I85PREP
⌘ K
GPNC(C) study materials
GPNC(C) study resources

GPNC(C) practice questions

One question at a time. Build your GPNC(C) understanding.

First 50 of 200 questions. Each one lists the choices, the correct answer, and an explanation. The checker at the top of this page saves progress in this browser when it is available.

Continue in the practice tool above to load more questions, 50 at a time.

Question 1Professional Nursing Practice and Ethics

A nurse tells a patient about the purpose and risks of a procedure and then obtains the patient's signed consent. Which ethical principle is being directly applied?

  1. Autonomy Correct answer.
  2. Justice
  3. Beneficence
  4. Fidelity

Explanation

Autonomy is the principle that respects a person's right to make informed decisions about their own care. Informed consent operationalizes autonomy by ensuring the patient understands and voluntarily agrees. The other principles address doing good, fairness in distribution, and keeping promises.

Question 2Professional Nursing Practice and Ethics

A nurse keeps a promise to return within ten minutes to reposition a patient and does so. Which professional value does this most directly demonstrate?

  1. Fidelity Correct answer.
  2. Nonmaleficence
  3. Veracity
  4. Paternalism

Explanation

Fidelity is faithfulness to commitments and promises made to patients. Following through on a stated timeframe shows reliability and respect for the patient's trust. Veracity is truthfulness, while nonmaleficence is avoiding harm.

Question 3Professional Nursing Practice and Ethics

Which action best illustrates the nurse acting as a patient advocate?

  1. Telling the patient which surgeon is most skilled
  2. Supporting the patient's request to discuss treatment options with the care team Correct answer.
  3. Documenting vital signs promptly after each check
  4. Reporting a suspected medication error to the charge nurse

Explanation

Advocacy means protecting and promoting the patient's rights, wishes, and interests, including facilitating informed participation in care. Supporting the patient's request to speak with the team empowers the patient's voice. Routine documentation and error reporting are important but do not center the patient's expressed wishes.

Question 4Professional Nursing Practice and Ethics

A competent adult patient refuses a prescribed antibiotic after receiving full information. What is the nurse's most appropriate response?

  1. Administer the medication because the prescriber ordered it
  2. Respect the refusal, document it, and notify the prescriber Correct answer.
  3. Ask a family member to persuade the patient to accept
  4. Withhold all further nursing care until the patient agrees

Explanation

A competent adult has the legal and ethical right to refuse treatment, even when the treatment is beneficial. The nurse must honor the refusal, document the discussion, and inform the prescriber so alternatives can be explored. Coercion or abandonment is never acceptable.

Question 5Professional Nursing Practice and Ethics

During a mass casualty event, a nurse assigns treatment priority based on severity and likelihood of survival rather than on order of arrival. Which ethical principle primarily guides this approach?

  1. Fidelity
  2. Autonomy
  3. Veracity
  4. Justice Correct answer.

Explanation

Justice governs fair allocation of limited resources, including triage decisions that maximize benefit across all casualties. Sorting by clinical need rather than arrival order reflects distributive fairness. The other principles concern truthfulness, self-determination, and promise-keeping.

Question 6Professional Nursing Practice and Ethics

A nurse discovers that a colleague has been diverting opioid medications. According to professional obligations, what should the nurse do first?

  1. Confront the colleague privately and agree to keep it confidential
  2. Report the concern through the organization's established channels Correct answer.
  3. Wait to see whether patient harm occurs before acting
  4. Discuss the matter with other staff to gather opinions

Explanation

Nurses have a professional duty to protect patients and report impaired or unsafe practice through proper channels. Confidential private agreements or delay place patients at risk. Gossiping with staff is unprofessional and does not fulfill the reporting obligation.

Question 7Professional Nursing Practice and Ethics

A patient asks a nurse whether a new chemotherapy drug will cure the cancer. The nurse does not know the answer. What is the most professionally appropriate response?

  1. Say the drug will probably cure the cancer to reduce anxiety
  2. Provide a general statistic from memory without verifying it
  3. State honestly that the answer is unknown and offer to help obtain accurate information Correct answer.
  4. Change the subject and let the physician handle it

Explanation

Veracity requires honesty, and the nurse should not fabricate or guess at clinical information. Acknowledging uncertainty and offering to seek accurate answers maintains trust. False reassurance or unverified statistics violate truthfulness.

Question 8Professional Nursing Practice and Ethics

Which situation best describes an ethical dilemma in nursing?

  1. A nurse forgets to document a dose given on time
  2. A nurse is late for a scheduled shift
  3. A nurse must choose between two options, each supported by a valid ethical principle Correct answer.
  4. A nurse is unsure which wound dressing protocol to follow

Explanation

An ethical dilemma arises when two or more morally defensible options conflict and no choice is clearly right. Clinical uncertainty, forgetfulness, and punctuality are practice issues rather than competing ethical obligations. Recognizing the conflict is the first step in ethical analysis.

Question 9Professional Nursing Practice and Ethics

A nurse uses the ethical decision-making model to address a conflict. Which step should come immediately after gathering relevant facts?

  1. Evaluating the outcome of the decision
  2. Identifying the ethical principles and values in conflict Correct answer.
  3. Implementing the chosen action
  4. Documenting the final decision in the chart

Explanation

Ethical decision-making models move from gathering facts to identifying the principles, values, and stakeholders in conflict. Only after that analysis should options be generated, an action chosen, implemented, and evaluated. Skipping the analysis weakens the justification for the decision.

Question 10Professional Nursing Practice and Ethics

Which behavior by a nurse best demonstrates professional accountability?

  1. Avoiding assignments that seem challenging
  2. Blaming a shift delay on the previous nurse during handoff
  3. Delegating all patient teaching to unlicensed staff
  4. Acknowledging a missed assessment and initiating corrective action Correct answer.

Explanation

Accountability means owning one's actions and outcomes, including errors, and taking corrective steps. Acknowledging a missed assessment and acting to correct it reflects responsibility. Blame-shifting, avoidance, and inappropriate delegation demonstrate the opposite.

Question 11Professional Nursing Practice and Ethics

A nurse is asked to participate in a research study involving patients on the unit. Which action best reflects respect for autonomy in research participation?

  1. Ensuring participation is voluntary and free of coercion Correct answer.
  2. Enrolling patients who seem unlikely to object
  3. Assuming consent from the patient's family
  4. Offering extra privileges only to those who enroll

Explanation

Research participation must be voluntary and free from coercion or undue influence. Obtaining genuine informed consent protects autonomy. Enrolling by assumption or pressuring patients through incentives or family consent violates this principle.

Question 12Professional Nursing Practice and Ethics

A dying patient asks the nurse to help complete an advance directive. What is the nurse's best action?

  1. Tell the patient that only the physician can discuss advance directives
  2. Refuse to discuss the topic because it may upset the patient
  3. Provide information, answer questions, and ensure the process is documented Correct answer.
  4. Complete and sign the document on the patient's behalf

Explanation

Nurses support patients in understanding and completing advance directives by providing information and facilitating discussion. The patient, not the nurse, signs the document, and avoiding the topic ignores the patient's request. Collaboration with the physician is helpful but does not bar nursing discussion.

Question 13Professional Nursing Practice and Ethics

Which statement best describes the ethical concept of nonmaleficence?

  1. The duty to distribute resources equally among all patients
  2. The duty to prevent harm and avoid actions that cause unnecessary harm Correct answer.
  3. The duty to follow through on promises made to patients
  4. The duty to tell the truth in all professional encounters

Explanation

Nonmaleficence is the obligation to avoid causing harm and to prevent harm where possible. It is often paired with beneficence, the duty to promote good. Truthfulness, fairness, and promise-keeping correspond to other principles.

Question 14Professional Nursing Practice and Ethics

A nurse notices that a patient's cultural beliefs conflict with a prescribed dietary plan. What is the most ethically sound approach?

  1. Ask the patient to abandon the cultural practice during hospitalization
  2. Insist on the prescribed diet because it is medically ordered
  3. Ignore the patient's beliefs because they are not medically relevant
  4. Explore the conflict with the patient and collaborate with the team on alternatives Correct answer.

