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Quality and Safety for Transformational Nursing 1st Edition Amer Test Bank

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Quality and Safety for Transformational Nursing 1st Edition Amer Test Bank

ISBN-13: 978-0132724128

ISBN-10: 013272412X

 

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Quality and Safety for Transformational Nursing 1st Edition Amer Test Bank

ISBN-13: 978-0132724128

ISBN-10: 013272412X

 

 

 

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Free Nursing Test Questions:

Amer Leadership for Quality and Safety, 1/E
Chapter 3

Question 1

Type: MCMA

A hospital administrator is meeting with the vice president of nursing to discuss the implementation of a transition to practice program for nurses. What reasons would the vice president of nursing explain as evidence to support this program?

Standard Text: Select all that apply.

  1. Reduces medication errors
  2. Reduces adverse events
  3. Combat the expertise gap
  4. Reduce turnover rate
  5. Improves salary levels

Correct Answer: 1,2,3,4

Rationale 1: When nurses’ mistakes are analyzed, reasons for errors are most often linked to lack of knowledge of hospital procedure and unfamiliarity with patients. A transition to practice program will help reduce medication errors. (See Page 42 Safety and Quality Are Prompting This Movement and Page 47 Safety and New Nurses)

Rationale 2: When nurses’ mistakes are analyzed, reasons for errors are most often linked to lack of knowledge of hospital procedure and unfamiliarity with patients. A transition to practice program will help reduce adverse events. (See Page 42 Safety and Quality Are Prompting This Movement and Page 47 Safety and New Nurses)

Rationale 3: When nurses’ mistakes are analyzed, reasons for errors are most often linked to lack of knowledge of hospital procedure and unfamiliarity with patients. A transition to practice program will help combat the expertise gap. (See Page 42 Safety and Quality Are Prompting This Movement and Page 47 Safety and New Nurses)

Rationale 4: When nurses’ mistakes are analyzed, reasons for errors are most often linked to lack of knowledge of hospital procedure and unfamiliarity with patients. A transition to practice program will reduce nursing turnover rates. (See Page 42 Safety and Quality Are Prompting This Movement and Page 47 Safety and New Nurses)

Rationale 5: When nurses’ mistakes are analyzed, reasons for errors are most often linked to lack of knowledge of hospital procedure and unfamiliarity with patients. A transition to practice program will not impact nurses’ salary levels. (See Page 42 Safety and Quality Are Prompting This Movement and Page 47 Safety and New Nurses)

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3-1

 

Question 2

Type: MCSA

A nursing leader is having difficulty convincing hospital administrators to implement a transition to practice program for nurses. Which information about evidence-based practice would add to the leader’s difficulty?

  1. Evidence-based practice integrates clinical expertise with patient values.
  2. Evaluation studies are available to use as evidence for the program.
  3. Expert opinions are available to use as evidence for the program.
  4. There are few randomized studies available to support the program.

Correct Answer: 4

Rationale 1: Evidence-based practice is the integration of clinical expertise with patient values. This would not hinder the implementation of a transition to practice program for nurses. (Page 47 Identifying the Evidence)

Rationale 2: Evaluation studies are available to use as evidence for the program. This would not hinder the implementation of a transition to practice program for nurses. (Page 47 Identifying the Evidence)

Rationale 3: Expert opinions are available to use as evidence for the program. This would not hinder the implementation of a transition to practice program for nurses. (Page 47 Identifying the Evidence)

Rationale 4: There are few randomized studies available to support the program. It is common in health care to not find randomized controlled trials because they are not always feasible or ethically possible. This information would hinder the implementation of a transition to practice program for nurses. (Page 47 Identifying the Evidence)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3-1

 

Question 3

Type: MCSA

The nurse manager identifies that an increase in medication errors and adverse patient incidents are occurring with the new nurses. What would be happening with the new nursing staff that is causing this increase in patient safety issues?

