Deck 26: Quality Management

Question 1

When a nurse assesses the necessity of receiving care before providing services,it is called a:

A) Concurrent audit
B) Retrospective audit
C) Prospective utilization review
D) Retrospective utilization review

Answer 1

Prospective utilization review

Question 2

Which resource would a public health nurse measuring quality assurance in the 1960s most likely have used?

A) American Nurses Association Standards of Practice
B) Joint Commission of Accreditation of Hospitals Nursing Audit Criteria
C) Community Health Nursing Practice Standards
D) Phaneuf nursing audit method

Answer 2

Phaneuf nursing audit method

Question 3

A public health agency is transitioning from a traditional management model for quality assurance to a total quality management (TQM)approach.What change will occur within the agency?

A) Increased administrative authority
B) Increased participation by all staff
C) Additional focus on quality assurance
D) Specialized accountability for services provided

Answer 3

Increased participation by all staff

Question 4

Which action would a nurse take when using the specific approach to quality improvement?

A) Evaluate an agency's ability to meet criteria or standards.
B) Implement the plan/do/check/act cycle.
C) Provide care to individual citizens.
D) Use criteria set forth by regulatory agencies.

Question 5

A nurse is concerned that there is an overuse of services by clients receiving care from a local physician.What is occurring in this situation?

A) Treatment decisions are made conservatively.
B) Disability and mortality are being reduced.
C) Disparities in quality of care provided are increasing.
D) Unnecessary tests, surgeries, and treatments are being ordered.

Question 6

An elderly female client was receiving home care after hospitalization for a cerebrovascular accident.After several weeks of physical and speech therapy,the client showed few signs of progress.The utilization review committee considered the client's condition to be stable and declined reimbursement for further home care.This client may reverse the decision through a process called:

A) Development of explicit criteria
B) Appeal mechanism
C) Concurrent utilization review
D) Medicare reversal process

Question 7

Which organization monitors implementation of the prospective reimbursement system for Medicare clients?

A) Professional Review Organizations (PROs)
B) Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
C) National Health Quality Improvement Act
D) Diagnostic Related Groups (DRGs)

Question 8

How can public health nurses provide the core function of assurance to the community?

A) By providing the same services to all citizens
B) By maintaining quality in the public health workforce
C) By eliminating low-quality services
D) By contracting with outside agencies to evaluate effectiveness

Question 9

A quality assurance manager does an audit and six months later returns to see if the problem has been eliminated.This step:

A) Involves selecting explicit criteria for quality care
B) Includes the review of records
C) Requires a peer review of all cases that do not meet criteria
D) Completes the audit process

Question 10

What is the purpose of implementing total quality management?

A) To provide quality care within an organization
B) To provide cost-efficient care across all age groups
C) To provide necessary care to clients in a cost-effective system
D) To provide efficient systems of primary care

Question 11

A nurse is given formal recognition as a professional with technical competence in a certain area of nursing practice.This is known as:

A) Licensure
B) Accreditation
C) Registration
D) Credentialing

Question 12

A nurse is using a concurrent audit to review documentation following home health visits.Why is this type of audit most appropriate in this situation?

A) It is less costly than a retrospective audit.
B) It represents the total picture of care that the client receives.
C) It provides more accurate data for planning corrective action.
D) It identifies problems at the time that care is given.

Question 13

A nurse implements the Institute of Medicine's definition of quality health care when providing care that is:

A) Licensed-all health care workers must have a license
B) Safe-avoiding injuries to patients from the care intended to help them
C) Timely-no waiting or delay for health care
D) Innovative-new innovations must be used when they become available

Question 14

A student has obtained a Bachelor of Science in Nursing degree.Why must the student be licensed as a registered nurse before beginning practice?

A) To formally recognize the student as a competent professional
B) To define the scope of professional practice
C) To control the quality of professional practice
D) To establish standards for educational programs

Question 15

A staff development program to teach nurses and other providers about how to reduce risk by properly documenting interventions provided is an example of which level of prevention?

A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quality care

Question 16

A nurse is working with a team to learn more about what its most important accomplishments have been and to identify what changes are desired.What is the best method to use to accomplish this task?

A) Compare job descriptions.
B) Analyze mission and goals.
C) Brainstorm.
D) Develop charts and diagrams.

Question 17

An example of a voluntary approach to quality control used primarily for institutions is:

A) Accreditation
B) Licensure
C) Certification
D) Credentialing

Question 18

What is the purpose of the National Health Quality Report (NHQR)?

A) To report on the Agency for Healthcare Research and Quality's goals for the year
B) To describe the yearly activities of the agency
C) To ensure national quality of services
D) To document if health care quality is stable, improving, or declining over time

Question 19

Which statement about the quality assurance process is accurate?

A) Processes are implemented to maintain quality.
B) Community needs are assessed while implementing quality programs.
C) Accountability of the provider is the primary concern.
D) Standards for care are established and evaluated.

Question 20

What is one performance area where quality improvement is used to effect process and outcomes of health care?

A) Provision of appropriate and effective care
B) Elimination of access barriers
C) Reduction of unjustified geographic variation in care
D) Application of managed care to all citizens

Question 21

Which statement about records is true? Select all that apply.

A) Records provide complete information about the client.
B) Records resolve legal issues in malpractice suits.
C) Records provide information for education and research.
D) Records allow anyone interested in a client's progress to view a chart.

Question 22

When developing a quality improvement program,what is the most important aspect of the program that should be considered?

A) Vision and values of the agency
B) Standards used to provide care
C) Results of nursing care
D) Evaluation of process changes

Question 23

In which situations would a nurse use a clinical practice guideline? Select all that apply.

A) When recommending the administration of the influenza vaccination to a client
B) When creating agency policies and procedures
C) When developing a program targeting obesity prevention
D) When researching interventions that would improve care for a tuberculosis client

Question 24

While implementing Plan-Do-Check-Act,which action is the nurse most likely to perform?

A) Documentation of client care
B) Obtain certification in a specialty area
C) Review data after changing practice
D) Provide equal access to care

Question 25

A nurse records the number of clients seen daily as well as the mode of transportation and miles driven.What type of record is being used?

A) Clinical record
B) Provider service record
C) Financial record
D) Central index system

Question 26

Which type of record is most appropriate to use when profiling the clients who are served by an agency as well as documenting services requested and provided?

A) Clinical record
B) Provider service record
C) Financial record
D) Central index system