NUR 529 EXAM 3 STUDY GUIDE –
COMPREHENSIVE COURSE REVIEW &
PREPARATION RESOURCE
1. A nurse is preparing to administer a high-alert medication. Which action best exemplifies
the "double-check" process recommended for such medications?
a) The nurse calculates the dose twice before administration.
b) The nurse asks the patient to verify their name and date of birth.
c) Two licensed healthcare professionals independently verify the drug, dose, and patient.
d) The nurse scans the patient's wristband and the medication barcode.
Answer: c) Two licensed healthcare professionals independently verify the drug, dose, and
patient.
2. The goal of a root cause analysis (RCA) following a sentinel event is primarily to:
a) Determine which individual staff member is at fault for the error.
b) Identify system-level failures that contributed to the event.
c) Create a report for the hospital's legal defense team.
d) Provide immediate disciplinary action for involved personnel.
Answer: b) Identify system-level failures that contributed to the event.
3. When using the SBAR (Situation, Background, Assessment, Recommendation)
communication tool, which component would include the patient's vital signs and current
clinical presentation?
a) Situation
b) Background
c) Assessment
d) Recommendation
Answer: c) Assessment
4. A patient has a documented allergy to sulfa drugs. The nurse is reviewing a new medication
order for Celecoxib (Celebrex). What is the nurse's most appropriate action?
a) Administer the medication as ordered; it is not an antibiotic.
b) Hold the medication and notify the prescribing provider immediately.
c) Administer the medication with an antihistamine to prevent a reaction.
d) Inform the patient that a mild rash is a common side effect.
Answer: b) Hold the medication and notify the prescribing provider immediately. (Celecoxib
contains a sulfonamide moiety and is contraindicated in patients with sulfa allergy.)
,5. Which finding by a nurse manager best indicates that a unit's fall prevention program is
effective?
a) The number of incident reports filed has decreased.
b) There has been a reduction in the unit's fall rate per 1000 patient-days.
c) All patients are now placed on bed rest.
d) Nurses report feeling more confident about fall protocols.
Answer: b) There has been a reduction in the unit's fall rate per 1000 patient-days.
6. The "Five Rights" of medication administration are a fundamental safety principle. Which
"right" is often the most challenging to ensure consistently?
a) Right patient
b) Right drug
c) Right dose
d) Right route
Answer: a) Right patient (Especially with issues like patient confusion, similar names, or
communication barriers).
7. A nurse is caring for a patient with Clostridioides difficile (C. diff). Which action is essential
for preventing transmission?
a) Wearing a sterile gown and gloves upon entering the room.
b) Using an alcohol-based hand sanitizer after patient contact.
c) Placing the patient in a negative pressure airflow room.
d) Using soap and water for hand hygiene after patient contact.
Answer: d) Using soap and water for hand hygiene after patient contact. (Alcohol-based
sanitizers are not effective against C. diff spores.)
8. During a code blue, the team leader assigns roles. This is an example of which crisis
resource management principle?
a) Knowing your environment
b) Allocating attention wisely
c) Using all available resources
d) Role clarity and assignment
Answer: d) Role clarity and assignment
9. Which intervention is most effective for preventing ventilator-associated pneumonia (VAP)?
a) Administering prophylactic broad-spectrum antibiotics.
b) Maintaining the head of the bed at 30-45 degrees.
c) Suctioning the endotracheal tube every 2 hours.
d) Using sterile water in the ventilator circuit.
Answer: b) Maintaining the head of the bed at 30-45 degrees.
,10. The Institute for Healthcare Improvement (IHI) Triple Aim framework focuses on:
a) Reducing costs, increasing nurse satisfaction, and improving technology.
b) Improving patient experience, improving population health, and reducing per capita costs.
c) Enhancing physician autonomy, expanding hospital services, and maximizing profits.
d) Decreasing medication errors, eliminating hospital-acquired infections, and shortening
lengths of stay.
Answer: b) Improving patient experience, improving population health, and reducing per
capita costs.
11. A nurse is using a clinical decision support system (CDSS) within the electronic health
record. The system alerts the nurse that a prescribed dose of vancomycin is higher than the
recommended range. The nurse's best action is to:
a) Override the alert, as the provider must know what they are doing.
b) Administer the medication but monitor the patient more closely.
c) Contact the pharmacist and the prescribing provider to clarify the order.
d) Document the alert in the nurse's notes and proceed.
Answer: c) Contact the pharmacist and the prescribing provider to clarify the order.
12. What is the primary purpose of a "time-out" or "pause before the procedure" in the
surgical setting?
a) To allow the surgical team to take a short break.
b) To confirm the correct patient, procedure, and site.
c) To count all sponges, needles, and instruments.
d) To administer preoperative antibiotics.