  1. Participation in a year-long transition to practice program continues
  2. Participation in a formal orientation program has ended
  3. More rigid disciplinary procedures for novice nurses
  4. Less rigid disciplinary procedures for novice nurses

Correct Answer: 2

Rationale 1: Participation in a year-long transition to practice program would reduce medication errors and adverse patient incidents. (See Page 49 Safety and New Nurses)

Rationale 2: When participation in a formal orientation program ends the stress levels of new nurses increases. This increase in stress results in more patient safety issues. (See Page 49 Safety and New Nurses)

Rationale 3: Disciplinary procedures tend to be less severe for novice nurses. More rigid disciplinary procedures is not occurring. (See Page 49 Safety and New Nurses)

Rationale 4: Disciplinary procedures tend to be less severe for novice nurses. The lack of discipline would not cause an increase in patient safety issues. (See Page 49 Safety and New Nurses)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3-1

 

Question 4

Type: MCMA

The nurse manager is analyzing why the number of medication errors and patient safety issues has significantly increased over the early summer months. What would be the reason for this increase?

Standard Text: Select all that apply.

  1. Experiencing a patient care problem for the first-time
  2. New nurses not being aware of the big picture
  3. Extreme disciplinary action by the preceptors
  4. Lack of knowledge about unit work flows
  5. Novices assisting novices

Correct Answer: 1,2,4,5

Rationale 1: An identified theme related to medication errors and patient safety issues includes new nurses experiencing patient care problems for the first time. (See Page 50 Safety and New Nurses)

Rationale 2: An identified theme related to medication errors and patient safety issues includes new nurses not being aware of the big picture. (See Page 50 Safety and New Nurses)

Rationale 3: Disciplinary action for medication errors and patient safety issues has been notoriously lenient for new nurses. This would not cause the number of medication errors and patient safety issues to increase. (See Page 50 Safety and New Nurses)

Rationale 4: An identified theme related to medication errors and patient safety issues includes a lack of knowledge about unit work flows. (See Page 50 Safety and New Nurses)

Rationale 5: An identified theme related to medication errors and patient safety issues includes novices assisting novices. (See Page 50 Safety and New Nurses)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3-1

 

Question 5

Type: MCMA

The number of new nurses hired for a patient care area equals the number of seasoned staff currently employed on the same unit. What is prone to occur on this patient care area?

Standard Text: Select all that apply.

  1. Falls
  2. Pressure ulcers
  3. Failure to rescue
  4. Few practice errors
  5. Improved care quality

Correct Answer: 1,2,3

Rationale 1: With too many inexperienced nurses, nursing care is omitted, which can lead to patient falls. (See Page 51 Safety and New Nurses)

Rationale 2: With too many inexperienced nurses, nursing care is omitted, which can lead to the development of pressure ulcers. (See Page 51 Safety and New Nurses)

Rationale 3: With too many inexperienced nurses, nursing care is omitted, which can lead to situations in which patients are not adequately resuscitated or failure to rescue. (See Page 51 Safety and New Nurses)

Rationale 4: With too many inexperienced nurses, nursing care is omitted, which can lead to more practice errors and not fewer practice errors. (See Page 51 Safety and New Nurses)

Rationale 5: With too many inexperienced nurses, nursing care is omitted, which can lead to reduced quality of care and not improved quality of care. (See Page 51 Safety and New Nurses)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3-2

 

Question 6

Type: MCMA

A new graduate nurse is overheard making plans to leave current employment on a patient care area. What workplace issues would contribute to this nurse’s decision to terminate employment?

Standard Text: Select all that apply.

