Chapter 2: The Nurse's Role in Healthcare Quality and Patient Safety Flashcards
A confused client entered the dirty supply room on the unit and was found rummaging through trash that contained blood and body fluids. An incident report has been completed about this event by the nurse who discovered the client. Which statement about the incident report is most accurate?
The nurse’s priority in completing the report is justifying and explaining her initial response to the incident.
The incident report becomes an attachment to the client’s health record.
The incident report will be used to inform changes so that the dirty supply room becomes less accessible to clients.
The incident report is completed anonymously, allowing the nurse to be frank with suggestions.
The incident report will be used to inform changes so that the dirty supply room becomes less accessible to clients.
A nurse has approached the unit manager and admitted to giving a client an incorrect dose of insulin. Which aspect of this event would suggest that it constitutes at-risk behavior rather than a human error?
The nurse made a similar insulin error 4 months ago and has also made an oral medication error.
The unit was exceptionally busy during the shift when the nurse made the error.
The nurse manager suspects that the nurse is not telling the truth about the timing of the error.
The nurse is a recent graduate and began working on the unit only 5 months ago.
The nurse made a similar insulin error 4 months ago and has also made an oral medication error.
The nurse is providing discharge teaching to the family of an older adult client. Which teaching will the nurse include to decrease the risk for electric shock?
Leave outlets and switches open so air circulates through them.
All machines that are used infrequently are to remain plugged in.
Remove the plug from the wall by pulling the electric cord.
Refrain from using extension cords.
Refrain from using extension cords.
A hospital client’s urine output is 35 mL over the past 5 hours, so the nurse has chosen to inform the client’s primary care provider by telephone. The nurse will use the SBAR tool to communicate and will begin the dialogue by:
giving an overview of the client’s circumstances and the exact reason for the call.
explaining the client’s symptoms and suggesting a preliminary plan.
describing the major objective signs that the client is exhibiting.
introducing the client and listing the client’s current medications.
giving an overview of the client’s circumstances and the exact reason for the call.
A client with dementia was assigned to a shared hospital room due to a shortage of private rooms. During the night, the client became acutely confused and attacked his roommate, seriously injuring him. When following up this adverse event, the institution must:
report this sentinel event to the Joint Commission and to relevant state agencies.
review the overall job performance of the nurse manager who made the decision to assign the client to a shared room.
provide supplementary education to staff members about the etiology and manifestations of dementia.
file a report describing the incident to the Centers for Medicare & Medicaid Services (CMS).
report this sentinel event to the Joint Commission and to relevant state agencies
A client suffered an acute kidney injury following a hypotensive episode. A review of the client’s chart reveals that the client’s blood pressure was within acceptable range less than an hour before the event. Later investigation, however, reveals that the nurse took the client’s blood pressure nearly 90 minutes earlier than she documented and that the discrepancy was an effort to cover this up. What is the most appropriate response to this nurse’s action?
Remedial education
Formal discipline
Reconciliation with the client
A change in work site
Formal discipline
A client’s hemoglobin level has been found to be 7.6 g/dL (normal range 13.8 to 17.2 g/dL) and the primary care provider has ordered a blood transfusion. A unit of blood has come up from the hospital’s blood bank and the client’s nurse has received it. In order to best promote the client’s safety, the nurse should:
have a colleague double-check the blood and the client’s identity.
disinfect the outside of the blood bag to reduce the client’s risk of infection.
perform a medication reconciliation to make sure that no drugs will react with the blood.
assess whether the client has ever been tested for hepatitis C or human immunodeficiency virus (HIV).
have a colleague double-check the blood and the client’s identity.
Health care workers may be exposed to a common occupational injury such as:
inadvertent needlestick.
sensory deprivation.
carbon monoxide exposure.
Intimate Partner Violence (IPV).
inadvertent needlestick.
A Medicare client who was being treated in the hospital for major depression attempted suicide by hanging and suffered brain damage due to hypoxia. The Centers for Medicare & Medicaid Services (CMS) has classified this as a “never event.” The nurse should recognize what consequence of this classification?
The hospital will have to bear the cost of treating the client’s brain injury.
Malpractice insurance will not cover any staff members who participated in the client’s care immediately before the event.
The hospital will no longer be reimbursed for the care of Medicare and Medicaid clients.
Staff members will likely be found negligent and may face criminal charges.
The hospital will have to bear the cost of treating the client’s brain injury.
A nurse mistakenly gave a client an immediate dose of an opioid, rather than the extended release form of the drug. The client developed respiratory depression that required resuscitation. The nurse did not admit to the error until forced to weeks later by persistent rumors among colleagues. Which statement about this nurse’s actions is most accurate?
The nurse demonstrated reckless behavior by not admitting the error.
The nurse demonstrated reckless behavior by administering the wrong version of the medication.
The nurse demonstrated at-risk behavior by covering up the error.
The nurse demonstrated human error by the attempts to cover up the mistake.
The nurse demonstrated reckless behavior by not admitting the error.
The poison control nurse receives a call from the parent of a 2-year-old child. The parent states, “I just took a quick shower, and when I finished, I walked into the kitchen and found my child with an open bottle of household cleaner.” What is the poison control nurse’s appropriate response?
“Did you leave the household chemical in reach of your child?”
“Is your child breathing at this time?”
“You should not have left your child alone while you showered.”
“Induce vomiting and call 911 right away.”
“Is your child breathing at this time?”
A hospital’s quality improvement committee is adapting the hospital’s policies and procedures to align with the Joint Commission 2015 Hospital National Patient Safety Goals. Which of the following is an explicit focus of the 2015 goals?
Screen every new client for intimate partner violence.
Use two unique client identifiers before giving medications.
Eliminate the use of shared client rooms to prevent healthcare-acquired infections (HAIs)
Identify clients at high risk of developing postoperative complications.
Use two unique client identifiers before giving medications.
A nurse is caring for a client who is being treated for complications of diabetes. Which action by the nurse best reduces the client’s risk of experiencing an adverse outcome while receiving care?
monitoring the client’s health status frequently and thoroughly
ensuring that the care provided is efficient and timely
delegating care appropriately and working closely with unlicensed care providers
documenting the care that the client receives in a timely and detailed manner
monitoring the client’s health status frequently and thoroughly
A hospital is being evaluated by the Centers for Medicare & Medicaid Services. Which of these findings from the evaluation may result in a reduction in the hospital’s reimbursement under the value-based purchasing (VBP) program?
The rate of postoperative complications is significantly higher than national averages.
The ratio of registered nurses to licensed practical nurses is significantly lower than in other similar-sized hospitals.
The hospital is not using the latest version of its electronic health records software.
The hospital has a policy of using generic drugs rather than brand-name drugs whenever possible.
The rate of postoperative complications is significantly higher than national averages.
Municipal authorities have requested that the local hospital become more environmentally responsible. Which action best promotes environmental sustainability in a hospital setting?
Ensuring that all waste is thoroughly and hygienically incinerated on-site.
Implementing a system to sort recyclables from waste that contains toxins or body fluids.
Obtaining an autoclave so disposable equipment can be safely sterilized for reuse.
Replacing washable bed linens with single-use sheets in order to save water.
Implementing a system to sort recyclables from waste that contains toxins or body fluids.
