5TH_Ed Test Bank Contemporary Nursing_Issues_Trends & Management by Barbara Cherry-Susan R.Jacob

5TH_Ed Test Bank Contemporary Nursing_Issues_Trends & Management by Barbara Cherry-Susan R.Jacob



Contemporary Nursing, Issues, Trends & Management Test-Bank 5 ed by Barbara Cherry, Susan R.Jacob


Authors: Barbara Cherry, Susan R.Jacob

Edition: 5th

Product Description

5TH_Ed Test Bank Contemporary Nursing_Issues_Trends & Management by Barbara Cherry-Susan R.Jacob

Cherry: Contemporary Nursing, 5th Edition

Chapter 22: Quality and Safety Education in Nursing (QSEN)

Test Bank


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 eliminated 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).


A benchmark is a standard for other providers or institutions to replicate.

A competency is the ability to practice safely based on knowledge, skills, and attitudes for a certain role.

Driving forces promote change and in this example may be a desire to be a magnet hospital or simply to be recognized as a safe place to receive care.

TeamSTEPPS is a team training and communication approach that enhances patient safety.

DIF: Application REF: Page 465

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 that resulted in a drop in the patient’s serum glucose from 160 to 100 mg while retaining stable vital signs.


Any procedure performed on a wrong person or organ constitutes a sentinel event.

The infection was not due to negligence of provider.

The patient chose the site and, although not the one indicated by the nurse, it was an appropriate site.

Although a medication error occurred, the death or permanent loss of function did not occur.

DIF: Application REF: Page 465

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.”


The nurse and dietitian are respecting patient values, preferences, and expressed needs.

Death or permanent loss of function did not occur.

No injury occurred due to medical care.

“Call out” occurs during critical situations so all members anticipate next steps in care.

DIF: Application REF: Page 468

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.


SBAR shares information during patient hand-offs.

Check-back is the process of repeating what was heard.

No checklist was used and no hand-off or transfer of care is occurring.

No problem was identified and the language would have included terms such as “I need some clarity.”

DIF:ApplicationREF:Page 471, Box 22-1

5.Following a complicated surgery, a patient who was received in the recovery room suddenly loses consciousness and become unstable. The nurse that arrives at the scene performs assessments and makes the following comments, “The patient is nonresponsive to verbal stimuli,” “The patient is not initiating any spontaneous respiration,” and “I am unable to palpate a femoral pulse,” and other members of the health care team react to the comments. The team is using the mental model for communication known as:

a. critical language.

b. call-out.

c. check-back.

d. hand-off.


The nurse is providing critical information so the team can anticipate what is needed next for the patient.

There is no indication to stop and there was no evidence of language such as “I am concerned” to indicate a concern.

Members of the team were not repeating what was heard.

The patient is not being transferred to another unit or provider at this time.

DIF:ApplicationREF:Page 471, Box 22-1

6.When planning a program to reduce the number of sentinel events in an organization, the program planner should focus on the leading cause of sentinel events, which is related to a problem with:

a. leadership or management.

b. staffing patterns.

c. environmental safety.

d. communication.


Approximately 65% of sentinel events are related to failed communication or problems with communication.

More than 10% but less than 20% are related to problems with leadership.

More than 20% but less than 30% are related to problems with staffing.

Less than 20% are related to environmental safety.

DIF: Comprehension REF: Pages 469, 470, Figure 22-1

7.Nurses, physicians, and social workers finalize the plan of care and coordinate discharge for a homeless person who will need wound care and follow up over the next 4 weeks. Each member contributes based on their area of expertise but also recognize other members’ strengths. Which of the QSEN competencies are being demonstrated?

a. Quality improvement

b. Evidence-based practice

c. Teamwork and collaboration

d. Patient-centered care


An interdisciplinary team is working to prevent hand-off errors on discharge.

The focus is on the functioning and coordination of team efforts to support care of the patient across the continuum rather than on data and improvement methods, although a well-functioning team does contribute to quality care.

Best practices” based on current evidence are not the focus.

This scenario is not considering patient preferences or incorporating the family into care.

DIF: Application REF: Page 469

8.Which of the following statements concerning the Institute of Medicine (IOM) competencies is correct?

a. Each competency is mutually exclusive.

b. The competencies focus on individual efforts to reduce errors.

c. Physicians lead the team to achieve each competency.

d. The competencies address both individual and system approaches to transform care.


Errors and cost of health care result from both health care workers and the system in which they deliver care.

Each concept overlaps, and what affects one competency often impacts other competencies.

Competencies focus on team efforts as well as individual members of the team.

Nurses have key roles in transforming health care through the IOM competencies.

