NURS 110: Patient Safety & Quality Improvement - 2026/2027 Update
2026 |WCU
1. Which QSEN competency focuses on the use of data to monitor the outcomes
of care processes and the design of changes to improve the health care system?
A. Evidence-Based Practice
B. Safety
C. Informatics
D. Quality Improvement
Answer: D
Rationale: Quality Improvement (QI) specifically involves using data to monitor outcomes
and implementing changes to improve system performance.
2. A nurse discovers a medication error but the patient suffered no harm. This
event is classified as:
A. A sentinel event
B. A benchmark event
C. An adverse event
D. A near miss
Answer: D
Rationale: A near miss is an unplanned event that did not result in injury, illness, or
damage—but had the potential to do so.
,3. According to the Joint Commission, what is the primary purpose of a Root
Cause Analysis (RCA) following a sentinel event?
A. To identify which staff member is responsible for the error
B. To fulfill legal requirements for malpractice defense
C. To identify underlying system failures and prevent recurrence
D. To provide a basis for terminating employment
Answer: C
Rationale: RCA is a retrospective process used to identify the underlying system-level
factors that contributed to an error, focusing on prevention rather than individual blame.
4. Which model of patient safety emphasizes that errors occur due to the
alignment of holes in multiple layers of defense?
A. The Domino Theory
B. The Swiss Cheese Model
C. The Pareto Principle
D. The Donabedian Model
Answer: B
Rationale: James Reason’s Swiss Cheese Model posits that systems have many layers of
defense, and errors occur when the ‘holes’ (weaknesses) in every layer align.
5. In a ‘Just Culture’ environment, what is the appropriate management
response to a nurse who makes a human error due to system fatigue?
A. Punitive action to deter others
B. Mandatory retraining and suspension
C. Consoling the nurse and evaluating the system
D. Ignoring the event if no harm occurred
Answer: C
, Rationale: Just Culture distinguishes between human error (console), risky behavior
(coach), and reckless behavior (punish). Human error is managed by system changes and
support.
6. Which nursing-sensitive indicator is most directly impacted by nurse staffing
levels and the frequency of patient turning?
A. Patient satisfaction with pain management
B. Catheter-associated urinary tract infections
C. Medication reconciliation rates
D. Hospital-acquired pressure injuries
Answer: D
Rationale: Pressure injuries are a classic nursing-sensitive indicator because they are
highly dependent on the quality and quantity of nursing care provided.
7. When using the SBAR communication tool, which component involves the
nurse suggesting a specific intervention or plan of action?
A. Situation
B. Background
C. Recommendation
D. Assessment
Answer: C
Rationale: Recommendation is the ‘R’ in SBAR, where the nurse states what they think
needs to happen or what they are requesting from the provider.
8. What is the first step in the PDSA cycle for quality improvement?
A. Plan the change and predict outcomes
B. Perform the change
C. Study the results of the change
D. Act on what was learned
Answer: A
2026 |WCU
1. Which QSEN competency focuses on the use of data to monitor the outcomes
of care processes and the design of changes to improve the health care system?
A. Evidence-Based Practice
B. Safety
C. Informatics
D. Quality Improvement
Answer: D
Rationale: Quality Improvement (QI) specifically involves using data to monitor outcomes
and implementing changes to improve system performance.
2. A nurse discovers a medication error but the patient suffered no harm. This
event is classified as:
A. A sentinel event
B. A benchmark event
C. An adverse event
D. A near miss
Answer: D
Rationale: A near miss is an unplanned event that did not result in injury, illness, or
damage—but had the potential to do so.
,3. According to the Joint Commission, what is the primary purpose of a Root
Cause Analysis (RCA) following a sentinel event?
A. To identify which staff member is responsible for the error
B. To fulfill legal requirements for malpractice defense
C. To identify underlying system failures and prevent recurrence
D. To provide a basis for terminating employment
Answer: C
Rationale: RCA is a retrospective process used to identify the underlying system-level
factors that contributed to an error, focusing on prevention rather than individual blame.
4. Which model of patient safety emphasizes that errors occur due to the
alignment of holes in multiple layers of defense?
A. The Domino Theory
B. The Swiss Cheese Model
C. The Pareto Principle
D. The Donabedian Model
Answer: B
Rationale: James Reason’s Swiss Cheese Model posits that systems have many layers of
defense, and errors occur when the ‘holes’ (weaknesses) in every layer align.
5. In a ‘Just Culture’ environment, what is the appropriate management
response to a nurse who makes a human error due to system fatigue?
A. Punitive action to deter others
B. Mandatory retraining and suspension
C. Consoling the nurse and evaluating the system
D. Ignoring the event if no harm occurred
Answer: C
, Rationale: Just Culture distinguishes between human error (console), risky behavior
(coach), and reckless behavior (punish). Human error is managed by system changes and
support.
6. Which nursing-sensitive indicator is most directly impacted by nurse staffing
levels and the frequency of patient turning?
A. Patient satisfaction with pain management
B. Catheter-associated urinary tract infections
C. Medication reconciliation rates
D. Hospital-acquired pressure injuries
Answer: D
Rationale: Pressure injuries are a classic nursing-sensitive indicator because they are
highly dependent on the quality and quantity of nursing care provided.
7. When using the SBAR communication tool, which component involves the
nurse suggesting a specific intervention or plan of action?
A. Situation
B. Background
C. Recommendation
D. Assessment
Answer: C
Rationale: Recommendation is the ‘R’ in SBAR, where the nurse states what they think
needs to happen or what they are requesting from the provider.
8. What is the first step in the PDSA cycle for quality improvement?
A. Plan the change and predict outcomes
B. Perform the change
C. Study the results of the change
D. Act on what was learned
Answer: A
