Content for exam 2 NMNC 1110 Questions with
Correct Answers
James is a first-year surgery resident on his first pediatric rotation. His
attending (supervising physician) asks him to start intravenous (IV)
replacement fluids on a two-year-old boy who is having vomiting and
diarrhea. Having trouble remembering the guidelines for calculating
fluid 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 Correct Answer-4. All of the above
-The best answer is all of the above. Patients and families are not the
only ones affected when a medical error occurs. In this case, James is
likely to be devastated, and Maria may be affected as well. Some
providers even leave their profession after committing errors leading to a
death.
"Patient safety" means:
1. Eliminating errors and adverse effects to patients associated with
health care
2. Eliminating waste in health care services
3. Eliminating health inequities in populations
,4. All of the above Correct Answer-1. Eliminating errors and adverse
effects to patients associated with health care
-Although all of these are important aims for health care systems, the
concept of patient safety refers specifically to eliminating harm to
patients. According to the World Health Organization (WHO), patient
safety is "the prevention of errors and adverse effects to patients
associated with health care."
A medical unit in a hospital is in the midst of hiring some new
physicians. During an orientation for new employees, a senior leader
stands up and says, "We 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 Correct Answer-2. Accountability
-Holding all employees to the same standards of professional behavior,
regardless of position, is an example of accountability.
What is most likely to happen if a health system punishes an individual
for an unintended error that was the result of a systems problem?
1. Staff may be less likely to talk openly about and learn from errors.
2. Staff will be more careful and errors will decrease.
3. The response will weaken the safety culture.
,4. Both staff may be less likely to talk openly about and learn from
errors AND the response will weaken the safety culture Correct Answer-
4. Both staff may be less likely to talk openly about and learn from
errors AND the response will weaken the safety culture
- Punishing individuals for blameless errors has a weakening effect on a
health system's culture of safety (an environment in which providers can
discuss errors and harm openly because they know they won't be
unfairly punished and have confidence that reporting safety events will
lead to improvement). Staff may view the punishment as unfair, and
worry that they will be punished if they make an error. This fear
decreases the chances of staff reporting errors so that the system can
learn from them. Staff trying to be more careful will ultimately not
eliminate errors caused by faulty systems.
Why is psychological safety a crucial component of a culture of safety?
1. Without it, patients will not follow their doctors' advice.
2. Without it, people won't be interested in improvement work.
3. It allows people to remove unsafe members of the team quickly.
4. It allows people to learn from mistakes and near-misses, reducing the
chances of further errors. Correct Answer-4. It allows people to learn
from mistakes and near-misses, reducing the chances of further errors.
-In psychologically safe environments, people understand that making
mistakes is rarely a sign of incompetence, and that they won't be judged
for discussing mistakes. Because of that, people are able to call out
errors - whether their own or others' - and improve the processes that
made the errors possible.
, At the large multi-specialty clinic in which you work, there have been
two near misses and one medical error because various clinicians did not
follow up on patient results. Different caregivers were involved each
time. After the second near miss, the physician involved was asked to
leave the clinic. A nurse who realized that his 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
Correct Answer-1. Investigating the problem and seeking systems
solutions
-The best answer is investigating the problem and seeking systems
solutions. An organization must develop a method to surface and learn
from defects and harm that occurs to patients. We know that incident
reports are one way to learn. They can also be an indicator of the culture
of the organization. That is, the more people are willing to report, the
safer they feel.
At the large multi-specialty clinic in which you work, there have been
two near misses and one medical error because various clinicians did not
follow up on patient results. Different caregivers were involved each
time. When asked why they failed to follow up, each caregiver said he or
she forgot.
Based on what you know, how would you classify the caregivers'
behavior?
Correct Answers
James is a first-year surgery resident on his first pediatric rotation. His
attending (supervising physician) asks him to start intravenous (IV)
replacement fluids on a two-year-old boy who is having vomiting and
diarrhea. Having trouble remembering the guidelines for calculating
fluid 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 Correct Answer-4. All of the above
-The best answer is all of the above. Patients and families are not the
only ones affected when a medical error occurs. In this case, James is
likely to be devastated, and Maria may be affected as well. Some
providers even leave their profession after committing errors leading to a
death.
"Patient safety" means:
1. Eliminating errors and adverse effects to patients associated with
health care
2. Eliminating waste in health care services
3. Eliminating health inequities in populations
,4. All of the above Correct Answer-1. Eliminating errors and adverse
effects to patients associated with health care
-Although all of these are important aims for health care systems, the
concept of patient safety refers specifically to eliminating harm to
patients. According to the World Health Organization (WHO), patient
safety is "the prevention of errors and adverse effects to patients
associated with health care."
A medical unit in a hospital is in the midst of hiring some new
physicians. During an orientation for new employees, a senior leader
stands up and says, "We 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 Correct Answer-2. Accountability
-Holding all employees to the same standards of professional behavior,
regardless of position, is an example of accountability.
What is most likely to happen if a health system punishes an individual
for an unintended error that was the result of a systems problem?
1. Staff may be less likely to talk openly about and learn from errors.
2. Staff will be more careful and errors will decrease.
3. The response will weaken the safety culture.
,4. Both staff may be less likely to talk openly about and learn from
errors AND the response will weaken the safety culture Correct Answer-
4. Both staff may be less likely to talk openly about and learn from
errors AND the response will weaken the safety culture
- Punishing individuals for blameless errors has a weakening effect on a
health system's culture of safety (an environment in which providers can
discuss errors and harm openly because they know they won't be
unfairly punished and have confidence that reporting safety events will
lead to improvement). Staff may view the punishment as unfair, and
worry that they will be punished if they make an error. This fear
decreases the chances of staff reporting errors so that the system can
learn from them. Staff trying to be more careful will ultimately not
eliminate errors caused by faulty systems.
Why is psychological safety a crucial component of a culture of safety?
1. Without it, patients will not follow their doctors' advice.
2. Without it, people won't be interested in improvement work.
3. It allows people to remove unsafe members of the team quickly.
4. It allows people to learn from mistakes and near-misses, reducing the
chances of further errors. Correct Answer-4. It allows people to learn
from mistakes and near-misses, reducing the chances of further errors.
-In psychologically safe environments, people understand that making
mistakes is rarely a sign of incompetence, and that they won't be judged
for discussing mistakes. Because of that, people are able to call out
errors - whether their own or others' - and improve the processes that
made the errors possible.
, At the large multi-specialty clinic in which you work, there have been
two near misses and one medical error because various clinicians did not
follow up on patient results. Different caregivers were involved each
time. After the second near miss, the physician involved was asked to
leave the clinic. A nurse who realized that his 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
Correct Answer-1. Investigating the problem and seeking systems
solutions
-The best answer is investigating the problem and seeking systems
solutions. An organization must develop a method to surface and learn
from defects and harm that occurs to patients. We know that incident
reports are one way to learn. They can also be an indicator of the culture
of the organization. That is, the more people are willing to report, the
safer they feel.
At the large multi-specialty clinic in which you work, there have been
two near misses and one medical error because various clinicians did not
follow up on patient results. Different caregivers were involved each
time. When asked why they failed to follow up, each caregiver said he or
she forgot.
Based on what you know, how would you classify the caregivers'
behavior?