Explanation

Culturally congruent care respects patient values while pursuing safe treatment, requiring exploration and collaboration. Dismissing or overriding beliefs violates autonomy and respect for persons. Open dialogue can often identify acceptable alternatives.

Question 15Professional Nursing Practice and Ethics

A nurse is caring for a patient who is an inmate and requires treatment. Which statement reflects the correct ethical obligation?

  1. The patient forfeits the right to confidentiality because of incarceration
  2. The nurse may disclose health information freely to correctional officers
  3. Security staff should decide which treatments the patient receives
  4. The nurse should provide the same standard of care owed to any patient Correct answer.

Explanation

Incarceration does not remove a person's right to respectful, standard care or confidentiality. Nurses owe the same ethical and clinical obligations to incarcerated patients as to any other patient. Security personnel do not determine clinical treatment decisions.

Question 16Professional Nursing Practice and Ethics

A nurse witnesses a colleague verbally berating a patient. What is the nurse's most appropriate immediate action?

  1. Confront the colleague later in front of other staff
  2. Record the incident in the patient's chart as a behavioral note
  3. Intervene to stop the behavior and report it through proper channels Correct answer.
  4. Ignore the incident to avoid conflict with the colleague

Explanation

Nurses have a duty to protect patients from harm, including psychological harm, and to report unprofessional conduct. Intervening and reporting through established channels addresses the harm and follows professional obligations. Public confrontation or silence fails to protect the patient appropriately.

Question 17Professional Nursing Practice and Ethics

Which action reflects the nurse's obligation under the principle of beneficence?

  1. Keeping a promise to call the family with an update
  2. Distributing limited supplies equally among patients
  3. Respecting a patient's decision to decline a treatment
  4. Administering a prescribed analgesic to relieve reported pain Correct answer.

Explanation

Beneficence is the duty to act in ways that promote the patient's good, such as relieving pain and suffering. The other options illustrate autonomy, justice, and fidelity respectively. Beneficence requires positive action to benefit the patient.

Question 18Professional Nursing Practice and Ethics

A nurse is uncertain whether to disclose a patient's diagnosis to the family when the patient has not authorized it. What is the best guide for the nurse's decision?

  1. The patient's right to control disclosure of protected health information Correct answer.
  2. The convenience of discussing the diagnosis during a busy shift
  3. The family's stated desire to know the information
  4. The nurse's personal judgment about what the family should know

Explanation

Confidentiality gives the patient control over disclosure of health information, and the nurse must not share it without authorization unless law requires. Family wishes or staff convenience do not override this right. The nurse should clarify the patient's preferences and follow privacy rules.

Question 19Professional Nursing Practice and Ethics

Which situation most clearly requires the nurse to use an ethics committee consultation?

  1. A nurse is uncertain about a medication dosage calculation
  2. A patient requests a different meal option
  3. A patient needs a routine dressing change
  4. A family and care team disagree about continuing aggressive treatment for a patient with unclear wishes Correct answer.

Explanation

Ethics committees assist when there is a genuine conflict about values or goals of care, especially when patient wishes are unclear. Routine procedures, dosage questions, and dietary preferences are resolved through standard clinical or operational channels. The committee provides structured ethical analysis and recommendations.

Question 20Professional Nursing Practice and Ethics

A patient with decision-making capacity asks the nurse to keep a new diagnosis secret from a spouse who is the emergency contact. How should the nurse respond?

  1. Ask the spouse to promise not to tell anyone else
  2. Honor the patient's confidentiality and discuss what information may be shared Correct answer.
  3. Tell the spouse because emergency contacts have automatic access to all information
  4. Refuse to provide any further care to the patient

Explanation

A patient with capacity controls disclosure, and emergency contact status does not automatically grant access to health information. The nurse should respect confidentiality and clarify with the patient what, if anything, may be shared. Refusing care or arranging secret-keeping agreements is inappropriate.

