Quality Improvement in Healthcare Final Exam
Course Introduction
Quality Improvement in Healthcare explores the principles, methodologies, and tools used to enhance patient care, safety, and outcomes within healthcare systems. The course covers the foundations of quality measurement, process improvement models such as Plan-Do-Study-Act (PDSA) cycles, and data-driven decision-making. Students examine case studies on reducing errors, increasing efficiency, and implementing evidence-based practices. The curriculum also highlights regulatory standards, patient-centered care approaches, and interprofessional teamwork, preparing learners to identify areas for improvement and lead initiatives that promote continuous quality advancement in diverse healthcare environments.
Recommended Textbook Nursing Leadership and Management 2nd Canadian Edition by Patricia Kelly
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Chapter 1: Canadas Health Care Environment
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Q1) Which of the following best describes the current health status of the Canadian population?
A) The Canadian population is generally healthier than ever.
B) Canadians are not affected by new infectious disease strains.
C) Cardiovascular disease is no longer prevalent among Canadians.
D) Canadians experience few mental health problems.
Answer: A
Q2) Which two components resulted from the split in 2004 of the block-funding grant called the Canada Health and Social Transfer (CHST)?
A) separate transfers for health and postsecondary education
B) medicare and an education transfer
C) the Canada Health Transfer and the Canada Social Transfer
D) a health funding transfer and a social assistance funding transfer
Answer: C
Q3) Which of these goals best describes the goal of population health?
A) to improve the health of an entire population
B) to analyze the health status of a population
C) to improve immunization rates among a population
D) to improve child health in a particular population
Answer: A
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Chapter 2: Basic Clinical Health Care Economics
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Q1) Which of these systems has replaced in-house costing in many Canadian hospitals?
A) case-costing
B) resource benchmarking
C) resource intensity weights (RIWs)
D) activity-based costing (ABC)
Answer: C
Q2) The purpose of analyzing records of what transpires in hospitals is to practice financial stewardship and determine whether it is,in fact,doing good or producing "mischievous outcomes." Which of these authors made this comment?
A) Laura Nosek
B) Ida Androwich
C) Pat Kelly-Heidenthal
D) Florence Nightingale
Answer: D
Q3) To which of the following does the term P3 refer?
A) public-private partnerships
B) for-profit services
C) out-of-pocket payments
D) private insurance
Answer: A
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Chapter 3: Evidence-Based Practice
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Q1) Which of these factors does evidence-based medicine and practice integrate with the best external evidence and individual clinical expertise?
A) RTCs
B) current practice
C) client choice
D) physician preferences
Answer: C
Q2) What is the purpose of the Canadian Health Services Research Foundation (CHSRF)?
A) to promote the development of evidence-based care
B) to bridge the gap between research and health care management and policy
C) to conduct primary research
D) to provide funding for research
Answer: B
Q3) Which of the following is referred to by the acronym KTE?
A) Knowledge Transfer and Exchange
B) Knowledge Terms and Education
C) Knowledge Technology and Education
D) Knowledge Transfer and Effect
Answer: A
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Page 5
Chapter 4: Nursing and Health Care Informatics
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Q1) Nursing Informatics has been formally recognized as an area for speciality certification in nursing by which of the following groups?
A) International Medical Informatics Association
B) Canadian Association of Schools of Nursing
C) American Nurses Association
D) Canadian Nurses Association
Q2) According to Statistics Canada what percentage of home Internet users have searched the Internet for health information?
A) 77 percent
B) 70 percent
C) 53 percent
D) 25 percent
Q3) What is the technology that allows practitioners to practice procedures realistically without an actual patient?
A) visualization
B) exposure therapy
C) virtual reality
D) simulation
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Chapter 5: Population-Based Health Care Practice
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Q1) Which nursing leader is known as one of the first to employ a population-focused practice using aggregated statistics as population-based indices and outcome measures?
A) Christina Mitchell
B) Florence Nightingale
C) Lawrence Green
D) Ethel Johns
Q2) What term refers to the idea that a whole population or a community has a state of health?
A) social factors
B) community health
C) population health
D) health promotion
Q3) Which of the following terms refers to the variables that increase or decrease the probability of illness or death?
A) health determinants
B) health disparities
C) vulnerable population groups
D) health risk factors
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Page 7
Chapter 6: Personal and Interprofessional Communication
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Q1) The traditional modes of communication are verbal and nonverbal.Which of the following is considered a third communication mode?
A) writing
B) touch
C) electronic methods
D) face to face
Q2) Anger can be dealt with in several ways,but all have potential drawbacks.To which of these reactions may expressing anger lead?
A) resentment
B) defensiveness
C) mistreatment
D) lack of trust
Q3) Which of the following trends benefits from nurses' ability to adapt the principles of communication?
