The National Academy of Medicine
Which of the following are part of The National Academy of Medicine (NAM’s) definition of health care quality?
Question 1
| a | Patient-centered, competent, free of errors, evaluated, culturally sensitive, and accessible |
| b | Safe, effective, patient-centered, timely, efficient, and equitable |
| c | Cost effectiveness, timeliness, accessibility, economical, pain well controlled, and fair |
| d | Protection against complications, equitable, patient centered, available, patient centered, and fair |
Question 2
Can a Health Care Organization implement several CQI projects at one time?
Question 2 options:
| a | No; there should only ever be one at a time. |
| b | Yes; there will occasionally be some overlap. |
| c | Yes; it is necessary and they must be prioritized. |
| d | Yes; often there will be two but never more than six. |
Question 3
Due to its focus on accreditation and safety, which of the following organizations specifically requires CQI in its mission?
Question 3 options:
| a | The Joint Commission |
| b | The Health Care Organization |
| c | The Office of the Inspector General |
| d | The Institute for Safe Medication Practices (ISMP) |
Question 4
In following a Continuous Quality Improvement approach, the nurse administrator would consider the following when a serious error has occurred
Question 4 options:
| a | an aggressive retraining program for the nurses |
| b | system factors that predispose to errors |
| c | terminating the nurse who made the error |
| d | revising policy to ensure such an error never happens again |
Question 5
Focusing on the prevention of harm benefits the Health Care Organization by allowing it to:
Question 5 options:
| a | construct an in-depth review of the harm data to determine the root cause. |
| b | identify limitations in medication systems and opportunities to learn. |
| c | determine if one unit in particular is having more frequent errors than other units |
| d | construct policies and procedures aimed at units identified as high-risk areas. |
Question 6
If a healthcare provider ordered a medication with an inappropriate administration method, what should the clinical decision support system do first?
Question 6 options:
| a | Send out a recall for the order to the pharmacy. |
| b | Send a correction of the order to the pharmacist and order the pharmacist not to fill the order. |
| c | Alert the nurses to not give the medication as ordered and give her the information on the correct administration method |
| d | Block the order when the provider enters the order and if the warning is overridden, send out a warning alert to the providers device. |
Question 7
Which of the following factors can contribute to health disparities?
Question 7 options:
| a | Unequal treatment of minorities and other groups against whom discrimination exists |
| b | Genetic Differences creating differential risks |
| c | Minorities don’t care as much about their health |
| d | A and B only |
Question 8
Which of the following graphs would best display changes over time?
Question 8 options:
| a | Radar graph |
| b | Pie chart |
| c | Line graph |
| d | Histogram |
Question 9
Which of the following types of variation should the nurse focus attention on first for a quality improvement project
Question 9 options:
| a | Special Cause Variation |
| b | Random Variation |
| c | Common Cause Variation |
| d | Stable Variation |
Question 10
Many HCOs now use electronic records, making data collection easier and more:
Question 10 options:
| a | interpretive. |
| b | adjustable. |
| c | accurate |
| d | hackable. |
Question 11
If a nurse evaluating a quality indicator finds there is only common cause variation in a process, the nurse can conclude:
Question 11 options:
| a | The process is stable |
| b | The process is unstable |
| c | A new process is needed |
| d | There is no need to try to improve the process |
Question 12
There are five rights of medication administration. What two additional rights have been suggested?
Question 12 options:
| a | Right patient room and right composition |
| b | Right method and right physician |
| c | Right education and right check for allergies |
| d | Right reason and right documentation |
Question 13
If a pharmacist aid fails to check the newly ordered drug with the other meds the patient is taking, which of the following can we say is true?
Question 13 options:
| a | This won’t be a problem because the physician has already checked to make sure the drug won’t interact with the patient’s other meds |
| b | Other parts of the system are changed because changing one part of a system is known to disturb the operation of the system as a whole |
| c | Medication errors are the natural and inevitable consequence of the pharmacy aide’s failure to perform as expected |
| d | There is no way to know what might happen as a result of this failure to perform. |
Question 14
Which of the following were goals of the Affordable Care Act (Obama Care)?
Question 14 options:
| a | Improvement in access to health insurance for working class families |
| b | Improvement in quality of care |
| c | Expansion of Medicaid |
| d | All of the above |
Question 15
What is at the core of healthcare delivery today and needs to be the core element of any QI program?
Question 15 options:
| a | Just culture |
| b | Safe Staffing |
| c | Patient-centered care |
| d | Safety circles |
Question 16
Which of the following is a key nursing indicator of the need to invest in a quality improvement project?
Question 16 options:
| a | Low staffing levels |
| b | An increase in patient complaints |
| c | Chronic excess inventory of IV bags |
| d | All of the above |
Question 17
To practice safely, new NPs should primarily make use of which of the following to guide their practice?
Question 17 options:
| a | Research results published in the last five years in a peer reviewed medical journal article |
| b | Information gained by reading a meta-analysis on the topic |
| c | National guidelines published by professional or government organizations that have been drawn from reviews of the evidence |
| d | Information obtained through pharmaceutical company vendors, lectures at national clinical conferences, and information in clinical journals |
Question 18
Which of the following factors is an essential component of every quality improvement project, regardless of focus or methodology?
Question 18 options:
| a | statistical analysis |
| b | measurement |
| c | process analysis |
| d | final report |
Question 19
Who typically develops the overall QI program plan and the operational plan?
Question 19 options:
| a | A core team of key players |
| b | The team leader alone |
| c | A QI team of internal experts |
| d | An outside team of external experts |
Question 20
Which of the following areas of planning is most likely to lead to a project failure if not performed?
Question 20 options:
| a | Stakeholder analysis |
| b | Gantt chart |
| c | Dedicated team focused solely on the project |
| d | Evaluation report |


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