Quality & Safety and Infrastructure

B. The nurse encourages the client to participate in all treatment decisions as the center of the health care team.

The Joint Commission (TJC) encourages clients to become active, involved, and informed participants on the health care team. What nursing action follows TJC recommendations for improving client safety by encouraging them to speak up? A. The nurse explains each procedure twice to prevent client questions from wasting time. B. The nurse encourages the client to participate in all treatment decisions as the center of the health care team. C. The nurse encourages clients to advocate for themselves instead of choosing a trusted family member or friend. D. The nurse assures the client who questions a medication that it is the right medication prescribed for him or her and administers the medicine.

B,D,E,F

The Quality and Safety Education for Nurses (QSEN) project has developed quality and safety competency categories. What are the quality and safety competency categories that students are encouraged to develop during prelicensure education? Select all that apply. A. Nursing process B. Client-centered care C. Therapeutic communication D. Teamwork and collaboration E. Evidence-based practice F. Quality improvement

A. Patient

The central figure in health care services is the: A. Patient B. Nursing assistant C. Nurse D. Physician

A, C, E, F

A nursing instructor is preparing a class on the changes that have occurred in health care over the past years. Which of the following would the instructor most likely include? A. Increasing cultural diversity of the population B. Static nature of diseases C. Expanding consumer expectations D. Lowered costs for health care E. Reductions in health care staffing F. Restructuring of health care institutions

A. The Joint Commission

A client has been admitted in the emergency care unit with conditions of respiratory distress and pneumonia. The client's condition worsens and requires mechanical ventilation. While visiting this client in the hospital, the family observes members of the health care team washing their hands upon entering and leaving the room. By implementing recommended hand hygiene measures, which organization's goals is the health care team supporting? A. The Joint Commission B. The National Council of State Boards of Nursing (NCSBN) C. Institute of Medicine (IOM) D. Agency for Healthcare Research and Quality (AHRQ)

A,B,C,D

A client has been diagnosed with a glioblastoma and the care team has determined that this brain tumor is inoperable. Which aspects of the client's subsequent care demonstrate adherence to the Quality and Safety Education for Nurses (QSEN) competencies? Select all that apply. A. The care team meets with the client and family promptly to identify their preferences for treatment. B. The care team ensures the client receives treatment promptly whenever possible C. Nurses proactively identify threats to the client's safety that may occur as treatment is provided. D. Each member of the care team uses the best available technology to organize and provide care. E. Treatments are chosen with the goal of minimizing the financial burden on the health care institution.

A. reducing the incidence of hospital-acquired infections.

A hospital has reaffirmed its commitment to meeting National Patient Safety Goals (NPSGs). The hospital is most likely to meet these goals by: A. reducing the incidence of hospital-acquired infections. B. decreasing the use of unlicensed care providers. C. encouraging researchers to conduct evidence-based studies within the hospital. D. involving clients and families in their care planning

D. New partnerships are established between the hospital and local schools of nursing.

A hospital is introducing Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). What activity will benefit most directly from this initiative? A. New systems are introduced to increase communication between nurses and the members of other health disciplines. B. Systems are reviewed with the goal of achieving the best client outcomes at the lowest cost. C. Hiring practices are reviewed to maximize the proportion of nurses who possess baccalaureate or graduate degrees. D. New partnerships are established between the hospital and local schools of nursing.

A. TJC

A nurse administrator is participating in an audit that has the goal of creating a quality improvement plan. Which organization will the nurse be reporting to? A. TJC B. National League for Nursing C. American Nurses Association D. Occupational Health and Safety Administration (OSHA)

D. Safety

A nurse assures a client newly admitted to the clinical unit that the client will not be harmed by any errors and can expect to be safe in the facility. This assurance represents which expectation of the health care environment? A. Transparency B. Individualization C. Control D. Safety

D. social welfare office.

A nurse is caring for a 17-year-old pregnant adolescent who needs to obtain assistance with essential infant items such as a crib. The client mentions not having any income from a job. The nurse should encourage the client to go to a: A. visiting nurse from a clinic. B. resale or thrift shop. C. rental equipment store. D. social welfare office.

A. Comparison of available health care plans

A nurse is helping clients access the health insurance marketplace. What is the goal of this health insurance coverage concept? A. Comparison of available health care plans B. Insurance for older adults C. Insurance assistance for women and children D. Insurance coverage for people needing orphan drugs

C,D,F

A nurse is interviewing for prospective employment in a managed care organization. When considering this type of health care delivery system, which of the following would be most important for the nurse to keep in mind? Select all that apply. A. Reimbursement for services is highly variable. B. Payment rates are usually determined after care is provided. C. Precertification for procedures is required. D. The choice of providers for services is often limited. E. Services are primarily limited to inpatient facilities. F. Utilization review is a key factor to determine cost-effectiveness.

