ANM Patient Safety and Advocacy 3 — Questions and Answers
Question 1: The Joint Commission's National Patient Safety Goals (NPSGs) primarily aim to:
- Standardize hospital billing practices
- Address specific patient safety problems identified through sentinel event analysis (Correct answer)
- Regulate nursing staff-to-patient ratios nationally
- Define scope of practice for advanced practice nurses
Correct answer: Address specific patient safety problems identified through sentinel event analysis
NPSGs are evidence-based goals developed from analysis of sentinel events to prevent recurring patient harm.
Question 2: A staff nurse reports that a physician dismissed her concern about a deteriorating patient. As the ANM, what is the most appropriate response?
- Tell the nurse to document the concern and wait
- Support the nurse in escalating through the chain of command and activate the rapid response team if warranted (Correct answer)
- Contact the physician directly to complain about dismissive behavior
- Reassure the nurse that the physician knows best
Correct answer: Support the nurse in escalating through the chain of command and activate the rapid response team if warranted
The ANM must empower staff to escalate safety concerns and activate rapid response when clinical deterioration warrants it.
Question 3: Which hand hygiene standard is most widely used to reduce healthcare-associated infections (HAIs) in US hospitals?
- WHO Five Moments for Hand Hygiene (Correct answer)
- CDC Surgical Hand Antisepsis Protocol
- OSHA Bloodborne Pathogen Standard
- APIC Environmental Cleaning Guidelines
Correct answer: WHO Five Moments for Hand Hygiene
The WHO Five Moments for Hand Hygiene is the internationally recognized standard adopted by US healthcare facilities to prevent HAIs.
Question 4: A patient's family member insists on being present during resuscitation efforts. The nurse manager should:
- Prohibit family presence because it disrupts the team
- Follow the facility's family presence during resuscitation (FPDR) policy and assign a support staff member to the family (Correct answer)
- Allow unlimited family members to observe with no guidance
- Ask the attending physician to remove the family immediately
Correct answer: Follow the facility's family presence during resuscitation (FPDR) policy and assign a support staff member to the family
Evidence supports family presence during resuscitation with proper support, and the ANM should follow facility policy and assign a support person.
Question 5: What is the primary purpose of using SBAR (Situation, Background, Assessment, Recommendation) in patient care?
- To document nursing assessments in the electronic health record
- To standardize communication and reduce misunderstandings during patient handoffs and critical updates (Correct answer)
- To replace the physician order entry system
- To track patient satisfaction scores
Correct answer: To standardize communication and reduce misunderstandings during patient handoffs and critical updates
SBAR provides a structured communication framework that reduces ambiguity and improves safety during critical communications.
Question 6: An ANM discovers that a nurse administered a medication to the wrong patient. After ensuring patient safety, what is the NEXT priority?
- Suspend the nurse pending investigation
- Complete an incident report and notify the physician and charge nurse immediately (Correct answer)
- Inform the patient's family before assessing the patient's condition
- Wait until the end of the shift to report the event
Correct answer: Complete an incident report and notify the physician and charge nurse immediately
After ensuring patient safety, completing an incident report and notifying the appropriate clinicians is the next required step for a medication error.
Question 7: Which action by the ANM best demonstrates a commitment to a 'just culture'?
- Disciplining all staff involved in errors regardless of context
- Distinguishing between human error, at-risk behavior, and reckless conduct when responding to adverse events (Correct answer)
- Encouraging staff not to report minor errors to avoid punishment
- Blaming the individual closest to the error
Correct answer: Distinguishing between human error, at-risk behavior, and reckless conduct when responding to adverse events
Just culture differentiates error types to promote accountability without punishing honest mistakes, fostering psychological safety and reporting.
ANM Patient Safety and Advocacy 3
The Joint Commission's National Patient Safety Goals (NPSGs) primarily aim to: