Leadership Exam 2 EAQs (doesn't have the 3 presentation things tho, too lazy rn)

Which strategy can be used to enhance leadership skills?

A. Modeling

B. Reflection

C. Rewarding

D. Simulation

B. Reflection

Rationale: Developing as a leader comes from knowing and understanding your authentic self. Reflection allows the leader to explore thoughts about experiences, actions, and reactions, and to assess the effect of choices and decisions. Modeling is displaying an example through actions and behaviors. Rewarding, or reward power, is used as a motivational force in leadership. Simulating a leadership role employs a scenario in which the participant responds, though it's not something that can be done frequently.

In which way will giving false information affect the nurse leader's relationship with employees?

A. Staff will lose trust in the nurse leader.

B. Team members will lose confidence in the leader's ability.

C. Employees will not have enough time to prepare for job loss.

D. Staff nurses will file complaints with the National Labor Relations Board.

A. Staff will lose trust in the nurse leader.

Rationale: Nurse leaders need to speak in truth. As leaders, truth reinforces integrity of practice and honors humanity. Giving false information to staff will result in loss of trust. Honesty, rather than ability, is the underlying issue involving intentional false information. There are no time suggestions related to informing staff of a possible lay off. Staff nurses are not likely to file complaints with the National Labor Relations Board because this organization addresses unfair labor practices and union-related situations.

Which characteristic reflects emotional intelligence? SATA

A. Considering one's self

B. Discerning emotions of others

C. Managing one's own emotions

D. Understanding one's own emotions

E. Predicting performance in the workplace

B. Discerning emotions of others

C. Managing one's own emotions

D. Understanding one's own emotions

E. Predicting performance in the workplace

Rationale: Emotional intelligence can be defined as understanding and managing one's own emotions with the added social awareness of discerning the emotions of others. Emotional intelligence is the single biggest predictor of performance in the workplace and the strongest driver of leadership and personal excellence. Self-awareness, not emotional intelligence, refers to one's ability to consider who he or she is.

Which aim of providing healthcare identified from the Institute of Medicine (IOM) 2001 report Crossing the Quality Chasm are is still relevant today? SATA

A. Safe

B. Equitable

C. Informed

D. Patient-centered

E. Efficient

F. Collaborative

A. Safe

B. Equitable

D. Patient-centered

E. Efficient

Rationale: The 2001 IOM report Crossing the Quality Chasm identified six aims of providing healthcare: safe, equitable, patient-centered, efficient, effective, and timely. All of these aims are still relevant today. Informed and collaborative are not aims of healthcare identified by the 2001 IOM report.

Which task does the nurse anticipate performing when asked to start a quality assurance program?

A. Chart review and audits

B. Professional development activities

C. Reviewing patient satisfaction surveys

D. Assembling an interprofessional team

A. Chart review and audits

Rationale: Quality assurance involves the discovery and prevention of errors. Essential tasks include chart reviews and audits in addition to inspection of nursing activities. Professional development, patient satisfaction surveys, and assembling interprofessional teams are all quality improvement activities, not quality assurance.

Embracing cultural differences is an important part of which initiative?

A. Healthy People 2020

B. Title VI of the Civil Rights Act

C. Purnell's Cultural Competence

D. Quality and Safety Education for Nurses

D. Quality and Safety Education for Nurses

Rationale: Quality and Safety Education for Nurses requires the provision of safe and quality health care by embracing cultural differences. Healthy People 2020 focuses on encouraging people to perform behaviors that will improve the health of the country. Title VI of the Civil Rights Act prevents discrimination on the basis of national origin, ethnicity, or race. Purnell's Cultural Competence is a model of performing culturally competent care.

Which person should the staff nurse approach while writing a proposal with the intention of increasing cultural diversity on the patient care unit?

A. Nurse manager

B. Human resources

C. Director of Nursing

D. Attending physician

A. Nurse manager

Rationale: The nurse manager sets the pace for cultural diversity on the unit and would be the best person to approach with a proposal on the subject. Human resources, the Director of Nursing, and attending physicians are not directly involved in setting cultural diversity norms on the patient care unit.

Which team members at a healthcare organization will generally be the first people to address cultural diversity?

A. Physicians

B. Registered nurses

C. Human resources department

D. The leadership and management team

D. The leadership and management team

Rationale: Leadership and management are the first people at most healthcare organizations to address cultural diversity. Leadership must give unwavering support to embracing diversity and creating a culturally sensitive workplace. Physician teams, registered nurses, and human resources departments are important elements ofa culturally sensitive organization but are not the first people within the organization to address diversity needs.

Which strategy would the nurse manager consider implementing when creating a more inclusive environment on the nursing unit? SATA

A. Provide flexible scheduling.

B. Avoid discussing unconscious biases.

C. Implement a strict managerial approach.

D. Create effective communication systems.

E. Support ongoing professional development.

A. Provide flexible scheduling.

D. Create effective communication systems.

E. Support ongoing professional development.

Rationale: There are several strategies that can be used to create a more inclusive work environment, including: providing flexible scheduling, creating effective communication systems, and increasing support for professional development. Nurse managers should identify unconscious biases to make the team more inclusive. The manager should use a shared governance leadership model instead of a strict managerial approach.

The nurse wishes to learn more about a patient's health-related beliefs. Which step should the nurse take?

A. Perform a cultural assessment.

B. Ask staff of the same cultural background.

C. Do research online about the patient's culture.

D. Discuss the patient's culture and beliefs with visitors, such as familyand friends.

A. Perform a cultural assessment.

Rationale: The nurse should perform a cultural assessment to learn more about the patient's health-related beliefs and values. Asking other staff members or doing research online can give general information about a person's culture, but nothing specific to the individual patient's values or beliefs. The nurse should get cultural information directly from the patient rather than from the patient's visitors, family, or friends.

The nurse is speaking with a patient who is much older and froma different part of the country. The patient is using words and phrases that are unfamiliar. Which action should the nurse take?

A. Request language translation services.

B. Ask the patient to clarify what is being said.

C. Ask the patient's family to translate the phrases.

D. Use the patient's nonverbal communication cues to determine the meaning.

B. Ask the patient to clarify what is being said.

Rationale: When speaking with a patient who is froma different part of the country or of a different generation, word choice may differ from what the nurse is familiar with. In this situation, it is best to ask the patient directly what is meant. There are no language translation services that provide this service. Asking the patient's family or using nonverbal cues may lead to misinterpretation of what the patient is trying to communicate.

Which skill is the nurse encouraging students to improve when suggesting that they speak with a patient of a different ethnicity to understand the unique challenges patients face when engaging with the healthcare system?

A. Empathy

B. Acculturation

C. Cultural sensitivity

D. Cultural marginality

C. Cultural sensitivity

Rationale: Cultural sensitivity describes the student's capacity to react to ideas, habits, customs, or traditions unique to a group of people. Empathy is the process of responding to someone with compassion and kindness. Acculturation is the process of adapting to the dominant culture. Cultural marginality is defined as feeling as if someone is living between two or more cultures, but never actually at the center of a culture.

Which statement by a nurse indicates the need for further teaching about quality management and quality improvement programs?

A. "Quality improvement is evidence-based and focuses on outcomes."

B. "Quality management works best in a democratic organizational structure."

C. "The goal of quality improvement is to determine who is at fault for an error."

D. "A shared commitment to quality improvement is essential for the program and the organization's success."

C. "The goal of quality improvement is to determine who is at fault for an error."

Rationale: The goal of quality improvement (Ql) is to improve the system and processes, not to determine who is at fault for an error. Ql is evidence-based and focuses on patient and system outcomes. Ql works best in a democratic organization, and a shared commitment is essential for the program and its success.

Which report published by the Institute of Medicine (IOM) is considered a major influence on patient safety? SATA

A. To Err is Human

B. Making Healthcare Safer II

C. Crossing the Quality Chasm

D. Triple Aim for Populations

E. Transforming Care at the Bedside

A. To Err is Human

C. Crossing the Quality Chasm

Rationale: Reports published by the Institute of Medicine (IOM) that are considered major influences on patient safety include: To Err is Human and Crossing the Quality Chasm. The report Making Healthcare Safer // was published by the Agency for Healthcare Research and Quality (AHRQ) to increase attention to safety within healthcare organizations. The Institute for Healthcare Improvement (IHI) published Transforming Care at the Bedside, which identified many past practices that had a negative influence on nurses and thus on patients, and Triple Aim for Populations.

Which is a competency of health professionals according to the Institute of Medicine (IOM)? SATA

A. Utilizing informatics

B. Establishing financial stability

C. Applying quality improvement

D. Providing patient-centered care

E. Enforcing scope-of-practice barriers

A. Utilizing informatics

C. Applying quality improvement

D. Providing patient-centered care

Rationale: According to the Institute of Medicine (IOM), competencies of health professionals include utilizing informatics, applying quality improvement measures to patient care services, and providing patient-centered care. Establishing financial stability is not a competency identified by IOM. An IOM recommendation regarding nursing practice suggests removing, not enforcing, scope-of-practice barriers.

Which concept did the report Keeping Patients Safe: Transforming the Work Environment of Nurses identify as contributing to the creation of an unsafe work environment for nurses? SATA

A. Unsafe equipment

B. Insufficient supplies

C. Peer-to-peer evaluations

D. Competency assessments

E. Lack of trust in organizations

A. Unsafe equipment

B. Insufficient supplies

E. Lack of trust in organizations

Rationale: Contributions to the creation of an unsafe work environment identified in Keeping Patients Safe: Transforming the Work Environment of Nurses include: unsafe equipment, insufficient supplies, and lack of trust in organizations. Unfortunately, some of these influences are still present today. Peerto-peer evaluations have been identified as an effective approach to improving safety on patient care units. Competency assessments increase safety in the work environment.

Which activity is considered an evidence-based practice standard in the healthcare setting? SATA

A. Interventions to reduce falls

B. Prevention of pressure injuries

C. Reduction of urinary catheter-related infections

D. Prevention of central line-associated infections

E. Tuition reimbursement to increase the number of baccalaureate nurses

A. Interventions to reduce falls

B. Prevention of pressure injuries

C. Reduction of urinary catheter-related infections

D. Prevention of central line-associated infections

Rationale: Evidence-based practice standards in the healthcare setting to improve the quality and safety of patient care include: interventions to reduce falls, prevention of pressure injuries, reducing urinary catheter-related infections, and prevention of central line-associated infections. Tuition reimbursement to increase the number of nurses with baccalaureate degrees in the clinical setting is not an evidence-based practice standard. However, it is associated with improved patient care outcomes.

Which is one of The Joint Commission's (TJC) national patient safety goals? SATA

A. Prevent infection

B. Use medications safely

C. Improve staff communication

D. Establish admission protocols

E. Create interdisciplinary teams

A. Prevent infection

B. Use medications safely

C. Improve staff communication

Rationale: The Joint Commission (TJC) established national patient safety goals based on patient care outcomes. The goals include: preventing infection, using medications safely, and improving staff communication. Establishing admission protocols is the responsibility of individual healthcare organizations. Creating interdisciplinary teams is not a national patient safety goal established by TJC.

Which is a competency identified by Quality and Safety Education for Nurses (QSEN)? SATA

A. Skills

B. Emotions

C. Reactions

D. Attitudes

E. Knowledge

A. Skills

D. Attitudes

E. Knowledge

Rationale: Competencies identified by Quality and Safety Education for Nurses (QSEN) include skills, attitudes, and knowledge learners need to develop to serve as safe practitioners. Emotions and reactions are not competencies identified by the QSEN program.

Which statement made by the student indicates effective teaching about clinical safety from the nursing instructor? SATA

A. "Practice hand hygiene."

B. "Avoid addressing observed unsafe situations."

C. "Keep current with the evidence and best practices."

D. "Do not remove faulty equipment unless replacements are available."

E. "Use the Institute of Medicine (IOM) competencies when providing patient care."

A. "Practice hand hygiene."

C. "Keep current with the evidence and best practices."

E. "Use the Institute of Medicine (IOM) competencies when providing patient care."

Rationale: Statements made by the nursing student that indicate understanding of tips for clinical safety include the following: "Practice hand hygiene," "Keep current with evidence and best practices,"and "Use the Institute of Medicine (IOM) competencies when providing patient care."The nurse should be prepared to intervene in unsafe situations, not avoid them. Faulty equipment should be removed and reported immediately.

Which implication for leaders and managers comes from the report Crossing the Quality Chasm? SATA

A. Provide substantial support for information technology.

B. Stimulate hospital boards to include reports on quality,

C. Move from discipline-centered to patient-centered care

D. Move from incident reporting to integrated safety reporting.

E. Acknowledge system errors asa more common cause of errors than individuals.

A. Provide substantial support for information technology.

C. Move from discipline-centered to patient-centered care

Rationale: Implications for leaders and managers from the report Crossing the Quality Chasm include the following: provision of substantial support for information technology and moving from discipline-centered to patient centered care. Moving from incident reporting to integrated safety reporting, stimulating hospital boards to include reports on quality on agendas, and acknowledging system errors as a more common cause of errors than individuals were generated by the To Err is Human report.

Which chart is best for the nurse to use to illustrate the process of diagnostic testing referral by fertility providers?

A. Histogram

B. Flowchart

C. Line graph

D. Trend chart

B. Flowchart

Rationale: A flowchart can be used to show a procedure in its proper sequence, such as the referral process for further diagnostic testing. A histogram is a bar chart that shows the frequency of certain events. A line graph shows the connection between different variables. A trend chart is similar to a line graph but shows the trend of a particular activity over time.

Which type of chart would the nurse select to help organize the results ofa brainstorming session to discuss concerns related to patient cancellations and no-shows at an outpatient clinic?

A. Fishbone

B. Flowchart

C. Trend chart

D. Pareto chart

A. Fishbone

Rationale: A fishbone chart helps organize the results of a brainstorming session. It contains an outcome on a horizontal line with the possibilities branching off from the main line. A flowchart can be used to show a procedure in its proper sequence, such as the referral process for further diagnostic testing. A trend chart is similar to a line graph but shows the trend of a particular activity over time. A Pareto chart is similar to a bar graph but lists the highest frequencies from left to right on the graph.

Which organization emphasizes outcomes, including data and efforts related to patient safety?

A. Institute of Medicine

B. The Joint Commission

C. National Quality Forum

D. Magnet Recognition Program

D. Magnet Recognition Program

Rationale: The Magnet Recognition® Program emphasizes outcomes, including data and efforts related to patient safety. The Institute of Medicine identifies practices that have negative effects on patient safety and quality issues. The Joint Commission is a not-for-profit organization that accredits healthcare organizations internationally. The National Quality Forum is a membership-based organization related to quality measurement and reporting.

Which entity focused on outcomes was developed to recognize nursing excellence?

A. Det Norske Veritas

B. The Joint Commission

C. National Quality Forum

D. Magnet Recognition Program

D. Magnet Recognition Program

Rationale: The Magnet Recognition® Program is a national designation built on and evolving through research that recognizes nursing excellence. The Joint Commission is a not-for-profit organization that accredits healthcare organizations internationally. The National Quality Forum is a membership-based organization related to quality measurement and reporting. Det Norske Veritas is an international organization that provides accreditation in a variety of fields.

Which program's key principle is geared toward teaching nursing students the competencies they will need to affect an organizational culture and create an environment that maximizes patient safety and health outcomes?

A. Magnet Recognition Program

B. American Nurses Association (ANA)

C. Quality and Safety Education for Nurses (QSEN)

D. American Association of Colleges of Nursing (AACN)

C. Quality and Safety Education for Nurses (QSEN)

Rationale: The QSEN program's key principle is geared toward teaching new nursing students the competencies they will need to affect organizational culture and create an environment that maximizes patient safety and health outcomes. The Magnet Recognition® Program facilitates recognition of nursing excellence. The ANA is an organization that represents the interests of nurses. The AACN works to establish quality standards for nursing education in baccalaureate and graduate nursing education.

Which tool would the nurse manager use to assess concerns regarding the handoff process between nurses at shift change?

