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

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

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. “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).

ANS: B
Correct: A benchmark is a standard for other providers or institutions to replicate.
Incorrect:
a. A competency is the ability to practice safely based on knowledge, skills, and attitudes for a certain role.
c. Driving forces promote change. In this example they may be a desire to be a magnet hospital or simply to be recognized as a safe place to receive care.
d. TeamSTEPPS is a team training and communication approach that enhances patient safety.

DIF: Application REF: p. 394 | p. 397

2. 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.

ANS: C
Correct: Any procedure performed on a wrong person or organ constitutes a sentinel event.
Incorrect:
a. The infection was not due to negligence of provider.
b. The patient chose the site and, although not the one indicated by the nurse, it was an appropriate site.
d. Although a medication error occurred, death or permanent loss of function did not occur.

DIF: Application REF: p. 394 | p. 397

3. 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.”

ANS: C
Correct: The nurse and dietitian are respecting patient values, preferences, and expressed needs.
Incorrect:
a. Death or permanent loss of function did not occur.
b. No injury occurred due to medical care.
d. “Call-out” occurs during critical situations, so all members anticipate next steps in care.

DIF: Application REF: p. 399

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.

ANS: B
Correct: Check-back is the process of repeating what was heard.
Incorrect:
a. SBAR shares information during patient hand-offs.
c. No checklist was used and no hand-off or transfer of care is occurring.
d. No problem was identified. A critical-language exchange would have included a phrase such as “I need some clarity.”

DIF: Application REF: p. 398; Box 22-1