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When providing customer service

training to employees from
multiple departments, what is the
most important concept to keep in
mind?
Your Answer: Lack of familiarity among trainees.
Incorrect :-(
Correct Answer: How di"erences may a"ect learning.

The most important thing to keep in mind when pro

viding customer service training for employees from
multiple departments is how di"erences may a"ect
learning. Learning style (visual, kinesthetic, audio), a
ge/generation, and literacy levels are all important c
onsiderations when planning education programs.
Without these considerations, education e"orts ma
y be ine"ective.

When uninsured patients come to

the emergency department,
Medicare-participating hospitals
with emergency services are
required to provide:
Your Answer: medical screening examination only.
Incorrect :-(
Correct Answer: medical screening examination and
stabilizing treatment.

When uninsured patients come to the emergency d

epartment, Medicare-participating hospitals with e
mergency services are required to provide a medical
screening examination and stabilizing treatment. Th
is is required by the Emergency Medical Treatment
and Labor Act (EMTALA). Once stabilized, the patient
can be transferred to another facility, such as a cou
nty hospital. If the hospital cannot stabilize the patie
nt, the patient may be transferred to another facility
with better capabilities. Patients in active labor must
be treated.

Which of the following maps the

expected course of
interdisciplinary care for those
with the same diagnosis over a
specific timeframe?
Your Answer: Clinical pathway. :-) Correct!!

A clinical pathway maps the expected course of inte

rdisciplinary care for those with the same diagnosis
over a specific timeframe, such as the number of da
ys of anticipated hospitalization for a patient. The p
athway indicates the expected nursing outcomes for
each day and the interventions needed. The clinical
pathway is based on average lengths of stay. Deviati
ons from the pathway should be immediately addre
ssed through team meetings and changes made to i
mprove outcomes.

The primary predictor of hospital

costs is:
Your Answer: patient diagnosis. Incorrect :-(
Correct Answer: length of stay.

The primary predictor of hospital costs is length of s

tay (LOS). When the LOS is beyond that anticipated,
the cost to the hospital can be considerable. Thus, t
he goal of care is often to decrease the LOS to at or
below the benchmark without increasing the risk of
complications or re-hospitalizations, both of which h
ave a negative e"ect on reimbursement. When LOS
decreases, the hospital has room available to admit
additional patients, increasing profits.

A patient care team is in

disagreement over new admissions
procedures. What decision-making
model should management use?
Your Answer: Consensus. Incorrect :-(
Correct Answer: Decision criteria.

Decision criteria is a decision-making model that ex

plores all options equally and gives unorthodox or u
npopular options a fair chance, even when they are
under dispute. Consensus is not the best choice bec
ause this approach often reduces decisions to optio
ns that everyone likes and discounts the unorthodo
x or unpopular options that could be appropriate an
d viable.

When Hospital A’s neonatal

infection rates rise unexpectedly,
the quality council establishes a
new set of performance measures.
They base their measures on
internal standards, customer
survey data, and employee survey
data. What important element are
the quality council members
disregarding?
Your Answer: Customer satisfaction data. Incorrect :-(
Correct Answer: External standards.

It is vital that quality council members take external

standards (such as national goals and requirement
s) into account when addressing the rising infection
rates. While assessing and utilizing internal data is i
mportant, external data will provide a context for th
e internal data, and distinguish where and how the f
acility falls compared to national standards. This ma
y make what appears as a negative data set more st
andard, or may make a positive data set quite negat
ive compared to how other health facilities manage
the issue.

If an organization is implementing
major changes in policies and
processes and experiences a sharp
increase in sta! turnover, this
likely indicates:
Your Answer: that the sta" members are not
adequately prepared for change. :-) Correct!!

If an organization is implementing major changes in

policies and processes and experiences a sharp incr
ease in sta" turnover, this likely indicates that the st
a" members are not adequately prepared for chang
e. Turnover is likely to increase if sta" members fear
that they may be laid o" or that their workload or re
sponsibilities will change and they have not received
adequate information about the changes.

From a safety perspective, the

Utilities Management Program
should work most closely with:
Your Answer: risk management. Incorrect :-(
Correct Answer: infection control.

From a safety perspective, the Utilities Management

Program should work most closely with infection co
ntrol. Controlling dust and monitoring and testing c
ooling towers and air-handlers is especially importa
nt and is generally done in cooperation with infectio
n control personnel. Any changes in the physical pla
nt, such as upgrades to equipment, can increase the
risk of infection from environmental contamination,
so pre-construction risk assessments should be carr
ied out in conjunction with infection control as well
as ongoing monitoring.