A. Root cause analysis

B. Total quality management

C. Performance improvement

D. Failure mode and effects analysis

D. Failure mode and effects analysis

Rationale: A failure mode and effects analysis is a systematic review of a process to see where and how it might fail. The nurse should use this process to review the way handoff occurs in an effort to improve it and reduce errors. Total quality management and performance improvement are other, interchangeable terms for quality improvement. A root cause analysis is a review of the events leading up to a sentinel event to determine the root causes.

Which process would the nurse anticipate participating in after a sentinel event?

A. Root cause analysis

B. Total quality management

C. Performance improvement

D. Failure mode and effects analysis

A. Root cause analysis

Rationale: After a sentinel event, the nurse should anticipate participating in a root cause analysis. Theanalysis is a retrospective review of an incident to identify the sequence of events with the goal of identifying the root causes. Total quality management and performance improvement are other, interchangeable terms for quality improvement. A failure mode and effects analysis is a systematic review of a process to see where and how it might fail.

Which represents the correct method and best practice for standardized documentation?

A. Situation, Best guess, Alternatives, and Research

B. Severity, Background, Assessment, and Research

C. Situation, Background, Assessment, and Recommendation

D. Subjective, Best guess, Alternatives, and Recommendation

C. Situation, Background, Assessment, and Recommendation

Rationale: The SBAR method of documentation has been a best practice for standardizing documentation. SBAR stands for situation, background, assessment, and recommendation. Severity, subjective, best guess, alternatives, and research are not included in the SBAR method of documentation.

Which type of event is demonstrated when the nurse realizes that a medication that is about to be given is actually one the patient is severely allergic to?

A. Near miss

B. Never event

C. Always event

D. Sentinel event

A. Near miss

Rationale: A near miss is an event with the potential to cause serious harm that is caught before it occurs. A never event is an event that should never happen. An always event is something that should always happen. A sentinel event is a serious unexpected event that causes death or physical/psychological harm.

Which type of error takes place if the wrong blood type is given to a patient during a blood transfusion?

A. Near miss

B. Never event

C. Always event

D. Sentinel event

B. Never event

Ratioanle: A never event is an error that should never happen, such as administering the wrong blood to a patient during a transfusion. A near miss is an event that almost happens, but the mistake is caught. An always event is something that should always happen, such as practicing proper hand hygiene. A sentinel event is a serious unexpected event that results in harm or death.

Which is the best reply by a potential nurse manager when asked during an interview about performing risk management activities on the unit?

A. "I will refer all adverse events to risk management as needed."

B. "Risk management must be undertaken by all nurses on the unit."

C. "I will make regular safety rounds to ensure compliance with standards."

D. "I will encourage an environment where people are held accountable when an error is reported."

C. "I will make regular safety rounds to ensure compliance with standards."

Ratioanle: The nurse manager should make regular safety rounds and praise employees for safe behaviors.Although the ideal situation would be members of the team undertaking risk management behaviors, the nurse manager must continue to encourage safe practice. Adverse events should be referred to risk management, but the nurse manager should be sure to take steps to prevent errors, rather than just respond to them. Risk management and quality improvement promote a blame-free environment.

Which is the best technique for the nurse manager to share with the team for improving patient recall with the goal of reducing phone calls after discharge by improving patient teaching?

A. Giving the patient a written outline of what is being taught

B. Asking the patient to explain the instructions in their own words

C. Ensuring the patient has family or friends with them after discharge

D. Scheduling one dedicated teaching session to review all of the instructions

B. Asking the patient to explain the instructions in their own words

Rationale: Teach back bruh

Which is the best response from the quality improvement team after receiving several complaints about long wait times for x-rays and blood tests 5 months after implementing a plan to reduce wait times in the emergency department?

A. Reconvene to discuss other options.

B. Request additional funding to hire new staff.

C. Eliminate the new plan and go back to the old policy.

D. Wait another 6 months to see if the situation improves.

A. Reconvene to discuss other options.

Rationale: Evaluation is an important part of the quality improvement process. If the plan is not working or creates new problems, the team should reconvene to discuss other options. Requesting additional funding for new staff may be an option, but the team should meet to discuss all options. The plan has already been in place for 5 months; waiting another 6 months will likely not improve the situation. Eliminating the new plan may address the new problems but will not address the old problems.

Which action is best for the quality improvement team to take after meeting with representatives from the hospital to discuss the increasing rate of medication errors and collecting data from the past 10 years?

A. Set a specific goal for improvement.

B. Assemble a team to deal with the situation.

C. Create a plan to address the rising rate of errors.

D. Evaluate the progress of the planned interventions.

A. Set a specific goal for improvement.

Rationale: After collecting and analyzing the data, the quality improvement (QI) team should establish outcomes by setting a goal for improvement. The team should be assembled before collecting data. The plan should be created after establishing outcomes and goal setting. Evaluating the plan should be the last step of the QI process.

Which program would the nurse consult to review the emergency department's performance compared with other emergency departments around the country?

A. The Joint Commission

B. Quality and Safety Education for Nurses

C. The Agency for Healthcare Research and Quality

D. The National Database of Nursing Quality Indicators

D. The National Database of Nursing Quality Indicators

Rationale: The National Database of Nursing Quality Indicators compares nursing performance on similar patient care units and could provide outcomes data from other emergency departments. The Joint Commission, Agency for Healthcare Research and Quality, and Quality and Safety Education for Nurses are quality improvement organizations that deal with healthcare quality issues but do not specifically compare outcomes on similar patient care units.

Which statement would be included in a presentation about the nurse manager's benchmarking review of the occurrence of postoperative infections on the surgical unit compared with other organizations?

A. "Reporting outcomes data is not enough to change behavior in the organization."

B. "There may be issues with data that has been reported publicly from other organizations."

C. "Differences in terminology, technology, and methodology can alter the reliability of reported data."

D. "Benchmarking helps identify which standards and outcomes we should measure our progress against."

D. "Benchmarking helps identify which standards and outcomes we should measure our progress against."

Rationale: Benchmarking can help identify outcomes against which progress can be measured. However, it also brings to light differences in public reporting of data. Differences in terminology and methodology can affect how reliable the data is, especially when compared with a different organization. In addition, publicly reported data does little to encourage changes in behavior within the organization.

Which source would the nurse consult for the latest evidence-based research to update clinical practice guidelines? SATA

A. The Joint Commission

B. A nearby competing hospital

C. The state's nurse practice acts

D. The National Academy of Medicine

E. Internal performance measurement data

A. The Joint Commission

C. The state's nurse practice acts

D. The National Academy of Medicine

E. Internal performance measurement data

Rationale: There are many sources the nurse could consult when updating clinical practice guidelines, including accrediting bodies, such as The Joint Commission, the state's nurse practice acts, healthcare advisory groups such as The National Academy of Medicine, and internal performance measurement data. Data from nearby competing hospitals are not evidence-based; therefore, it is not appropriate for the nurse to consult them when updating clinical practice guidelines.

Which is an example of a nursing-sensitive indicator in a quality improvement program?

A. Hospital readmission rate

B. Number of pressure ulcers

C. Primary cesarean section rate

D. Number of cases of ventilator-associated pneumonia

B. Number of pressure ulcers

Rationale: Nursing-sensitive indicators are dependent upon the quality or quantity of nursing care. Number of pressure ulcers is directly dependent on the nursing care received by a patient. Readmission rates, primary cesarean section rates, and cases of ventilator-associated pneumonia are dependent on medical care or decisions and are not nursing-sensitive.

Which organization would a consumer contact to review information regarding the quality of care of a healthcare agency?

A. The Joint Commission

B. The National Quality Forum

C. The Quality and Safety Education for Nurses

D. The Agency for Healthcare Research and Quality

A. The Joint Commission

Rationale: Accountability measures are core quality indicators that have a significant effect on patient outcomes. Healthcare organizations are often held to specific standards of performance on these measures, which are publicly available through The Joint Commission and Hospital Compare. The National Quality Forum, Quality and Safety Education for Nurses, and The Agency for Healthcare Research and Quality are all agencies concerned with quality control, but they are not responsible for publishing data about these core indicators.