A) the "X" generation
B) cultural diversity
C) telephone technology
D) kinesthetic communication
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Chapter 7: Politics and Consumer Partnerships
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Q1) Which of the following refers to participating in public policy-making efforts that support consumer-professional association partnerships and their political agenda?
A) build political credibility
B) soothe and bargain
C) report,publicize,and lobby
D) reaffirm,redefine,or discontinue
Q2) Which level of government has jurisdiction over the regulation of nursing practice?
A) municipal
B) provincial or territorial
C) federal
D) House of Commons
Q3) Which of these groups defines and controls health policy decisions?
A) those with the most political influence
B) researchers
C) professional associations
D) consumer groups
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Chapter 8: Nursing Leadership and Management
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Q1) Which of the following are the desirable leadership characteristics identified by Kirkpatrick and Locke?
A) respectability,trustworthiness,flexibility
B) self-confidence,innate qualities,progression of experiences,influence of significant others,personal life factors
C) intelligence,self-confidence,determination,integrity,sociability
D) drive,desire to lead,honesty,self-confidence,cognitive ability,knowledge of business
Q2) Which of these is a characteristic of the consideration dimension of leadership behaviour?
A) focus on the work to be done
B) focus on the task
C) focus on production
D) focus on the employee
Q3) Which of these theories is a process motivation theory?
A) equity theory
B) Maslow's theory
C) Alderfer's theory
D) Herzberg's theory
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Chapter 9: Effective Team Building
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Q1) In which stage of the group process is agreement most important?
A) storming
B) norming
C) performing
D) adjourning
Q2) In a team setting,which of these factors should be considered when selecting a decision-making approach?
A) next meeting date
B) complexity of the situation
C) anticipated outcome
D) situation and desired outcome
Q3) Which functional group member keeps things energized?
A) creator
B) coordinator
C) mobilizer
D) questioner
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Page 11
Chapter 10: Budget Concepts for Client Care
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Q1) What is the term for the number and type of staff needed for a procedure or to care for a fixed number of clients?
A) staffing model
B) direct patient preparation
C) pre-procedure care
D) post-procedure care
Q2) In relation to budget preparation,which of these terms refers to the units or subsections within a facility?
A) financial unit
B) cost sections
C) compartments
D) cost centres
Q3) Which of these terms refers to a budget that indicates designated funds for the purchase of major new equipment?
A) unit budget
B) construction budget
C) capital budget
D) equipment budget
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Chapter 11: Effective Staffing
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Q1) What is the management tool for seeking out the best practices in one's industry?
A) accreditation
B) factor system
C) benchmarking
D) scorecard
Q2) What is a disadvantage of functional nursing?
A) serves large number of clients
B) utilizes different skill levels to deliver care
C) client receives task-focused care
D) client receives segmented care from several staff
Q3) What is an advantage of primary nursing?
A) accountability
B) cost
C) geographic boundaries
D) One person provides all care.
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Chapter 12: Delegation of Nursing Care
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Q1) Which of the following refers to verbal directions by the delegator?
A) appropriate delegation
B) direct delegation
C) timely delegation
D) indirect delegation
Q2) As a new graduate nurse,which of these statements best describes how you are likely to react to the necessity of delegation?
A) ready to delegate to others
B) shocked to learn you are expected to delegate
C) comfortable assigning tasks to others
D) expect it to be part of your role
Q3) What is the most important consideration for nurses in any delegation situation?
A) client safety
B) accomplishing all necessary tasks
C) making clients receive treatments on time
D) support staff capabilities are carefully assessed
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Chapter 13: Strategic Planning and Organizing Client Care
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Q1) You have observed a senior nurse planning her client care assignment taking into account the whole of her responsibilities and her client's needs,not just a series of tasks.Which level of Benner's clinical practice promotion ladder is demonstrated by this behaviour?
A) novice level
B) advanced beginner level
C) competent level
D) proficient level
Q2) Which of the following is a domain of the Bassett Quality Compass?
A) process outcomes
B) revenue
C) client satisfaction
D) operational status
Q3) In shared governance,whom do the vested parties include?
A) the multi-disciplinary team
B) nurse managers
C) nurses practicing indirect care
D) finance managers
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Chapter 14: Change and Conflict Resolution
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Q1) Which of the following series of changes are included in Rogers' Diffusion of Innovations Theory of Change?
A) diagnose,assess,select progressive change objective,choose role of change agent,maintain change,and terminate helping relationship
B) unfreeze,move,refreeze
C) create awareness,encourage interest,evaluate,trial,adopt
D) build relationship,diagnose problem,acquire resources,choose,gain acceptance
Q2) Which of these is a characteristic of an effective change agent?
A) restrained
B) manages change
C) objective
D) trustworthy
Q3) Which characteristic of Lewin's change theories causes it to have limited application in health care organizations?
