ANM Patient Safety and Advocacy 2 — Questions and Answers
Question 1: A nurse manager notices staff are frequently skipping the timeout procedure before surgical procedures. What is the most appropriate first action?
- Immediately report all staff to administration
- Conduct a staff education session on the purpose and importance of the surgical timeout (Correct answer)
- Revise the timeout policy without staff input
- Accept the practice if no adverse events have occurred
Correct answer: Conduct a staff education session on the purpose and importance of the surgical timeout
Education helps staff understand the rationale behind safety protocols, increasing compliance and reducing surgical errors.
Question 2: Which of the following best describes the role of a patient advocate in a clinical setting?
- Ensuring patients comply with physician orders
- Supporting and promoting patients' rights, preferences, and informed decision-making (Correct answer)
- Limiting family involvement to protect patient privacy
- Prioritizing cost-effective care over patient preferences
Correct answer: Supporting and promoting patients' rights, preferences, and informed decision-making
Patient advocacy centers on protecting patient rights and ensuring their values guide care decisions.
Question 3: A patient refuses a blood transfusion on religious grounds despite a life-threatening hemoglobin level. The nurse manager should:
- Override the refusal to save the patient's life
- Document the refusal and ensure an informed refusal form is signed after confirming decision-making capacity (Correct answer)
- Convince the patient to accept treatment by withholding other care
- Transfer the patient to another facility without discussion
Correct answer: Document the refusal and ensure an informed refusal form is signed after confirming decision-making capacity
Competent adult patients have the right to refuse treatment; the nurse manager must document the informed refusal and respect autonomy.
Question 4: What does the chain of command in patient safety refer to?
- The hierarchy for disciplinary actions against staff
- A structured escalation process used when safety concerns are not addressed at the immediate level (Correct answer)
- The order in which patients receive care based on severity
- Administrative reporting structure for budget approvals
Correct answer: A structured escalation process used when safety concerns are not addressed at the immediate level
The chain of command is a formal escalation pathway nurses use when patient safety issues are not resolved by the immediate supervisor.
Question 5: An ANM is reviewing a near-miss event where a patient almost received the wrong medication. The BEST action is to:
- Reprimand the nurse involved to prevent recurrence
- Conduct a root cause analysis to identify system-level factors contributing to the near-miss (Correct answer)
- File the incident report and take no further action
- Increase the nursing workload to improve attentiveness
Correct answer: Conduct a root cause analysis to identify system-level factors contributing to the near-miss
Root cause analysis focuses on system-level fixes rather than individual blame, which is the foundation of a just culture and safety improvement.
Question 6: Which safety initiative is specifically designed to reduce catheter-associated urinary tract infections (CAUTIs)?
- SBAR communication protocol
- Central line bundle
- CAUTI prevention bundle including daily necessity review and aseptic technique (Correct answer)
- Rapid response team activation
Correct answer: CAUTI prevention bundle including daily necessity review and aseptic technique
CAUTI prevention bundles include daily review of catheter necessity, proper insertion technique, and maintenance protocols.
Question 7: A confused elderly patient repeatedly tries to climb out of bed. After least-restrictive interventions have failed, the nurse manager authorizes a physical restraint. Which action is required?
- No further documentation is needed once the restraint is applied
- Obtain a physician order, document the clinical justification, and reassess at defined intervals (Correct answer)
- Notify the family only after 24 hours
- Maintain the restraint continuously until discharge
Correct answer: Obtain a physician order, document the clinical justification, and reassess at defined intervals
Restraint use requires a physician order, clear clinical documentation, and regular reassessment to ensure safety and explore alternatives.
ANM Patient Safety and Advocacy 2
A nurse manager notices staff are frequently skipping the timeout procedure before surgical procedures.
What is the most appropriate first action?