Which is the first step the nurse takes when initiating a quality improvement program in a private medical facility?

A. Schedule a meeting about new policies

B. Prepare a proposed initiative plan for the year

C. Collect data about errors and patient outcomes

D. Make recommendations based upon the nurse's experience

C. Collect data about errors and patient outcomes

Rationale: The best first step for the nurse to take when initiating quality improvement activities is to gather data about errors and near-miss incidents. It is not enough to simply go by the nurse's own experience, because there may have been incidents the nurse is not aware of. Preparing a proposed initiative plan and scheduling a meeting should be done after the data has been collected and analyzed.

Which member of the quality improvement team should be sent to provide support to the surgical team who is distraught after accidentally removing the wrong leg during an amputation?

A. A staff nurse

B. The attorney

C. A nurse manager

D. The senior leader

D. The senior leader

Rationale: The senior leader is the best person to provide support to the surgical team after a sentinel event. Although it is important for the attorney to speak with the surgical team, the attorney is not the best person to provide support. It is not appropriate for the nurse manager or staff nurse tot speak with the surgical team after such a serious error.

Which task would be appropriate for the nurse manager to delegate to a staff nurse when working with the quality improvement team?

A. Generate ideas for quality improvement efforts

B. Share information with other units about efforts being used

C. Provide support for a unit after a sentinel event has occurred

D. Schedule the rest of the staff for quality improvement measures

A. Generate ideas for quality improvement efforts

Rationale: The staff nurse would be capable of generating ideas for quality improvement efforts. Sharing information with other units and scheduling time for quality improvement measures is a task best suited to nurse managers. Providing support after a sentinel event should be the task of a senior leader, not the staff nurse.

Which statement needs correction when discussing a recent near-miss event during a quality improvement meeting?

A. "Medication errors are a serious problem for the organization."

B. "It is the doctors' fault, because they never call us back when we need them at night."

C. "There should be a designated call person who stays awake and can find a physician if we need one."

D. "The error occurred because there wasn't a healthcare provider available to verify a medication error."

B. "It is the doctors' fault, because they never call us back when we need them at night."

Ratioanle: Quality improvement measures are not in place to assign blame or determine who is responsible for an error. Statements that discuss the error and possible solutions are appropriate and can further the conversation about how to prevent future errors.

Which group of employees would the nurse manager include when distributing a memo and training materials on a quality improvement initiative for the hospital?

A. The nurses

B. The physicians

C. Upper management

D. The entire clinical staff

D. The entire clinical staff

Rationale: A successful quality improvement program depends on cooperation and support from the entire clinical staff. Physicians, nurses, and any other members of the healthcare team must embrace quality improvement as a part of their role on a daily basis. Involving only physicians, nurses, or upper management teams would not set the program up for success.

Which designation is given to an organization with low staff burnout rates and high-quality patient care?

A. Magnet

B. Value-based

C. High-reliability

D. Culture of safety

A. Magnet

Rationale: Magnet hospital designation recognizes healthcare organizations that are known for quality patient care and nursing excellence and innovativeness. As a result of these attributes, they tend to have lower burnout rates. Value-based programs such as Medicare or Medicaid provide incentives for highquality care, but they are not associated with low staff burnout rates. High-reliability organizations are designated as such because they have achieved the highest quality and safety standards. A culture of safety is a blame-free environment that encourages staff to report errors.

Which element must be included when initiating a quality improvement (QI) program? SATA

A. Process

B. Structure

C. Outcomes

D. Satisfaction

E. Assessment

A. Process

B. Structure

C. Outcomes

Rationale: A QI program must include the assessment of structure, process, and outcomes. Assessment is a tool or technique but is not an element included in a Ql program. Patient satisfaction is an important tool considered in most Ql programs but is not assessed or evaluated as part of the program.

Which skill is an essential safety initiative according to the Agency for Healthcare Research and Quality (AHRQ) and STEPPS 2.0 programs?

A. Listening

B. Teamwork

C. Communication

D. Emotional intelligence

B. Teamwork

Rationale: According to the AHRQ STEPPS and STEPPS 2.0 programs, teamwork is a key safety initiative that can have a major effect on healthcare facilities. Although listening, communication, and emotional intelligence are important skills, working well together as a team is essential to safety.

Which program would the nurse manager of the emergency department consider when trying to implement a new quality management (QM) program to eliminate the unnecessary waste of time and resources?

A. Lean Sigma

B. Risk Management

C. Root Cause Analysis

D. Failure Mode and Effects Analysis

A. Lean Sigma

Rationale: Lean Sigma and Six Sigma programs tend to work well in departments that work in a linear fashion, such as the emergency department. These programs encourage all healthcare staff to eliminate unnecessary steps and reduce wasted time and processes. Risk management is not a method of quality control. Root Cause Analysis and Failure Mode and Effects Analysis are types of QM but are not focused on reducing unnecessary waste.

Which benefit of participation in the unit's quality management (QM) program does the manager include in a discussion with the staff? SATA

A. Improved job satisfaction

B. Fewer resource constraints

C. Increased financial rewards

D. Reduced risk of patient errors

E. Reduction of malpractice lawsuits

A. Improved job satisfaction

B. Fewer resource constraints

E. Reduction of malpractice lawsuits

Rationale: Good QM programs have many benefits, including improved job satisfaction, fewer issues with resource availability, and a reduction in malpractice suits. QM is not associated with financial rewards or reduced risk of patient errors.

Which member of the healthcare team is primarily responsible for early warning monitoring?

A. The nurse

B. The physician

C. The pharmacist

D. Unlicensed personnel

A. The nurse

Rationlae: Nurses are primarily responsible for early warning monitoring because of their key role at a patient's bedside. Physicians and pharmacists do not spend an entire shift with a patient. Unlicensed personnel and nursing assistants are not responsible for assessing patients or determining when a patient is at risk for complications.

Which reply is the best response when a patient asks a nurse why the hospital has the "high-reliability organization" designation?

A. "The hospital has the highest quality of nursing care."

B. "The hospital has passed its recent accreditation inspection."

C. "The hospital is working toward improving safety standards."

D. "The hospital has achieved the highest quality and safety standards."

D. "The hospital has achieved the highest quality and safety standards."

Rationale: The Joint Commission gives hospitals the designation of a high-reliability organization to signal the organization has achieved the highest quality and safety standards through a number of markers, including organizational effectiveness, efficiency, customer satisfaction, compliance, organizational culture, and documentation. It does not specify quality of nursing care, does not mean the hospital is improving safety standards, nor does it signal the hospital passed a recent accreditation inspection.

Which element acknowledges nursing excellence and emphasizes empirical quality results?

A. Six Sigma processes

B. Outcomes management

C. Staff certification of practice

D. Magnet Recognition® Program

D. Magnet Recognition® Program

Rationale: The Magnet Recognition Program is designed to acknowledge nursing excellence. From initial designation to redesignation, greater emphasis is placed on empirical quality results. Staff certification of practice, outcomes management, and Six Sigma processes are required for Magnet Recognition

Which intervention would be most effective if the nurse wants to improve the rate of healthcare providers reporting errors?

A. An anonymous error reporting system

B. A zero-tolerance policy for medication errors

C. Regular continuing education programs about error prevention

D. A two-party sign-off policy for all nursing and medical procedures

A. An anonymous error reporting system

Rationale: Creation of a blame-free system, such as an anonymous error reporting system, can help employees feel more comfortable reporting errors. Because of the fear of consequences,a zero-tolerance policy may make error reporting less likely. Regular continuing education programs and a two-party sign-off policy for critical procedures may help prevent errors but will not improve the rate of healthcare providers reporting errors.

Which are principles of quality management and quality improvement? SATA

A. Quality management operates most effectively within a democratic structure.

B. Managers and workers must be committed to quality improvement.

C. The goal of quality management is to assign blame.

D. Quality improvement focuses on outcomes.

E. Decisions must be based on data.

F. Nurses define quality.

A. Quality management operates most effectively within a democratic structure.

B. Managers and workers must be committed to quality improvement.

D. Quality improvement focuses on outcomes.

E. Decisions must be based on data.

Rationale: The following are principles of quality managment and quality improvement: quality management operates most effectively within a democratic structure; managers and workers must be committed to quality improvement; quality improvement focuses on outcomes; and decisions must be based on data.The goal of quality management is to improve systems and processes, not to assign blame. Customers, not nurses, define quality.

