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12) Which phrase best explains the Institute of Medicine's (IOM) 21st century rule, "Care based
on continuous healing relationships?"
1. Sharing of information
2. Patient-centered care
3. Access is critical
4. Care based on evidence
13) The Institute of Medicine (IOM) uses two dimensions in the quality matrix to describe
quality. Which factors are included in the first dimension? Select all that apply.
1. Patient-centeredness
2. Effectiveness
3. Timeliness
4. End-of-life care
5. Staying healthy
14) The nurse works with breast cancer survivors in a "Reach for Recovery" program. Which
portion of the Institute of Medicine's (IOM) focus on quality care does this work represent?
1. Staying healthy
2. Getting better
3. Living with illness or disability
4. Coping with palliative care or end-of-life issues
15) Match each of the National Quality Strategic Plan aims with appropriate priorities.
1. Aim: Better care
2. Aim: Healthy people/healthy communities
3. Aim: Affordable care
Match with these Choices:
A. Making care safer by reducing harm caused in the delivery of care.
B. Ensuring that each person and family is engaged as partners in their care.
C. Promoting effective communication and coordination of care.
D. Promoting the most effective prevention and treatment practices for the leading causes of
mortality, starting with cardiovascular disease.
E. Working with communities to promote wide use of best practices to enable healthy living.
F. Making quality care more affordable for individuals, families, employers, and governments by
developing and spreading new healthcare delivery models.
16) The faculty of a school of nursing has decided to follow the guidelines listed by the Institute
of Medicine (IOM) Health Professions Education report. Which competencies should the faculty
include in the school curriculum? Select all that apply.
1. How to use informatics
2. Information on working in interprofessional teams
3. How to tailor care to be patient-centered
4. The application of quality improvement to practice
5. How to use evidence-based information in practice
17) Select the option that reflects the focus of the "U" portion of the Joint Commission's "Speak
Up" program.
1. Use education to remain healthy.
2. Undergo as few medical procedures as possible.
3. Use accredited healthcare organizations.
18) High reliability organizations are best described by which statement?
1. An HCO that is ranked high in a national report card about healthcare quality
2. An HCO that views a near miss as a sign we are catching errors
3. Reliability in an organization requires that managers consider staff input
4. When operations are viewed as effective this is good sign
19) Which information would be used to monitor the process element of a hospital's quality?
1. The average daily census reports
2. Changes in community health status
3. Total percentage of nursing department salary hours paid to registered nurses
4. Patient satisfaction survey results regarding interaction with clinicians
20) Which statement, made by a staff nurse, indicates that the nurse understands the meaning of
Medicare HACs?
1. "I am a very good nurse, so it is unlikely that one of my patients would experience one of
these events."
2. "It is so hard when a patient experiences one of these events since they are not survivable."
3. "Thankfully, most nurses will never see a patient experience one of these events."
4. "I am working on the safety committee to help prevent the occurrence of these events."
21) The nurse commits an error while caring for a patient who receives Medicare benefits. The
error results in a complication that is on the Centers for Medicare and Medicaid Services' "never
list." What is the implication of this error?
1. The nurse will be investigated by the state's Board of Nursing.
2. The nurse's employment will be terminated.
3. Medicare will not pay for the cost of the complication.
4. The patient will have to share the cost of the care for the complication with Medicare.
22) What is true of quality in healthcare?
1. It is easy to define.
2. It is easy to measure.
3. It is complex.
4. It is unachievable.
23) A nurse works as a reviewer of Medicare claims. In this capacity, the nurse frequently denies
these claims. What is the primary rationale for this action?
1. It helps to protect the Medicare Trust Fund.
2. It serves to control unnecessary testing.
3. It keeps physician practice from becoming too independent.
4. It helps ensure that nursing care is safe.
24) The healthcare provider is aware that an error was made in the care of a hospitalized patient.
The provider is aware that information about the error would make it less likely that the same or
a similar error would happen to another patient. However, the provider is fearful of retribution
regarding the error. To which group should the provider consider reporting this information?
1. Patient Safety Organization (PSO)
2. Joint Commission
3. National Institute of Health (NIH)
4. Health Resources and Services Administration (HRSA)
25) The hospital's quality improvement department focuses on measuring structure, process, and
outcomes and identifying errors and hazards in the care provided. What other foci should the
department develop to become an effective quality improvement program? Select all that apply.
1. Assessing current practices and comparing them to what is done in other facilities.
2. Designing and testing interventions to improve quality.
3. Finding better resources for funding of initiatives.
4. Helping practitioners identify methods of improving personal practice.
5. Helping the facility recruit and retain qualified nurses.
