Content for exam 2 NMNC 1110 UPDATED ACTUAL Questions
and CORRECT Answers
James is a first-year surgery resident on his first pediatric 4. All of the above
rotation. His attending (supervising physician) asks him to -The best answer is all of the above. Patients and families are not the only ones
start intravenous (IV) replacement fluids on a two-year- affected when a medical error occurs. In this case, James is likely to be
old boy who is having vomiting and diarrhea. Having devastated, and Maria may be affected as well. Some providers even leave their
trouble remembering the guidelines for calculating fluid profession after committing errors leading to a death.
replacement rates for very small children, James asks
Maria, a nurse on the unit. Maria responds, "You're the
doctor. It's your job to decide this." James picks a rate that
is much too high, putting the child into fluid overload.
Who is likely to be negatively affected by this medical
error?
1. The patient and his family
2. James (the first-year surgery resident)
3. Maria (the nurse on the unit)
4. All of the above
"Patient safety" means: 1. Eliminating errors and adverse effects to patients associated with health care
1. Eliminating errors and adverse effects to patients -Although all of these are important aims for health care systems, the concept of
associated with health care patient safety refers specifically to eliminating harm to patients. According to the
2. Eliminating waste in health care services World Health Organization (WHO), patient safety is "the prevention of errors and
3. Eliminating health inequities in populations adverse effects to patients associated with health care."
4. All of the above
,A medical unit in a hospital is in the midst of hiring some 2. Accountability
new physicians. During an orientation for new -Holding all employees to the same standards of professional behavior,
employees, a senior leader stands up and says, "We regardless of position, is an example of accountability.
expect that the same rules apply to everyone on the unit,
regardless of position."
Which aspect of a culture of safety does this unit seem to
value?
1. Psychological safety
2. Accountability
3. Negotiation
4. None of these
What is most likely to happen if a health system punishes 4. Both staff may be less likely to talk openly about and learn from errors AND the
an individual for an unintended error that was the result response will weaken the safety culture
of a systems problem? - Punishing individuals for blameless errors has a weakening effect on a health
1. Staff may be less likely to talk openly about and learn system's culture of safety (an environment in which providers can discuss errors
from errors. and harm openly because they know they won’t be unfairly punished and have
2. Staff will be more careful and errors will decrease. confidence that reporting safety events will lead to improvement). Staff may view
3. The response will weaken the safety culture. the punishment as unfair, and worry that they will be punished if they make an
4. Both staff may be less likely to talk openly about and error. This fear decreases the chances of staff reporting errors so that the system
learn from errors AND the response will weaken the can learn from them. Staff trying to be more careful will ultimately not eliminate
safety culture errors caused by faulty systems.
Why is psychological safety a crucial component of a 4. It allows people to learn from mistakes and near-misses, reducing the chances
culture of safety? of further errors.
1. Without it, patients will not follow their doctors' advice. -In psychologically safe environments, people understand that making mistakes is
2. Without it, people won't be interested in improvement rarely a sign of incompetence, and that they won't be judged for discussing
work. mistakes. Because of that, people are able to call out errors - whether their own
3. It allows people to remove unsafe members of the or others' - and improve the processes that made the errors possible.
team quickly.
4. It allows people to learn from mistakes and near-
misses, reducing the chances of further errors.
At the large multi-specialty clinic in which you work, there 1. Investigating the problem and seeking systems solutions
have been two near misses and one medical error -The best answer is investigating the problem and seeking systems solutions. An
because various clinicians did not follow up on patient organization must develop a method to surface and learn from defects and harm
results. Different caregivers were involved each time. that occurs to patients. We know that incident reports are one way to learn. They
After the second near miss, the physician involved was can also be an indicator of the culture of the organization. That is, the more
asked to leave the clinic. A nurse who realized that his people are willing to report, the safer they feel.
colleagues weren't consistently following up on patient
results reported the problem to the clinic leadership right
away.
Which response would be most consistent with a culture
of safety?