Which action by a nurse manager contributes to quality improvement?

A. Writing up staff members for medication errors

B. Reviewing employee satisfaction surveys

C. Maintaining a balanced budget

D. Ordering minimal supplies

B. Reviewing employee satisfaction surveys

Rationale: Managers must enhance work environments to support higher quality care, less patient risk, and more satisfied nurses. Using information from employee satisfaction surveys to implement change leads to more satisfied nurses. Writing up staff members for medication errors goes against the concept of a fairand just culture that leads to quality improvement. Maintaining a balanced budget is a job of the nurse manager, but it does not necessarily contribute to quality improvement. Ordering minimal supplies goes against the concept of supporting higher quality care.

Arrange the steps of a quality improvement project in the correct order from first to last. IDFK how to format this shit

- Identify needs most important to the consumer of healthcare services.

- Establish measurable outcomes and quality indicators.

- Collect data to measure the current status of consumer needs and services.

- Select and implement a plan to meet the outcomes

- Assemble an interprofessional team to review the identified consumer needs and services.

- Collect data to evaluate the implementation of the plan and the achievement of outcomes.

1. Identify needs most important to the consumer of healthcare services.

2. Assemble an interprofessional team to review the identified consumer needs and services.

3. Collect data to measure the current status of consumer needs and services.

4. Establish measurable outcomes and quality indicators.

5. Select and implement a plan to meet the outcomes.

6. Collect data to evaluate the implementation of the plan and the achievement of outcomes.

Rationale: Steps in the quality improvement process should be carried out in this sequence: identify needs most important to the consumer of healthcare services; assemble an interprofessional team to review the identified consumer needs and services; collect data to measure the current status of these services; establish measurable outcomes and quality indicators; select and implement a plan to meet the outcomes; and collect data to evaluate the implementation of the plan and the achievement of outcomes.

From which industry has healthcare borrowed and applied models of continuous quality improvement?

A. Aerospace

B. Finance

C. Business

D. Real estate

C. Business

Rationale: The healthcare industry has borrowed and applied models of continuous quality improvement with principles and practices originally developed from business. Models of quality improvement from the aerospace, finance, and real estate industries do not translate to the healthcare industry.

Which process has had the most significant effect on the development of quality improvement systems in healthcare?

A. Federal reimbursement

B. Private accreditation

C. State reimbursement

D. State licensure rules and regulations

B. Private accreditation

Rationale: The private accreditation process has had the most significant effect on the development of quality improvement systems in healthcare. Healthcare organizations have always been required to meet standards for federal and state reimbursement regulations and state licensure rules and regulations to operate.

Which change should quality improvement efforts be focused on implementing?

A. Changes that are the most cost efficient

B. Changes that the majority of nurses request

C. Changes that the majority of patients request

D. Changes that will have the greatest effect on patient care

D. Changes that will have the greatest effect on patient care

Rationale: Quality improvement efforts should be concentrated on changes to patient care that will have the greatest effect. To determine which clinical activities are most important, nurse managers or direct care nurses may interview or survey patients about their healthcare experiences or may review unmet quality standards. Although changes may be more cost efficient or be requested by the patient or the nurse, patient care should drive quality improvement efforts.

Which are the three categories of healthcare quality and standards?

A. Structure, process, and goals

B. Process, goals, and outcome

C. Structure, process, and outcome

D. Goals, outcome, and benchmark

C. Structure, process, and outcome

Rationale: Healthcare quality standards and measures can be grouped into three categories: structure, process, and outcome. Goals and benchmarks are involved in quality improvement but are not part of the three categories.

Pretty sure it was an answer to another question

Which action will the nurse leader take once a quality improvement (Ql) topic is identified?

A. Set a goal for improvement

B. Gather data using various tools

C. Assemble an interprofessional team

D. Document that outcomes are being met

C. Assemble an interprofessional team

Rationale: The OI process begins with the selection of a clinical activity for review. Once an activity is selected for possible improvement, an interprofessional team implements the QI process. After the interprofessional team forms, the group collects data to measure the current status of the activity, service, or procedure under review using various data tools. After analyzing the data, the team next sets a goal for improvement. As the plan is implemented, the team continues to gather and evaluate data to document that the new outcomes are being met.

Which nursing activity would be subject to process standards in a quality assurance program? SATA

A. The urinalysis reports a resistant organism.

B. A research article will be available for staff to read.

C. Families can help a patient select from a menu of food options.

D. Pain assessment will be completed 30 minutes after pain medication administration.

E. A nursing admission will be completed within 24 hours of a patient admission.

F. Postoperative patients will be discharged in a wheelchair at the hospital's front door.

D. Pain assessment will be completed 30 minutes after pain medication administration.

E. A nursing admission will be completed within 24 hours of a patient admission.

F. Postoperative patients will be discharged in a wheelchair at the hospital's front door.

Rationlae: One method used to monitor healthcare is quality assurance (QA) programs, which ensure conformity to a standard. Many QA activities focus on process standards (e.g., documentation, adherence to practice standards). Process standards outline activities, interventions, and the sequence of caregiving events. Pain assessment 30 minutes after administration, 24 hours to complete a nursing admission assessment, and discharge methods and destinations are examples of process standards for workflow. Families helping patients, a research article, and a urinalysis report are not measurable, observational studies of workflow and are therefore not subject to established process standards.

Which factor would the Consumer Assessment of Healthcare Providers and Systems Hospital Survey identify regarding patient perspectives on care experienced during a hospital stay? SATA

A. Communication with physicians

B. The cost of the hospital stay and billing accuracy

C. Cleanliness of the hospital environment

D. Discharge information

E. Medication errors

A. Communication with physicians

C. Cleanliness of the hospital environment

D. Discharge information

Rationale: The Consumer Assessment of Healthcare Providers and Systems Hospital Survey includes patient perspectives about communication with physicians, discharge information, cleanliness of the hospital environment, communication with nurses, responsiveness of hospital staff, pain management, communication about medicines, and quietness of the hospital environment. Billing is a patient concern, but HCAHPS does not assess financial or billing issues, nor does it address medication errors.

Which element reflects quality measures that produce the greatest positive effect on patient outcomes?

A. Quality management

B. Quality improvement

C. Accountability measures

D. Nursing-sensitive indicators

C. Accountability measures

Rationale: Accredited hospitals are required to collect and report data on performance for core quality indicators, called accountability measures, that produce the greatest positive effect on patient outcomes. Quality management refers to a philosophy that defines a healthcare culture emphasizing customer satisfaction, innovation, and employee involvement. Quality improvement refers to an ongoing process of innovation, prevention of error, and staff development used by institutions that adopt the quality management philosophy. Nursing-sensitive indicators reflect the structure, process, and outcomes of nursing care.

Which organization released a report based on the issue of medical errors that launched a major national focus on the safety of healthcare systems and processes?

A. Institute of Medicine (IOM)

B. The Joint Commission (TJC)

C. American Nurses Association (ANA)

D. Centers for Medicare and Medicaid Services (CMS)

A. Institute of Medicine (IOM)

Rationale: A landmark report from the IOM based on the issue of medical errors launched a major national focus on the safety of healthcare systems and processes. The ANA, TJC, and CMS are all involved in safety in healthcare, but this particular report was released by IOM.

Which activity would help meet the 2010 Institute of Medicine (IOM) report The Future of Nursing: Leading Change, Advancing Health recommendation that nurses practice to the full extent of their education and training?

A. Increasing practice autonomy

B. Participating in lifelong learning

C. Increasing direct-practice arrangements with physicians

D. Collaborating with physicians and other healthcare professionals

A. Increasing practice autonomy

Rationale: Increasing practice autonomy would help nurses practice to the full extent of their education and training. Participating in lifelong learning and collaborating with other healthcare professionals would support safe, effective, high-quality patient care but would not necessarily increase practice autonomy. Increasing direct-practice arrangements with physicians would decrease practice autonomy of nurses.

