chapter 2 qs

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 Joint Commission 2015 Hospital National Patient Safety Goals have been introduced during an educational session for nurses. Which action by a nurse best demonstrates the implementation of these goals?

A nurse promptly telephones a client's primary care provider to report the client's critically low hemoglobin.

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 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 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."

The Centers for Medicare & Medicaid Services (CMS) is unlikely to reimburse a hospital for treatment of which adverse event?

A client suffers a hip fracture after falling off of a commode.

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 states that the client's recent fall was caused by his scheduled antihypertensive medications being mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow?

Document the client's claims and the events surrounding the alleged incident.

A nurse makes a medication error and fills out an incident report. What will the nurse do with the incident report once it is filled out?

Maintain it according to agency policy.

A nurse enters a client's room and finds that the client has fallen on her way to the bathroom. What is a prudent nursing intervention for this client?

Document the incident, assessment, and interventions in the client's medical record.

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.

Two male clients with the same surname were waiting for admission in an outpatient clinic. The nurse began the admission assessment of one of the clients for the procedure that the other client was scheduled for. What is the most appropriate response to this incident?

Formally document and report this near miss so that systems and procedures can be improved.

A system of automated drug dispensing cabinets has been introduced throughout a hospital. It has come to the attention of the nurse manager that some nurses are using a "work around" in which a supply of common p.r.n. (as needed) medications are being removed for a shift, rather than removing individualized doses. How should this practice be addressed?

Nurses should be educated about the risks to client safety posed by this practice.

The goal of evidence-based practice related to restraints is to avoid the use of restraints.

TRUE

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?

The hospital will have to bear the cost of treating the client's brain injury.

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 hospital is being evaluated by the Centers for Medicare & Medicaid Services. Which of these findings from the evaluation may result in a reduction in the hospital's reimbursement under the value-based purchasing (VBP) program?

The rate of postoperative complications is significantly higher than national averages.

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 client identifiers before giving medications.

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 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.

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.