Question 21Professional Nursing Practice and Ethics

A nurse manager must decide how to allocate a limited number of home-care slots. Which approach best reflects the ethical principle of justice?

  1. Allocating slots by the order in which names were drawn randomly without regard to need
  2. Awarding slots to patients who are personally known to staff
  3. Giving slots to patients who request them most loudly
  4. Using consistent, transparent criteria based on clinical need Correct answer.

Explanation

Justice requires fair, consistent, and transparent allocation based on relevant criteria such as clinical need. Favoritism and volume of demands undermine fairness. Random allocation may be fair in some contexts but ignores need when need is the relevant criterion.

Question 22Professional Nursing Practice and Ethics

A nurse observes that a physician has written an order that the nurse believes is unsafe. What is the most appropriate first action?

  1. Ask another nurse to administer the order instead
  2. Clarify the order with the prescriber before implementing it Correct answer.
  3. Carry out the order and document concerns afterward
  4. Alter the order independently to a safer dose

Explanation

Nurses are accountable for safe practice and should clarify questionable orders with the prescriber before acting. Carrying out a known unsafe order or shifting it to a colleague does not remove the risk. Nurses cannot independently change prescribed orders.

Question 23Professional Nursing Practice and Ethics

Which statement best explains why informed consent is an ethical requirement rather than only a legal formality?

  1. It protects the hospital from liability in all circumstances
  2. It expresses respect for the patient's right to make informed choices about care Correct answer.
  3. It is required only for surgical procedures and not for other treatments
  4. It transfers decision-making authority from the patient to the physician

Explanation

Informed consent is grounded in respect for autonomy: patients have the right to understand and choose among options affecting their bodies and lives. Although it has legal dimensions, reducing it to liability protection or a signature misses its ethical purpose. Consent applies broadly to treatments, not only surgery.

Question 24Professional Nursing Practice and Ethics

A nurse feels morally distressed because a patient's pain is undertreated despite repeated advocacy. Which action is most appropriate?

  1. Express frustration to the patient about the care team
  2. Quietly accept the situation to avoid conflict
  3. Document concerns, escalate through the chain of command, and seek support Correct answer.
  4. Stop documenting the pain reports to reduce conflict

Explanation

Moral distress should be addressed through documentation, escalation, and appropriate support systems rather than silence. Escalation follows professional obligations to advocate for the patient. Voicing frustration to the patient or suppressing documentation is unprofessional and harmful.

Question 25Patient Safety and Quality Improvement

A nurse notices that a patient's identification band is missing before administering medication. Which action best reflects the principle of patient identification as a safety practice?

  1. Skip the medication dose until the next shift
  2. Administer the medication and replace the band afterward
  3. Ask another nurse to give the medication instead
  4. Confirm the patient's identity using two identifiers before giving the medication Correct answer.

Explanation

Safe practice requires verifying identity with at least two independent identifiers (such as name and date of birth) before any intervention. Replacing the band later or deferring to another nurse does not resolve the identification risk at the point of care.

Question 26Patient Safety and Quality Improvement

Which measure is the most reliable way to reduce catheter-associated urinary tract infections?

  1. Clamping the catheter between voiding episodes
  2. Changing the drainage bag every shift
  3. Removing unnecessary urinary catheters promptly Correct answer.
  4. Irrigating the catheter daily with saline

Explanation

The single most effective intervention is avoiding unnecessary catheterization and removing catheters as soon as they are no longer indicated. Routine irrigation, frequent bag changes, and clamping increase contamination risk rather than reduce it.

Question 27Patient Safety and Quality Improvement

During a handoff, which communication technique is designed to standardize the transfer of critical information between caregivers?

  1. SBAR Correct answer.
  2. FMEA
  3. RCA
  4. PDCA

Explanation

SBAR structures communication as Situation, Background, Assessment, and Recommendation, reducing omissions during handoffs. PDCA, FMEA, and RCA are quality-improvement or analysis tools, not handoff formats.

Question 28Patient Safety and Quality Improvement

A patient falls in the bathroom and is found on the floor. What is the priority first action?