Which approach by a large healthcare system would effectively address the recommendation in the 2010 Institute of Medicine (IOM, now known as the National Academy of Medicine) report The Future of Nursing: Leading Change, Advancing Health to support development of interprofessional relationships?

A. Offering collaborative learning opportunities for nurses, physicians, and other healthcare professionals

B. teaching nurses about the importance of referring patients to other disciplines when necessary to support effective care

C. Presenting classes to physicians on how to effectively communicate with nurses and other healthcare professionals

D. Providing online classes in collaboration, communication, and cooperation to all hospital staff and employees

A. Offering collaborative learning opportunities for nurses, physicians, and other healthcare professionals

Rationale: Offering opportunities for nurses, physicians, and other healthcare professionals to collaboratively learn can support the development of interprofessional relationships. Teaching nurses about the need to refer patients involves use of appropriate resources but does not support the development of interprofessional relationships. Offering classes to physicians on how to effectively communicate with nurses would not best support development of interprofessional relationships. Providing online classes on collaboration, communication, and cooperation would support development of some of the skills needed for interprofessional collaboration but would not necessarily support development of interprofessional relationships.

Which need did the 2010 report The Future of Nursing: Leading Change, Advancing Health, an initiative of the Institute of Medicine (IOM, now known as the National Academy of Medicine) and the Robert Wood Johnson Foundation (RWJF), respond too?

A. Clarifying registered nurse entry levels

B. Preparing more nurses at the doctoral level

C. Transforming the nursing profession

D. Increasing the number of nurses in response to the nursing shortage

C. Transforming the nursing profession

Rationale: The Future of Nursing report responded to the need to assess and transform the nursing profession because of the massive changes occurring in the healthcare delivery system. If the eight recommendations were fully implemented, quality of care and safety would be enhanced. The report was not an initiative to clarify registered nurse entry levels, nor was it an initiative to prepare more nurses at the doctoral level or a response to the nursing shortage.

Which recommendation of the 2010 Institute of Medicine (IOM, now known as the National Academy of Medicine) report The Future of Nursing: Leading Change, Advancing Health does creating a system to collect information about the professionals employed across a healthcare system support?

A. Ensuring that nurses engage in lifelong learning

B. Promoting workforce planning and policy making

C. Removing scope-of-practice barriers for professionals

D. Supporting nurses as they plan change and advance health

B. Promoting workforce planning and policy making

Rationale: The IOM stated that effective workforce planning and policy making require better data collection and information infrastructure. Development of such a system would not ensure that nurses engage in lifelong learning, remove scope-of-practice barriers, or support nurses as they plan change and advance health.

Which Institute of Medicine (IOM, now known as the National Academy of Medicine) report in 2004 stressed that leaders should create work environments that are more conducive to nurses providing safer patient care?

A. Future of Nursing

B. Keeping Patients Safe

C. Crossing the Quality Chasm

D. Civility, Respect, and Engagement in the Workplace

B. Keeping Patients Safe

Rationale: The IOM report Keeping Patients Safe encouraged leaders to create work environments that are more conducive to nurses providing safer patient care. The Future of Nursing report focused on nurses being ready to assume leadership roles. Crossing the Quality Chasm addressed improvements for today's lower-performing healthcare system. Civility, Respect, and Engagement in the Workplace is a 2012 report on analyzing a workplace intervention to improve workplace atmospheres.

freakin duh

Which evidence-based nursing response was created to address nursing outcomes, including patient safety?

A. Magnet Recognition Program

B. American Nurses Association (ANA)

C. American Nurses Credentialing Center (ANCC)

D. National Council of the State Boards of Nursing (NCSBN)

A. Magnet Recognition Program

Rationale: The Magnet Recognition Program was created as a result of the IOM's raised awareness of patient safety and quality of care issues, and the focus of the program is on outcomes, including data and efforts related to patient safety. The ANA represents the interests of nurses. The NCSBN is the regulatory licensing agency for nursing. The Magnet Recognition® Program is a credentialing program of the ANCС.

Which professional organization published multiple key, evidence-based reports related to patient safety and quality of healthcare?

A. Institute of Medicine (IOM)

B. American Nurses Credentialing Center (ANCC)

C. American Organization of Nurse Executives (AONE)

D. National Database of Nursing Quality Indicators (NDNQI)

A. Institute of Medicine (IOM)

Rationale: The IOM, now known as the National Academy of Medicine, published multiple key reports, which had a major effect on patient safety and quality of healthcare initiatives. The ANCC focuses on education and credentialing programs. The AONE's focus is leadership.The NDNQI provides reporting on structure, process, and outcome indicators to evaluate nursing care at the unit level.

Which area of nursing leadership does the American Nurses Credentialing Center's (ANCC's) Magnet program recognize?

A. Democratic

B. Facilitative

C. Visionary

D. Transformational

D. Transformational

Rationale: The ANCC's Magnet® program recognizes transformational leadership. Democratic, facilitative, and visionary leadership are not types of leadership recognized in the ANCC's Magnet® program.

Which variable plays a powerful yet underestimated role in how nurses communicate and interact with one another or mediate conflict among themselves?

A. Cultural diversity

B. Years of experience

C. Educational background

D. Leadership experience

A. Cultural diversity

Rationale: Cultural diversity is an underestimated but powerful variable that influences the way nurses interact with eachother and deal with conflict, ultimately affecting healthcare consumers. Respecting cultural diversity in the team fosters cooperation and supports sound decision making. Years of experience, educational background, and leadership experience can all additionally create differences, but cultural diversity is the factor that plays a powerful role that is often not acknowledged.

Which step is included in SBAR communication? SATA

A. Setting

B. Reliance

C. Situation

D. Assessment

E. Background

C. Situation

D. Assessment

E. Background

Rationale: Steps of SBAR communication include: Situation, Background, Assessment, and Recommendation. Reliance and setting are not part of the SBAR communication technique.

Which aspect of leading and managing can affect safety and quality of patient care? SATA

A. Staffing

B. intuition

C. Technology

D. Budgeting decisions

E. Delegation decisions

A. Staffing

C. Technology

D. Budgeting decisions

E. Delegation decisions

Rationale: The core concern of any healthcare agency, and of nurses, is safety. Safety and quality should drive aspects of leading and managing such as staffing, technology, budgeting, and delegation decisions. Intuition or hunches should not be part of the decision-making process.

Which would have the greatest influence on staffing decisions made by the nurse manager when determining the staffing and budgeting needs for a patient care unit?

A. Satisfaction of nurses on the unit

B. Safety and quality of patient care

C. Input from staff members regarding staffing

D. Remaining within the unit's budget when staffing

B. Safety and quality of patient care

Rationale: The greatest influence on staffing decisions when leading and managing should be safety and quality of patient care. Satisfaction of nurses on the unit should not influence decisions based on quality and safety. Input from staff members may be considered; however, provision of high quality, safe care is paramount. Remaining within the unit's budget when staffing may not be appropriate depending on patient census and acuity.

Which outcome may result when the nurse manager reduces the number of nurses on a patient care unit to increase revenue for budgetary reasons?

A. Patient care omissions

B. Anger from staff nurses

C. Nurse manager pay raise

D. Decreased noise level on the unit

A. Patient care omissions

Rationlae: Nurse leaders and managers have an obligation to promote, and have the greatest influence on, patient safety. Decreasing the number of nurses on a patient care unit with the purpose of increasing revenue puts patients at risk. Several research studies have identified omissions in patient care related to nurse staffing and overtime. Nurses may become angry regarding reduction in staff, but the potential for patient care omissions takes priority. A perceived incentive for reduction in staff may be to secure a pay raise; however, omissions in care and violations in patient safety can result in preventable injuries and denial of payment for services. Decreasing staff does not necessarily equate to less unit noise.

Which action would the nurse manager take to address an increase in musculoskeletal injuries occurring in nurses working on the orthopedic unit?

