Which of the following is an example of a sentinel event?

Correct Answer: C

Rationale: The correct answer is C because a sentinel event is a serious, unexpected occurrence in a healthcare setting that results in death or serious physical or psychological harm to a patient. A patient suicide while in a healthcare facility meets this criteria. A is incorrect as a fall with no injury is not a sentinel event. B is incorrect as a medication error resulting in no harm is not a sentinel event. D is incorrect as a near miss incident, although serious, does not result in harm to the patient.

Correct Answer: A

Rationale: The primary role of a nurse in a PCMH is to coordinate patient care. This involves ensuring all aspects of a patient's care are well-managed, communicating with various healthcare providers, and advocating for the patient's needs. This role aligns with the core principles of a PCMH, which emphasize comprehensive, coordinated, and patient-centered care. Administering treatments (B) is typically the role of physicians or other healthcare providers. Providing health education (C) is important but not the primary role of a nurse in a PCMH. Conducting research (D) is not a direct responsibility of nurses in a clinical setting like a PCMH.

Correct Answer: C

Rationale: The correct answer is C: Continuous improvement. Total Quality Management (TQM) focuses on constantly improving processes, products, and services to meet or exceed customer expectations. TQM involves all employees in identifying and solving problems, emphasizing continuous learning and innovation. A: Top-down management is incorrect because TQM encourages involvement and empowerment of employees at all levels, not just top management. B: Employee-centered approach is incorrect because while TQM values employees and their contributions, it is primarily focused on improving overall quality and processes, not solely centered on employees. D: Quality control is incorrect because TQM goes beyond traditional quality control methods to encompass a holistic approach to quality management through continuous improvement efforts.

Correct Answer: D

Rationale: The correct answer is D because it presents a situation where a nurse must navigate conflicting values, such as respecting patient autonomy while upholding professional ethical standards. By complying with the patient's request, the nurse may compromise ethical principles. A: Choosing between two equally undesirable alternatives is a moral dilemma, not necessarily an ethical dilemma. B: Reporting a colleague's unethical behavior is an ethical obligation, not a dilemma. C: Balancing patient confidentiality with the need to disclose information is an ethical consideration, but it does not inherently present a dilemma as it can be managed through established guidelines.

Correct Answer: B

Rationale: The primary goal of a root cause analysis (RCA) in healthcare is to prevent future errors by identifying underlying causes. This is because RCA focuses on understanding the fundamental reasons behind incidents to implement effective preventive measures. By identifying root causes, healthcare providers can implement strategies to mitigate risks and enhance patient safety. The other choices are incorrect because RCA is not about assigning blame (A), improving patient satisfaction (C), or analyzing financial impact (D), but rather about understanding and addressing the core issues to prevent recurrence.