,
,
,
,Select all that apply.
1. A nurse asks visitors to leave because it is after visiting hours.
2. At 2:00 p.m. the nurse orders a lunch tray for a client who has just been removed from
nothing by mouth (NPO) status.
3. A nurse tells the manager that a housekeeper's work is not up to standards.
4. A nurse volunteers to take a Spanish language class to be able to communicate with clients.
5. A nurse who has not made a medication error in two years asks for a salary increase.
Answer: 2, 3, 4
Explanation: 1. The philosophy of quality management is focus on the needs of the client. If
there is no reason for the visitors to leave other than it is after visiting hours, this is not
focused on client need.
2. Even though 2:00 p.m. is after "lunchtime," this nurse is focused on the client's needs. This
is an example of quality management.
3. Quality management empowers the employee to evaluate quality.
4. This nurse has seen a need and is working to improve the quality of service. This is quality
management.
5. Salary increases can be tied to quality improvement initiatives, but just asking for an
increase is not quality management.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
resulting from implementation of the Affordable Care Act; demands to reduce errors and
improve patient safety; and evolving medical and communication technology.
,5) A client who was discharged yesterday is very upset about the quality of care received
during hospitalization for gastric surgery. What options for reporting concerns does this client
have?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. There is no mechanism for complaint because the client is no longer hospitalized.
2. The client can indicate dissatisfaction on the survey often sent to clients after discharge.
3. The client can call the hospital administration.
4. The client can make a formal complaint through the American Nursing Association
(ANA).
5. The client can make a public report through the Agency for Healthcare Research and
Quality (AHRQ).
Answer: 2, 3, 5
Explanation: 1. The client can still voice concerns even after discharge.
2. These client satisfaction surveys are a good mechanism for discussing care issues.
3. Telephone calls are a means of discussing client care issues.
4. ANA is not a forum for complaints about care in a specific hospitalization.
5. The AHRQ has a mechanism for reporting care issues.
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
resulting from implementation of the Affordable Care Act; demands to reduce errors and
improve patient safety; and evolving medical and communication technology.
6) A client needs a high-risk surgical procedure. According to the Leapfrog Group, the client
should choose which hospital for care during this procedure?
1. The hospital closest to the client's home
2. The hospital that has done the greatest number of these surgeries in the last two years
3. The hospital chosen by the client's primary healthcare provider
4. The hospital with the highest performance ratings for this procedure
Answer: 4
Explanation: 1. This may or may not be the best choice of hospital for this procedure.
2. Just because a hospital is high volume does not mean it is high quality.
3. This may or may not be the best hospital for this procedure.
4. The Leapfrog Group focuses on quality indicators including the use of higher-performing
hospitals for high-risk procedures.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Coordination of Care
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
resulting from implementation of the Affordable Care Act; demands to reduce errors and
improve patient safety; and evolving medical and communication technology.
,7) The quality management director of a large healthcare conglomerate wishes to initiate
benchmarking strategies to assess care. Which directive should this manager publish?
1. We will compare outcome indicators with other healthcare conglomerates of similar size
and organization.
2. Outcome data of hospitals within the organization will be compared to assess quality.
3. Each client care unit in the organization will establish specific unit goals for quality.
4. Each unit in the organization will create a quality monitor to assess how well unit policies
are followed.
Answer: 1
Explanation: 1. Benchmarking uses an organization's outcome data and compares it with that
of a similar organization to address strengths and challenges.
2. Because the hospitals with the organization are likely managed in a similar manner, this is
not an example of benchmarking.
3. While establishing goals is a part of quality management, it is not benchmarking.
4. Setting up a quality monitor is a quality initiative, but it is not benchmarking.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
resulting from implementation of the Affordable Care Act; demands to reduce errors and
improve patient safety; and evolving medical and communication technology.
8) The nurse manager has decided to use evidence-based practice (EBP) to solve an issue and
has called staff nurses together for input. Which question, as posed by the manager, reflects
the first step of the EBP process?
1. "What outcomes are we expecting from this work?"