A. Discipline nurses not wearing protective back braces.

B. Increase the number of nursing assistants on the unit.

C. Establish a clinical safety committee including orthopedic nurses.

D. Collect data on musculoskeletal injuries occurring on the unit to establish a pattern.

C. Establish a clinical safety committee including orthopedic nurses.

Rationale: Numerous issues related to clinical safety can be addressed by clinical safety committees involving nurses. Protective back braces are not mandatory in all organizations, nor do they prevent other types of musculoskeletal injuries. Increasing the number of nursing assistants on the unit does not address improper lifting techniques and assumes staffing is the cause of the problem. Collecting data on the unit may be helpful in identifying, but will not address, the problem of increased injuries.

The nurse is documenting in a patient's electronic health record and enters the "greater than" symbol (>) to describe the size of a wound. Which agency's recommendations is the nurse violating?

A. The Joint Commission (TJC)

B. Institute for Healthcare Improvement (IHI)

C. Centers for Disease Control and Prevention (CDC)

D. Agency for Healthcare Research and Quality (AHRQ)

A. The Joint Commission (TJC)

Rationale: The Joint Commission (TJC) is a not-for-profit organization that accredits healthcare organizations. The focus of TJC is on outcomes with an emphasis on safety. TJC issues annual patient safety goals that are setting-specific, including a list of "do-not-use" symbols such as "greater than." The Institute for Healthcare Improvement (IHI) is dedicated to rapidly improving care through a variety of mechanisms including rapid cycle change projects. The Centers for Disease Control and Prevention (CDC) is considered the nation's health protection agency, protecting people from threats to health and safety. The Agency for Healthcare Research and Quality (AHRQ) uses research and evidence-based practice tools to improve the quality and safety of healthcare.

Which teaching point makes use of the Institute of Medicine (now the National Academy of Medicine) competencies for health professionals with regard to tips for teaching staff nurses about clinical safety?

A. "Pursue a baccalaureate degree in nursing to keep employment secure."

B. "Fill out incident reports for all medication errors and safety violations."

C. "Become certified in basic cardiac life support (BLS) when providing direct patient care."

D. "Utilize informatics to communicate, manage knowledge, mitigate error, and support decision making."

D. "Utilize informatics to communicate, manage knowledge, mitigate error, and support decision making."

Rationale: The teaching point that is consistent with the Institute of Medicine (IOM) competencies for health professionals is utilizing informatics to communicate, manage knowledge, mitigate error, and support decision making. Facilities with Magnet® status are required to work toward an all baccalaureate nursing degree staff. The American Association of Colleges of Nursing also recommends the baccalaureate nursing degree to be the minimum educational requirement. Current recommendations regarding errors in health care are to create blame-free environments and are not part of the IOM competencies. Becoming certified in basic cardiac life support is important; however, it is not a competency identified by the IOM.

Which action by the nurse is a recommendation included in The Future of Nursing report?

A. Engaging in lifelong learning

B. Following policy and procedure

C. Providing patient-centered care

D. Working in interdisciplinary teams

A. Engaging in lifelong learning

Rationale: The Future of Nursing report contains numerous citations of evidence related to education, scope of practice, and leadership. A recommendation from the report is to ensure nurses are engaging in lifelong learning. Following policy and procedure within an organization is a professional requirement. Working in interdisciplinary teams and providing patient-centered care are competencies identified in the report Health Professions Education: A Bridge to Quality.

Which action will the Centers for Medicare and Medicaid Services (CMS) take in response to a Medicare patient who fell out of bed multiple times while hospitalized, one of the falls resulting in a hip fracture that needed surgical intervention?

A. Withdraw the facility's Magnet status ☐

B. Will no longer continue to provide accreditation to the facility

C. Deny payment for care related to the fall and subsequent hip fracture

D. May require additional testing to assure the patient has no further injury

C. Deny payment for care related to the fall and subsequent hip fracture

Rationale: The Centers for Medicare and Medicaid Services (CMS) will not pay for certain conditions that result from what might be termed as poor practices or events that should not occur while the patient was under the care of a healthcare professional. Magnet® status is awarded by the American Nurses Credentialing Center, not CMS. The Joint Commission, not CMS, is the organization that accredits healthcare organizations. The patient's primary healthcare provider will assess the patient to determine if further testing is required.

Which agency provides current information on sentinel events in the clinical setting?

A. The Joint Commission (TJC)

B. National Institutes of Health (NIH)

C. Centers for Disease Control and Prevention (CDC)

D. Centers for Medicare and Medicaid Services (CMS)

A. The Joint Commission (TJC)

Ratioanle: The Joint Commission (TJC) is a non-profit organization that accredits healthcare organizations and sets standards of care for quality and safety. A sentinel event is an unexpected occurrence involving serious harm, death, or psychological injury to a patient. TJC tracks and reports these events for safety and quality improvement. The National Institutes of Health (NIH) is a medical research center providing evidence to enhance the provision of quality healthcare services. The Centers for Disease Control and Prevention (CDC) strive to protect people from health, safety, and security threats. The Centers for Medicare and Medicaid Services (CMS) provide financial assistance for healthcare services based on age or disease/illness.

Which report provided a framework for considering how nurses could determine staffing requirements?

A. To Err is Human (2000)

B. Crossing the Quality Chasm (2001)

C. Health Professions Education: A Bridge to Quality (2003)

D. Keeping Patients Safe: Transforming the Work Environment of Nurses (2004)

D. Keeping Patients Safe: Transforming the Work Environment of Nurses (2004)

Rationale: Keeping Patients Safe: Transforming the Work Environment of Nurses (2004) provided a framework for considering how nurses could determine staffing requirements. Crossing the Quality Chasm (2001) identified the six major aims in providing healthcare. Health Professions Education: A Bridge to Quality (2003) addressed the issue of silo education among the health professionals in basic and continuing education. To Err is Human (2000) moved safety issues from the incident report level to an integrated patient safety report for healthcare organizations.

Which level of education does the Institute of Medicine (IOM) suggest 80% of nurses should have by 2020?

A. Diploma

B. Master's degree

C. Associate's degree

D. Baccalaureate degree

D. Baccalaureate degree

Ratioanle: In the report Future of Nursing: Leading Change, Advancing Health (2010), the Institute of Medicine (IOM) recommends that 80% of nurses have a baccalaureate degree by 2020. The diploma, associate's degree, and master's degree were not identified by the IOM as needing to change proportionally with other academic levels.

Which core concern of any healthcare organization, and therefore nurses, drives aspects of leading and managing?

A. Safety

B. Documentation

C. Communication

D. Infection control

A. Safety

Ratioanle: The core concern of any healthcare organization, and therefore the core concern for nurses, is safety. Safety, and subsequently quality, should drive aspects of leading and managing such as staffing and budgeting decisions, personnel policies and change, information technology, delegation decisions, workplace environment, and personal practice. Communication is an important aspect of safety. Documentation is the recording of data that can be clustered and used to improve patient care services. Infection control is another important aspect of safety; the prevention of infection decreases hospital stays and the complications associated with other health conditions.

Which report moved safety issues from the incident report level to an integrated patient safety report for the organization?

A. To Err is Human (2000)

B. Crossing the Quality Chasm (2001)

C. Health Professions Education: A Bridge to Quality (2003)

D. Keeping Patients Safe: Transforming the Work Environment of Nurses (2004)

A. To Err is Human (2000)

Rationale: To Err Is Human (2000) moved safety issues from the incident report level to an integrated patient safety report for healthcare organizations. Crossing the Quality Chasm (2001) identified six major aims in providing healthcare. Health Professions Education: A Bridge to Quality (2003) addressed the issue of silo education among health professionals in basic and continuing education. Keeping Patients Safe: Transforming the Work Environment of Nurses (2004) identified many practices from the past that had a negative influence on nurses and, therefore, patients.

Which organization is responsible for issuing annual patient safety goals?