Which of the following is likely to

be most disruptive to healthcare
quality?
Your Answer: Increasing costs. :-) Correct!!

Increasing costs is likely to be most disruptive of he

althcare quality because of the costs involved in ma
king significant changes or remaining current (such
as through purchase of new equipment) and the tre
nd toward decreased reimbursement and value-bas
ed reimbursement. For example, an increased nurs
e-to-patient ratio directly correlates with better pati
ent outcomes but is one of the most expensive appr
oaches to patient care. Hospitals are increasingly co
ntracting for services, and this can negatively impact
continuity of care and commitment to quality.

The type of outcomes data that

includes measures of mortality,
longevity, and cost-e!ectiveness is:
Your Answer: clinical Incorrect :-(
Correct Answer: integrative.

Outcomes data types include:

· Integrative: Measures of mortality, longevity, and c
ost-e"ectiveness.
· Clinical: Symptoms, diagnoses, staging of disease a
nd those indicators of patient health.
· Physiological: Measures of physical abnormalities, l
oss of function, activities of daily living.
· Psychosocial: Feelings, perceptions, beliefs, functio
nal impairment.
· Perception: Customer perceptions, evaluations, an
d satisfaction.
· Organization-wide clinical: Readmissions, adverse r
eactions, and deaths.

The federal agency that is the

leader in quality care research is:
Your Answer: AHRQ. :-) Correct!!

The federal agency that is the leader in quality care r

esearch is the Agency for Healthcare Research and
Quality (AHRQ), so designated by Congress in 1999.
CMS monitors quality of care provided to Medicare
and Medicaid patients, and the National Quality For
um provides measures and facilitates public reporti
ng of quality measures through HEDIS. Quality meas
ures are reported through AHRQ’s National Quality
Measures Clearinghouse. AHRQ has developed Qual
ity Indicators related to prevention, inpatient care, p
atient safety, and pediatric care.

A patient who has had

nonbehavioral restraints applied
must be examined by an
independent licensed professional
within:
Your Answer: 6 hours. Incorrect :-(
Correct Answer: 24 hours.

A patient who has had nonbehavioral restraints (suc

h as to prevent falls) applied must be examined by a
licensed professional (physician) with 24 hours. The
order must be renewed every 24 hours, based on di
rect examination by the physician. If the restraint is i
nitiated by a nurse based on risk of injury, the physi
cian must be notified immediately and a written or v
erbal order procured within 12 hours of application
of the restraint. Restraints should be the least restri
ctive necessary and for the least amount of time.

Which of the following

abbreviations is generally
acceptable for written
documentation?
Your Answer: mL. :-) Correct!!

The abbreviation for milliliters (mL) with a capital L i

s generally acceptable for written documentation. O
ther abbreviations are not yet on the Do-Not-Use lis
t but are generally avoided because they may be mi
sinterpreted:
· Cc: May be read as U for unit.
· mg: May be misread as mg, and some may not kno
w what it means as “mcg” is commonly used for mic
rograms.
· > and <: May be confused with numbers (7) or lette
rs (L) or interpreted in reverse.
· @: May be confused with the number “2.”

As a manager, you are working

with a new employee who has
challenges with appropriate
customer service processes.
Together you are establishing a
performance improvement plan.
Which of the following should not
be a part of the plan?
Your Answer: Specific action steps to be taken as part
of the plan. Incorrect :-(
Correct Answer: Research into the causes of the
employee’s challenges.

Researching the causes of an employee’s challenges

has no place in the performance improvement plan
process. A clear problem statement, specific action s
teps, and a goal behavior are all important elements
in creating a performance improvement plan. These
elements will contribute to changed actions to addr
ess the employee’s challenges, while researching do
es not move the performance improvement process
forward.

If Joint Commission standards

generally require that a pharmacist
review a prescription before the
medication can be dispensed and
administered to a patient, what is
the procedure if the pharmacy is
not open during the night?
Your Answer: The pharmacist does a retrospective
review as soon as possible. :-) Correct!!

If Joint Commission standards generally require that

a pharmacist review a prescription before the medic
ation can be dispensed and administered to a patie
nt, the procedure if the pharmacy is not open durin
g the night is for the pharmacist to do a retrospectiv
e review as soon as possible when the pharmacy re
opens. Medications should not be withheld in this ci
rcumstance if doing so may result in adverse e"ects
to the patient, such as in emergent conditions.

If planning to carry out a needs

assessment to determine gaps in
knowledge or performance, the
first step is to identify the:
Your Answer: target learners. :-) Correct!!

