Health Care Quality

Healthcare quality refers to the degree to which healthcare services meet the needs of patients and meet established standards of care. Evidence-based practice, performance improvement projects, and interprofessional collaboration are essential for nurses to participate in healthcare quality improvement initiatives.

The urine output of a 40-year-old male patient with a urethral catheter has decreased from 80 mL/h to 15 mL/h. Which action should the nurse take first?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 4
  • Topics: Assessment Cardiovascular Communication & Documentation Delegation, Prioritization and Leadership Disease Prevention Elimination Fluid and Electrolytes Health Care Quality Health Screening

The registered nurse asks the unlicensed assistive personnel to obtain the patient’s vital signs and to assist the patient to ambulate in the hallway. Which term is used to describe this nursing function?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Delegation, Prioritization and Leadership Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality

Which nursing intervention is the highest priority for the patient admitted with a chronic obstructive pulmonary disease (COPD) exacerbation?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 7
  • Topics: Delegation, Prioritization and Leadership Respiratory Acid-Base Health Care Quality Inflammation Nursing Interventions

The patient is brought to the emergency department following a serious motor vehicular accident (MVA). List the assessments the nurse performs in order from highest to lowest priority.

  • Question Type:   Put in Order
  • Difficulty: 8
  • Topics: Crisis Management Delegation, Prioritization and Leadership Assessment Cardiovascular Cognition Communication & Documentation Health Care Quality Health Screening HEENT Intracranial Regulation Lifestyle Choices and High Risk Behavior Respiratory Tissue Integrity

The nurse is involved in a motor vehicular accident in which a minor injury from the seatbelt was sustained. Which action does the nurse take first in helping the other victims?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Delegation, Prioritization and Leadership Assessment Cognition Communication & Documentation Crisis Management Disease Prevention Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Health Screening Nursing Interventions Tissue Integrity

A local celebrity is admitted to hospital following rupture of the appendix. The charge nurse submits an incident report if which individual accesses the patient’s chart?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Nursing Interventions

The nurse learns that a fellow nurse is viewing the electronic chart of a patient with whom she went to high school. Which action does the nurse take first?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 2
  • Topics: Communication & Documentation Delegation, Prioritization and Leadership Health Care Ethics, Law, and Policy Health Care Quality

The grandparents of a baby in the newborn intensive care unit (NICU) ask the nurse about the age of another baby. Which response by the nurse is most appropriate?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 4
  • Topics: Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality Neonatal Care Nursing Interventions Patient Education

The nurse delegates a pre-prandial blood sugar check to the unlicensed assistive personnel who fails to perform it before the patient’s food tray arrives and the patient eats breakfast. Who is most at fault?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 6
  • Topics: Communication & Documentation Delegation, Prioritization and Leadership Endocrine Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Health Screening Nursing Interventions

As instructed by the registered nurse, the unlicensed assistive personnel (UAP) obtained vitals on a patient. The UAP obtained and charted the following vital signs monitoring results: blood pressure 90/42 mm Hg, pulse 128 bpm, oxygen saturation 86% on room air, and temperature 38.2°C. (100.8°F). The UAP left the floor for a break after charting the results, but did not tell the nurse. Thirty minutes later the patient is found unresponsive and a code blue is initiated. Who is responsible for this patient’s deterioration of condition?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 6
  • Topics: Delegation, Prioritization and Leadership Assessment Cardiovascular Communication & Documentation Health Care Quality Nursing Interventions

Which task is most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 6
  • Topics: Communication & Documentation Delegation, Prioritization and Leadership Assessment Cardiovascular Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Nursing Interventions Sexuality and Reproduction

The patient from India tells the nurse that, in addition to his conventional medical treatment, he would also like to be treated according to the principles of Ayurvedic medicine. The nurse plans care based on which understanding of the focus of Ayurvedic medicine?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 4
  • Topics: Disease Prevention Communication & Documentation Culture Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Nursing Interventions

The patient with malignant hypertension has suffered from a transient ischemic attack. He asks the nurse if he can continue taking his St. John’s wort for depression. Which answer by the nurse is most appropriate?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 4
  • Topics: Cardiovascular Disease Prevention Communication & Documentation Health Care Quality Intracranial Regulation Medication and Blood Products Neurology Patient Education

The nurse is assigned to care for a patient who speaks minimal English but is fluent in Farsi. Which is the best practice for the nurse to take when communicating with this patient?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Communication & Documentation Culture Delegation, Prioritization and Leadership Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Nursing Interventions

The nurse is providing discharge instructions and education to a patient with stomach cancer who is interested in alternative/complementary medicine. Which low-risk therapies does the nurse include in the discussion? Select all that apply.

