chapter 5

Question 1

In an effort to control costs and maximize revenues, the Rehabilitation Unit at Cross
Hospital reduces the number of its nursing managers. Within a year the number of adverse
events on the units has doubled. This may be attributable to:

a. The overload of work for staff nurses.
b. Inability of staff at the bedside to make good choices.
c. A change in reporting systems.
d. Fewer clinical leaders and advocates for necessary resources.

Answer 1

D

Question 2

Traditional approaches to ensuring patient safety have focused on:

a. Assigning blame.
b. Finding solutions to systems issues.
c. Instituting best practices in response to errors.
d. Hiding errors from potential litigation.

Answer 2

A

Question 3

What is the primary purpose of nursing standards?

a. To inform performance appraisals at the unit level.
b. To identify the desired level of performance.
c. To inform the courts in relation to negligence and malpractice cases.
d. To educate other health care professionals about the role of the nurse.

Answer 3

B

Question 4

During review of back injuries, it is determined that mechanical lifts and transfer belts are
not being properly used. In addressing this concern, the unit manager:

a. Meets individually with nurses, who are observed using the lifts incorrectly, to
review the correct procedure.
b. Consults with the staff about the review to determine how best to proceed.
c. Blames the system for inadequate funding for resources.
d. Reviews the system of reporting adverse events to ensure that appropriate
reporting is occurring.

Answer 4

B

Question 5

The nursing manager changed the current model of implementing nursing rounds of patients
each day at 1200 hours to implementing interdisciplinary rounds of patients at 1000 hours.
This change reflects:

a. A patient-centred care initiative.
b. Delegation of responsibility from nursing to other health care professionals.
c. Lack of consultation among the nursing staff.
d. An inappropriate time to complete patient rounds and will probably not work.

Answer 5

A

Question 6

Which of the following represents an activity that supports patient-centred care?

a. Posting of visiting hours on the entrance way to each hospital unit
b. Regular staff surveys to monitor organizational satisfaction
c. Reserved parking spots at the main hospital entrance for physicians
d. Creating e-health stations on each inpatient unit

Answer 6

D

Question 7

After consulting with practice environments about quality and safety concerns in health
care, the Dean of Health Programs at a Canadian university develops:

a. A nursing program that emphasizes the development of a strong disciplinary
identity.
b. Programming that stresses discipline-based research.
c. Partnerships with health care professionals to develop software for reporting of
adverse events.
d. An interdisciplinary program for nurses, pharmacists, and medical practitioners
that emphasizes collaborative learning teams.

Answer 7

D

Question 8

In designing a high-quality, safe health care environment, the primary emphasis needs to be
on:

a. Evidence-informed practice.
b. Informatics.
c. Staffing.
d. The patient.

Answer 8

D

Question 9

As a patient care advocate, you regularly coach patients in how to stay safe in health care by
educating them about:

a. The need to understand and record all medications being taken.
b. Bringing their own linens and other personal items to the hospital.
c. Washing hands frequently while in a health care environment and using a hand
sanitizer.
d. Following closely the directions and orders of health care providers.

Answer 9

A

Question 10

What is the focus in a culture of safety?

a. Employee safety.
b. Investigating who is making health care errors.
c. Effective systems and team work
d. Professional nursing standards and ethical codes

Answer 10

C

Question 11

Which attribute is a common feature of a culture of safety?

a. Voluntary reporting of incidents.
b. Organization behaviour.
c. Individual-focused policies.
d. A nonpunitive approach to adverse event reporting and analysis.

Answer 11

D

Question 12

Which of the following depicts a nursing-sensitive outcome?

a. Programming that increases individual nurse competency to offer smoking
cessation programs.
b. Implementation of informatics at the patient’s bedside.
c. Staff–manager conferences to review reporting of adverse events.
d. Patient council meetings to review food, recreation, and nurse–patient relations.

