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Quality and Safety Education for
Nurses, 3rd Edition -
Test Bank
Chapter:
Unit I: Role of the Nurse in Healthcare
Chapter 1: Patient Safety and Quality of Care as Measures of Nursing Competence
Chapter 2: Nurses as Leaders and Managers for Safe, High-Quality Patient Care
Chapter 3: Systems Thinking
Chapter 4: Legal and Ethical Aspects of Nursing Quality and Safety
Chapter 5: Delegation and Setting Priorities for Safe, High-Quality Patient Care
Unit II: Quality and Safety Competencies
Chapter 6: Person-Centered Care
Chapter 7: Interprofessional Teamwork and Collaboration
Chapter 8: Informatics
Chapter 9: Evidence-Based Nursing Practice
Chapter 10: Patient Safety
Chapter 11: Quality Improvement Essentials Free
Chapter 12: Quality Improvement Tools
Unit III: Application for Practice
Chapter 13: Implementation Science
Chapter 14: Quality Improvement and Project Management
Chapter 15: Population Health and the Role of Quality and Safety
Chapter 16: Professional Role Development in Patient Safety and Quality:
Transitioning to Practice
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Chapter 1: Patient Safety and Quality of Care as Measures
of Nursing Competence
Question 1. A nurse is caring for a patient scenario related to Patient Safety and
Quality of Care as Measures of Nursing Competence. Which action is the best
immediate nursing response?
A. Delay intervention until the next team huddle
B. Use unit protocol and verify patient-specific risk factors
C. Ask unlicensed staff to decide the priority
D. Document first and assess later
✅ Correct Answer: B. Use unit protocol and verify patient-specific risk factors
Rationale: Applying Patient Safety and Quality of Care as Measures of Nursing
Competence requires timely use of protocol plus patient-specific assessment to
reduce harm and improve outcomes.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 1]
MSC: NCLEX Client Needs Category: [Safe and Effective Care Environment]
Question 2. During bedside handoff, a concern linked to Patient Safety and Quality
of Care as Measures of Nursing Competence is identified. What should the nurse
do first?
A. Clarify the concern with closed-loop communication
B. Wait for the provider round before speaking
C. Remove the concern from report to avoid alarm
D. Escalate directly to administration without assessment
✅ Correct Answer: A. Clarify the concern with closed-loop communication
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Rationale: Closed-loop clarification prevents information loss and supports safe,
coordinated action.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 2]
MSC: NCLEX Client Needs Category: [Management of Care]
Question 3. A newly admitted patient has a risk profile that may worsen outcomes
unless Patient Safety and Quality of Care as Measures of Nursing Competence
principles are used. Which intervention is priority?
A. Implement standardized screening and reassess at defined intervals
B. Rely on memory instead of checklists
C. Postpone care plan updates until discharge
D. Use a one-size-fits-all intervention
✅ Correct Answer: A. Implement standardized screening and reassess at defined
intervals
Rationale: Standardized screening and scheduled reassessment identify
deterioration early and guide individualized care.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 3]
MSC: NCLEX Client Needs Category: [Safety and Infection Control]
Question 4. The charge nurse audits practice on a unit focus related to Patient
Safety and Quality of Care as Measures of Nursing Competence. Which finding
indicates best practice?
A. Variation in care despite identical indications
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B. Use of evidence-based bundle elements with documentation
C. No discussion of near misses
D. Frequent workarounds around safety checks
✅ Correct Answer: B. Use of evidence-based bundle elements with documentation
Rationale: Consistent use of evidence-based bundle elements is linked to better
reliability and safer outcomes.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 4]
MSC: NCLEX Client Needs Category: [Health Promotion and Maintenance]
Question 5. A nurse must choose between two tasks while applying Patient Safety
and Quality of Care as Measures of Nursing Competence. Which task should be
completed first?
A. Nonurgent teaching for a stable patient
B. Assessment of a patient with new high-risk symptoms
C. Routine stock check
D. Optional committee email
✅ Correct Answer: B. Assessment of a patient with new high-risk symptoms
Rationale: Prioritization under Patient Safety and Quality of Care as Measures of
Nursing Competence emphasizes immediate assessment of high-risk changes
before nonurgent activities.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 5]
MSC: NCLEX Client Needs Category: [Psychosocial Integrity]
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Question 6. A patient/family asks why a specific safety step is needed under
Patient Safety and Quality of Care as Measures of Nursing Competence. What is
the best response?
A. "It is just unit habit."
B. "This step lowers preventable harm and helps us detect problems early."
C. "You do not need to know details."
D. "We only do it for legal reasons."
✅ Correct Answer: B. "This step lowers preventable harm and helps us detect
problems early."
Rationale: Clear patient-centered explanation improves engagement and adherence
while reinforcing safety purpose.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 6]
MSC: NCLEX Client Needs Category: [Physiological Integrity]
Question 7. In a debrief about a near miss involving Patient Safety and Quality of
Care as Measures of Nursing Competence, which nurse statement reflects systems
thinking?