2. "Is anyone prepared to evaluate the statistics we will find?"
3. "What is the exact clinical issue with which we are dealing?"
4. "Where can we look for information?"
Answer: 3
Explanation: 1. Assessing outcomes is the last step of the EBP process.
2. Evaluation of the evidence is step 3.
3. Identifying the clinical question is the first step in the EBP process.
4. Acquiring the evidence to answer the question is step 2.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Planning/Leadership
Learning Outcome: 1-2: Describe how nursing management is influenced by changes in
society.
,9) The nurse manager asks a staff nurse why a procedure is done in a certain manner. The
nurse replies, "I don't know why I started doing it this way. I've never read any research on it,
but this technique always works for me." The manager would place this technique into which
category of evidence?
1. Case study
2. Anecdotal
3. Nonexperimental design research
4. Statistical
Answer: 2
Explanation: 1. A case study is an in-depth analysis used to translate evidence into other
clinical situations.
2. Anecdotal evidence is derived from experience.
3. Nonexperimental design research includes gathering factors related to a clinical condition.
4. Statistical evidence is built from a scientific approach.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the
future.
,10) A nurse manager is directing a team of staff nurses working to solve a clinical problem
using evidence-based practice (EBP). Which of the following statements would direct these
nurses to the forms of strongest clinical evidence?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. "We may find studies that use only one group of participants."
2. "Look for articles that report on how to use evidence in other clinical situations."
3. "The studies we want are built around the scientific approach to solving problems."
4. "Our focus should be on studies that use both experimental and control groups to
determine intervention effectiveness."
5. "Many articles will have information reported by someone who is an expert in the field."
Answer: 3, 4
Explanation: 1. Studies using only one group of participants are done in a quasi-experimental
design. This is not one of the two strongest forms of evidence.
2. An in-depth analysis used to translate information to other clinical situations is a case study
approach. This is not one of the two strongest forms of evidence.
3. Using the scientific approach results in statistical evidence, which is one of the two
strongest forms.
4. Studies that use both experimental and control groups are randomized control trials. This is
one of the two strongest forms of evidence.
5. Evidence reported by an expert in the field is testimonial evidence. It is not one of the two
strongest forms of evidence.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Planning/Leadership
Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the
future.
11) A healthcare system is considering applying to the Magnet Recognition Program. The
leaders of this health system should prepare to address ________ qualities or "Forces of
Magnetism."
Answer: 14
Explanation: There are 14 qualities or "Forces of Magnetism" that must be demonstrated to
achieve Magnet status.
Cognitive Level: Understanding
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Planning/Quality of Practice
Learning Outcome: 1-2: Describe how nursing management is influenced by changes in
society.
, 12) Which organization would the hospital management team contact to pursue certification
as a Magnet hospital?
1. Magnet Recognition Program
2. American National Magnet Commission
3. The Joint Commission
4. American Medical Association (AMA)
Answer: 1
Explanation: 1. The Magnet Recognition Program, developed by the American Nurses
Credentialing Center, designates healthcare organizations that provide nursing excellence.
2. The American National Magnet Commission is fictitious.
3. The Joint Commission accredits healthcare organizations, but does not award Magnet
status.
4. The AMA does not award Magnet status. Magnet status is focused on nursing excellence.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Leadership
Learning Outcome: 1-2: Describe how nursing management is influenced by changes in
society.
13) A graduating nurse is deciding which nursing specialty would be a good place to begin a
nursing career and ensure long-term stability. Which specialty is most likely to have the
greatest growth in need?
1. Pediatric nursing
2. Psychiatric nursing
3. Geriatric nursing
4. Maternity nursing
Answer: 3
Explanation: 1. Pediatric nursing is not likely to see as much growth as another specialty.
2. Psychiatric nursing is not likely to see as much growth as another specialty.
3. As baby boomers age, geriatric nursing will be needed more than any other specialty. Not
only are the baby boomers a large segment of the population, but better health practices are
resulting in people living longer.
4. Maternity nursing is not likely to see as much growth as another specialty.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Planning/Professional Practice Evaluation
Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the
future.