A, C, D, E

A nurse is preparing a presentation for a local community group about health, wellness, and illness. When describing the concept of wellness, which of the following features would the nurse include? Select all that apply. A. Performing to one's best ability B. Being completely without illness C. Feeling that everything is together D. Being able to adjust and adapt E. Experiencing a feeling of well-being

B. By critically appraising the outcomes of care that is provided

A nurse is providing care for a client who is postoperative day one following a bowel resection for the treatment of colorectal cancer. How can the nurse best exemplify the QSEN competency of quality improvement? A. By liaising with the members of the interdisciplinary care team B. By critically appraising the outcomes of care that is provided C. By integrating the client's preferences into the plan of care D. By documenting care in the electronic health record in a timely fashion

B, C, E

A nurse is reading a journal article about the U.S. health care delivery system. When reading this article, which topics would the nurse expect to find? Select all that apply. A. An increased emphasis on disease treatment and cure B. View of a person's state of health as ever-changing C. Diverse cultural backgrounds affecting responses to health care D. Decreased prevalence of disabilities and chronic illnesses E. Increased ethical issues related to technological advancements

C. The nurse researches best current practices for prevention of the spread of infection in health care provider offices.

A nurse is using the QSEN competency of evidence-based practice when caring for clients. What is an example of this competency? A. The nurse works with other health care team members to provide care for a client diagnosed with Alzheimer's disease. B. The nurse manager holds an in-service for staff to teach them the safe operation of a new piece of equipment. C. The nurse researches best current practices for prevention of the spread of infection in health care provider offices. D. The nurse uses computer-generated care plans for client care.

A. Filling out an incident report accurately after a client went missing from the unit

A nurse on a medical unit recognizes the need to demonstrate the Institute of Medicine's focus on safety in clinical practice. Which action best demonstrates the skills necessary to meet this standard? A. Filling out an incident report accurately after a client went missing from the unit B. Appreciating the relationship between continuing education and client safety C. Understanding the functions of a new automated intravenous pump that has been introduced to the unit D. Valuing the contributions of clients and their families who suggest possible improvements in care

A, B, C

A nurse working in an acute care setting volunteers to participate in a research study. The nurse understands that research findings add to the scientific base of nursing practice. Evidence-based practice (EBP) accomplishes which results? Select all that apply. A. Improve patient outcomes B. Establish best nursing practices C. Decrease health care costs D. Validate nursing diagnoses E. Delineate the health-illness continuum F. Provides answers to ethical questions

D. evaluation of outcomes

A nurse, when documenting the health details of a client in an acute care agency, fills out all the details under assessment, diagnosis, planning, and implementation. What did the nurse miss as per the Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) standards? A. client's past medical history B. physician's feedback C. client's diet chart D. evaluation of outcomes

A. location, onset, alleviating factors, and aggravating factors

According to The Joint Commission's pain assessment and management standards, which of the following are essential components of a comprehensive pain assessment? A. location, onset, alleviating factors, and aggravating factors B. quality, location, intensity, and family history C. nutritional deficiencies, onset, duration, and effects of pain D. intensity, variations, range of motion, and the client's goal for pain control

D. Registered nurse

According to established standards, which health care provider should conduct a holistic assessment for all clients admitted to the hospital? A. Health care provider B. Admission clerk C. Licensed practical nurse D. Registered nurse

D. Nursing certification

All of the following are standards monitored by the Quality and Safety Education for Nurses (QSEN), EXCEPT: A. Evidence-based practice B. Client-centered care C. Informatics Quality improvement D. Nursing certification

A, B,D

Continuous quality improvement (CQI) was identified in the 1990s as a system that would focus on improving quality of care by applying processes. Select all of the processes that apply to CQI, EXCEPT: A. Analyzing similar clinical situations to identify repetitive tasks B. Assessing the impact of financial parameters and reimbursement models on patient care delivery C. Reviewing medication errors for individual patients D. Examining different processes that affect patient care

C. Predetermined payment for services based on medical diagnoses

Medicare uses a prospective payment plan based on diagnosis-related groups (DRGs). What are DRGs? A. Locally supported health care financing, usually by donations B. A public assistance program for low-income individuals C. Predetermined payment for services based on medical diagnoses D. A private insurance plan for subscribers who pay a copayment

C. Review the scheduled procedure, site, and client.

Once the operating team has assembled in the room, the circulating nurse calls for a "time out." What action should the nurse take during the time out? A. Ensure that sufficient surgical supplies are available. B. Check that all surgical personnel are properly attired. C. Review the scheduled procedure, site, and client. D. Confirm that informed consent has been obtained.