  • Question Type:   Multiple Choice - Select All
  • Difficulty: 3
  • Topics: Disease Prevention Communication & Documentation Culture Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Hematology/Oncology Nursing Interventions Patient Education

The patient reports an interest in using a herbal supplement to help with his depression. The nurse discusses herbal supplements with the patient based on which understanding of the nurse’s role in alternative and complementary medicine?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Communication & Documentation Disease Prevention Culture Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Nursing Interventions Patient Education

A medical-surgical floor nurse is asked to float to the intensive care unit (ICU) to alleviate understaffing. Which reason for refusing the assignment is legal?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 4
  • Topics: Delegation, Prioritization and Leadership Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality

Which statement is true regarding professional liability insurance for a nurse who is sued in a wrongful death case?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Health Care Ethics, Law, and Policy Health Care Quality

The patient has accused the nurse of stabbing him with a syringe on purpose because he would not remain still during the procedure. If true, the nurse is guilty of which infraction?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Health Care Ethics, Law, and Policy Health Care Quality

A nurse is assigned to care for a terminally ill patient who is of the orthodox Jewish faith. The nurse anticipates the patient will have which opinion of organ donation?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: End of Life Issues Culture Health Care Ethics, Law, and Policy Health Care Quality

The surgeon is attempting to obtain informed consent from a capable patient about to undergo a surgical procedure who says he is squeamish and doesn’t wish to know any details about the procedure. Which statement is correct regarding informed consent for this patient?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality

The patient with human immunodeficiency virus (HIV) wishes his diagnosis to remain confidential. The patient’s insurance company calls to ask questions about the diagnosis prior to releasing payment for his medical treatment. Which response by the nurse is appropriate?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality Infection

A hospital administrator requests access to the medical record of a patient with a terminal illness for a quality review project. Which action does the nurse take?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 5
  • Topics: Communication & Documentation Delegation, Prioritization and Leadership Health Care Ethics, Law, and Policy Health Care Quality

The nurse mistakenly gives the patient with malignant hypertension the wrong dose of antihypertensive medication, and the patient complains of several hours of dizziness. Which action by the nurse is most appropriate?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 4
  • Topics: Communication & Documentation Cardiovascular Health Care Ethics, Law, and Policy Health Care Quality Medication and Blood Products Nursing Interventions

The nurse receives a telephone order from the healthcare provider for intravenous pain medication to be administered to a patient with cancer pain. Which statement is correct regarding this medication order?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Communication & Documentation Medication and Blood Products Health Care Ethics, Law, and Policy Health Care Quality Nursing Interventions

A nurse suspects that a co-worker is abusing drugs and is under the influence while at work. Which action does the nurse take?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Communication & Documentation Delegation, Prioritization and Leadership Lifestyle Choices and High Risk Behavior Crisis Management Health Care Ethics, Law, and Policy Health Care Quality

The nurse hears the patient calling for help and enters the room to find the patient on the floor. One of the side rails is down on the bed. Which documentation is most appropriate?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 5
  • Topics: Communication & Documentation Assessment Health Care Ethics, Law, and Policy Health Care Quality Mobility

The nurse has just assisted an elderly client safely back into bed after a fall, and it has been determined by the nurse and the provider that no injury is present. After submitting an incident report form, which nursing action is the priority?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 7
  • Topics: Communication & Documentation Delegation, Prioritization and Leadership Assessment Health Care Ethics, Law, and Policy Health Care Quality

The nurse makes an error while documenting a patient’s history. Which action does the nurse take to correct the error?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality

The nurse attempts, but is unable, to contact the provider to clarify a prescription that is much higher than the normal dosage. Which action by the nurse is appropriate?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 4
  • Topics: Communication & Documentation Delegation, Prioritization and Leadership Medication and Blood Products Disease Prevention Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Nursing Interventions

Which patient is triaged as first to be treated following a hurricane?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 7
  • Topics: Crisis Management Delegation, Prioritization and Leadership Cardiovascular Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Health Screening Intracranial Regulation Neurology Respiratory

The patient is brought to the emergency department following an accident with significant burns. The patient is conscious and alert with 3rd-degree burns over 50% of his body. The nurse helps to get a history and perform a thorough physical examination of this patient. Which type of assessment is the nurse performing?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 4
  • Topics: Crisis Management Delegation, Prioritization and Leadership Assessment Health Care Ethics, Law, and Policy Health Care Quality Health Screening

The nurse is helping to ambulate a patient who is recovering from hip surgery and is a fall risk. An unlicensed assistive personnel (UAP) tells the nurse that another one of her assigned patients is in severe pain and requires pain medication. Which is the most appropriate action?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Delegation, Prioritization and Leadership Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality Mobility

Which is the most appropriate patient assignment to assign to an unlicensed assistive personnel (UAP)?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 7
  • Topics: Delegation, Prioritization and Leadership Communication & Documentation Elimination Health Care Ethics, Law, and Policy Health Care Quality Laboratory Studies