DIF:ApplicationREF:Pages 466-467

9.Nurses working on an orthopedic unit use personal digital assistants (PDAs) to review medications prior to administration to reduce potential drug interactions. Software is also installed that provides video clips of common procedures performed by nurses. Nurses on this unit are best demonstrating which QSEN competencies?

a. Patient-centered care

b. Informatics

c. Teamwork

d. Quality improvement


Technology (PDA) is used to aid decision making and reduce errors.

Patient-centered care considers values and diversity of patients and their families.

The emphasis is on the use of technology to ensure quality care.

The use of technology does continue to improve quality but not analyze data or processes for improvement.

DIF: Application REF: Page 474

10.A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency?

a. Safety

b. Timely

c. Equitable

d. Patient-centered care.


Standardization contributes to safety and improves individual performance of care providers.

The focus of the team was on standardization rather than timeliness and timeliness is not an IOM competency.

The focus is not on providing care that is impartial and equitable is not an IOM competency.

The focus is on safety rather than cultural or patient preferences.

DIF: Application REF: Page 473

11.During team rounds, a member states, “Ms. Jones has a positive tuberculin skin test and is scheduled for sputum cultures.” The nurse notices that the antibiotic infusing has the wrong patient name and the patient is allergic to this particular medication. The nurse tells the team, “I need some clarity” to alert the team:

a. that they have breached patient confidentiality.

b. the patient is not aware of the diagnosis of tuberculosis.

c. that the patient is contagious.

d. that there is a safety concern.


The phrase “I need some clarity” is used to alert the team that there is a problem.

All members are involved in patient care and privileged to patient information.

The phrase “I need some clarity” is not used to alert the team to a lack of knowledge by the patient.

The phrase “I need some clarity” is not used to indicate the risk of contracting a contagious disease.

DIF:ApplicationREF:Page 471, Box 22-1

12.The ability to clearly demonstrate the knowledge, skills, attitudes, and professional judgment required to practice safely and ethically in a designated role and setting is termed:

a. human factors.

b. competency.

c. evidence-based practice.

d. workarounds


Competency is having the skill set to provide safe care within the scope of practice and context.

Human factors is the cognitive ability and social influences that affect practices.

Evidence-based practice is the use of scientific information to inform practice.

Workarounds are nonstandard work processes used by nurses and other healthcare professionals when standard work is blocked by dysfunctional processes such as unavailability of supplies or lack of information.

DIF: Knowledge REF: Page 465


1.A nurse educator is explaining to licensed staff that health care is no longer safe and describes The Quality and Safety for Nursing (QSEN) recommended competencies for educating nursing professionals which include: (Select all that apply.)

a. advanced health assessment techniques.

b. patient-centered care.

c. prescriptive pharmacology content.

d. quality improvement.

e. safety.

ANS: B, D, E

Patient-centered care is a recommended competency, along with teamwork and collaboration, evidence-based practice, and informatics.

Quality improvement is a recommended competency, along with patient-centered care, teamwork and collaboration, evidence-based practice, and informatics.

Safety is a recommended competency, along with patient-centered care, teamwork and collaboration, evidence-based practice, and informatics.

Although it is important to know correct health assessment skills, advanced techniques are not an IOM competency.

Although a comprehensive pharmacology foundation is needed to administer and evaluate pharmacologic treatments, the IOM does not address prescriptive content.

DIF: Comprehension REF: Page 466

2.What are some of the driving forces for change to improve the quality and safety competencies for nursing in the United States? (Select all that apply.)

a. The U.S. health care system is one of the world’s least technically advanced systems.

b. Health care has led other industries in establishing quality and safety standards.

c. System failures occur regularly.

d. The U.S. public has confidence in its system to reduce morbidity and mortality rates.

e. Outcomes are unpredictable and costly.


Although the U.S. system has the advantage of technologic advancement, system errors are not unusual.

Outcomes of care fail to follow predicted outcomes, resulting in extended stays and increased death and illness.

The U.S. health care system is one of the world’s most technically advanced systems.

Aviation, business, and nuclear power industries have outpaced health care in setting and achieving quality and safety standards.

The public has increased knowledge about morbidity and mortality related to health care errors resulting in a loss of confidence in the U.S. health care system.

DIF: Comprehension REF: Page 466


1.While taking a shower, a patient pushes the emergency light. When the nurse arrives the patient complains of feeling dizzy and unsteady. The nurse turns to reach for the patient’s walker and the patient falls, hitting the right side of the face resulting in loss of vision in the right eye. This scenario represents a _______ event.



A sentinel event is an occurrence that results in death or serious illness and requires immediate investigation

DIF: Application REF: Page 465



5TH_Ed Test Bank Contemporary Nursing_Issues_Trends & Management by Barbara Cherry-Susan R.Jacob