A,B,C

Quality assurance (QA) programs were put into place in the 1980s by the Joint Commission to establish and maintain accountability to the public. These programs are responsible to the public for maintaining certain standards. Choose all of the activities that apply to QA programs. A. Cost of health care services B. Quality delivery of services C. Appropriate standards of care D. Staff-patient ratios for nursing care

C. National Patient Safety Goals

The hospital is having a problem with healthcare-associated infections. A committee has been established to study the problem and make recommendations. The nurse working on the committee knows that this work addresses what? A. Inpatient quality indicators B. Prevention quality indicators C. National Patient Safety Goals D. Patient safety indicators

D. Drug interactions

The nurse caring for a 91-year-old client diagnosed with osteoarthritis is reviewing the client's chart. This client is on a variety of medications prescribed by different care providers in the community. Regarding safety, what is the nurse's greatest client related concern? A. Depression B. Chronic illness C. Inadequate pain control D. Drug interactions

A,B,E

The nurse manager is reviewing the QSEN quality and safety competencies for nurses. Which competencies are included in this initiative? Select all that apply. A. Client-centered care B. Teamwork and collaboration C. Establishment of clinical career ladders D. Revamping the licensing requirements for foreign-educated nurses E. Quality improvement (QI)

D. The nurse researches new technological advances in the treatment of cancer.

The nurse uses the QSEN competency of Informatics when planning care for clients. What is an example of the use of this skill? A. The nurse works collaboratively with a dietitian to devise a client meal plan. B. The nurse orients a visually impaired client to the hospital room. C. The nurse checks with the client for priorities when planning client care. D. The nurse researches new technological advances in the treatment of cancer.

C. identifies client's full name and date of birth

The nursing instructor is observing a nursing student who is about to administer a medication. Which nursing student behavior concerning client identification does the nursing instructor validate as appropriate? A. identifies client's last name and room number B. identifies client's date of birth and last name C. identifies client's full name and date of birth d. identifies client's room number and full name

A. Respite care

The wife of an elderly man with Alzheimer's disease contacts a community health nurse because she is planning to visit her sister in a neighboring state and needs assistance in arranging care for her husband while she is away. Which type of care is the wife seeking? A. Respite care B. Rehabilitation care C. Hospice services D. Parish nursing services

D. Ask the client's permission to move the furniture.

What must a nurse do before altering the arrangement of furniture in the home to facilitate care? A. Nothing; the nurse may move the furniture if needed. B. Document the need to move the furniture. C. Tell the client that the furniture has to be moved. D. Ask the client's permission to move the furniture.

B. Clients must be viewed as individual persons, members of a family, and part of a community.

When providing care to clients, which of the following would be most important for the nurse to keep in mind? A. Clients seeking care often have little understanding about their health care options. B. Clients must be viewed as individual persons, members of a family, and part of a community. C. The fact that a client is seeking care indicates that the person is considered dependent. D. Regardless of health problem or status, clients' needs commonly are consistently identical.

A. including the client in the morning rounds of the health care team

Which action by the nurse is the best indication that the nurse is incorporating the quality and safety education for nursing (QSEN) competency of teamwork and collaboration in the plan of care for a client? A. including the client in the morning rounds of the health care team B. keeping up all four side rails for a confused client to prevent falls C. using a new client positioning technique described in research to prevent pressure injuries D. asking a client about his or her personal goals for rehabilitation following a stroke

B. The nurse asks the client about health goals.

Which is the best example of a client-centered approach to care? A. The nurse helps a client ambulate. B. The nurse asks the client about health goals. C. The nurse asks the client what the client would like to order from the menu. D. The nurse draws a blood sample from a client.

C. Facilitating transition between settings

Which phrase best describes continuity of care? A. Focusing on acute care in the hospital B. Serving the needs of children C. Facilitating transition between settings D. Providing single-episode care services

A. They enable nursing to be accountable for the quality of care.

Why are quality-assurance programs important in nursing? A. They enable nursing to be accountable for the quality of care. B. They facilitate increased enrollment in educational programs. C. They specify how resources are used or not used. D. They allow increased retention of qualified nurses.