Question 1

The nurse gives an inaccurate dose of medication to a client. Following assessment of the client, the nurse completes an incident report. The nurse notifies the nursing supervisor of the medication error and calls the physician to report the occurrence. The nurse who administered the inaccurate medication dose understands that the?

Accepted Answer

Answer reason: The purpose of an incident report is not punitive; it is a part of the facility’s risk management and quality assurance program to identify patterns, prevent future errors, and promote safe practice. Disciplinary action is not automatic unless negligence or harm is proven.

Question 2

A patient is scheduled for a CT scan with iodinated contrast. Which assessment is most important before the procedure?

Accepted Answer

Answer reason: Assessing for an allergy to contrast media (especially iodine or previous contrast reactions) is essential to avoid severe hypersensitivity reactions, including anaphylactoid responses.

Question 3

Which situation MOST clearly requires involvement of the risk management team?

Accepted Answer

Answer reason: Events that result in patient harm, such as falls with injury, require risk management involvement to evaluate liability, system factors, and prevention strategies. Minor delays or documentation timing issues do not typically trigger risk management review.

Question 4

After a medication error reaches the client and causes temporary harm, which action BEST aligns with risk management principles?

Accepted Answer

Answer reason: Risk management emphasizes transparent disclosure, accurate factual documentation, and timely response following adverse events. Punitive actions or delaying care-related steps do not support patient safety or ethical practice.

Question 5

Which action BEST demonstrates a proactive risk management strategy?

Accepted Answer

Answer reason: Proactive risk management involves identifying and addressing near misses before harm occurs. This approach strengthens systems and reduces the likelihood of serious adverse events.

Question 6

A nurse identifies that several infusion pumps on the unit frequently alarm due to battery failure. Which action BEST reflects effective risk management?

Accepted Answer

Answer reason: Risk management relies on identifying and reporting hazards before harm occurs. Reporting faulty equipment enables evaluation, maintenance, and system-level prevention.

Question 7

Following a sentinel event, which action is MOST appropriate for the risk management team to initiate?

Accepted Answer

Answer reason: Sentinel events require a structured root cause analysis to uncover underlying system failures. The goal is prevention, not punishment or public disclosure.

Question 8

Which documentation practice BEST supports risk management following an adverse event?

Accepted Answer

Answer reason: Accurate, objective documentation supports continuity of care and legal integrity. Opinions, blame, or references to incident reports should not appear in the medical record.

Question 9

A nurse notices that the unit’s fall-risk assessment tool has not been updated to reflect current evidence-based guidelines. Which action BEST supports risk management?

Accepted Answer

Answer reason: Risk management involves identifying system-level gaps that increase the likelihood of harm. Reporting outdated tools enables evidence-based updates that reduce risk across the unit.

Question 10

After a client experiences an adverse reaction to a medication, which nursing action MOST appropriately reduces legal and safety risk?

Accepted Answer

Answer reason: Immediate assessment and intervention prioritize patient safety, while objective documentation supports legal integrity. Delays or explanations without action increase risk.

Question 11

Which scenario BEST illustrates proactive risk management rather than reactive response?

Accepted Answer

Answer reason: Proactive risk management identifies and mitigates hazards before harm occurs. Safety rounds allow early detection and correction of risks.

Question 12

A nurse gives a client the wrong medication. After assessing the client, the nurse completes an incident report. Which statement describes what will occur next?

Accepted Answer

Answer reason: Incident reports are internal quality and safety documents used to identify system causes of errors, trend events, and prevent recurrence through process improvement. After the client is assessed and stabilized, the report is routed to management/risk management for review, follow-up, and possible policy or workflow changes. It is not automatically an ADR report because the event is a medication administration error rather than an unexpected pharmacologic reaction. Reporting to the state board or automatic suspension depends on severity, intent, and organizational/disciplinary processes and is not the standard next step triggered solely by completing an incident report.

Question 13

The nurse reviews the admission findings after treating the client who had fallen and determines that a fall assessment was not completed on admission. Which is the best action by the nurse?