  1. Inability to understand team dynamics
  2. Lack of support with coordinating care
  3. Communication issues
  4. Supportive leadership
  5. The stress of change

Correct Answer: 1,2,3,5

Rationale 1: New graduates are expected to become skilled in a wide range of skills to include team dynamics. The inability to understand team dynamics could cause a new graduate to seek other employment. (See Page 51 Competence and New Nurses)

Rationale 2: New graduates are expected to become skilled in a wide range of skills to coordinating care. The lack of support with coordinating care could cause a new graduate to seek other employment. (See Page 51 Competence and New Nurses)

Rationale 3: New graduates are expected to become skilled in a wide range of skills to include communication. Issues with communication could cause a new graduate to seek other employment. (See Page 51 Competence and New Nurses)

Rationale 4: Leadership that is supportive to the needs of the new graduate would be positive and not cause a new graduate to seek other employment. (See Page 51 Competence and New Nurses)

Rationale 5: New graduates are expected to become skilled in a wide range of skills to include change. The stress of change could cause a new graduate to seek other employment. (See Page 51 Competence and New Nurses)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3-2

 

Question 7

Type: MCSA

The nurse manager is evaluating the competency of new graduate nurses when providing patient care. On which area do most graduate nurses need more assistance and focus?

  1. Delegation
  2. Conflict resolution
  3. Tracking multiple responsibilities
  4. Understanding quality improvement

Correct Answer: 1

Rationale 1: Of the new nurse graduate competencies, the area where employers identify lacking is the new nurses’ ability to delegate tasks. (See Page 52 Table 3-1 New Nurse Graduate Competencies Employers Find Lacking)

Rationale 2: Of the new nurse graduate competencies, conflict resolution is not an area identified as lacking in the ability of new nurses. (See Page 52 Table 3-1 New Nurse Graduate Competencies Employers Find Lacking)

Rationale 3: Of the new nurse graduate competencies, tracking multiple responsibilities is not an area identified as lacking in the ability of new nurses. (See Page 52 Table 3-1 New Nurse Graduate Competencies Employers Find Lacking)

Rationale 4: Of the new nurse graduate competencies, understanding quality improvement was ranked as the strongest competency in the ability of new nurses. (See Page 52 Table 3-1 New Nurse Graduate Competencies Employers Find Lacking)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3-2

 

Question 8

Type: MCSA

A new nurse has been working on a patient care area for 5 months. In an organization without a transition to practice program, what is likely to occur with this nurse?

  1. Improved quality of care
  2. Greater satisfaction
  3. Practice breakdown
  4. Fewer errors

Correct Answer: 3

Rationale 1: Three to six months after hire is considered to be a vulnerable period when nurses report more stress, less competence, and at risk for practice breakdown. Improved quality of care is not something that will occur during the 5-month period. (See Page 52 Competence and New Nurses)

Rationale 2: Three to six months after hire is considered to be a vulnerable period when nurses report more stress, less competence, and at risk for practice breakdown. Greater satisfaction is not something that will occur during the 5-month period. (See Page 52 Competence and New Nurses)

Rationale 3: Three to six months after hire is considered to be a vulnerable period when nurses report more stress, less competence, and at risk for practice breakdown. (See Page 52 Competence and New Nurses)

Rationale 4: Three to six months after hire is considered to be a vulnerable period when nurses report more stress, less competence, and at risk for practice breakdown. Fewer errors is not something that will occur during the 5-month period. (See Page 52 Competence and New Nurses)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3-2

 

Question 9

Type: MCSA

The nursing leader is reviewing a transition to practice program implemented in Ireland. What is a characteristic of this program?

  1. Occurs during the students’ last year of school
  2. Provides the new graduate with a provisional license
  3. Incorporates an on-line mentorship program
  4. Includes a voluntary year-long transition program

Correct Answer: 1

Rationale 1: In Ireland a transition program occurs that is a part of the students’ last year of school. (See Page 44 Status of International Transition Programs)

Rationale 2: Providing the new graduate with a provisional license is a characteristic of the transition to practice program in Portugal. (See Page 44 Status of International Transition Programs)

Rationale 3: Incorporating an on-line mentorship program is a characteristic of the transition to practice program in Scotland. (See Page 44 Status of International Transition Programs)

Rationale 4: Including a voluntary year-long transition program is a characteristic of the transition to practice program in Australia. (See Page 44 Status of International Transition Programs)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3-3

 

Question 10

Type: MCSA

A new graduate nurse is seen crying when leaving work at the end of a scheduled shift. When asked about the emotional response, the reply is “this is not what I expected nursing to be.” What is this nurse most likely experiencing?

