NR 446 Patient Safety & Quality Improvement Practice Pack 2026
|Chamberlain College
1. What is the primary goal of a Root Cause Analysis (RCA) in a hospital setting?
A. To identify the specific person responsible for an error
B. To uncover systemic failures rather than individual blame
C. To determine the legal liability of the healthcare institution
D. To reduce the costs associated with medical malpractice claims
Answer: B
Rationale: RCA is a process for identifying the factors that underlie variation in
performance, including the occurrence or possible occurrence of a sentinel event. It focuses
primarily on systems and processes, not on individual performance.
2. Which nursing-sensitive quality indicator is tracked by the National Database
of Nursing Quality Indicators (NDNQI)?
A. Patient satisfaction with physician communication
B. Pressure injury prevalence
C. Hospital readmission rates for pneumonia
D. The number of surgeries performed per year
Answer: B
Rationale: Pressure injury prevalence is a classic nursing-sensitive indicator as it reflects
the quality of nursing care and interventions provided to the patient.
,3. According to The Joint Commission, which of the following is classified as a
sentinel event?
A. A patient falling without sustaining an injury
B. A medication error that is caught before reaching the patient
C. A post-operative infection that resolves with antibiotics
D. A patient suicide in a 24-hour staffed setting
Answer: D
Rationale: A sentinel event is a patient safety event that reaches a patient and results in
death, permanent harm, or severe temporary harm. Patient suicide in a setting where they
are monitored 24/7 is a specific example.
4. In the SBAR communication tool, what does the ‘B’ stand for?
A. Behavior
B. Background
C. Beliefs
D. Benchmark
Answer: B
Rationale: SBAR stands for Situation, Background, Assessment, and Recommendation.
Background provides the clinical context and history of the patient.
5. Which quality improvement methodology focuses on eliminating waste and
improving process flow?
A. Lean
B. Six Sigma
C. Total Quality Management
D. Failure Mode and Effects Analysis
Answer: A
Rationale: Lean methodology focuses on improving process efficiency by eliminating non-
value-added activities or ‘waste’.
, 6. What is the first step in the PDSA cycle?
A. Perform the change on a small scale
B. Act on the findings to implement at scale
C. Study the data and results
D. Plan the change and predict the results
Answer: D
Rationale: PDSA stands for Plan, Do, Study, Act. Planning the change is the initial step.
7. Which strategy is most effective for preventing medication errors during
patient transfers?
A. Verbal reporting only
B. Medication reconciliation
C. Checking the patient’s wristband
D. Using high-alert medication labels
Answer: B
Rationale: Medication reconciliation is the process of comparing a patient’s medication
orders to all of the medications that the patient has been taking to avoid errors such as
omissions, duplications, or dosing errors.
8. A nurse identifies an error before it reaches the patient. This is known as a:
A. Sentinel Event
B. Adverse Event
C. Near Miss
D. No-Harm Event
Answer: C
Rationale: A near miss (or close call) is an unplanned event that did not reach the patient
but had the potential to do so.
|Chamberlain College
1. What is the primary goal of a Root Cause Analysis (RCA) in a hospital setting?
A. To identify the specific person responsible for an error
B. To uncover systemic failures rather than individual blame
C. To determine the legal liability of the healthcare institution
D. To reduce the costs associated with medical malpractice claims
Answer: B
Rationale: RCA is a process for identifying the factors that underlie variation in
performance, including the occurrence or possible occurrence of a sentinel event. It focuses
primarily on systems and processes, not on individual performance.
2. Which nursing-sensitive quality indicator is tracked by the National Database
of Nursing Quality Indicators (NDNQI)?
A. Patient satisfaction with physician communication
B. Pressure injury prevalence
C. Hospital readmission rates for pneumonia
D. The number of surgeries performed per year
Answer: B
Rationale: Pressure injury prevalence is a classic nursing-sensitive indicator as it reflects
the quality of nursing care and interventions provided to the patient.
,3. According to The Joint Commission, which of the following is classified as a
sentinel event?
A. A patient falling without sustaining an injury
B. A medication error that is caught before reaching the patient
C. A post-operative infection that resolves with antibiotics
D. A patient suicide in a 24-hour staffed setting
Answer: D
Rationale: A sentinel event is a patient safety event that reaches a patient and results in
death, permanent harm, or severe temporary harm. Patient suicide in a setting where they
are monitored 24/7 is a specific example.
4. In the SBAR communication tool, what does the ‘B’ stand for?
A. Behavior
B. Background
C. Beliefs
D. Benchmark
Answer: B
Rationale: SBAR stands for Situation, Background, Assessment, and Recommendation.
Background provides the clinical context and history of the patient.
5. Which quality improvement methodology focuses on eliminating waste and
improving process flow?
A. Lean
B. Six Sigma
C. Total Quality Management
D. Failure Mode and Effects Analysis
Answer: A
Rationale: Lean methodology focuses on improving process efficiency by eliminating non-
value-added activities or ‘waste’.
, 6. What is the first step in the PDSA cycle?
A. Perform the change on a small scale
B. Act on the findings to implement at scale
C. Study the data and results
D. Plan the change and predict the results
Answer: D
Rationale: PDSA stands for Plan, Do, Study, Act. Planning the change is the initial step.
7. Which strategy is most effective for preventing medication errors during
patient transfers?
A. Verbal reporting only
B. Medication reconciliation
C. Checking the patient’s wristband
D. Using high-alert medication labels
Answer: B
Rationale: Medication reconciliation is the process of comparing a patient’s medication
orders to all of the medications that the patient has been taking to avoid errors such as
omissions, duplications, or dosing errors.
8. A nurse identifies an error before it reaches the patient. This is known as a:
A. Sentinel Event
B. Adverse Event
C. Near Miss
D. No-Harm Event
Answer: C
Rationale: A near miss (or close call) is an unplanned event that did not reach the patient
but had the potential to do so.