Answer: b) To confirm the correct patient, procedure, and site.
13. A patient with heart failure is being discharged. Which metric is the best indicator of a
successful transition of care and reduction in readmissions?
a) Patient satisfaction score at discharge.
b) 30-day hospital readmission rate for heart failure.
c) Number of medications prescribed at discharge.
d) The length of the patient's hospital stay.
Answer: b) 30-day hospital readmission rate for heart failure.
14. Which action by a nurse demonstrates the principle of "just culture" after a medication
error occurs?
a) Immediately suspending the nurse without pay.
b) Focusing solely on the individual's mistake for disciplinary action.
c) Investigating the system factors that led to the error while holding individuals accountable for
reckless behavior.
, d) Keeping the error a secret to protect the unit's reputation.
Answer: c) Investigating the system factors that led to the error while holding individuals
accountable for reckless behavior.
15. For a patient at high risk for suicide, the most important nursing intervention is:
a) Providing a supportive and empathetic environment.
b) Ensuring one-to-one constant observation.
c) Administering PRN anti-anxiety medication.
d) Placing the patient in a room far from the nurses' station.
Answer: b) Ensuring one-to-one constant observation.
16. The use of checklists in healthcare, such as for central line insertion, is primarily intended
to:
a) Replace clinical judgment.
b) Standardize and ensure adherence to evidence-based steps.
c) Reduce the need for experienced personnel.
d) Speed up the procedure time.
Answer: b) Standardize and ensure adherence to evidence-based steps.
17. A nurse is preparing to administer a blood transfusion. After obtaining the blood product
from the blood bank, the nurse must initiate the transfusion within what time frame to
ensure patient safety?
a) 15 minutes
b) 30 minutes
c) 2 hours
d) 4 hours
Answer: b) 30 minutes
18. Which strategy is most effective in reducing catheter-associated urinary tract infections
(CAUTIs)?
a) Using antiseptic solutions in the catheter drainage bag.
b) Implementing a nurse-driven protocol for catheter removal.
c) Irrigating the catheter with sterile saline daily.
d) Securing the catheter to the patient's thigh.
Answer: b) Implementing a nurse-driven protocol for catheter removal.
19. When a nurse "delegates" a task to unlicensed assistive personnel (UAP), the nurse retains
accountability for:
a) The UAP's hourly wage and schedule.
b) The supervision and outcome of the delegated task.
COMPREHENSIVE COURSE REVIEW &
PREPARATION RESOURCE
1. A nurse is preparing to administer a high-alert medication. Which action best exemplifies
the "double-check" process recommended for such medications?
a) The nurse calculates the dose twice before administration.
b) The nurse asks the patient to verify their name and date of birth.
c) Two licensed healthcare professionals independently verify the drug, dose, and patient.
d) The nurse scans the patient's wristband and the medication barcode.
Answer: c) Two licensed healthcare professionals independently verify the drug, dose, and
patient.
2. The goal of a root cause analysis (RCA) following a sentinel event is primarily to:
a) Determine which individual staff member is at fault for the error.
b) Identify system-level failures that contributed to the event.
c) Create a report for the hospital's legal defense team.
d) Provide immediate disciplinary action for involved personnel.
Answer: b) Identify system-level failures that contributed to the event.
3. When using the SBAR (Situation, Background, Assessment, Recommendation)
communication tool, which component would include the patient's vital signs and current
clinical presentation?
a) Situation
b) Background
c) Assessment
d) Recommendation
Answer: c) Assessment
4. A patient has a documented allergy to sulfa drugs. The nurse is reviewing a new medication
order for Celecoxib (Celebrex). What is the nurse's most appropriate action?
a) Administer the medication as ordered; it is not an antibiotic.
b) Hold the medication and notify the prescribing provider immediately.
c) Administer the medication with an antihistamine to prevent a reaction.
d) Inform the patient that a mild rash is a common side effect.
Answer: b) Hold the medication and notify the prescribing provider immediately. (Celecoxib
contains a sulfonamide moiety and is contraindicated in patients with sulfa allergy.)
,5. Which finding by a nurse manager best indicates that a unit's fall prevention program is
effective?
a) The number of incident reports filed has decreased.
b) There has been a reduction in the unit's fall rate per 1000 patient-days.
c) All patients are now placed on bed rest.
d) Nurses report feeling more confident about fall protocols.
Answer: b) There has been a reduction in the unit's fall rate per 1000 patient-days.
6. The "Five Rights" of medication administration are a fundamental safety principle. Which
"right" is often the most challenging to ensure consistently?
a) Right patient
b) Right drug
c) Right dose
d) Right route
Answer: a) Right patient (Especially with issues like patient confusion, similar names, or
communication barriers).