,
,
,Select all that apply.
1. A nurse asks visitors to leave because it is after visiting hours.
2. At 2:00 p.m. the nurse orders a lunch tray for a client who has just been removed from
nothing by mouth (NPO) status.
3. A nurse tells the manager that a housekeeper's work is not up to standards.
4. A nurse volunteers to take a Spanish language class to be able to communicate with clients.
5. A nurse who has not made a medication error in two years asks for a salary increase.
Answer: 2, 3, 4
Explanation: 1. The philosophy of quality management is focus on the needs of the client. If
there is no reason for the visitors to leave other than it is after visiting hours, this is not
focused on client need.
2. Even though 2:00 p.m. is after "lunchtime," this nurse is focused on the client's needs. This
is an example of quality management.
3. Quality management empowers the employee to evaluate quality.
4. This nurse has seen a need and is working to improve the quality of service. This is quality
management.
5. Salary increases can be tied to quality improvement initiatives, but just asking for an
increase is not quality management.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
resulting from implementation of the Affordable Care Act; demands to reduce errors and
improve patient safety; and evolving medical and communication technology.
,5) A client who was discharged yesterday is very upset about the quality of care received
during hospitalization for gastric surgery. What options for reporting concerns does this client
have?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. There is no mechanism for complaint because the client is no longer hospitalized.
2. The client can indicate dissatisfaction on the survey often sent to clients after discharge.
3. The client can call the hospital administration.
4. The client can make a formal complaint through the American Nursing Association
(ANA).
5. The client can make a public report through the Agency for Healthcare Research and
Quality (AHRQ).
Answer: 2, 3, 5
Explanation: 1. The client can still voice concerns even after discharge.
2. These client satisfaction surveys are a good mechanism for discussing care issues.
3. Telephone calls are a means of discussing client care issues.
4. ANA is not a forum for complaints about care in a specific hospitalization.
5. The AHRQ has a mechanism for reporting care issues.
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
resulting from implementation of the Affordable Care Act; demands to reduce errors and
improve patient safety; and evolving medical and communication technology.
6) A client needs a high-risk surgical procedure. According to the Leapfrog Group, the client
should choose which hospital for care during this procedure?
1. The hospital closest to the client's home
2. The hospital that has done the greatest number of these surgeries in the last two years
3. The hospital chosen by the client's primary healthcare provider
4. The hospital with the highest performance ratings for this procedure
Answer: 4
Explanation: 1. This may or may not be the best choice of hospital for this procedure.
2. Just because a hospital is high volume does not mean it is high quality.
3. This may or may not be the best hospital for this procedure.
4. The Leapfrog Group focuses on quality indicators including the use of higher-performing
hospitals for high-risk procedures.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Coordination of Care
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
resulting from implementation of the Affordable Care Act; demands to reduce errors and
improve patient safety; and evolving medical and communication technology.
,7) The quality management director of a large healthcare conglomerate wishes to initiate
benchmarking strategies to assess care. Which directive should this manager publish?
1. We will compare outcome indicators with other healthcare conglomerates of similar size
and organization.
2. Outcome data of hospitals within the organization will be compared to assess quality.
3. Each client care unit in the organization will establish specific unit goals for quality.
4. Each unit in the organization will create a quality monitor to assess how well unit policies
are followed.
Answer: 1
Explanation: 1. Benchmarking uses an organization's outcome data and compares it with that
of a similar organization to address strengths and challenges.
2. Because the hospitals with the organization are likely managed in a similar manner, this is
not an example of benchmarking.
3. While establishing goals is a part of quality management, it is not benchmarking.
4. Setting up a quality monitor is a quality initiative, but it is not benchmarking.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
resulting from implementation of the Affordable Care Act; demands to reduce errors and
improve patient safety; and evolving medical and communication technology.
8) The nurse manager has decided to use evidence-based practice (EBP) to solve an issue and
has called staff nurses together for input. Which question, as posed by the manager, reflects
the first step of the EBP process?
1. "What outcomes are we expecting from this work?"