  1. Reaction to being a novice nurse
  2. Low self-esteem
  3. Culture shock
  4. Reality shock

Correct Answer: 4

Rationale 1: The novice nurse is identified as being in the first year of education. This is a new graduate who would be classified as an advanced beginner. (See Page 45 Status of U.S. Transition Programs)

Rationale 2: The new graduate nurse’s emotional response and statement are not consistent with that of having low self-esteem. (See Page 45 Status of U.S. Transition Programs)

Rationale 3: The new graduate nurse’s emotional response and statement are not consistent with culture shock. (See Page 45 Status of U.S. Transition Programs)

Rationale 4: Reality shock is a shocklike reaction of new workers when they find themselves in a work situation for which they have spent several years preparing and for which they thought they were going to be prepared and then suddenly find out that they are not prepared. The new graduate nurse is experiencing reality shock. (See Page 45 Status of U.S. Transition Programs)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 3-3

 

Question 11

Type: MCSA

Several nursing leaders are asked to participate on a task force to study the feasibility of a national standardized transition to practice nursing program. What is the major reason for the development of such a program in the United States?

  1. Practice settings are failing
  2. Education programs are failing
  3. New graduates need to be prepared to work on day one
  4. Response to changes in health care over the last 20 years

Correct Answer: 4

Rationale 1: The development of a national standardized transition to practice program is not occurring because practice settings are failing. The need for this program is because of the changes in health care in the past 20 years. (See Page 46 Status of U.S. Transition Programs)

Rationale 2: The development of a national standardized transition to practice program is not occurring because education programs are failing. The need for this program is because of the changes in health care in the past 20 years. (See Page 46 Status of U.S. Transition Programs)

Rationale 3: The development of a national standardized transition to practice program is not because new nurses need to be prepared to work on day one. The need for this program is because of the changes in health care in the past 20 years. (See Page 46 Status of U.S. Transition Programs)

Rationale 4: The development of a national standardized transition to practice program is not occurring because practice settings are failing. The need for this program is because of the changes in health care in the past 20 years. (See Page 46 Status of U.S. Transition Programs)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3-3

 

Question 12

Type: MCSA

An organization is planning to implement the National Council of the State Boards of Nursing’s (NCSBN) transition to nursing practice model. What is a guiding principle of this model?

  1. Promote public safety by supporting new nurses
  2. Outcomes to be consistent with safe nursing care
  3. Select best practice models to protect the public
  4. Focus learning on repetition of specific skills

Correct Answer: 2

Rationale 1: Promoting public safety by supporting new nurses is the goal of the National Council of the State Boards of Nursing’s (NCSBN) transition to nursing practice model. (See Page 56 Box 3-2 Goal, Guiding Principles, and Definitions for NCSBN’s Transition to Practice Model)

Rationale 2: A guiding principle of the National Council of the State Boards of Nursing’s (NCSBN) transition to nursing practice model is ensuring outcomes are consistent with those of safe nursing care. (See Page 56 Box 3-2 Goal, Guiding Principles, and Definitions for NCSBN’s Transition to Practice Model)

Rationale 3: A guiding principle of the National Council of the State Boards of Nursing’s (NCSBN) transition to nursing practice model is the use of evidence-based practice models and not best practice models to protect the public. (See Page 56 Box 3-2 Goal, Guiding Principles, and Definitions for NCSBN’s Transition to Practice Model)

Rationale 4: The focus of learning on repetition of specific skills is a definition of deliberate practice and not a guiding principle of the National Council of the State Boards of Nursing’s (NCSBN) transition to nursing practice model. (See Page 56 Box 3-2 Goal, Guiding Principles, and Definitions for NCSBN’s Transition to Practice Model)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3-3

 

Question 13

Type: MCSA

A healthcare organization has decided to suspend the transition to nursing practice program because of budgetary constraints. Within several months one care area reported an increase in breaches of confidential patient information. Which part of the NCSBN’s transition to practice model is needed at this time?