Accepted Answer

Answer reason: The priority after identifying a missed safety assessment is to immediately reduce the patient’s risk of further harm using standardized, evidence-based interventions. Initiating the facility fall-prevention bundle (risk identification, environmental modifications, assistance with mobility, alarms as indicated, and patient education) directly addresses the current clinical safety need. Incident/variance reporting and manager notification are important for system improvement, but they do not by themselves protect the patient right now. Restraints are a last resort with significant risks and require strict indications and orders; they are not an appropriate primary fall-prevention measure.

Question 14

You are the nurse manager of the surgical acute care unit. You have noticed that a number of clients have almost been sent to the preoperative suite when they are not scheduled for a planned surgical procedure. Fortunately, no clients have gotten a “wrong surgery” because this possible error was caught in time. What is your priority action as the nurse manager?

Accepted Answer

Answer reason: Near misses are considered medical errors that did not reach the patient. The priority is to investigate the system to identify root causes and prevent future harm. This is not yet a sentinel event because no actual harm occurred.

Question 15

Medicare has enacted a new policy that states that, if a client develops certain conditions while in the hospital, the hospital will not be reimbursed for the care of the client. Which condition does a nurse know that quality care can prevent?

Accepted Answer

Answer reason: Medicare identifies preventable hospital-acquired conditions as indicators of quality care. Poor glycemic control can be prevented with appropriate monitoring and management protocols. The other options are not standard preventable conditions tied to reimbursement policies.

Question 16

The client with hyperglycemia is receiving a continuous IV insulin drip. The nurse checking the client’s blood glucose hourly obtains a reading of 32 mg/dL. The client who was alert is now lethargic and does not respond to questions. The nurse administers 25 mL of D50W per protocol. The client begins to respond. Which additional risk-management action should be taken by the nurse?

Accepted Answer

Answer reason: A blood glucose of 32 mg/dL with altered mental status is a severe hypoglycemic event and represents a significant safety incident, especially in a client receiving an insulin infusion. Even though the nurse appropriately treated the hypoglycemia, this event requires reporting per institutional risk-management and safety protocols to evaluate contributing factors and prevent recurrence. Option A is unsafe; the insulin infusion should be reassessed or held. Option C is inappropriate because glucose should be rechecked much sooner (e.g., within minutes). Option D is unnecessary once the client improves unless hypoglycemia persists.

Question 17

The nursing profession has a responsibility to provide quality cost-effective care. A priority nursing judgment is to recognize that financial reimbursement for care will be lost for certain hospital-acquired conditions if the?

Accepted Answer

Answer reason: Hospital-acquired conditions (HACs), such as pressure ulcers, are considered preventable events. When these occur during hospitalization, reimbursement may be reduced or denied because they reflect lapses in quality and safety care. Option B reflects a pre-existing condition present on admission. Option C is a common complication but not typically classified as a non-reimbursable HAC. Option D describes a safe assisted fall, which is not considered a preventable adverse event in the same category as HACs.

Question 18

In reviewing an HCP’s orders for the client, the oncoming shift nurse finds that an antibiotic was prescribed but is not listed on the client’s MAR. Three doses were missed. Which action should minimize the nurse’s malpractice risk?

Accepted Answer

Answer reason: Completing an incident/variance report ensures the error is formally documented, triggers system-level review, and supports patient safety and legal protection. Proper reporting demonstrates adherence to institutional policy and reduces malpractice risk.

Question 19

Should the investigation of the fall go further, which of the following is the best source of factual information?

Accepted Answer

Answer reason: An incident report is specifically designed to document objective, detailed information about unexpected events such as falls. It includes factual data for internal investigation, quality improvement, and risk management. While nurse’s notes may describe the event, the incident report provides the most structured and comprehensive factual record for formal review.

Question 20

A risk is any event that causes problems or benefits on the healthcare institution. The medical director knows that potential risks must be identified across the hospital in order to prevent the following EXCEPT ...?

Accepted Answer

Answer reason: Risk management aims to prevent negative outcomes such as financial loss, accidents, and injuries. Incident reports are not outcomes to be prevented; they are documentation tools used after events occur to analyze and improve safety systems. Therefore, incident reports do not represent a preventable risk outcome.

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