A) narrow in scope
B) too complex
C) difficult to apply
D) linear and simplistic
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16
Chapter 15: Power
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Q1) What is an organizational outcome of recognizing the value of nurses' experience and knowledge?
A) motivation
B) self-help
C) empowerment
D) control
Q2) Which author's(s')definition of empowerment reflects the organizational subcomponent of empowerment?
A) Greenberg and Baron
B) Riger
C) Laschinger and Wong
D) Tyne
Q3) How are rewards viewed in terms of acting as a power sources?
A) a way to motivate others
B) a source of resentment
C) effective for changing attitudes
D) an uncertain instrument for influencing others
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Chapter 16: Managing Performance and Outcomes Using an Organizational Quality Improvement Model
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Q1) What is the focus of quality assurance?
A) meeting the needs of the consumer
B) assessing work processes to identify opportunities for improved performance
C) improving performance when standards are not met
D) building quality performance into work processes
Q2) Which of these people has made an important contribution to the science of improvement?
A) Katz
B) Drucker
C) Deming
D) Plsek
Q3) Which of these terms could include the example of a client who is having a chest X-ray done?
A) system
B) process
C) benchmarking
D) sentinel event
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Page 18
Chapter 17: Decision Making
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Q1) To which of the following has the nursing profession in Canada been compared?
A) a highly visible force
B) a strong force
C) a sleeping giant
D) other female-dominated occupations
Q2) What type of choice would include a decision to continue using the same technique or procedure rather than trial a new one?
A) maintenance
B) bureaucratic
C) individual
D) positive change
Q3) According to the text,what is the best source of clinical decision making?
A) technology
B) professional practitioner
C) policies and procedures
D) client classification system
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Chapter 18: Legal Aspects of Client Care
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Q1) Which of Canada's legal systems consists of legal rules and principles written into a civil code?
A) English common law
B) criminal law
C) French civil law
D) public law
Q2) Which of these is a written document representing the wishes and values of an adult in regard to life-sustaining treatments?
A) living will
B) power of attorney
C) personal health care directive
D) hybrid form
Q3) In which legislation is the "general duty provision" for workplace safety found?
A) common law
B) The Canada Health Act
C) tort law
D) occupational health and safety legislation
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Chapter 19: Spirituality and the Profession of Nursing
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Q1) How can nurses benefit from use of the ASSET model?
A) increases understanding about religion
B) promotes cultural sensitivity
C) increases nurses' self-awareness about spirituality
D) helps assess clients' spiritual needs
Q2) Which of the following differentiates spirituality from religion?
A) Religion is characterized by boundaries.
B) Religion involves rituals.
C) Spirituality is defined by boundaries.
D) They involve different beliefs.
Q3) Which of these terms means "to remember one's value"?
A) a memorial
B) recall
C) posthumous
D) legacy
Q4) Who has developed a complete model for palliative care in Canada?
A) Canadian Nurses Association (CNA)
B) Canadian Medical Association (CMA)
C) Canadian Pastoral Association (CPA)
D) Canadian Hospice Palliative Care Association (CHPCA)
Page 21
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Chapter 20: Ethics and the Profession of Nursing
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Q1) New technologies,choices,and concerns about intervening in the lives of others have led to a subspecialty within the field of ethical inquiry.What is this subspecialty now called?
A) professional ethics
B) bioethics
C) social values
D) ethics algorithms
Q2) What is the name of a document that contains the wishes of the client to be carried out when they are no longer competent?
A) power of attorney
B) an advance directive
C) a will
D) a DNR order
Q3) Which principle is being reflected when an individual utilizes self-governance and control over decision-making concerningherself?
A) respect for human dignity
B) beneficence
C) paternalism
D) autonomy
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Page 22
Chapter 21: Collective Bargaining
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Q1) What length of time is usual for selecting a collective bargaining unit and negotiating a contract?
A) 1 month
B) 2 months
C) 1 year
D) 3 months to 3 years
Q2) What is the term for closing a place of business to force employees to accept management's terms?
A) strike
B) lockout
C) fact finding
D) free speech
Q3) Which of these terms is used for a formal complaint or dispute between management and a union member regarding the terms of the collective agreement?
A) arbitration
B) grievance
C) mediation
D) dispute
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Chapter 22: Career Planning and Development: Creating
Path to the Future
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Q1) What is the second phase in the Donner-Wheeler Model?
A) educational credentials
B) self-assessment
C) identifying your references
D) writing your résumé
Q2) What is the best response to the interview question,"Why do you want to work here?"
A) "I am looking for good benefits."
B) "You are located close to my home."
C) "I admire the service your organization provides."
D) "Your organization can help my career."
Q3) Which of these factors is most important when sending an electronic résumé?
A) timing
B) spell-check
C) being concise
D) sending it in the requested format
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