A. Institute of Medicine (IOM)

B. The Joint Commission (TJC)

C. Institute for Healthcare Improvement (IHI)

D. Quality and Safety Education for Nurses (QSEN)

B. The Joint Commission (TJC)

Ratioanle: The organization responsible for issuing annual patient safety goals is The Joint Commission (TJC). The Institute of Medicine (IOM) is a non-profit organization devoted to providing leadership on healthcare and serves as an excellent source for leaders and managers to gain access to current research and publications devoted to healthcare. The Institute for Healthcare Improvement (IHI) is dedicated to rapidly improving care through a variety mechanisms including rapid change projects. Quality and Safety Education tor Nurses (QSEN) 15 a project addressing the challenges OT preparing future nurses with the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the healthcare systems within which they work.

Which is a possible effect when a culturally diverse nursing staff has open and effective communication?

A. Cultural incapacity is evident during patient care and staff interactions, revealing cultural competence.

B. There is a lack of understanding during patient care because of communication barriers.

C. During a dispute among the staff, it may be difficult to see the other's perspective because of a lack of understanding.

D. The competencies and contributions of staff members from all cultural groups are supported, resulting in quality patient care.

D. The competencies and contributions of staff members from all cultural groups are supported, resulting in quality patient care.

Rationale: The nurse manager supports the competencies and contributions ofthe diverse nursing staff members, and the result is quality patient care as the team is working well, collaborating, and communicating. With knowledge of various cultural groups comes an increased understanding and decreased barriers. Cultural incapacity is a negative effect and is on the lower scale of cultural competence. People may be reluctant to admit they don't understand another perspective because of language differences. Open and effective communication helps eliminate a lack of understanding.

Which concept was introduced by the Institute for Healthcare Improvement in collaboration with the National Patient Safety Foundation?

A. Rapid cycle change

B. QSEN competencies

C. Choosing Wisely approach

D. Magnet Recognition Program

A. Rapid cycle change

Rationale: The Institute for Healthcare Improvement's work introduced the concept of rapid cycle change to improve care. Choosing Wisely is a multidisciplinary approach to helping patients make wise decisions, started by the American Board of Internal Medicine. A project known as Quality and Safety Education for Nurses (QSEN) serves as a repository for resources related to the knowledge, skills, and attitudes needed to serve as safe practitioners.The Magnet Recognition® Program is a national designation designed to acknowledge nursing excellence.

Which competency, according to the 2010 Institute of Medicine (IOM, now known as the National Academy of Medicine) report The Future of Nursing: Leading Change, Advancing Health, must nurses have to effectively make decisions that encourage change, promote quality, and advance health?

A. Technical

B. Leadership

C. Interpersonal

D. Communication

B. Leadership

Rationale: The Future of Nursing report recommends that nurses have leadership competencies to lead change to advance health and to diffuse collaborative improvement efforts. Technical, interpersonal, and communication skills are also important skills, but without leadership, these would not contribute to the ability to effect change or quality.

Which opportunity would support effective transition of new nurses, nurses to different specialty areas, and nurses to advanced practice according to the 2010 Institute of Medicine (IOM, now known as the National Academy of Medicine) report The Future of Nursing: Leading Change, Advancing Health?

A. Provision of clinical ladders for nurses

B. Residency programs for all levels of nurses

C. Monthly educational offerings on changes occurring in health care

D. Monetary support for membership in professional organizations

B. Residency programs for all levels of nurses

Rationale: Residency programs for all nurses, including new nurses, those moving to a different specialty area, and those beginning advanced practice roles, would help support effective transitions. Clinical ladders, monthly educational offerings, and monetary support for membership in professional organizations can provide ongoing support and development of nurses; however, these opportunities would not support effective transitions.

Which percentage of the registered nurse workforce, according to the 2010 Institute of Medicine (IOM, now known as the National Academy of Medicine) report The Future of Nursing: Leading Change, Advancing Health, should beeducated at the baccalaureate level?

A. 65%

B. 70%

C. 80%

D. 100%

C. 80%

Rationale: The 2010 Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health recommended that at least 80% of registered nurses be baccalaureate prepared, because evidence supports lower morbidity and mortality rates with a better-educated nursing workforce.The percentages 65% and 70% are lower than recommended, and 100% is higher than recommended.

Which education recommendation was made by the Institute of Medicine (IOM, now known as the National Academy of Medicine) in the 2010 report The Future of Nursing: Leading Change, Advancing Health?

A. Doubling the number of nurses with a doctorate by 2020

B. Requiring a baccalaureate degree forall registered nurses by 2020

C. Increasing the percentage of nurses enrolled in advanced practice programs by 30% by 2030

D. Changing the entry-level requirement for initial preparation of nurses to a master's degree by 2050

A. Doubling the number of nurses with a doctorate by 2020

Rationale: The 2010 IOM (now known as the National Academy of Medicine) report The Future of Nursing: Leading Change, Advancing Health recommended that, by 2020, the number of nurses with doctorate degrees should be doubled. The report recommended that by 2020, 80% of nurses should have a baccalaureate degree. The report did not make any recommendations concerning the percentage of nurses enrolled in advanced practice programs or the entry-level requirement for nurses.

In which way have the Institute of Medicine's (IOM, now known as the National Academy of Medicine) reports influenced the nursing profession?

A. Addressing quality and patient safety

B. Increasing requirements for education

C. Focusing on reimbursement for patient care

D. Moving safety issues to the incident report level

A. Addressing quality and patient safety

Rationale: The IOM's reports have influenced the profession of nursing by addressing quality and patient safety. The reports do not increase requirements for education; they have increased the expectation of lifelong learning. The IOM has not focused on reimbursement for care. The IOM moved safety issues away from the incident report level to an integrated patient safety report for the organization.

Which overall benefit values diversity among nursing staff and patients? SATA

A. Cultural differences enrich all of us when we make deliberate efforts to include them in our daily values.

B. Showing respect to all patients irrespective of their cultural differences tells the staff that their differences are also valued.

C. Embracing differences will enhance the American Association of Colleges of Nursing (AACN) Quality and Safety Education for Nurses (QSEN) initiative.

D. Embracing differences among people, along with respect for all patients and staff regardless of their cultural differences, will empower staff to provide patient- and family-centered care.

E. Incorporating the goal of the QSEN initiative, recognition of worth and respect of individuals or groups, will help drive patient-centered care.

A. Cultural differences enrich all of us when we make deliberate efforts to include them in our daily values.

B. Showing respect to all patients irrespective of their cultural differences tells the staff that their differences are also valued.

C. Embracing differences will enhance the American Association of Colleges of Nursing (AACN) Quality and Safety Education for Nurses (QSEN) initiative.

D. Embracing differences among people, along with respect for all patients and staff regardless of their cultural differences, will empower staff to provide patient- and family-centered care.

Rationale: Understanding and valuing cultural differences benefits both staff and patients. Having multiple cultures on one unit is challenging and yet enriches perspectives of diversity. Showing respect for the staff and patients will ensure everyone is valued for who they are. Embracing differences enhances the AACN QSEN initiative, and, along with unconditional respect for those differences, it empowers staff to provide family- and patient-centered care. The goal of the QSEN initiative is to prepare nurses with the knowledge, skills,and attitudes needed to continuously deliver quality patient care.

Culture involves the differences among people, not only regarding health beliefs and practices, but also in regard to which factors? SATA

A. Race

B. Skin color

C. Tone of voice

D. Economic status

E. Physical challenges

A. Race

C. Tone of voice

D. Economic status

E. Physical challenges

Rationale: Culture includes race, ethnicity, religion, age, lifestyle, and gender. Body movements, eye contact, gestures, verbal tone, and physical closeness when communicating are all also part of a person's culture. Culture can also be construed more broadly to include differences in health beliefs and practices by gender, race, ethnicity, economic status, sexual preference, age, and disability or physical challenge. As a result, race, tone of voice, economic status, and physical challenges are all correct answer choices. Skin color is not a part of culture; individuals with the same skin color might have very different cultural backgrounds and influences.

Which cause of health disparities are among ethnic minority populations in the United States? SATA

A. Environment

B. Poor education

C. Access to care

D. Health behaviors

E. Adequate financial resources

A. Environment

B. Poor education

C. Access to care

D. Health behaviors

Rationale: Health disparities in the United States are not a new concern, and they exist for multiple reasons, including environment, poor education, access to care, and health behaviors. They also exist because of inadequate, not adequate, financial resources.