Nursing: Vaccine and Radiology Case Questions

D.) To promote safety by investigating the incidents

A.) To deny reimbursement to the facility

D.) Institute a policy to identify patients most likely to fall and procedures to assist in ambulating

which indicated that 75% of patients at this office are dissatisfied with long wait times in the waiting room.

What should the doctor's office do to increase patient satisfaction?

A.) Schedule patients with serious illnesses in the morning
B.) Reduce the number of patients scheduled per time slot
C.) Extend the daily office hours until later into the evenings
D.) Decrease the amount of time spent treating each patient

D.) Business process re-engineering

D.) Business process re-engineering

D.) Occupational Safety and Health Administration

B.) Increase staff awareness on patient pain control techniques

a quarterly employee injury report was submitted to a hospital's safety committee. The committee noted low compliance with the requirement that managers complete an investigation within 24 hours of an employee injury. The hospital risk manager has requested action plans from those departments with low compliance

Which action will bring the facility back into compliance with this requirement?

A.) Revise the hospital's policy to remove the investigation requirement
B.) Send an e-mail to managers asking them to complete the investigations
C.) Request the injured employee complete the investigation within 24 hours
D.) Have departments in violation submit their action plans to senior management

B.) Identify the cause of variances from evidence-based interventions

A.) Gather baseline data

the residents reported improvement.

Why is this continuous improvement practice successful?

A.) Because the food temperature is satisfactory
B.) Because the temperatures are now taken twice
C.) Because the residents have timely meal delivery
D.) Because the delivery is delayed by logging times

B.) Because the facility has fewer residents missing signed orders

leaving sensitive patient information available to other viewers.

Which action by the staff member will reduce security risk?

A.) Lock the staff member's computer screen
B.) Evaluate the feasibility of the current policy
C.) Discuss the incident with other staff members
D.) Request that staff members tell someone when leaving their computers

A.) Evaluate the stretchers for mechanical problems

but the hospital pharmacy is closed. A nurse provides the worker the access code to obtain narcotics from a drug dispensing unit on the floor. Another worker observes the event and reports the situation the next morning.

What should the hospital do first to reduce the immediate safety risks in this situation?

A.) Discipline the nurse.
B.) Change the access code.
C.) Perform a pharmacy inventory.
D.) Ask both workers to report to human resources.

A.) The nurse should lock the workstation prior to leaving for another room
B.) The nursing assistant should log into the chart using their own password

A.) Pull the fire alarm

A.) Patient outcomes will improve

A.) It increases the level of risk.

only a name was requested as an identifier when medications were being administered.

How does this decision affect quality?

A.) Efficiency may improve since rounds can be completed in less time.
B.) Medication errors may increase since control procedures were reduced.
C.) Patient satisfaction may decrease since they are asked fewer questions.
D.) Security of information may be enhanced since computer access is limited.

the nurse realized that the dosage administered was less than it should be

as regulated by the Occupational Safety and Health Administration (OSHA).

How should the manager monitor if these standards are met?

A.) Frequently checking how often PPE is ordered
B.) Communicating with each employee how PPE is stored
C.) Routinely logging observations of how employees use PPE
D.) Documenting how often employees receive training on PPE

A.) Audit employee training records

C.) Observe work areas to confirm PPE is available

C.) Conduct periodic security risk assessments

unauthorized access to a patient's electronic medical record (EMR) was found to have occurred. This is a breach of confidentiality in the Health Insurance Portability and Accountability Act (HIPAA).

What should the organization monitor to prevent similar problems in the future?

A.) Reports of password sharing among staff
B.) Documentation of staff training with the EMR
C.) Examination of staff understanding of HIPAA law
D.) Auditing of the frequency of access to health records

C.) Training on the safe handling and lifting of patients on transport

C.) Installing patient lift equipment in care areas

A.) Consideration of alternatives to termination prior to the decision
C.) Documentation of employee training on handling of drug samples

A.) Add an electronic alert to prompt for signatures

specifically the ones caused by lifting and transporting patients. OSHA discovered the workers were not performing these tasks appropriately.

Which risk management strategy should management implement to minimize these incidences in the future?

A.) Require all staff to be tested on ergonomics
B.) Educate all staff on the need for specific lifting devices
C.) Require all staff to have weight bearing training
D.) Educate all staff on the need for two people when lifting

it did not inquire about homeopathic remedies or other supplements. The physician prescribed a medication that caused a negative reaction due to the oversight.

Which risk management strategy should be implemented to avoid this situation in the future?

A.) Educating staff on which medications are safe
B.) Educating staff on asking about alternate therapies
C.) Educating staff on looking at patient past social history
D.) Educating staff on examining patient prescription history

while the neighbor was unharmed. The child was transported to the nearest emergency department (ED) via ambulance. Upon arrival

D.) Wait for the mother to return to complete the consent

D.) Provide credit monitoring for those impacted by identity theft

the doctor has vowed to change his methods.

How can the officer manager reduce this risk in the future?

A.) Advise patients to review the billing statements for accuracy
B.) Compare allowable amounts with the doctors existing fee structure
C.) Post the doctor's typical fees in the office for patients to see before services are rendered
D.) Question the doctor on whether procedures that were performed in the past are medically necessary

B.) Conduct a root cause analysis

C.) Train staff on the Health Insurance Portability and Accountability Act

D.) Involve Human Resources in workplace relationships and hiring

the Health Information Management director notices that a treatment was billed as an outpatient

this had happened more than once with this surgeon

B.) Enforce disciplinary action upon noncompliant employees

the patient develops shortness of breath and hives.