  1. Return the patient to bed immediately to prevent further harm
  2. Notify the risk manager before assessing the patient
  3. Complete an incident report before assisting the patient
  4. Assess the patient for injury before moving them Correct answer.

Explanation

The immediate priority after a fall is clinical assessment for injury, especially head trauma or fracture, before any movement. Documentation and notification follow the clinical response, not precede it.

Question 29Patient Safety and Quality Improvement

Which of the following is a core element of a just culture in healthcare?

  1. Separating system failures from reckless behavior when responding to errors Correct answer.
  2. Eliminating incident reporting to reduce blame
  3. Avoiding reporting of errors to protect staff
  4. Disciplining all staff involved in any error equally

Explanation

Just culture distinguishes honest errors and at-risk behavior from reckless conduct, addressing system factors while holding individuals accountable for intentional risk-taking. Blanket discipline and suppression of reporting undermine safety.

Question 30Patient Safety and Quality Improvement

A hospital wants to reduce medication administration errors. Which intervention has the strongest evidence for preventing wrong-patient errors at the bedside?

  1. Posting reminder signs in the medication room
  2. Weekly staff meetings about medication safety
  3. Annual competency testing on drug calculations
  4. Bar-code scanning linked to the electronic medication administration record Correct answer.

Explanation

Bar-code medication administration that verifies the patient, drug, dose, and time against the electronic record directly intercepts errors at the point of administration. Education and signage support awareness but do not provide a reliable system barrier.

Question 31Patient Safety and Quality Improvement

Which metric is a process measure rather than an outcome measure in a quality-improvement project on surgical site infections?

  1. Rate of surgical site infections per 100 operations
  2. Percentage of surgical patients receiving timely prophylactic antibiotics Correct answer.
  3. Readmission rate within 30 days
  4. Average length of stay after surgery

Explanation

Process measures capture whether recommended care was delivered, such as timely antibiotic prophylaxis. Infection rates, length of stay, and readmissions are outcome measures reflecting results.

Question 32Patient Safety and Quality Improvement

A root cause analysis is best initiated under which circumstance?

  1. Before implementing any new clinical protocol
  2. Routinely every quarter for all units
  3. After a sentinel event causing serious harm Correct answer.
  4. Whenever a patient expresses dissatisfaction

Explanation

Root cause analysis is a retrospective, in-depth method reserved for serious adverse events, particularly sentinel events. It is not used for routine feedback or as a pre-implementation planning tool.

Question 33Patient Safety and Quality Improvement

Which action best demonstrates closed-loop communication during a resuscitation?

  1. The leader gives orders without waiting for confirmation
  2. The team leader confirms that the receiver repeats back an order and reports when it is complete Correct answer.
  3. Instructions are written on a whiteboard for later review
  4. Team members speak simultaneously to ensure all information is heard

Explanation

Closed-loop communication requires the sender to direct the message to a specific person, who repeats it back and confirms completion. This prevents missed or duplicated actions in high-stakes settings.

Question 34Patient Safety and Quality Improvement

A patient safety committee reviews an increase in pressure injuries. Which tool would best help the team organize possible contributing factors into categories such as staffing, equipment, and process?

  1. Cause-and-effect diagram Correct answer.
  2. Control chart
  3. Balanced scorecard
  4. Run chart

Explanation

A cause-and-effect (fishbone) diagram organizes potential causes into categories to guide improvement work. Control charts and run charts display variation over time, and a balanced scorecard summarizes performance across domains.

Question 35Patient Safety and Quality Improvement

Which practice most directly reduces the risk of wrong-site surgery?

  1. Having the surgeon mark the site in the operating room after anesthesia
  2. A preoperative time-out with the full team confirming patient, site, and procedure Correct answer.
  3. Scheduling site verification by the front desk at admission
  4. Relying on the consent form alone as verification

Explanation

A formal time-out immediately before the procedure, with the entire team confirming patient identity, site, and procedure, is the key safeguard against wrong-site surgery. Marking after anesthesia or relying on a single document removes independent checks.

Question 36Patient Safety and Quality Improvement

In the Swiss cheese model of accident causation, what does the model illustrate?

