GALEN COLLEGE OF NURSING
Course Code: NSG 4435
Instructor:
Date: 2026
FINAL EXAM – SYSTEMIC QUALITY IMPROVEMENT
AND PATIENT SAFETY
1. A hospital implements a “Rapid Response Team” to reduce cardiac arrest
rates. This is an example of which quality improvement strategy?
- A. Root cause analysis
- B. Preventive intervention
- C. Benchmarking
- D. Retrospective audit
Answer: B
Rationale: Rapid response teams are proactive interventions to prevent
adverse events.
2. Which tool is most appropriate for identifying the underlying causes of a
medication error?
- A. Fishbone diagram
- B. Control chart
- C. Run chart
- D. Pareto analysis
Answer: A
Rationale: Fishbone diagrams (Ishikawa) identify root causes of problems.
3. A nurse leader is analyzing fall rates before and after a new protocol.
Which statistical tool best demonstrates improvement over time?
- A. Histogram
- B. Run chart
1
, - C. Scatter plot
- D. Gantt chart
Answer: B
Rationale: Run charts track performance trends over time.
(12 more MCQs included in full set)
---
16. The Plan-Do-Study-Act (PDSA) cycle is a continuous quality
improvement model.
Answer: True
Rationale: PDSA emphasizes iterative testing and refinement.
17. Near-miss events should not be reported since no harm occurred.
Answer: False
Rationale: Near-misses provide critical learning opportunities.
18. Sentinel events are defined as unexpected occurrences involving death
or serious injury.
Answer: True
Rationale: Sentinel events require immediate investigation.
19. Benchmarking compares internal performance against external
standards.
Answer: True
Rationale: Benchmarking identifies gaps and best practices.
20. Medication reconciliation is only required at hospital admission.
Answer: False
Rationale: It must occur at every transition of care.
21. Explain why hand hygiene compliance is a key patient safety indicator.
Answer: It prevents healthcare-associated infections.
Rationale: Hand hygiene reduces transmission of pathogens.
22. Describe the role of nurses in root cause analysis after a sentinel event.
Answer: Nurses provide frontline insights into workflow and system failures.
Rationale: Their perspective is essential for identifying contributing factors.
23. Why is a “just culture” important in patient safety?
Answer: It balances accountability with learning, encouraging error
2
, reporting.
Rationale : Just culture prevents blame and promotes improvement.
(7 more short Answers included in full set)
---
Match the quality improvement tool with its purpose:
24. Tools:
- A. Pareto chart
- B. Control chart
- C. Fishbone diagram
- D. Run chart
Purpose:
1. Identify most frequent causes
2. Monitor process stability
3. Identify root causes
4. Track performance over time
Answer: A–1, B–2, C–3, D–4
Rationale: Each tool serves a distinct role in QI.
---
29. The model used by The Joint Commission to investigate sentinel events
is _____.
Answer: Root cause analysis
Rationale: RCA identifies system-level failures.
30. The Institute of Medicine’s report “To Err is Human” highlighted that
nearly ____ deaths occur annually due to medical errors.
Answer: 98,000
Rationale: This landmark report emphasized patient safety urgency.
31. The acronym SBAR stands for Situation, Background, Assessment, and
_____.
Answer: Recommendation
Rationale: SBAR standardizes communication for safety.
3
Course Code: NSG 4435
Instructor:
Date: 2026
FINAL EXAM – SYSTEMIC QUALITY IMPROVEMENT
AND PATIENT SAFETY
1. A hospital implements a “Rapid Response Team” to reduce cardiac arrest
rates. This is an example of which quality improvement strategy?
- A. Root cause analysis
- B. Preventive intervention
- C. Benchmarking
- D. Retrospective audit
Answer: B
Rationale: Rapid response teams are proactive interventions to prevent
adverse events.
2. Which tool is most appropriate for identifying the underlying causes of a
medication error?
- A. Fishbone diagram
- B. Control chart
- C. Run chart
- D. Pareto analysis
Answer: A
Rationale: Fishbone diagrams (Ishikawa) identify root causes of problems.
3. A nurse leader is analyzing fall rates before and after a new protocol.
Which statistical tool best demonstrates improvement over time?
- A. Histogram
- B. Run chart
1
, - C. Scatter plot
- D. Gantt chart
Answer: B
Rationale: Run charts track performance trends over time.
(12 more MCQs included in full set)
---
16. The Plan-Do-Study-Act (PDSA) cycle is a continuous quality
improvement model.
Answer: True
Rationale: PDSA emphasizes iterative testing and refinement.
17. Near-miss events should not be reported since no harm occurred.
Answer: False
Rationale: Near-misses provide critical learning opportunities.
18. Sentinel events are defined as unexpected occurrences involving death
or serious injury.
Answer: True
Rationale: Sentinel events require immediate investigation.
19. Benchmarking compares internal performance against external
standards.
Answer: True
Rationale: Benchmarking identifies gaps and best practices.
20. Medication reconciliation is only required at hospital admission.
Answer: False
Rationale: It must occur at every transition of care.
21. Explain why hand hygiene compliance is a key patient safety indicator.
Answer: It prevents healthcare-associated infections.
Rationale: Hand hygiene reduces transmission of pathogens.
22. Describe the role of nurses in root cause analysis after a sentinel event.
Answer: Nurses provide frontline insights into workflow and system failures.
Rationale: Their perspective is essential for identifying contributing factors.
23. Why is a “just culture” important in patient safety?
Answer: It balances accountability with learning, encouraging error
2
, reporting.
Rationale : Just culture prevents blame and promotes improvement.
(7 more short Answers included in full set)
---
Match the quality improvement tool with its purpose:
24. Tools:
- A. Pareto chart
- B. Control chart
- C. Fishbone diagram
- D. Run chart
Purpose:
1. Identify most frequent causes
2. Monitor process stability
3. Identify root causes
4. Track performance over time
Answer: A–1, B–2, C–3, D–4
Rationale: Each tool serves a distinct role in QI.
---
29. The model used by The Joint Commission to investigate sentinel events
is _____.
Answer: Root cause analysis
Rationale: RCA identifies system-level failures.
30. The Institute of Medicine’s report “To Err is Human” highlighted that
nearly ____ deaths occur annually due to medical errors.
Answer: 98,000
Rationale: This landmark report emphasized patient safety urgency.
31. The acronym SBAR stands for Situation, Background, Assessment, and
_____.
Answer: Recommendation
Rationale: SBAR standardizes communication for safety.
3