2. "Is anyone prepared to evaluate the statistics we will find?"
3. "What is the exact clinical issue with which we are dealing?"
4. "Where can we look for information?"
Answer: 3
Explanation: 1. Assessing outcomes is the last step of the EBP process.
2. Evaluation of the evidence is step 3.
3. Identifying the clinical question is the first step in the EBP process.
4. Acquiring the evidence to answer the question is step 2.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Planning/Leadership
Learning Outcome: 1-2: Describe how nursing management is influenced by changes in
society.
,9) The nurse manager asks a staff nurse why a procedure is done in a certain manner. The
nurse replies, "I don't know why I started doing it this way. I've never read any research on it,
but this technique always works for me." The manager would place this technique into which
category of evidence?
1. Case study
2. Anecdotal
3. Nonexperimental design research
4. Statistical
Answer: 2
Explanation: 1. A case study is an in-depth analysis used to translate evidence into other
clinical situations.
2. Anecdotal evidence is derived from experience.
3. Nonexperimental design research includes gathering factors related to a clinical condition.
4. Statistical evidence is built from a scientific approach.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the
future.
,10) A nurse manager is directing a team of staff nurses working to solve a clinical problem
using evidence-based practice (EBP). Which of the following statements would direct these
nurses to the forms of strongest clinical evidence?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. "We may find studies that use only one group of participants."
2. "Look for articles that report on how to use evidence in other clinical situations."
3. "The studies we want are built around the scientific approach to solving problems."
4. "Our focus should be on studies that use both experimental and control groups to
determine intervention effectiveness."
5. "Many articles will have information reported by someone who is an expert in the field."
Answer: 3, 4
Explanation: 1. Studies using only one group of participants are done in a quasi-experimental
design. This is not one of the two strongest forms of evidence.
2. An in-depth analysis used to translate information to other clinical situations is a case study
approach. This is not one of the two strongest forms of evidence.
3. Using the scientific approach results in statistical evidence, which is one of the two
strongest forms.
4. Studies that use both experimental and control groups are randomized control trials. This is
one of the two strongest forms of evidence.
5. Evidence reported by an expert in the field is testimonial evidence. It is not one of the two
strongest forms of evidence.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Planning/Leadership
Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the
future.
11) A healthcare system is considering applying to the Magnet Recognition Program. The
leaders of this health system should prepare to address ________ qualities or "Forces of
Magnetism."
Answer: 14
Explanation: There are 14 qualities or "Forces of Magnetism" that must be demonstrated to
achieve Magnet status.
Cognitive Level: Understanding
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Planning/Quality of Practice
Learning Outcome: 1-2: Describe how nursing management is influenced by changes in
society.
, 12) Which organization would the hospital management team contact to pursue certification
as a Magnet hospital?
1. Magnet Recognition Program
2. American National Magnet Commission
3. The Joint Commission
4. American Medical Association (AMA)
Answer: 1
Explanation: 1. The Magnet Recognition Program, developed by the American Nurses
Credentialing Center, designates healthcare organizations that provide nursing excellence.
2. The American National Magnet Commission is fictitious.
3. The Joint Commission accredits healthcare organizations, but does not award Magnet
status.
4. The AMA does not award Magnet status. Magnet status is focused on nursing excellence.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Leadership
Learning Outcome: 1-2: Describe how nursing management is influenced by changes in
society.
13) A graduating nurse is deciding which nursing specialty would be a good place to begin a
nursing career and ensure long-term stability. Which specialty is most likely to have the
greatest growth in need?
1. Pediatric nursing
2. Psychiatric nursing
3. Geriatric nursing
4. Maternity nursing
Answer: 3
Explanation: 1. Pediatric nursing is not likely to see as much growth as another specialty.
2. Psychiatric nursing is not likely to see as much growth as another specialty.
3. As baby boomers age, geriatric nursing will be needed more than any other specialty. Not
only are the baby boomers a large segment of the population, but better health practices are
resulting in people living longer.
4. Maternity nursing is not likely to see as much growth as another specialty.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Planning/Professional Practice Evaluation
Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the
future.
