being used B. A hair dryer is placed next to the sink

B

The poison control nurse receives a call from the caregiver of a young school-age child who may have ingested a poisonous substance. Which is the priority response by the nurse?

Check breathing and heart rate

An experienced nurse has a reputation for being conscientious and caring, so the nurse is shocked and embarrassed to have committed a medication error for the first time in her career. The nurse's supervisor should use what approach when responding to this event?

Collaborate with the nurse to identify any supplementary education that would be beneficial.

A nurse has been caring for a client with a diagnosis of heart failure for several weeks, and the client's prescribed dose of digoxin has been unchanged since admission. However, after scanning the bar code on the medication prior to this morning's dose, the nurse notes that the computer is prompting a higher dose than on previous days. What is the nurse's most appropriate response?

Confirm in the client's health record that a change in dose has been ordered and then administer the new dose.

A client has gone into cardiac and respiratory arrest and resuscitation is being attempted at the client's hospital bedside. The nurse recognizes the high potential for errors in this emergency setting. Which action is most likely to prevent adverse incidents in this situation?

Ensure clear, accurate communication between each of the team members

The poison control nurse receives a call from the parent of a 2-year-old child. The parent states, "I just took a quick shower, and when I finished, I walked into the kitchen and found my child with an open bottle of household cleaner." What is the poison control nurse's appropriate response?

Is your child breathing at this time?

A hospital is in the process of integrating Tall Man Letters into all of documentation that is used at the facility. When promoting this change in practice, what potential benefit should be described?

Medication errors involving drugs with similar names can be reduced

Local media reports have focused on the large amounts of waste that are produced by a local hospital, and there is public pressure to reduce waste. What principle should guide the hospital's waste-reduction efforts?

Much hospital waste is considered a biohazard, but much other waste can be conventionally recycled

An individual calls the telehealth nurse and reports that a family member was just found on the floor of an enclosed garage while a car was still running. The family member is unconscious and cherry red in color. What direction will the telehealth nurse provide?

Open garage doors and windows, and call 911

Analysis is being conducted of a sentinel event that result in injury to a client. When putting forward recommendations to prevent future similar events, the safety committee should prioritize which of the following?

Recommended changes are consistently implemented at the point of care

The nurse is admitting a client to a medical-surgical unit who states, "If someone brings balloons to me, I might have trouble breathing." What is the appropriate nursing action?

Replace common health care items with latex-free equipment

A nurse was covering for a colleague during the colleague's scheduled break and nearly administered an intravenous antibiotic to the wrong client, catching the error while programming the IV pump. What is the nurse's best response to this adverse incident?

Report the event using the appropriate documentation so processes can be examined to promote safety

The nurse is teaching the caregiver of a 8-month-old infant about safety. Which teaching will the nurse include?

Supervise your child on the changing table

The nurse is teaching the caregiver of an infant about safety. Which teaching will the nurse include?

Supervise your child on the changing table

A confused client entered the dirty supply room on the unit and was found rummaging through trash that contained blood and body fluids. An incident report has been completed about this event by the nurse who discovered the client. Which statement about the incident report is most accurate?

The incident report will be used to inform changes so that the dirty supply room becomes less accessible to clients.

A nurse has approached the unit manager and admitted to giving a client an incorrect dose of insulin. Which aspect of this event would suggest that it constitutes at-risk behavior rather than a human error?

The nurse made a similar insulin error 4 months ago and has also made an oral medication error

A nurse is struggling to provide adequate care during an exceptionally busy shift. Which action is most likely a violation of Occupational Safety and Health Administration (OSHA) regulations?

The nurse manually lifts a heavy client rather than using a mechanical lift

A hospital's quality improvement committee is adapting the hospital's policies and procedures to align with the Joint Commission 2015 Hospital National Patient Safety Goals. Which of the following is an explicit focus of the 2015 goals?

Use two unique patient identifiers

A client has been admitted with a gastrointestinal bleed. Two nurses should perform checks before which intervention is performed?

administering a unit of packed red blood cells

A client has been recovering in the hospital following bowel resection surgery. The care team has identified that the client is at a high risk for developing venous thromboembolism during the immediate postoperative period. The nurse can best promote this client's safety by:

closely monitoring the client for changes in health status

A nurse prepared a client's medication, brought it to the client's bedside and then realized at the last minute that the medication was for another client of similar age and appearance. Follow-up to this event should include:

completing an incident report describing this near miss

The nurse manager on a medical unit has scheduled a debriefing session. Which of the following is the most likely subject of this meeting?

discussing a recent event when a newly-admitted client went into cardiac and respiratory arrest

A series of medication errors have prompted a reevaluation of the drug administration practices on a unit. Which of the following strategies is most likely to prevent errors and enhance safety?

eliminating interruptions to nurses while they are preparing medications

A hospital unit's safety committee is evaluating current practices while performing a root cause analysis of an error. Which initiative on the unit has the greatest potential to reduce the number of errors?

enhancing the communication that takes placed between team members

A care facility has introduced care bundles for clients who have indwelling urinary catheters. When describing the use of care bundles, what benefit should be explained?

ensuring that each necessary element of catheter care is consistently provided

A hospital client's urine output is 35 mL over the past 5 hours, so the nurse has chosen to inform the client's primary care provider by telephone. The nurse will use the SBAR tool to communicate, so will begin the dialogue by:

giving an overview of the client's circumstances and the exact reason for the call

A client's hemoglobin level has been found to be 7.6 g/dL (normal range 13.8 to 17.2 g/dL) and the primary care provider has ordered a blood transfusion. A unit of blood has come up from the hospital's blood bank and the client's nurse has received it. In order to best promote the client's safety, the nurse should:

have a colleague double-check the blood and the client's identity

A health care institution's most recent strategic plan includes a commitment to creating a culture of safety. The organization can best meet this commitment by:

having every employee focus on safety, not only direct care providers

A sentinel event involving a client's suicide attempt on a hospital unit is being analyzed by the hospital's quality and safety committee. The committee should prioritize what consideration when performing this analysis?

identifying strategies for preventing a repeat of this event

Root cause analysis was conducted for an incident in which a client's feeding tube was connected to the client's intravenous port. Recommendations from the analysis include the adoption of mistake-proof tubing. Tubing would be considered to be mistake proof if it:

is designed so incompatible tubes cannot be connected

A nurse has completed an incident report after a client tripped on an electrical cord in the hospital hallway and had a fall. The incident report will most likely be analyzed by:

the hospital's health and safety committee