A. "The individual is solely to blame."
B. "Let us map process gaps and latent conditions that allowed the error."
C. "Near misses are not worth reviewing."
D. "Punishment is the only effective fix."
✅ Correct Answer: B. "Let us map process gaps and latent conditions that allowed
the error."
Rationale: Systems analysis targets process defects and latent risks, producing
sustainable improvement.
, 7
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 7]
MSC: NCLEX Client Needs Category: [Reduction of Risk Potential]
Question 8. A nurse is precepting a novice on Patient Safety and Quality of Care as
Measures of Nursing Competence. Which teaching point is most accurate?
A. Standardization limits clinical judgment
B. Standardization supports judgment by reducing avoidable variation
C. Documentation is optional when care is obvious
D. Escalation should wait until shift end
✅ Correct Answer: B. Standardization supports judgment by reducing avoidable
variation
Rationale: Reliable standards reduce variation and cognitive load so clinical
judgment can focus on patient-specific needs.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 8]
MSC: NCLEX Client Needs Category: [Pharmacological and Parenteral Therapies]
Question 9. When applying Patient Safety and Quality of Care as Measures of
Nursing Competence in a high-acuity setting, which indicator most strongly
suggests risk escalation?
A. Stable trends over 24 hours
B. New abnormal vital-sign trend with delayed response
C. Completed admission checklist
D. Family satisfaction with meals
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✅ Correct Answer: B. New abnormal vital-sign trend with delayed response
Rationale: Unaddressed abnormal trends indicate potential deterioration and
require urgent escalation.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 9]
MSC: NCLEX Client Needs Category: [Safe and Effective Care Environment]
Question 10. A quality dashboard for Patient Safety and Quality of Care as
Measures of Nursing Competence is reviewed. Which metric is most actionable for
frontline nursing improvement?
A. A broad annual mission statement
B. Unit-level process compliance linked to outcomes
C. Hospital parking utilization
D. Number of decorative posters
✅ Correct Answer: B. Unit-level process compliance linked to outcomes
Rationale: Frontline teams can act on process measures tied to outcomes to
improve reliability.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 10]
MSC: NCLEX Client Needs Category: [Management of Care]
Question 11. The nurse identifies a barrier to Patient Safety and Quality of Care as
Measures of Nursing Competence implementation. Which strategy is best?
A. Ignore resistance and continue silently
B. Use brief coaching, data feedback, and role modeling
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Quality and Safety Education for
Nurses, 3rd Edition -
Test Bank
Chapter:
Unit I: Role of the Nurse in Healthcare
Chapter 1: Patient Safety and Quality of Care as Measures of Nursing Competence
Chapter 2: Nurses as Leaders and Managers for Safe, High-Quality Patient Care
Chapter 3: Systems Thinking
Chapter 4: Legal and Ethical Aspects of Nursing Quality and Safety
Chapter 5: Delegation and Setting Priorities for Safe, High-Quality Patient Care
Unit II: Quality and Safety Competencies
Chapter 6: Person-Centered Care
Chapter 7: Interprofessional Teamwork and Collaboration
Chapter 8: Informatics
Chapter 9: Evidence-Based Nursing Practice
Chapter 10: Patient Safety
Chapter 11: Quality Improvement Essentials Free
Chapter 12: Quality Improvement Tools
Unit III: Application for Practice
Chapter 13: Implementation Science
Chapter 14: Quality Improvement and Project Management
Chapter 15: Population Health and the Role of Quality and Safety
Chapter 16: Professional Role Development in Patient Safety and Quality:
Transitioning to Practice
, 3
Chapter 1: Patient Safety and Quality of Care as Measures
of Nursing Competence
Question 1. A nurse is caring for a patient scenario related to Patient Safety and
Quality of Care as Measures of Nursing Competence. Which action is the best
immediate nursing response?
A. Delay intervention until the next team huddle
B. Use unit protocol and verify patient-specific risk factors
C. Ask unlicensed staff to decide the priority
D. Document first and assess later
✅ Correct Answer: B. Use unit protocol and verify patient-specific risk factors
Rationale: Applying Patient Safety and Quality of Care as Measures of Nursing
Competence requires timely use of protocol plus patient-specific assessment to
reduce harm and improve outcomes.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 1]
MSC: NCLEX Client Needs Category: [Safe and Effective Care Environment]
Question 2. During bedside handoff, a concern linked to Patient Safety and Quality
of Care as Measures of Nursing Competence is identified. What should the nurse
do first?
A. Clarify the concern with closed-loop communication
B. Wait for the provider round before speaking
C. Remove the concern from report to avoid alarm
D. Escalate directly to administration without assessment
✅ Correct Answer: A. Clarify the concern with closed-loop communication
, 4
Rationale: Closed-loop clarification prevents information loss and supports safe,
coordinated action.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 2]
MSC: NCLEX Client Needs Category: [Management of Care]
Question 3. A newly admitted patient has a risk profile that may worsen outcomes
unless Patient Safety and Quality of Care as Measures of Nursing Competence
principles are used. Which intervention is priority?
