Sullivan, Effective Leadership and Management, 8/e
Chapter 6
Question 1
Type: MCSA
Which situation is an example of the overall goal of quality management in today’s health care activities?
1. The nurse manager realizes a policy was ineffective in reducing incidents.
2. The administrator walks around making a list of potential problems.
3. The human resources department fires nonproductive employees.
4. The nurse wipes up a spilled drink before clients are allowed to enter a room.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 6-1: Describe how total quality management, continuous quality management, Six Sigma,
Lean Six Sigma, and DMAIC address quality.
Question 2
Type: MCSA
As part of the process of promoting quality improvement, the nursing manager is comparing data between two
hospitals on average length of stay for a total hip replacement. This comparison is an example of which process or
step?
Sullivan, Effective Leadership and Management, 8/e Test Bank
1. Benchmarking
2. Outcome standard
3. Indicator
4. Process standard
Rationale 1: CQI is the actual process, not the philosophy, used to improve quality and performance.
Rationale 2: TQM is a management philosophy emphasizing a commitment to excellence throughout the
organization. It is founded on four core concepts: client, organizational involvement, quantitative measurement of
outcomes, and processes for improvement.
Rationale 3: The PDCA cycle is a scientific method used to build knowledge, make decisions, and improve
quality outcomes within an organization. It is a process, not a philosophy.
Rationale 4: Six Sigma is a quality management program that uses measures, goals, and management
involvement to monitor performance and ensure progress. It is a process, not a philosophy.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 6-1: Describe how total quality management, continuous quality management, Six Sigma,
Lean Six Sigma, and DMAIC address quality.
Question 4
Type: MCSA
The nursing task force is developing measurable goals for each client on the orthopedic unit. The statement “Each
client will have a written assessment and plan of care document within eight hours of admission” is an example of
which component of quality management?
1. Indicator
2. Structure standard
3. Benchmark
4. Process standard
Rationale 4: A process standard is a written statement that defines actual delivery of nursing care to a specific
population.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 6-1: Describe how total quality management, continuous quality management, Six Sigma,
Lean Six Sigma, and DMAIC address quality.
Question 5
Type: MCMA
Which situation would be included in reporting for Joint Commission mandatory national patient safety goals?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The average wait time in the emergency department has increased by 5 minutes over last year’s average.
2. A client is left waiting in the hallway because the transport person did not make contact with the client’s nurse.
3. A nurse gives a medication by the wrong route.
4. A client developed sepsis after insertion of a urinary catheter.
5. Surgery is done on a client’s right eye instead of the left eye.
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 6-2: Describe national efforts to improve the quality of health care.
Question 6
Type: MCMA
Efforts to increase nurses’ use of evidence-based practice (EBP) to improve client care in the hospital have failed.
Which answers are nurses likely to give when asked why this is occurring?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. “I’m not interested in this program.”
2. “I don’t have time to finish everything I already have to do each shift.”
3. “I don’t want to practice nursing just like everyone else.”
4. “The library at our hospital doesn’t have many journals.”
5. “If administration wanted us to use EBP, they would get us some more nurses to share the work.”
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
Learning Outcome: 6-3: Explain how evidence-based practice, electronic medical records, and dashboards can
improve quality.
Question 7
Type: MCSA
A client has been told that chemotherapy must be postponed until he is hydrated. The client refuses the
intravenous hydration and demands to go home. How would the nurse best categorize this situation?
1. As a nonreportable incident
2. As a medical-legal incident
3. As client dissatisfaction with care
4. As a medication error
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 6-4: Point out how nurses are involved in reducing risks.
Question 8
Type: MCSA
Immediately following a barium swallow, a client noticed hives and a feeling of shortness of breath. Although
there were no known allergies to food or drugs prior to this incident, the diagnosis was allergic reaction to the
preservatives in the barium. Which is the correct risk category for this incident?
1. Medication error
Sullivan, Effective Leadership and Management, 8/e Test Bank
2. Medical-legal incident
3. Procedure complication
4. This incident does not fall into a risk category.
Rationale 2: The words accidentally should not be used to document incidents.
Rationale 3: The nurse is not certain the IV was turned off by the previous shift, so that entry should not be used.
Rationale 4: The fact that an incident report was completed should not be documented.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 6-4: Point out how nurses are involved in reducing risks.
Question 10
Type: MCSA
The following documentation was entered in the client’s medical record: “The client was found lying on the floor.
Dr. X was notified. Apparently the restraints were improperly applied.” Which statement best describes this
documentation?
1. Appropriately written
2. Inappropriate because it places blame on an individual
3. Inappropriate because it does not include that the client’s family was notified
4. Appropriately written because it only documents the facts
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 6-4: Point out how nurses are involved in reducing risks.
Question 11
Type: MCMA
The nurse is assigned to the Risk Management Team. Which events would be addressed by this team?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. A client’s hand is injured during an arterial blood gas draw.
2. A client’s family is dissatisfied with the breakfast just served.
3. A client leaves the hospital against medical advice (AMA).
4. A client claims he is not ready to be discharged.
5. The family does not want a client to be transferred from the intensive care unit (ICU).
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 6-4: Point out how nurses are involved in reducing risks.
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
Question 12
Type: MCSA
Which statement reflects a characteristic common to all methods of quality management?
1. Each method uses all staff members in the organization.
2. None of the methods are designed to place blame on an individual.
3. All methods provide clinical information.
4. Most methods focus on cost containment.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 6-1: Describe how total quality management, continuous quality management, Six Sigma,
Lean Six Sigma, and DMAIC address quality.
Question 13
Type: MCSA
The director of quality improvement reports that the hospital will soon be using “dashboards” as part of the
quality management process. How should the staff interpret this information?
1. Surveyors are driving to clients’ homes to collect data on hospital visits.
2. This electronic tool makes it easy to aggregate and display data.
3. “Dashboard” is an acronym for the topics covered in client satisfaction surveys.
Sullivan, Effective Leadership and Management, 8/e Test Bank