Answer 12

A

Question 13

Having team “huddles” each day on the nursing unit is a reflection of:

a. Nurses’ need to socialize.
b. Creating a culture of safety.
c. Ensuring distribution of equal workloads.
d. The manager`s need to talk with staff nurses on a daily basis.

Answer 13

B

Question 14

Approximately what percentage of Canadian hospital admissions can be expected to include
an adverse event?

a. 5
b. 7.5
c. 10
d. 12.5

Answer 14

B

Question 15

Having access to information, evidence, and research is an important driver for quality and;

a. Nurse safety.
b. Patient safety.
c. Organizational policy development.
d. Patient-centred care.

Answer 15

B

Question 16

Which of the following represents a potential use of nurse-sensitive outcomes?

a. Informing best practices.
b. Accountability for nursing behaviours.
c. Performance appraisals.
d. Maintaining the status quo.

Answer 16

A

Question 17

Which of the following is a CPSI safety competency?

a. Practise patient-centred care.
b. Optimize human and environmental factors.
c. Analyze nurse-sensitive outcomes.
d. Assess nurse staffing and skill mix.

Answer 17

B

Question 18

On the basis of a review of increased falls with injury and increased use of restraint during
evening hours, you as the unit manager are most likely to:

a. Review daytime and evening staffing mixes.
b. Schedule continuing education for all staff members.
c. Review the safety of ambulation devices.
d. Continue your current practices and procedures.

Answer 18

A

Question 19

As the nurse was about to administer an oral mediation, the patient states, “That pill is the
wrong colour.” The nurse goes back to the medication administration area to check the
medication and realizes that it is indeed the wrong pill. Does this situation require the
completion of an adverse event report?

a. No; there was no actual error.
b. No; it was the patient who stopped an error from occurring.
c. Yes; an error almost occurred, and close calls are to be reported.
d. It is up to the nurse to decide whether to complete an adverse event report.

Answer 19

C

Question 20

Which of the following is the CPSIs flagship program?

a. Patients Are First.
b. Safer Healthcare Now.
c. Safe Healthcare for All.
d. Patient Safety Culture Improvement.

Answer 20

B

Question 21

Organizational changes that promote systems thinking, collective accountability, and
team-based care are examples of:

a. Activities that promote patient-centred care.
b. Accreditation standards that hospitals must meet.
c. Outdated practices that are not grounded in current evidence.
d. Quality improvement initiatives.

Answer 21

A

Question 22

Robert, an experienced nurse, discovered a medication order was incorrectly translated.
The pharmacist filled the medication and sent it to be administered to the patient. When the
medication arrived Robert questioned the dose and consulted with the nurse manager. The
order was clarified with the physician and changed to the correct dose. When reviewing the
incident the nurse manager determined the near miss was related to which of the following?

a. Individual error.
b. System error.
c. An individual and system error.
d. Attributed to increased workload.

Answer 22

C

Question 23

Gail, a senior nursing student, consults with her preceptor about a patient who has refused
his medication. When speaking with the patient he expresses that he does not believe the
medication is helping with his pain level. From a nursing sensitive outcome, which
outcomes are addressed in this situation? (Select all that apply.)

a. Quality of nursing care.
b. Symptom management.
c. Patient satisfaction.
d. Functional status.

Answer 23

B,C

Question 24

Gathering information on patient outcomes leads to which of the following? (Select all that
apply.)

a. Evaluating different approaches to care.
b. Increasing quality of nursing care.
c. Decreasing nursing autonomy.
d. Having a positive impact at the individual, unit, and organization levels.

Answer 24

A,B,D

Question 25

Rose a new nursing graduate chose hospital X for its culture of safety. Which of the
following attributes contribute to this culture of safety? (Select all that apply.)

a. Trusting and open communication
b. Organizational learning
c. A system rather that an individual approach to safety
d. Teamwork

Answer 25

A,B,C,D

Question 26

Which of the following contribute to improved patient safety? (Select all that apply.)

a. Leadership capability.
b. Patient involvement in own care.
c. Data collection.
d. Increased staff mix.

Answer 26

A,B,C