AND TRENDS 11TH EDITION BY ZERWEKH
ISBN-10; 0323810152/ISBN-13; 978-
0323810159 -100% VERIFIED
# TEST BANK FOR NURSING TODAY: TRANSITION AND TRENDS 11TH EDITION BY ZERWEKH (Continued)
## Chapter 22: Quality Patient Care
**1. The primary role of The Joint Commission (TJC) is:**
a. Granting magnet status to excellent hospitals.
b. Lobbying Congress on behalf of Medicare/Medicaid patients.
c. Ensuring medical facilities meet patient safety guidelines.
d. Inspecting hospitals for compliance of infection control standards.
**Correct Answer: C**
**Rationale:** The Joint Commission (TJC) is the primary accrediting body for health care institutions.
Its standards directly address patient safety issues. Magnet status is approved by the American Nurses
Association. TJC does not lobby Medicare/Medicaid issues. The CDC is the agency that maintains
standards regarding infection control for hospital compliance.
---
,**2. The Joint Commission publishes a Sentinel Event Alert every month. Which of the following is the
best example of a sentinel event?**
a. Tylenol #3 is given to a patient when plain Tylenol was ordered.
b. Code pink is called after a newborn is discovered missing from the nursery.
c. After receiving the correct medication, the patient complains of itching all over, and a rash is noted on
the patient's trunk.
d. During a blood transfusion, the patient's temperature increases to 100.4° F, and the patient complains
of generalized pruritus.
**Correct Answer: B**
**Rationale:** A sentinel event is an unexpected occurrence involving death or loss of limb or function.
Examples of sentinel events include serious medication errors, significant drug reactions, surgery
performed on the wrong body site, blood transfusion reactions, and infant abductions.
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**3. A nurse is reviewing the technique used to identify the factors involved in an error. Which
statement indicates the nurse has an adequate understanding?**
a. "The rapid cycle test is a technique that is widely used."
b. "A root cause analysis is a process designed to investigate and categorize the root cause of the event."
c. "A failure mode and effects analysis is a procedure to investigate the cause of the error."
d. "Define, measure, analyze, improve, control prevents events from occurring."
**Correct Answer: B**
**Rationale:** When an error is analyzed, the primary causes need to be determined so that a workable
and effective solution can be developed. A root cause analysis is such a process designed to investigate
and categorize the root cause of the event. The Six Sigma DMAIC process (define, measure, analyze,
improve, control) is used primarily for improving existing processes that do not meet institutional goals
,or national norms. Rapid cycle tests are components of continuous quality improvement. A failure mode
and effects analysis (FMEA) is a procedure in product development and operations management for
analysis of potential failure modes within a system for classification by the severity and likelihood of the
failure.
---
**4. A nurse is discussing the Pareto principle (80/20 rule), which leads to the idea of total quality
management. Which statement indicates an adequate understanding of this principle?**
a. Peter Pareto
b. Joseph Juran
c. Phillip Crosby
d. Edward Deming
**Correct Answer: B**
**Rationale:** Joseph Juran is one of the forefathers of quality initiatives. He stressed the meaning of
the Pareto principle and how it applies to improving quality in all organizations.
---
**5. The nurse manager is educating a new hire on The Joint Commission (TJC). The manager tells the
new hire that TJC mandates the use of continuous quality improvement and measurement of specific
quality outcomes for patients with certain diagnoses. The teaching has been effective when the new
hire states:**
a. "These mandates include patients admitted with Acute MI and COPD."
b. "Outcomes measures are mandated for patients with a diagnosis of congestive heart failure and brain
attack."
c. "Acute renal failure and deep vein thrombosis have mandated outcomes by The Joint Commission."
, d. "Outcome measures are mandated for patients admitted with community-acquired pneumonia and
congestive heart failure."
**Correct Answer: D**
**Rationale:** TJC mandates outcome measures for patients admitted with a diagnosis of acute MI,
congestive heart failure, community-acquired pneumonia, surgical infection prophylaxis, pregnancy-
related conditions, and deep vein thrombosis. Keep in mind that each item in the option must be correct
for the option to be correct, which is the reason acute MI and COPD as well as congestive heart failure
and brain attack are incorrect.
---
**6. A nurse manager is providing education to a new nurse on barriers to the implementation of quality
improvement processes. The manager judges the teaching to be effective when the new nurse states:**
a. "Expense is a primary barrier."
b. "Resistance to change is a primary barrier."
c. "One of the primary barriers is complacency with the status quo."
d. "Not identifying the correct problem is a primary barrier."
**Correct Answer: A**
**Rationale:** A primary barrier to implementing effective quality improvement (QI) programs is the
cost. The cost of providing health care has greatly increased over the past few decades. However,
through quality improvement measures, overall health care costs can be reduced. Other barriers (but
not the primary one) to QI are nurses' loyalty to old practices and failure to recognize that changes are
needed. Hospital administrators often oppose change of any kind because they may value traditional
practices, have an authoritative management style, or may not value innovators. Nurses are often
unaware or unwilling to change their practice from the way they have always done things—complacency
with the status quo. Many practicing nurses remain resistant to change because it seems threatening
and because it requires effort, retraining, and restructuring of habits, but cost still remains the primary
barrier to implementing QI.