If planning to carry out a needs assessment to deter

mine gaps in knowledge or performance, the first st
ep is to identify the target learners, whether individ
uals or group. Data may be collected through literat
ure research, questionnaires, pretests, surveys, inte
rviews, and observation of the individuals and other
healthcare providers. Once needs are identified, the
n they should be prioritized and resources identified
to support these educational needs and lesson plan
s with expected outcomes developed.

Which of the following is the best

definition of “vision” in regards to
creating an organizational vision
statement?
Your Answer: An outline of future organizational
purpose. Incorrect :-(
Correct Answer: An ideal future state.

In the creation of an organizational vision statemen

t, vision is a description—realistic or not—of an idea
l future state. This description of an ideal future stat
e gives shape to the goals of an organization. A visio
n statement does not involve detailed descriptions a
bout the specific actions necessary for bringing the
vision to fruition.

When evaluating the e!ectiveness

of safety initiatives that were
introduced 12 months earlier, the
most reliable measures include:
Your Answer: sta" surveys regarding awareness of
initiatives. Incorrect :-(
Correct Answer: Worker’s Compensation claims and
sick time records.

When evaluating the e"ectiveness of safety initiative

s that were introduced 12 months earlier, the most
reliable measures include Workers’ Compensation cl
aims (including the number of claims and the type o
f injuries) and sick time records because these direc
tly reflect workplace injuries. These records should
be compared with those for at least 2 to 3 years pre
ceding implementation of the new initiatives in orde
r to determine if the current data reflect real change
or reflect common cause variances.

If a mental health patient has

eloped from a locked unit when the
exit was inadvertently left ajar, the
initial response should be to:
Your Answer: notify security and search the facility. :-)
Correct!!

If a mental health patient has eloped from a locked

unit when the exit was inadvertently left open, the i
nitial response should be to notify security and sear
ch the facility. Security should monitor exits and revi
ew video footage if available. If the patient is not loc
ated, then the patient’s home should be called as th
at is typically a patient’s destination. Whether or not
to call the police depends on the patient’s decision-
making capacity and risk to self or others.

It is confirmed that a patient who

sat for 30 minutes in the waiting
room of your clinic was diagnosed
with measles. What necessary
infection-control step should be
taken?
Your Answer: Contact all patients who may have been
in the waiting room that day. :-) Correct!!

The most important infection-control step in this sit

uation, after reporting the confirmation to the local
health jurisdiction immediately, would be to contact
all patients who may have been in the waiting room
that day. The measles are a highly communicable an
d dangerous disease; therefore every patient that w
as exposed to the carrier must be assessed and info
rmed of possible consequences of this exposure.

While reviewing year-end statistics,

you notice your hospital performs
many more tonsillectomies than
other hospitals in the area. What
response would be most
appropriate to determine the
cause of this statistical anomaly?
Your Answer: Peer review. Incorrect :-(
Correct Answer: Medical record review.

In a statistical anomaly situation involving medical p

rocedures, a medical record review would be warra
nted to determine why tonsillectomies were being p
erformed more often than at other regional hospital
s. This particular statistic is not necessarily a reflecti
on of a successful surgical unit. Peer review and pati
ent advocacy are not relevant in the cause of this st
atistical anomaly.

If utilizing the DMAiC (define,

measure, analyze, improve,
control) model of Six Sigma®, what
should be included in the “define”
phase?
Your Answer: Baseline data. Incorrect :-(
Correct Answer: Costs and benefits.

If utilizing the DMAiC (define, measure, analyze, imp

rove, control) model of Six Sigma®, costs and benefi
ts that will result from change should be included in
the “define” phase. During this phase, a list of custo
mer needs should be developed, based on custome
r complaints and requests. Six Sigma® is a perform
ance improvement model developed by Motorola to
improve business practices and increase profits. DM
AIC is used for existing processes or products that n
eed improvement and DMADV (define, measure, an
alyze, design, verify) for development of new high-q
uality processes or products.

During a surgical procedure, a

small medical implement was left
inside a patient. The follow-up
surgery to remove the implement
is an example of:
Your Answer: quality improvement. Incorrect :-(
Correct Answer: quality assurance.

Quality assurance is a focus on outputs or quality af

ter the point of production, including any corrective
actions necessary to optimize post-production quali
ty, as in the surgery performed to remove the imple
ment left in the patient. A, B, and D are incorrect be
cause they refer to quality processes that take place
on di"erent levels and are not corrective in the way
that quality assurance is.

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