A. Implement standardized screening and reassess at defined intervals
B. Rely on memory instead of checklists
C. Postpone care plan updates until discharge
D. Use a one-size-fits-all intervention
✅ Correct Answer: A. Implement standardized screening and reassess at defined
intervals
Rationale: Standardized screening and scheduled reassessment identify
deterioration early and guide individualized care.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 3]
MSC: NCLEX Client Needs Category: [Safety and Infection Control]
Question 4. The charge nurse audits practice on a unit focus related to Patient
Safety and Quality of Care as Measures of Nursing Competence. Which finding
indicates best practice?
A. Variation in care despite identical indications
, 5
B. Use of evidence-based bundle elements with documentation
C. No discussion of near misses
D. Frequent workarounds around safety checks
✅ Correct Answer: B. Use of evidence-based bundle elements with documentation
Rationale: Consistent use of evidence-based bundle elements is linked to better
reliability and safer outcomes.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 4]
MSC: NCLEX Client Needs Category: [Health Promotion and Maintenance]
Question 5. A nurse must choose between two tasks while applying Patient Safety
and Quality of Care as Measures of Nursing Competence. Which task should be
completed first?
A. Nonurgent teaching for a stable patient
B. Assessment of a patient with new high-risk symptoms
C. Routine stock check
D. Optional committee email
✅ Correct Answer: B. Assessment of a patient with new high-risk symptoms
Rationale: Prioritization under Patient Safety and Quality of Care as Measures of
Nursing Competence emphasizes immediate assessment of high-risk changes
before nonurgent activities.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 5]
MSC: NCLEX Client Needs Category: [Psychosocial Integrity]
, 6
Question 6. A patient/family asks why a specific safety step is needed under
Patient Safety and Quality of Care as Measures of Nursing Competence. What is
the best response?
A. "It is just unit habit."
B. "This step lowers preventable harm and helps us detect problems early."
C. "You do not need to know details."
D. "We only do it for legal reasons."
✅ Correct Answer: B. "This step lowers preventable harm and helps us detect
problems early."
Rationale: Clear patient-centered explanation improves engagement and adherence
while reinforcing safety purpose.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 6]
MSC: NCLEX Client Needs Category: [Physiological Integrity]
Question 7. In a debrief about a near miss involving Patient Safety and Quality of
Care as Measures of Nursing Competence, which nurse statement reflects systems
thinking?
A. "The individual is solely to blame."
B. "Let us map process gaps and latent conditions that allowed the error."
C. "Near misses are not worth reviewing."
D. "Punishment is the only effective fix."
✅ Correct Answer: B. "Let us map process gaps and latent conditions that allowed
the error."
Rationale: Systems analysis targets process defects and latent risks, producing
sustainable improvement.
, 7
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 7]
MSC: NCLEX Client Needs Category: [Reduction of Risk Potential]
Question 8. A nurse is precepting a novice on Patient Safety and Quality of Care as
Measures of Nursing Competence. Which teaching point is most accurate?
A. Standardization limits clinical judgment
B. Standardization supports judgment by reducing avoidable variation
C. Documentation is optional when care is obvious
D. Escalation should wait until shift end
✅ Correct Answer: B. Standardization supports judgment by reducing avoidable
variation
Rationale: Reliable standards reduce variation and cognitive load so clinical
judgment can focus on patient-specific needs.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 8]
MSC: NCLEX Client Needs Category: [Pharmacological and Parenteral Therapies]
Question 9. When applying Patient Safety and Quality of Care as Measures of
Nursing Competence in a high-acuity setting, which indicator most strongly
suggests risk escalation?
A. Stable trends over 24 hours
B. New abnormal vital-sign trend with delayed response
C. Completed admission checklist
D. Family satisfaction with meals
, 8
✅ Correct Answer: B. New abnormal vital-sign trend with delayed response
Rationale: Unaddressed abnormal trends indicate potential deterioration and
require urgent escalation.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 9]
MSC: NCLEX Client Needs Category: [Safe and Effective Care Environment]
Question 10. A quality dashboard for Patient Safety and Quality of Care as
Measures of Nursing Competence is reviewed. Which metric is most actionable for
frontline nursing improvement?
A. A broad annual mission statement
B. Unit-level process compliance linked to outcomes
C. Hospital parking utilization
D. Number of decorative posters
✅ Correct Answer: B. Unit-level process compliance linked to outcomes
Rationale: Frontline teams can act on process measures tied to outcomes to
improve reliability.
DIF: [Applying]
TOP: [Patient Safety and Quality of Care as Measures of Nursing
Competence/Core concept 10]
MSC: NCLEX Client Needs Category: [Management of Care]
Question 11. The nurse identifies a barrier to Patient Safety and Quality of Care as
Measures of Nursing Competence implementation. Which strategy is best?
A. Ignore resistance and continue silently
B. Use brief coaching, data feedback, and role modeling