7. A nurse is caring for a patient with Clostridioides difficile (C. diff). Which action is essential
for preventing transmission?
a) Wearing a sterile gown and gloves upon entering the room.
b) Using an alcohol-based hand sanitizer after patient contact.
c) Placing the patient in a negative pressure airflow room.
d) Using soap and water for hand hygiene after patient contact.
Answer: d) Using soap and water for hand hygiene after patient contact. (Alcohol-based
sanitizers are not effective against C. diff spores.)
8. During a code blue, the team leader assigns roles. This is an example of which crisis
resource management principle?
a) Knowing your environment
b) Allocating attention wisely
c) Using all available resources
d) Role clarity and assignment
Answer: d) Role clarity and assignment
9. Which intervention is most effective for preventing ventilator-associated pneumonia (VAP)?
a) Administering prophylactic broad-spectrum antibiotics.
b) Maintaining the head of the bed at 30-45 degrees.
c) Suctioning the endotracheal tube every 2 hours.
d) Using sterile water in the ventilator circuit.
Answer: b) Maintaining the head of the bed at 30-45 degrees.
,10. The Institute for Healthcare Improvement (IHI) Triple Aim framework focuses on:
a) Reducing costs, increasing nurse satisfaction, and improving technology.
b) Improving patient experience, improving population health, and reducing per capita costs.
c) Enhancing physician autonomy, expanding hospital services, and maximizing profits.
d) Decreasing medication errors, eliminating hospital-acquired infections, and shortening
lengths of stay.
Answer: b) Improving patient experience, improving population health, and reducing per
capita costs.
11. A nurse is using a clinical decision support system (CDSS) within the electronic health
record. The system alerts the nurse that a prescribed dose of vancomycin is higher than the
recommended range. The nurse's best action is to:
a) Override the alert, as the provider must know what they are doing.
b) Administer the medication but monitor the patient more closely.
c) Contact the pharmacist and the prescribing provider to clarify the order.
d) Document the alert in the nurse's notes and proceed.
Answer: c) Contact the pharmacist and the prescribing provider to clarify the order.
12. What is the primary purpose of a "time-out" or "pause before the procedure" in the
surgical setting?
a) To allow the surgical team to take a short break.
b) To confirm the correct patient, procedure, and site.
c) To count all sponges, needles, and instruments.
d) To administer preoperative antibiotics.
Answer: b) To confirm the correct patient, procedure, and site.
13. A patient with heart failure is being discharged. Which metric is the best indicator of a
successful transition of care and reduction in readmissions?
a) Patient satisfaction score at discharge.
b) 30-day hospital readmission rate for heart failure.
c) Number of medications prescribed at discharge.
d) The length of the patient's hospital stay.
Answer: b) 30-day hospital readmission rate for heart failure.
14. Which action by a nurse demonstrates the principle of "just culture" after a medication
error occurs?
a) Immediately suspending the nurse without pay.
b) Focusing solely on the individual's mistake for disciplinary action.
c) Investigating the system factors that led to the error while holding individuals accountable for
reckless behavior.
, d) Keeping the error a secret to protect the unit's reputation.
Answer: c) Investigating the system factors that led to the error while holding individuals
accountable for reckless behavior.
15. For a patient at high risk for suicide, the most important nursing intervention is:
a) Providing a supportive and empathetic environment.
b) Ensuring one-to-one constant observation.
c) Administering PRN anti-anxiety medication.
d) Placing the patient in a room far from the nurses' station.
Answer: b) Ensuring one-to-one constant observation.
16. The use of checklists in healthcare, such as for central line insertion, is primarily intended
to:
a) Replace clinical judgment.
b) Standardize and ensure adherence to evidence-based steps.
c) Reduce the need for experienced personnel.
d) Speed up the procedure time.
Answer: b) Standardize and ensure adherence to evidence-based steps.
17. A nurse is preparing to administer a blood transfusion. After obtaining the blood product
from the blood bank, the nurse must initiate the transfusion within what time frame to
ensure patient safety?
a) 15 minutes
b) 30 minutes
c) 2 hours
d) 4 hours
Answer: b) 30 minutes
18. Which strategy is most effective in reducing catheter-associated urinary tract infections
(CAUTIs)?
a) Using antiseptic solutions in the catheter drainage bag.
b) Implementing a nurse-driven protocol for catheter removal.
c) Irrigating the catheter with sterile saline daily.
d) Securing the catheter to the patient's thigh.
Answer: b) Implementing a nurse-driven protocol for catheter removal.
19. When a nurse "delegates" a task to unlicensed assistive personnel (UAP), the nurse retains
accountability for:
a) The UAP's hourly wage and schedule.
b) The supervision and outcome of the delegated task.