  1. Accidents are random and cannot be analyzed
  2. Defenses fail only because of individual incompetence
  3. A single error always causes an adverse event
  4. Harm occurs when weaknesses in multiple defensive layers align Correct answer.

Explanation

The model depicts layers of defense with gaps; harm results when gaps in several layers line up and allow a hazard to pass through. It emphasizes system defenses rather than blaming a single individual.

Question 37Patient Safety and Quality Improvement

A nurse manager wants to monitor whether a new fall-prevention bundle is producing a sustained improvement over several months. Which display is most appropriate?

  1. Statistical process control chart Correct answer.
  2. Patient satisfaction survey
  3. Annual incident summary
  4. Pie chart of fall locations

Explanation

A control chart distinguishes common-cause variation from special-cause signals over time, showing whether a change produced sustained improvement. Pie charts and annual summaries do not reveal trends over time.

Question 38Patient Safety and Quality Improvement

Which behavior is an example of at-risk behavior rather than a human error under a just-culture framework?

  1. Misreading a label despite adequate lighting and training
  2. Forgetting a step because the protocol was unclear
  3. Routinely bypassing a safety check because it is slow, without intending harm Correct answer.
  4. Making a slip while following the correct procedure

Explanation

At-risk behavior is a conscious choice to take a shortcut where risk is not recognized or is mistakenly justified. Slips, lapses, and unclear protocols are human errors addressed through system redesign and coaching.

Question 39Patient Safety and Quality Improvement

A hospital's central line-associated bloodstream infection rate falls after a bundle is introduced, but the rate also dropped on a comparison unit that did not adopt the bundle. What is the best interpretation?

  1. The data must be incorrect because two units changed
  2. The comparison unit should be excluded from reporting
  3. The improvement may reflect secular trends, so further analysis is needed Correct answer.
  4. The bundle is proven effective and should be expanded immediately

Explanation

Improvement on a non-adopting comparison unit suggests secular trends or concurrent changes rather than a specific bundle effect. Rigorous interpretation requires comparing trends and ruling out confounders before attributing causality.

Question 40Patient Safety and Quality Improvement

Which set of measures best represents the Institute for Healthcare Improvement's Triple Aim?

  1. Infection rate, length of stay, and readmission
  2. Population health, patient experience of care, and per-capita cost Correct answer.
  3. Mortality, morbidity, and staffing ratio
  4. Staff satisfaction, bed occupancy, and revenue

Explanation

The Triple Aim seeks to improve population health, enhance the patient experience of care (including quality and satisfaction), and reduce per-capita cost. The other sets are operational or clinical metrics rather than the Triple Aim framework.

Question 41Patient Safety and Quality Improvement

A team uses a Plan-Do-Study-Act cycle. Which action belongs in the Study phase?

  1. Implementing the change across all units
  2. Testing the change on a small scale with real patients
  3. Deciding which change idea to try next
  4. Comparing the observed results with the prediction and analyzing what happened Correct answer.

Explanation

The Study phase compares measured results against the prediction and analyzes discrepancies to inform the next cycle. Testing occurs in Do, planning in Plan, and spread follows successful cycles rather than being part of Study.

Question 42Patient Safety and Quality Improvement

Which action best reflects the principle of speaking up for safety when a nurse observes a colleague about to administer a medication to the wrong patient?

  1. Assume the colleague has already verified the patient
  2. Wait until the shift ends to report the observation
  3. Document the observation in the chart without intervening
  4. Interrupt the administration and voice the concern immediately Correct answer.

Explanation

Speaking up requires an immediate, respectful interruption to prevent harm when an error is imminent. Deferring reporting or assuming verification allows a preventable error to reach the patient.

Question 43Patient Safety and Quality Improvement

Which of the following is an example of an active failure in a medication error?

  1. Inadequate staffing on the unit
  2. Poor lighting in the medication room
  3. A nurse administers a look-alike drug to the wrong patient Correct answer.
  4. Confusing packaging of two similar drugs

Explanation

Active failures are unsafe acts by individuals at the point of care, such as administering the wrong drug. Latent conditions are underlying system factors like lighting, staffing, and packaging that set the stage for error.

