Deck 22: Quality and Safety in Nursing Education in Nursing: The QSEN Project

Question 1

During team rounds, a member states, "Ms. Jones has a positive tuberculin skin test and is scheduled for sputum cultures." The nurse notices that the antibiotic infusing has the wrong patient name and the patient is allergic to this particular medication. The nurse tells the team, "I need some clarity" to alert the team:

A) that they have breached patient confidentiality.
B) the patient is not aware of the diagnosis of tuberculosis.
C) that the patient is contagious.
D) that there is a safety concern.

Answer 1

that there is a safety concern.

Question 2

Nurses working on an orthopedic unit use personal digital assistants (PDAs) to review medications prior to administration to reduce potential drug interactions. Software is also installed that provides video clips of common procedures performed by nurses. Nurses on this unit are best demonstrating which QSEN competencies?

A) Patient-centered care
B) Informatics
C) Teamwork
D) Quality improvement

Answer 2

Informatics

Question 3

A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency?

A) Safety
B) Timely
C) Equitable
D) Patient-centered care

Answer 3

Safety

Question 4

During resuscitation efforts, a provider states, "I need to give a 1.5 mg/kg bolus of lidocaine because the patient is in ventricular tachycardia." The nurse responds, "I have a lidocaine bolus equal to 1.5 mg/kg." This communication model is known as:

A) situation background assessment recommendation (SBAR).
B) check-back.
C) hand-off check.
D) critical-language.

Question 5

The ability to clearly demonstrate the knowledge, skills, attitudes, and professional judgment required to practice safely and ethically in a designated role and setting is termed:

A) human factors.
B) competency.
C) evidence-based practice.
D) workarounds.

Question 6

"Ninety-five percent of all patients presenting to the emergency department with chest pain will receive aspirin 80 mg within 15 minutes of arrival unless contraindicated." Top hospital emergency departments use this standard to eliminate sudden death related to chest pain. Hospitals desiring to replicate these results establish compliance rates known as:

A) competencies.
B) benchmarks.
C) driving force.
D) Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS).

Question 7

A nurse receives a verbal order which was understood to be for Avert 6. The physician actually ordered Antivert 25 mg daily. The patient is also taking Prozac/Sarafem (fluoxetine), which when taken with Avert can be life threatening. The patient's condition stabilizes and an interdisciplinary team meets to perform a root cause analysis hoping to learn from the mistake. The nurse was part of the group formed to help identify ways the system could be changed to prevent similar errors. This situation describes:

A) just culture.
B) standard of care.
C) a call-out.
D) benchmarking.

Question 8

Following a complicated surgery, a patient who was received in the recovery room suddenly loses consciousness and becomes unstable. The nurse who arrives at the scene performs assessments and makes the following comments, "The patient is nonresponsive to verbal stimuli," "The patient is not initiating any spontaneous respiration," and "I am unable to palpate a femoral pulse," and other members of the health care team react to the comments. The team is using the mental model for communication known as:

A) critical language.
B) call-out.
C) check-back.
D) hand-off.

Question 9

Nurses, physicians, and social workers finalize the plan of care and coordinate discharge for a homeless person who will need wound care and follow up over the next 4 weeks. Each member contributes based on his or her area of expertise but also recognize other members' strengths. Which of the QSEN competencies are being demonstrated?

A) Quality improvement
B) Evidence-based practice
C) Teamwork and collaboration
D) Patient-centered care

Question 10

A nurse calls a physician and after identifying herself and the patient, the nurse informs the physician that the patient is vomiting and complaining of abdominal pain. Which component of SBAR communication is being used in this situation?

A) Situation
B) Background
C) Assessment
D) Recommendation

Question 11

What are some of the driving forces for change to improve the quality and safety competencies for nursing in the United States? (Select all that apply.)

A) The U.S. health care system is one of the world's least technically advanced systems.
B) Health care has led other industries in establishing quality and safety standards.
C) System failures occur regularly.
D) The U.S. public has confidence in its system to reduce morbidity and mortality rates.
E) Outcomes are unpredictable and costly.

Question 12

While taking a shower, a patient pushes the emergency light. When the nurse arrives, the patient complains of feeling dizzy and unsteady. The nurse turns to reach for the patient's walker and the patient falls, hitting the right side of the face resulting in loss of vision in the right eye. This scenario represents a _______ event.

Question 13

Which of the following statements concerning the Institute of Medicine (IOM) competencies is correct?

A) Each competency is mutually exclusive.
B) The competencies focus on individual efforts to reduce errors.
C) Physicians lead the team to achieve each competency.
D) The competencies address both individual and system approaches to transform care.

Question 14

A nurse calls a physician and gives a brief statement about the situation, "The patient is having increasing chest pain and the ECG shows ST elevation." What component of SBAR communication would be used in the following statements: The nurse tells the physician that the patient's blood pressure is 190/100 and rates the pain as 9 on a scale of 10 (10 being most severe pain) with a nitroglycerin drip infusing at 5 mcg/min?

A) Situation
B) Background
C) Assessment
D) Recommendation

Question 15

When planning a program to reduce the number of sentinel events in an organization, the program planner should focus on the leading cause of sentinel events, which is related to a problem with:

A) leadership or management.
B) staffing patterns.
C) environmental safety.
D) communication.

Question 16

Which of the following occurrences would be classified as a sentinel event?

A) A postpartum patient who elects to breastfeed only twice daily develops mastitis.
B) A newly diagnosed diabetic patient self-injects insulin in the abdominal area rather than the upper thigh as instructed by the patient educator.
C) A nurse assisting with the delivery of twins places the "Twin 1" name tag on the second-born twin, causing the first-born twin to undergo surgery that was scheduled for the other twin.
D) A nurse administers 3 units of regular insulin rather than 3 units of NPH insulin subcutaneously, resulting in a drop in the patient's serum glucose from 160 mg to 100 mg.

Question 17

A nurse educator is explaining to licensed staff that health care is no longer safe and describes The Quality and Safety for Nursing (QSEN) recommended competencies for educating nursing professionals. These include: (Select all that apply.)

A) advanced health assessment techniques.
B) patient-centered care.
C) prescriptive pharmacology content.
D) quality improvement.
E) safety.

Question 18

A nurse is the frequent target of lateral violence from a co-worker who is placed in charged this shift. The nurse receives an assignment that requires multiple intravenous infusions, care of a patient in isolation, and another receiving peritoneal dialysis. Later the nurse discovers a medication was hung on the wrong patient and one drug omitted entirely. The nurse in charge is heard saying, "I'll make sure the manager knows she made the error." The aspect of the work environment that led to the errors is known as:

A) workarounds.
B) human factors.
C) benchmark.
D) just culture.

Question 19

A nurse hung an intravenous antibiotic to infuse but failed to check patency of the IV resulting in infiltration causing pain and redness but no tissue damage. This situation would be a(n):

A) adverse event.
B) workaround.
C) breach in patient-centered care.
D) sentinel event.

Question 20

A patient is ordered a low-protein, low-calorie diet but the patient's family brings fish, lentils, and unleavened bread for a meal to observe a cultural practice. The nurse works with the dietitian to adjust the next few meals to accommodate for this variance. This situation would represent:

A) a sentinel event.
B) an adverse event.
C) patient-centered care.
D) the communication technique of "call-out."

Question 21

The ability to clearly exhibit the knowledge, skills, attitudes, and professional judgment needed to practice safely and ethically in a designated role such as professional nurse is ___________.