, Question 1
A nurse manager is analyzing unit data showing increased central
line-associated bloodstream infections (CLABSIs) despite full compliance with
the insertion bundle. Which action best applies the Plan-Do-Study-Act (PDSA)
framework to address this outlier?
A. Re-educate all staff on the existing insertion bundle and monitor
compliance weekly.
B. Convene an interprofessional team to map maintenance practices and
test a new scrub-the-hub protocol.
C. Report the data to the infection control committee and await their
directive.
D. Increase the frequency of dressing changes from every 7 days to every
3 days.
Correct Answer: B - Convene an interprofessional team to map
maintenance practices and test a new scrub-the-hub protocol.
RATIONALE
The PDSA cycle requires identifying a specific problem (maintenance
practices), forming a team, and testing a change (scrub-the-hub) in a
small cycle. Option A repeats a failed intervention; C abdicates
leadership; D is not evidence-based and may increase infection risk.
Question 2
During a mass casualty event, a charge nurse must assign a float pool nurse to
triage. Which competency is most critical for the charge nurse to verify before
making this assignment?
A. The float nurse's familiarity with the electronic health record.
B. The float nurse's completion of a hospital orientation module on
disaster response.
C. The float nurse's documented competency in emergency triage
protocols.
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, D. The float nurse's seniority within the float pool.
Correct Answer: C - The float nurse's documented competency in
emergency triage protocols.
RATIONALE
Delegation requires verifying the delegatee's specific competency for
the assigned task. Triage during a disaster demands validated skills;
familiarity with EHR or orientation completion does not ensure
competency. Seniority is irrelevant to skill verification.
Question 3
A nurse is considering a lateral move to a different unit. Which factor is most
important for the nurse to evaluate when assessing the new unit's culture of
safety?
A. The unit's average length of stay.
B. The manager's approach to error reporting and just culture.
C. The availability of free parking for night shift.
D. The number of years the unit manager has been in the role.
Correct Answer: B - The manager's approach to error reporting
and just culture.
RATIONALE
A just culture and non-punitive error reporting are hallmarks of a
safety culture. Length of stay, parking, and manager tenure are not
direct indicators of psychological safety or error transparency.
Question 4
A hospital is implementing a new sepsis protocol. Which strategy best reflects
Kotter's model of change by creating a sense of urgency?
A. Distributing a memo outlining the new protocol steps.
B. Presenting data on current sepsis mortality rates and benchmark
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, comparisons.
C. Offering a financial bonus to the first unit that achieves compliance.
D. Forming a committee to revise the protocol annually.
Correct Answer: B - Presenting data on current sepsis mortality
rates and benchmark comparisons.
RATIONALE
Kotter's first step is creating urgency by highlighting a compelling
problem, such as high mortality. A memo, bonuses, or committee
formation do not establish urgency. Data presentation is key to
motivating change.
Question 5
A nurse manager is preparing a budget and must decide between hiring a new
graduate or an experienced nurse. Which consideration is most relevant to
fiscal stewardship?
A. The new graduate's potential for long-term retention.
B. The cost of orientation and the impact on unit productivity.
C. The experienced nurse's ability to mentor others.
D. The new graduate's familiarity with the latest technology.
Correct Answer: B - The cost of orientation and the impact on
unit productivity.
RATIONALE
Fiscal stewardship involves analyzing the total cost of hire, including
orientation length and productivity loss. Retention, mentoring, and
tech familiarity are important but not the primary fiscal consideration.
Question 6
A nurse is delegating a task to a UAP. Which statement by the nurse best
reflects the principle of mutual respect in delegation?
Page 4
A nurse manager is analyzing unit data showing increased central
line-associated bloodstream infections (CLABSIs) despite full compliance with
the insertion bundle. Which action best applies the Plan-Do-Study-Act (PDSA)
framework to address this outlier?
A. Re-educate all staff on the existing insertion bundle and monitor
compliance weekly.
B. Convene an interprofessional team to map maintenance practices and
test a new scrub-the-hub protocol.
C. Report the data to the infection control committee and await their
directive.
D. Increase the frequency of dressing changes from every 7 days to every
3 days.
Correct Answer: B - Convene an interprofessional team to map
maintenance practices and test a new scrub-the-hub protocol.
RATIONALE
The PDSA cycle requires identifying a specific problem (maintenance
practices), forming a team, and testing a change (scrub-the-hub) in a
small cycle. Option A repeats a failed intervention; C abdicates
leadership; D is not evidence-based and may increase infection risk.
Question 2
During a mass casualty event, a charge nurse must assign a float pool nurse to
triage. Which competency is most critical for the charge nurse to verify before
making this assignment?
A. The float nurse's familiarity with the electronic health record.
B. The float nurse's completion of a hospital orientation module on
disaster response.
C. The float nurse's documented competency in emergency triage
protocols.
Page 2
, D. The float nurse's seniority within the float pool.
Correct Answer: C - The float nurse's documented competency in
emergency triage protocols.
RATIONALE
Delegation requires verifying the delegatee's specific competency for
the assigned task. Triage during a disaster demands validated skills;
familiarity with EHR or orientation completion does not ensure
competency. Seniority is irrelevant to skill verification.
Question 3
A nurse is considering a lateral move to a different unit. Which factor is most
important for the nurse to evaluate when assessing the new unit's culture of
safety?
A. The unit's average length of stay.
B. The manager's approach to error reporting and just culture.
C. The availability of free parking for night shift.
D. The number of years the unit manager has been in the role.
Correct Answer: B - The manager's approach to error reporting
and just culture.
RATIONALE
A just culture and non-punitive error reporting are hallmarks of a
safety culture. Length of stay, parking, and manager tenure are not
direct indicators of psychological safety or error transparency.
Question 4
A hospital is implementing a new sepsis protocol. Which strategy best reflects
Kotter's model of change by creating a sense of urgency?
A. Distributing a memo outlining the new protocol steps.
B. Presenting data on current sepsis mortality rates and benchmark
Page 3
, comparisons.
C. Offering a financial bonus to the first unit that achieves compliance.
D. Forming a committee to revise the protocol annually.
Correct Answer: B - Presenting data on current sepsis mortality
rates and benchmark comparisons.
RATIONALE
Kotter's first step is creating urgency by highlighting a compelling
problem, such as high mortality. A memo, bonuses, or committee
formation do not establish urgency. Data presentation is key to
motivating change.
Question 5
A nurse manager is preparing a budget and must decide between hiring a new
graduate or an experienced nurse. Which consideration is most relevant to
fiscal stewardship?
A. The new graduate's potential for long-term retention.
B. The cost of orientation and the impact on unit productivity.
C. The experienced nurse's ability to mentor others.
D. The new graduate's familiarity with the latest technology.
Correct Answer: B - The cost of orientation and the impact on
unit productivity.
RATIONALE
Fiscal stewardship involves analyzing the total cost of hire, including
orientation length and productivity loss. Retention, mentoring, and
tech familiarity are important but not the primary fiscal consideration.
Question 6
A nurse is delegating a task to a UAP. Which statement by the nurse best
reflects the principle of mutual respect in delegation?
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