  1. Informatics
  2. Communication
  3. Patient-centered care
  4. Quality improvement

Correct Answer: 1

Rationale 1: Confidentiality of information is stressed in the informatics section of the NCSBN’s transition to practice model. (See Page 59 Informatics)

Rationale 2: Confidentiality of information is stressed in the informatics section of the NCSBN’s transition to practice model. The focus of communication is between teams with a focus on role socialization. (See Page 59 Informatics)

Rationale 3: Confidentiality of information is stressed in the informatics section of the NCSBN’s transition to practice model. The focus of patient-centered care is on prioritizing and organizing care. (See Page 59 Informatics)

Rationale 4: Confidentiality of information is stressed in the informatics section of the NCSBN’s transition to practice model. The focus of quality improvement is on safety and methods to reduce errors. (See Page 59 Informatics)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3-4

 

Question 14

Type: MCSA

During an exit interview a graduate nurse says that the only feedback received during the last 3 months occurred at the end of the probationary period. What would be the consequences of not providing ongoing feedback to new graduates during the transition period?

  1. Practice will not improve
  2. Communication will suffer
  3. Confidential information will be shared
  4. No ability to learn how to think like a nurse

Correct Answer: 1

Rationale 1: If new nurses do not receive feedback on their practice, their practice will not improve. (See Page 60 Feedback and Reflection)

Rationale 2: If new nurses do not receive feedback on their practice, their practice will not improve. Communication may or may not suffer with the lack of feedback. (See Page 60 Feedback and Reflection)

Rationale 3: If new nurses do not receive feedback on their practice, their practice will not improve. This does not mean that nurses will share confidential information. (See Page 60 Feedback and Reflection)

Rationale 4: If new nurses do not receive feedback on their practice, their practice will not improve. The ability to learn how to think like a nurse is learned through clinical reasoning and not feedback. (See Page 60 Feedback and Reflection)

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3-4

 

Question 15

Type: MCSA

A nurse tells the staff development trainer to not assign any new staff to preceptor for at least a year. What could be done to change this nurse’s decision?

  1. Orient the preceptor to the role.
  2. Use simulation to help with decision making.
  3. Review the concepts of Six Sigma.
  4. Reduce the transition program to 2 months.

Correct Answer: 1

Rationale 1: Preceptors need to be skilled in the role through orientation. Once more nurses receive preceptor training, preceptor “burnout” will reduce. (See Page 60 Preceptor-Nurse Relationship)

Rationale 2: The use of simulation to help with decision making would assist with clinical reasoning and not preceptor burnout. (See Page 60 Preceptor-Nurse Relationship)

Rationale 3: The concepts of Six Sigma support the quality improvement process. (See Page 60 Preceptor-Nurse Relationship)

Rationale 4: The critical time period for new graduate nurses is between 3 and 6 months. Reducing the transition program to 2 months in length would increase the new graduates’ stress and lead to more patient safety errors. (See Page 60 Preceptor-Nurse Relationship)

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3-4

 

Question 16

Type: MCSA

A new graduate has been providing patient care for several months and the preceptor has decided to change the relationship to one of benevolent surveillance. What action will the preceptor perform when practicing this type of surveillance?

  1. Being approachable
  2. Encouraging question asking
  3. Providing constructive feedback
  4. Keeping an eye on the new graduate

Correct Answer: 4

Rationale 1: Keeping an eye on the new graduate is providing benevolent surveillance. Being approachable is a component of support. (See Page 62 Length of the Transition to Practice Program)

Rationale 2: Keeping an eye on the new graduate is providing benevolent surveillance. Encouraging the new graduate to ask questions is a component of support. (See Page 62 Length of the Transition to Practice Program)

Rationale 3: Keeping an eye on the new graduate is providing benevolent surveillance. Providing constructive feedback is a component of support. (See Page 62 Length of the Transition to Practice Program)

Rationale 4: Keeping an eye on the new graduate is providing benevolent surveillance. (See Page 62 Length of the Transition to Practice Program)

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3-4

 

 

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