The charge nurse is making patient assignments for an unlicensed assistive personnel, a registered nurse, and a licensed vocational/practical nurse. Which patient is the most appropriate assignment for the LVN/LPN?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 7
  • Topics: Delegation, Prioritization and Leadership Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Mobility Nursing Interventions

Which tool is most effective for promoting safety when ambulating an elderly patient who is a fall risk?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 4
  • Topics: Disease Prevention Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Mobility Nursing Interventions

The provider orders physical restraints for a patient in alcohol withdrawal who is delirious, combative, and a fall risk. Which statement is true regarding use of physical restraints for this patient?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 4
  • Topics: Disease Prevention Mental Health Disorders Cognition Communication & Documentation Crisis Management Health Care Ethics, Law, and Policy Health Care Quality Lifestyle Choices and High Risk Behavior

The nurse is the first responder to a 3-year-old male who is with his mother, having recently ingested a large quantity of household cleaner. The patient is unconscious but is hemodynamically stable and breathing. An ambulance has already been called. Which action by the nurse is appropriate?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 6
  • Topics: Gastrointestinal Pediatrics Assessment Communication & Documentation Crisis Management Disease Prevention Elimination Health Care Quality Health Promotion Lifestyle Choices and High Risk Behavior Nursing Interventions

The patient with neurosyphilis who has attempted to stab the nurse with scissors, pulled out several IVs, and is a fall risk is placed in wrist restraints per physician order. How frequently does the nurse assess the patient’s skin integrity?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 7
  • Topics: Disease Prevention Mental Health Disorders Assessment Cognition Communication & Documentation Crisis Management Delegation, Prioritization and Leadership Health Care Ethics, Law, and Policy Health Care Quality Lifestyle Choices and High Risk Behavior Neurology Nursing Interventions Tissue Integrity

The nurse is supervising the care of a patient with a wound infected with methicillin-resistant staphylococcus aureus (MRSA). Which action by the student nurse would prompt the nurse to intervene?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 8
  • Topics: Disease Prevention Communication & Documentation Delegation, Prioritization and Leadership Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Tissue Integrity

A unit has experienced a significant rise in the incidence of hospital-acquired urinary tract infections (UTIs). Which action item will be most effective to reduce the incidence of hospital-acquired UTIs?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Disease Prevention Elimination Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Immunity Infection

The nurse is supervising the care of a diabetic patient with stomach cancer. After surgery, the patient is placed on total parenteral nutrition (TPN). Which information does the nurse provide the nursing student about the TPN?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 6
  • Topics: Disease Prevention Cardiovascular Communication & Documentation Delegation, Prioritization and Leadership Endocrine Fluid and Electrolytes Health Care Quality Health Promotion Laboratory Studies Medication and Blood Products Routes of Administration

The nurse is most vigilant for signs of which complication in a patient receiving total parenteral nutrition (TPN)?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 6
  • Topics: Gastrointestinal Medication and Blood Products Cardiovascular Disease Prevention Health Care Quality Health Promotion Respiratory Routes of Administration

The patient with tears of the right medial meniscus asks the nurse about the use of therapeutic massage. Which response by the nurse is appropriate?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 4
  • Topics: Acid-Base Disease Prevention Health Care Quality Health Promotion Inflammation Mobility Musculoskeletal Nursing Interventions Patient Education

Which explanation of the mechanism of action of the cutaneous stimulation method in reducing pain is correct?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 3
  • Topics: Neurology Cognition Health Care Quality Health Promotion

The nurse is teaching a nursing student about hand washing. Which statement by the nursing student indicates understanding of the teaching?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 5
  • Topics: Communication & Documentation Disease Prevention Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Nursing Interventions Patient Education

During a lumbar puncture, which event warrants immediate intervention by the nurse?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 8
  • Topics: Communication & Documentation Neurology Health Care Ethics, Law, and Policy Health Care Quality Health Promotion Nursing Interventions Patient Education

Which task is most appropriate for the registered nurse to delegate to an unlicensed assistive personnel?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 6
  • Topics: Delegation, Prioritization and Leadership Cardiovascular Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality

Which patient must be triaged for emergency department care first?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 7
  • Topics: Cardiovascular Musculoskeletal Respiratory Communication & Documentation Delegation, Prioritization and Leadership Health Care Ethics, Law, and Policy Health Care Quality

The patient requiring mechanical ventilation is dying of tuberculosis and is responsive only to tactile and painful stimulation. The family would like to give him holy water to drink in order to have peace in the afterlife. Which response by the nurse is most appropriate?

  • Question Type:   Multiple Choice - Select One
  • Difficulty: 5
  • Topics: Communication & Documentation Culture End of Life Issues Health Care Ethics, Law, and Policy Health Care Quality

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