NR-584NP: QUALITY AND SAFETY FOR ANP
REAL EXAM GUIDE | 200+ APPROVED
PRACTICE QUESTIONS VERIFIED ANSWERS &
RATIONALE 2026/2027 UPDATED | BRAND NEW
ALERT!! A+ GRADED
Question 1:
A nurse is reviewing the IOM Six Aims for Quality. Which aim focuses
on avoiding harm to patients?
A. Effective
B. Efficient
C. Safe
D. Patient-centered
Rationale: Correct answer: C. Safe = avoiding harm to patients
(freedom from accidental injury). Effective (A) = providing
evidence-based care. Efficient (B) = avoiding waste. Patient-centered
(D) = respecting patient preferences.
Question 2:
A quality improvement team is using the Donabedian Model. The team
measures nurse-to-patient ratios. This is an example of which type of
measure?
A. Structure
B. Process
,
C. Outcome
D. Balancing
Rationale: Correct answer: A. Structure measures attributes of
settings where care occurs (nurse-to-patient ratios, ICU beds, EHR
availability). Process (B) = what is done to/for patient (hand
hygiene). Outcome (C) = effects of care (mortality, falls).
Question 3:
A hospital implements a barcode medication administration (BCMA)
system to reduce medication errors. According to human factors
engineering, this is an example of:
A. Standardization
B. Automation
C. Forcing function
D. Simplification
Rationale: Correct answer: B. Automation uses technology to reduce
reliance on memory. BCMA automates patient and medication
identification. Forcing function (C) makes error impossible (e.g.,
ECG cable prevents lead misplacement).
Question 4:
A sentinel event (wrong-site surgery) occurs at a hospital. What is the
required timeframe for completing a root cause analysis (RCA)?
A. 7 days
,
B. 30 days
C. 45 days
D. 90 days
Rationale: Correct answer: C. The Joint Commission requires RCA
within 45 days of a sentinel event, with an action plan submitted to
TJC.
Question 5:
A nurse is using the PDSA cycle to improve hand hygiene. During which
phase does the nurse analyze the data collected after the intervention?
A. Plan
B. Do
C. Study
D. Act
Rationale: Correct answer: C. Study = analyze data collected during
the "Do" phase. Plan (A) = develop plan. Do (B) = implement on
small scale. Act (D) = decide to adopt, adapt, or abandon.
Question 6:
An NP is leading a quality improvement project to reduce CAUTI rates.
Which nurse-sensitive indicator should be measured?
A. CLABSI
B. CAUTI (catheter-associated urinary tract infection)
,
C. VAP
D. Falls
Rationale: Correct answer: B. CAUTI is a nurse-sensitive indicator
measured per 1000 catheter days. CLABSI (A) is central line-
associated bloodstream infection. VAP (C) is ventilator-associated
pneumonia.
Question 7:
According to Just Culture, a nurse who comes to work impaired (under
the influence of alcohol) is displaying which type of behavior?
A. Human error
B. At-risk behavior
C. Reckless behavior
D. Negligence
Rationale: Correct answer: C. Reckless behavior = conscious
disregard for substantial risk (e.g., coming to work impaired,
intentionally violating safety rules). Discipline, suspend, or
terminate. Human error (A) = unintentional slip/lapse. At-risk
behavior (B) = behavioral choice with perceived acceptable risk.
Question 8:
A hospital uses the I-PASS handoff tool. What does the "A" in I-PASS
stand for?
A. Assessment
REAL EXAM GUIDE | 200+ APPROVED
PRACTICE QUESTIONS VERIFIED ANSWERS &
RATIONALE 2026/2027 UPDATED | BRAND NEW
ALERT!! A+ GRADED
Question 1:
A nurse is reviewing the IOM Six Aims for Quality. Which aim focuses
on avoiding harm to patients?
A. Effective
B. Efficient
C. Safe
D. Patient-centered
Rationale: Correct answer: C. Safe = avoiding harm to patients
(freedom from accidental injury). Effective (A) = providing
evidence-based care. Efficient (B) = avoiding waste. Patient-centered
(D) = respecting patient preferences.
Question 2:
A quality improvement team is using the Donabedian Model. The team
measures nurse-to-patient ratios. This is an example of which type of
measure?
A. Structure
B. Process
,
C. Outcome
D. Balancing
Rationale: Correct answer: A. Structure measures attributes of
settings where care occurs (nurse-to-patient ratios, ICU beds, EHR
availability). Process (B) = what is done to/for patient (hand
hygiene). Outcome (C) = effects of care (mortality, falls).
Question 3:
A hospital implements a barcode medication administration (BCMA)
system to reduce medication errors. According to human factors
engineering, this is an example of:
A. Standardization
B. Automation
C. Forcing function
D. Simplification
Rationale: Correct answer: B. Automation uses technology to reduce
reliance on memory. BCMA automates patient and medication
identification. Forcing function (C) makes error impossible (e.g.,
ECG cable prevents lead misplacement).
Question 4:
A sentinel event (wrong-site surgery) occurs at a hospital. What is the
required timeframe for completing a root cause analysis (RCA)?
A. 7 days
,
B. 30 days
C. 45 days
D. 90 days
Rationale: Correct answer: C. The Joint Commission requires RCA
within 45 days of a sentinel event, with an action plan submitted to
TJC.
Question 5:
A nurse is using the PDSA cycle to improve hand hygiene. During which
phase does the nurse analyze the data collected after the intervention?
A. Plan
B. Do
C. Study
D. Act
Rationale: Correct answer: C. Study = analyze data collected during
the "Do" phase. Plan (A) = develop plan. Do (B) = implement on
small scale. Act (D) = decide to adopt, adapt, or abandon.
Question 6:
An NP is leading a quality improvement project to reduce CAUTI rates.
Which nurse-sensitive indicator should be measured?
A. CLABSI
B. CAUTI (catheter-associated urinary tract infection)
,
C. VAP
D. Falls
Rationale: Correct answer: B. CAUTI is a nurse-sensitive indicator
measured per 1000 catheter days. CLABSI (A) is central line-
associated bloodstream infection. VAP (C) is ventilator-associated
pneumonia.
Question 7:
According to Just Culture, a nurse who comes to work impaired (under
the influence of alcohol) is displaying which type of behavior?
A. Human error
B. At-risk behavior
C. Reckless behavior
D. Negligence
Rationale: Correct answer: C. Reckless behavior = conscious
disregard for substantial risk (e.g., coming to work impaired,
intentionally violating safety rules). Discipline, suspend, or
terminate. Human error (A) = unintentional slip/lapse. At-risk
behavior (B) = behavioral choice with perceived acceptable risk.
Question 8:
A hospital uses the I-PASS handoff tool. What does the "A" in I-PASS
stand for?
A. Assessment
