NP Quality Control & Assurance 2 — Questions and Answers
Question 1: A nurse practitioner participates in a root cause analysis (RCA) after a patient fall. What is the PRIMARY purpose of an RCA?
- Assign blame to the staff member involved
- Identify system and process failures to prevent recurrence (Correct answer)
- Document the incident for legal purposes
- Determine if disciplinary action is warranted
Correct answer: Identify system and process failures to prevent recurrence
RCA focuses on identifying underlying system and process vulnerabilities rather than individual blame to drive systemic improvement.
Question 2: Which quality improvement model uses Plan-Do-Study-Act (PDSA) cycles as its framework?
- Six Sigma
- Lean methodology
- The Model for Improvement (Correct answer)
- Total Quality Management (TQM)
Correct answer: The Model for Improvement
The Model for Improvement, developed by the Institute for Healthcare Improvement, uses PDSA cycles to test and implement changes.
Question 3: A quality dashboard shows a clinic's diabetes HbA1c control rate is at the 30th percentile compared to national benchmarks. This type of comparison is known as:
- Sentinel event review
- Benchmarking (Correct answer)
- Utilization review
- Gap analysis
Correct answer: Benchmarking
Benchmarking compares an organization's performance metrics against external standards or peer organizations.
Question 4: Under the CMS Hospital Readmissions Reduction Program (HRRP), NPs managing transition of care should prioritize which action to prevent penalties?
- Discharging patients earlier to free up beds
- Ensuring robust follow-up within 7-14 days post-discharge (Correct answer)
- Avoiding documentation of high-risk diagnoses
- Transferring high-risk patients to SNFs automatically
Correct answer: Ensuring robust follow-up within 7-14 days post-discharge
Timely post-discharge follow-up is a key evidence-based strategy to reduce preventable readmissions targeted by HRRP.
Question 5: A nurse practitioner notices that opioid prescribing patterns in the practice vary widely among providers. Which tool best visualizes this variation to initiate a QI discussion?
- Fishbone diagram
- Run chart
- Pareto chart
- Control chart (Correct answer)
Correct answer: Control chart
A control chart plots data over time with statistical control limits to distinguish common-cause variation from special-cause variation among providers.
Question 6: Which federal legislation established the framework for value-based purchasing and quality reporting for physicians and advanced practice providers?
- HIPAA (1996)
- ACA (2010)
- MACRA (2015) (Correct answer)
- EMTALA (1986)
Correct answer: MACRA (2015)
MACRA (Medicare Access and CHIP Reauthorization Act) created MIPS and APMs, linking provider reimbursement to quality performance.
Question 7: A patient safety officer reports a near-miss event where a wrong medication was caught before administration. What should the NP do FIRST?
- Notify the patient immediately
- Document the event in the incident reporting system (Correct answer)
- Contact the pharmacy to dispense the correct medication
- Report the nurse to the manager
Correct answer: Document the event in the incident reporting system
Near-miss events must be reported in the incident reporting system to enable analysis and process improvement to prevent future errors.
NP Quality Control & Assurance 2
A nurse practitioner participates in a root cause analysis (RCA) after a patient fall.
What is the PRIMARY purpose of an RCA?