1. Investigating the problem and seeking systems
solutions
2. Thanking the nurse and asking him to keep quiet about
it
3. Transferring the nurse to another clinic
4. Placing the item on the agenda for the leadership
meeting next year
, At the large multi-specialty clinic in which you work, there 1. Human error
have been two near misses and one medical error -The best answer is human error, as there is no reason to believe the caregivers'
because various clinicians did not follow up on patient acted with intentional disregard for safety. The fact that multiple people made the
results. Different caregivers were involved each time. same mistake further suggests the problem was due to a poorly designed system
When asked why they failed to follow up, each caregiver rather than at-risk or reckless behavior by individuals.
said he or she forgot.
Based on what you know, how would you classify the
caregivers' behavior?
1. Human error
2. At-risk behavior
3. Reckless behavior
4. None of the above
What is one of the major attributes of health care law? It defines the expected behavior of persons in the business of health care.
-The law or rule is easy to interpret and comply with.
-It is established by any health care authority.
-It defines the expected behavior of persons in the
business of health care.
-The creator must be an expert in health care.
An obstetric nurse comes across an automobile accident. The nurse took actions beyond those that are standard and appropriate.
The driver seems to have a crushed upper airway, and
while waiting for emergency medical services to arrive,
the nurse makes a cut in the trachea and inserts a straw
from a purse to provide an airway. The patient survives
and has a permanent problem with vocal cords, making it
difficult to talk. Which statement is true regarding the
nurse’s performance?
-The nurse acted appropriately and saved the patient’s
life.
-The nurse took actions beyond those that are standard
and appropriate.
-The nurse stayed within the guidelines of the Good
Samaritan Law.
-The nurse should have just stayed with the patient and
waited for help.
A nursing student has been written up several times for "You are expected to perform at the level of a professional nurse."
being late with providing patient care and for omitting
aspects of patient care and not knowing basic
procedures that were taught in the skills course one term
earlier. The nursing student says, “I don’t understand what
the big deal is. As my instructor, you are there to protect
me and make sure I don’t make mistakes.” What is the
best response from the nursing instructor?
-“You are practicing under the license of the hospital’s
insurance.”
-“You are expected to perform at the level of a
professional nurse.”
-“You are expected to perform at the level of a prudent
nursing student.”
-“You are practicing under the license of the nurse
assigned to the patient.”
and CORRECT Answers
James is a first-year surgery resident on his first pediatric 4. All of the above
rotation. His attending (supervising physician) asks him to -The best answer is all of the above. Patients and families are not the only ones
start intravenous (IV) replacement fluids on a two-year- affected when a medical error occurs. In this case, James is likely to be
old boy who is having vomiting and diarrhea. Having devastated, and Maria may be affected as well. Some providers even leave their
trouble remembering the guidelines for calculating fluid profession after committing errors leading to a death.
replacement rates for very small children, James asks
Maria, a nurse on the unit. Maria responds, "You're the
doctor. It's your job to decide this." James picks a rate that
is much too high, putting the child into fluid overload.
Who is likely to be negatively affected by this medical
error?
1. The patient and his family
2. James (the first-year surgery resident)
3. Maria (the nurse on the unit)
4. All of the above
"Patient safety" means: 1. Eliminating errors and adverse effects to patients associated with health care
1. Eliminating errors and adverse effects to patients -Although all of these are important aims for health care systems, the concept of
associated with health care patient safety refers specifically to eliminating harm to patients. According to the
2. Eliminating waste in health care services World Health Organization (WHO), patient safety is "the prevention of errors and
3. Eliminating health inequities in populations adverse effects to patients associated with health care."
4. All of the above
,A medical unit in a hospital is in the midst of hiring some 2. Accountability
new physicians. During an orientation for new -Holding all employees to the same standards of professional behavior,
employees, a senior leader stands up and says, "We regardless of position, is an example of accountability.
expect that the same rules apply to everyone on the unit,
regardless of position."
Which aspect of a culture of safety does this unit seem to
value?
1. Psychological safety
2. Accountability
3. Negotiation
4. None of these
What is most likely to happen if a health system punishes 4. Both staff may be less likely to talk openly about and learn from errors AND the
an individual for an unintended error that was the result response will weaken the safety culture
of a systems problem? - Punishing individuals for blameless errors has a weakening effect on a health
1. Staff may be less likely to talk openly about and learn system's culture of safety (an environment in which providers can discuss errors
from errors. and harm openly because they know they won’t be unfairly punished and have
2. Staff will be more careful and errors will decrease. confidence that reporting safety events will lead to improvement). Staff may view
3. The response will weaken the safety culture. the punishment as unfair, and worry that they will be punished if they make an
4. Both staff may be less likely to talk openly about and error. This fear decreases the chances of staff reporting errors so that the system
learn from errors AND the response will weaken the can learn from them. Staff trying to be more careful will ultimately not eliminate
safety culture errors caused by faulty systems.
Why is psychological safety a crucial component of a 4. It allows people to learn from mistakes and near-misses, reducing the chances
culture of safety? of further errors.
1. Without it, patients will not follow their doctors' advice. -In psychologically safe environments, people understand that making mistakes is
2. Without it, people won't be interested in improvement rarely a sign of incompetence, and that they won't be judged for discussing
work. mistakes. Because of that, people are able to call out errors - whether their own
3. It allows people to remove unsafe members of the or others' - and improve the processes that made the errors possible.
team quickly.
4. It allows people to learn from mistakes and near-
misses, reducing the chances of further errors.
At the large multi-specialty clinic in which you work, there 1. Investigating the problem and seeking systems solutions
have been two near misses and one medical error -The best answer is investigating the problem and seeking systems solutions. An
because various clinicians did not follow up on patient organization must develop a method to surface and learn from defects and harm
results. Different caregivers were involved each time. that occurs to patients. We know that incident reports are one way to learn. They
After the second near miss, the physician involved was can also be an indicator of the culture of the organization. That is, the more
asked to leave the clinic. A nurse who realized that his people are willing to report, the safer they feel.
colleagues weren't consistently following up on patient
results reported the problem to the clinic leadership right
away.
Which response would be most consistent with a culture
of safety?
1. Investigating the problem and seeking systems
solutions
2. Thanking the nurse and asking him to keep quiet about
it
3. Transferring the nurse to another clinic
4. Placing the item on the agenda for the leadership
meeting next year
, At the large multi-specialty clinic in which you work, there 1. Human error
have been two near misses and one medical error -The best answer is human error, as there is no reason to believe the caregivers'
because various clinicians did not follow up on patient acted with intentional disregard for safety. The fact that multiple people made the
results. Different caregivers were involved each time. same mistake further suggests the problem was due to a poorly designed system
When asked why they failed to follow up, each caregiver rather than at-risk or reckless behavior by individuals.
said he or she forgot.
Based on what you know, how would you classify the
caregivers' behavior?
1. Human error
2. At-risk behavior
3. Reckless behavior
4. None of the above
What is one of the major attributes of health care law? It defines the expected behavior of persons in the business of health care.
-The law or rule is easy to interpret and comply with.
-It is established by any health care authority.
-It defines the expected behavior of persons in the
business of health care.
-The creator must be an expert in health care.
An obstetric nurse comes across an automobile accident. The nurse took actions beyond those that are standard and appropriate.
The driver seems to have a crushed upper airway, and
while waiting for emergency medical services to arrive,
the nurse makes a cut in the trachea and inserts a straw
from a purse to provide an airway. The patient survives
and has a permanent problem with vocal cords, making it
difficult to talk. Which statement is true regarding the
nurse’s performance?
-The nurse acted appropriately and saved the patient’s
life.
-The nurse took actions beyond those that are standard
and appropriate.
-The nurse stayed within the guidelines of the Good
Samaritan Law.
-The nurse should have just stayed with the patient and
waited for help.
A nursing student has been written up several times for "You are expected to perform at the level of a professional nurse."
being late with providing patient care and for omitting
aspects of patient care and not knowing basic
procedures that were taught in the skills course one term
earlier. The nursing student says, “I don’t understand what
the big deal is. As my instructor, you are there to protect
me and make sure I don’t make mistakes.” What is the
best response from the nursing instructor?
-“You are practicing under the license of the hospital’s
insurance.”
-“You are expected to perform at the level of a
professional nurse.”
-“You are expected to perform at the level of a prudent
nursing student.”
-“You are practicing under the license of the nurse
assigned to the patient.”