Which strategy can reduce the risk associated with this procedure?

A.) Ask the manager to increase staffing prior to the CT
B.) Ask the patient to identify their allergies prior to the CT
C.) Have the staff complete a safety report following the CT
D.) Have the patient sign informed consent following the CT

a nurse observes that the patient room is very cold and the television is loud. There is also a dinner tray from last night on the table

A.) Place the patient in an isolation area

new employees already receive training in proper disinfection methods.

What should be added to the infection risk control plan to improve effectiveness?

A.) Compare practices among newly hired housekeeping staff
B.) Employ a private cleaning service agency to disinfect rooms
C.) Provide regular performance feedback to housekeeping staff
D.) Use infectious disease specialists to clean patient care areas

C.) Increased number of unexpected patient deaths

B.) Poor physician bedside manner

A.) Civil Rights Act

but the supervisor decides to terminate the employee.

Which federal regulation has been violated in this scenario?

A.) National Labor Relations Act
B.) Famiily and Medical Leave Act
C.) Americans with Disabilities Act
D.) Emergency Medical Treatment and Active Labor Act

which is a new service for the hospital. Because employees will now go into patient homes to provide care

which provides in-home medical support including pain relief for dying patients. Care of terminally ill patients presents new risk management concerns for the facility.

What should be added to the facility's risk management plan to manage this new risk?

A.) Permit the use of restraints if a patient unexpectedly exhibits violent behavior
B.) Allow caregivers to communicate privileged information when abuse is suspected
C.) Create a procedure for storing controlled substances to prevent diversion by family members
D.) Provide guidance for staff in defining when family members can be present during treatment

D.) Discipline workers who transfer without using the lift

a hospital risk manager plans to update the risk management and safety plan.

What should the manager recommend to mitigate this risk?

A.) Conduct regular infant abduction scenario drills
B.) Educate local police on infant abduction protocols
C.) Provide fliers on infant abduction in waiting rooms
D.) Hold community awareness sessions on infant abduction

C.) Send valuables home with a family member

and the patient has an adverse reaction. A team reviews the risk management plan and identifies the problem as a miscalculated dosage.

Which action could the manager take to mitigate this risk?

A.) Assess the nurse's competence for dosage calculations
B.) Ensure future use of bar-coded medication administration
C.) Complete incident reports for medication calculation errors
D.) Have the patient confirm the accuracy of medication dosages

C.) Include the parent in the patient identification process

A.) Count Sponges in the same manner every time: STANDARDIZE THE PROCESS
B.) Make use of a checklist during final sponge counts: USE COGNITIVE AIDS
C.) Use radio frequency identification-enabled sponges: ADD ENGINEERING CONTROLS
D.) Require two staff members to independently confirm accuracy of sponge counts: IMPLEMENT DOUBLE CHECKS

so the medication is inadvertently discontinued when the resident returns. The patient later suffers a stroke due to the missing blood thinner.

Which patient safety action should be incorporated into the risk management plan to prevent recurrence of this type of event?

A.) Require the medical director to interview all returning residents
B.) Ask returning residents if any medical treatments were changed
C.) Review physician orders for returning residents to identify medication changes
D.) Contact the family of returning residents to get updated medication information

the incidence of hospital-acquired heel pressure ulcers is found to be slightly higher.

Which action should improve the effectiveness of the plan?

A.) Daily multidisciplinary end-of-shift huddles
B.) Patient bedding changed on a regular basis
C.) Completion of incident reports for new pressure ulcers
D.) Regular audits of nurse compliance with expected practices

the director reports an increase in pressure ulcers for bedridden residents.

Which action will improve the effectiveness of this risk management plan?

A.) Hold a nurses' meeting to review admission screening
B.) Hire a consultant to review the repositioning guidelines
C.) Ask residents to report noncompliance of turning requirement
D.) Conduct a staff focus group to determine barriers to compliance

this resident did not have one on.

How can the effectiveness of the risk management plan be improved?

A.) Evaluate sensor system for effective operations
B.) Check for electronic bracelet placement at shift change
C.) Visit resident bedrooms hourly to determine their location
D.) Assist residents in developing an understanding of local geography

which is incorrect. The organization's risk management plan includes following the code status of each patient.

Which practice can be implemented to improve the effectiveness of this risk management plan?

A.) Call patient's next-of-kin prior to starting CPR
B.) Retrain nursing staff on how to perform CPR
C.) Ask physicians to discuss code status with patients
D.) Use color wrist bands to identify patient code status

C.) The risk management plan was ineffective because the nurse failed to match the order with the vaccine chosen

B.) Patients can explain how medications should be taken

B.) Patient readmission rates decline

and a risk management plan was implemented that involved improved patient monitoring and staff training.

How would the effectiveness of the plan be evaluated?

A.) Number of staff members that attend the training
B.) Percent of patients that fall during night hours
C.) Percent of patients monitored during night hours
D.) Number of staff members that conduct required patient monitoring

the patient suffered a fatal cardiopulmonary arrest. According to the hospital's risk management plan

the patient's blood pressure dropped significantly