Question 44Patient Safety and Quality Improvement

A quality team wants to prioritize improvement efforts. Which approach best identifies the few causes responsible for most of a problem?

  1. Force-field analysis
  2. Nominal group technique
  3. SWOT analysis
  4. Pareto analysis Correct answer.

Explanation

Pareto analysis applies the 80/20 principle to identify the small number of causes producing most of the effect, guiding prioritization. The other tools support brainstorming, stakeholder analysis, or strategy rather than frequency-based prioritization.

Question 45Patient Safety and Quality Improvement

A patient with limited English proficiency is being consented for a procedure. What is the most appropriate safety practice?

  1. Proceed with consent in English if the patient nods
  2. Rely on written translated materials alone
  3. Use a qualified medical interpreter during the consent discussion Correct answer.
  4. Have a bilingual family member interpret the consent

Explanation

Effective communication and informed consent require a qualified interpreter to ensure the patient understands risks and benefits. Using family members or relying on written materials alone risks miscommunication and invalid consent.

Question 46Patient Safety and Quality Improvement

Which statement best describes the purpose of a failure mode and effects analysis (FMEA)?

  1. Audit individual clinician performance annually
  2. Retrospectively determine the cause of a serious event
  3. Compare costs of two equipment vendors
  4. Prospectively identify where a process could fail and prioritize risks Correct answer.

Explanation

FMEA is a proactive technique that maps a process, identifies potential failure modes, and ranks them by severity, likelihood, and detectability before harm occurs. It contrasts with retrospective methods like RCA.

Question 47Patient Safety and Quality Improvement

A hospital notices that incident reports spike after a new reporting system launches. What is the most likely explanation?

  1. The data should be discarded as unreliable
  2. Staff are fabricating incidents
  3. Increased reporting reflects improved detection rather than necessarily worse safety Correct answer.
  4. The new system is causing more errors

Explanation

A rise in reported incidents after a reporting system change often reflects improved detection and a stronger reporting culture. Interpreting it as worsening safety without adjusting for reporting behavior is a measurement pitfall.

Question 48Patient Safety and Quality Improvement

Which element is essential for a safety huddle to be effective?

  1. Written minutes distributed weeks later
  2. Attendance limited to senior leadership
  3. A lengthy review of all historical incidents
  4. A brief, focused discussion of current risks with clear action assignments Correct answer.

Explanation

Safety huddles are short, frontline-focused conversations that surface current risks and assign immediate actions. Lengthy historical reviews or delayed documentation defeat the purpose of a timely huddle.

Question 49Health Assessment and Clinical Reasoning

A patient reports crushing substernal chest pressure that radiates to the left arm and jaw and began 30 minutes ago. Which finding is most characteristic of an acute myocardial infarction rather than stable angina?

  1. The discomfort is relieved promptly by rest
  2. The discomfort is described as sharp and pleuritic
  3. The discomfort worsens with deep inspiration
  4. The discomfort persists despite rest and sublingual nitroglycerin Correct answer.

Explanation

Ischemic pain of acute myocardial infarction typically lasts longer than 20 minutes and is not relieved by rest or nitroglycerin, reflecting sustained coronary occlusion. Stable angina follows a predictable pattern and resolves with rest or nitrates within minutes. Pleuritic, positional pain points toward pericardial or pulmonary causes instead.

Question 50Health Assessment and Clinical Reasoning

During assessment of an older adult, which finding should the nurse interpret as a normal age-related change rather than pathology?

  1. Slightly diminished vibratory sense in the feet Correct answer.
  2. Sudden onset of unilateral weakness
  3. New confusion developing over hours
  4. A resting tremor that appears at rest and disappears with movement

Explanation

Peripheral nerve changes with aging commonly reduce vibratory and position sense distally in a symmetric pattern. Acute unilateral weakness or new confusion suggests stroke or delirium and requires urgent evaluation. A resting tremor that abates with voluntary movement is characteristic of parkinsonism, not normal aging.