NCLEX RN Quality Improvement
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
Question 1
A nurse manager wants to reduce medication errors on a medical-surgical unit.
What should be the nurse's first action?
A. Discipline nurses who make medication errors
B. Review existing medication-error data and identify patterns
C. Purchase new medication-administration equipment
D. Require all nurses to work additional hours
Answer: Review existing medication-error data and identify patterns
Rationale: Quality improvement begins with assessment of current
performance and identification of patterns or system problems before
interventions are selected.
Question 2
Which statement best describes quality improvement (QI)?
A. Identifying individual nurses responsible for errors
B. Comparing nurses with one another
C. Continuously improving processes and patient outcomes
D. Eliminating the need for nursing documentation
Answer: Continuously improving processes and patient outcomes
Rationale: QI is an ongoing, systematic process designed to improve
healthcare processes, safety, efficiency, and patient outcomes.
,Question 3
A hospital tracks the percentage of patients who develop pressure injuries
during hospitalization. This measurement is an example of which type of
indicator?
A. Structure indicator
B. Process indicator
C. Outcome indicator
D. Financial indicator
Answer: Outcome indicator
Rationale: Outcome indicators measure the results of healthcare, such as
pressure injuries, infections, complications, or mortality.
Question 4
Which activity is an example of a process measure?
A. Patient mortality rate
B. Number of hospital beds
C. Percentage of patients receiving antibiotics within the recommended time
D. Patient satisfaction after discharge
Answer: Percentage of patients receiving antibiotics within the recommended
time
Rationale: Process measures evaluate whether specific evidence-based
actions are performed appropriately.
Question 5
A nurse participates in a root cause analysis after a patient falls. What is the
primary purpose of this activity?
A. Determine which nurse should be punished
B. Identify underlying system factors contributing to the event
,C. Calculate the cost of the patient's hospitalization
D. Determine whether the patient should be discharged
Answer: Identify underlying system factors contributing to the event
Rationale: Root cause analysis examines underlying factors and system
failures that contributed to an adverse event so recurrence can be prevented.
Question 6
Which event would most appropriately trigger a root cause analysis?
A. A patient's routine discharge
B. A serious preventable medication error causing harm
C. A patient's request for a blanket
D. A routine change of shift
Answer: A serious preventable medication error causing harm
Rationale: Root cause analysis is commonly used after serious or sentinel
events to identify contributing factors and prevent recurrence.
Question 7
A nurse discovers that two patients received medications intended for each
other. What is the nurse's priority action?
A. Complete a performance evaluation of the administering nurse
B. Assess both patients for potential harm
C. Immediately notify the media
D. Wait until the next staff meeting to report the incident
Answer: Assess both patients for potential harm
Rationale: Patient safety is the immediate priority after a medication error.
The patients must be assessed before reporting and investigating the event.
Question 8
, Which action best demonstrates a culture of safety?
A. Encouraging staff to report errors and near misses
B. Punishing every employee involved in an error
C. Discouraging incident reports
D. Keeping safety data confidential from staff
Answer: Encouraging staff to report errors and near misses
Rationale: A safety culture encourages reporting and learning from errors
and near misses rather than focusing primarily on individual blame.
Question 9
A nurse reports that a medication was almost administered to the wrong
patient but was caught before administration. How should this event be
classified?
A. Sentinel event
B. Near miss
C. Never event with patient injury
D. Malpractice
Answer: Near miss
Rationale: A near miss is an event that could have caused harm but was
intercepted before reaching the patient or causing injury.
Question 10
Which tool is commonly used to identify possible causes of a quality problem
by organizing causes into categories?
A. Fishbone diagram
B. Medication administration record
C. Nursing care plan
D. Braden Scale
Answer: Fishbone diagram
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
Question 1
A nurse manager wants to reduce medication errors on a medical-surgical unit.
What should be the nurse's first action?
A. Discipline nurses who make medication errors
B. Review existing medication-error data and identify patterns
C. Purchase new medication-administration equipment
D. Require all nurses to work additional hours
Answer: Review existing medication-error data and identify patterns
Rationale: Quality improvement begins with assessment of current
performance and identification of patterns or system problems before
interventions are selected.
Question 2
Which statement best describes quality improvement (QI)?
A. Identifying individual nurses responsible for errors
B. Comparing nurses with one another
C. Continuously improving processes and patient outcomes
D. Eliminating the need for nursing documentation
Answer: Continuously improving processes and patient outcomes
Rationale: QI is an ongoing, systematic process designed to improve
healthcare processes, safety, efficiency, and patient outcomes.
,Question 3
A hospital tracks the percentage of patients who develop pressure injuries
during hospitalization. This measurement is an example of which type of
indicator?
A. Structure indicator
B. Process indicator
C. Outcome indicator
D. Financial indicator
Answer: Outcome indicator
Rationale: Outcome indicators measure the results of healthcare, such as
pressure injuries, infections, complications, or mortality.
Question 4
Which activity is an example of a process measure?
A. Patient mortality rate
B. Number of hospital beds
C. Percentage of patients receiving antibiotics within the recommended time
D. Patient satisfaction after discharge
Answer: Percentage of patients receiving antibiotics within the recommended
time
Rationale: Process measures evaluate whether specific evidence-based
actions are performed appropriately.
Question 5
A nurse participates in a root cause analysis after a patient falls. What is the
primary purpose of this activity?
A. Determine which nurse should be punished
B. Identify underlying system factors contributing to the event
,C. Calculate the cost of the patient's hospitalization
D. Determine whether the patient should be discharged
Answer: Identify underlying system factors contributing to the event
Rationale: Root cause analysis examines underlying factors and system
failures that contributed to an adverse event so recurrence can be prevented.
Question 6
Which event would most appropriately trigger a root cause analysis?
A. A patient's routine discharge
B. A serious preventable medication error causing harm
C. A patient's request for a blanket
D. A routine change of shift
Answer: A serious preventable medication error causing harm
Rationale: Root cause analysis is commonly used after serious or sentinel
events to identify contributing factors and prevent recurrence.
Question 7
A nurse discovers that two patients received medications intended for each
other. What is the nurse's priority action?
A. Complete a performance evaluation of the administering nurse
B. Assess both patients for potential harm
C. Immediately notify the media
D. Wait until the next staff meeting to report the incident
Answer: Assess both patients for potential harm
Rationale: Patient safety is the immediate priority after a medication error.
The patients must be assessed before reporting and investigating the event.
Question 8
, Which action best demonstrates a culture of safety?
A. Encouraging staff to report errors and near misses
B. Punishing every employee involved in an error
C. Discouraging incident reports
D. Keeping safety data confidential from staff
Answer: Encouraging staff to report errors and near misses
Rationale: A safety culture encourages reporting and learning from errors
and near misses rather than focusing primarily on individual blame.
Question 9
A nurse reports that a medication was almost administered to the wrong
patient but was caught before administration. How should this event be
classified?
A. Sentinel event
B. Near miss
C. Never event with patient injury
D. Malpractice
Answer: Near miss
Rationale: A near miss is an event that could have caused harm but was
intercepted before reaching the patient or causing injury.
Question 10
Which tool is commonly used to identify possible causes of a quality problem
by organizing causes into categories?
A. Fishbone diagram
B. Medication administration record
C. Nursing care plan
D. Braden Scale
Answer: Fishbone diagram
