C-ONQS Practice Questions

Ready to take your knowledge to the next level? These C-ONQS practice questions are designed to sharpen your skills, test your understanding, and build confidence for exam day. Dive in, challenge yourself, and see how much you know! 

(answers are at the very bottom).

1.  What is the acronym that serves as a memory aid for the six domains of quality outlined in the IOM's 2001 report?

A) STEADY

B) STEEEP

C) CHAMP

2. A multidisciplinary team identifies that their unit has an increased length of stay time in their triage unit. The team reviews all the steps in the process from when the patient arrives to triage through discharge. One area of opportunity identified is delays in bloodwork processing. All bloodwork throughout the hospital was initially received in a central lab area, and STAT labs could not be easily identified. They often remained in this area until obstetric staff called inquiring for results. The team streamlines this process to add (1) easily identifiable pink stickers to STAT labs, ensuring lab personnel can easily identify the bloodwork, and (2) a phone call from the labor unit staff to the lab to ensure they are on the lookout for the specimens. As a result of this intervention, triage length of stay is reduced by 30 min. Which domain of quality has this work improved?

A) Safety

B) Timeliness

C) Effectiveness

3. How does the World Health Organization (WHO) define quality in healthcare?

A) The degree to which health services increase costs for individuals and populations

B) The efficiency of healthcare organizations

C) The degree to which health services increase the likelihood of desired health outcomes for individuals and populations

4. How does the Institute for Healthcare Improvement define an adverse event?

A) A known complication of surgery or medical care

B) Unintended physical injury resulting from or contributed to by medical care that requires additional monitoring, treatment, or hospitalization, or that results in death

C) Intentional physical injury resulting from medical care

Which of the following are examples of adverse events? 

5. Which of the following are examples of adverse events? 

A) Missed antibiotic orders and administration on a labor patient that was positive for group B streptococcus (GBS), resulting in no harm to the newborn 

B) Surgery on the wrong patient, retained foreign objects, falls leading to patient death or serious injury, and maternal or neonatal death or serious injury associated with labor or delivery in a low-risk pregnancy

6. What does the Joint Commission define as a sentinel event?

A) Any patient safety event that reaches a patient

B) Death, permanent harm, or severe temporary harm and life-sustaining intervention resulting from a patient safety event that reaches a patient

C) Any adverse event or near miss

7. What do structure measures, based on Avedis Donabedian's framework, evaluate in hospitals and healthcare organizations?

A) The frequency of care interventions

B) Available resources and supplies, such as nurse-to-patient ratios, the skill mix of staff, technology, and policies and guidelines for care

C) Waiting times for patients

8. A hospital implements quality improvement work around decreasing hospital acquired infection rates. They implement education around the importance of handwashing prior to and after patient encounters. Secret shoppers are employed to observe if staff are handwashing with soap and water or using alcohol-based hand sanitizers before entering and leaving patient rooms. Which metric is an example of a process measure for this work?

A) Hospital-acquired infection rates

B) Handwashing compliance rate

C) Development of a hand hygiene guideline 

9. Using this same example above, which metric is an example of an outcome measure for this work?

A) Surgical site infection rates

B) Handwashing rate

C) Venous thromboembolism rate 

10. In a just culture, who is held accountable for patient safety?

A) Only individuals

B) Only organizations

C) Both individuals and organizations

D) Neither individuals nor organizations

11. A multiparous woman at 39 weeks 4 days presented in spontaneous labor.   Her history was significant for one previous cesarean section at term. Several hours later, a bradycardia was noted to a nadir of 60 beats per minute. Emergency cesarean delivery was initiated and a baby boy was found to be in the abdominal cavity; with a rupture noted along the entire uterine scar. The Apgar scores were 4 and 6 at 1 and 5 minutes. Due to the catastrophic nature of this event, the physician caring for this patient was more likely to recommend precautionary cesarean delivery for subsequent patients. This is an example of what type of cognitive bias?

A) Visceral bias

B) Framing effect

C) Availability bias

Answers 

1. B STEEEP- Safety, Timeliness, Effectiveness, Efficiency, Equitability, and Patient-centered. 

2. B Timeliness- this work has helped to reduce length of stay and delays in care

3. C The degree to which health services increase the likelihood of desired health outcomes for individuals and populations. Explanation: Quality is focused on how the system impacts patient outcomes.  

4. B Unintended physical injury resulting from or contributed to by medical care that requires additional monitoring, treatment, or hospitalization, or that results in death

5. B Surgery on the wrong patient, retained foreign objects, falls leading to patient death or serious injury, and maternal or neonatal death or serious injury associated with labor or delivery in a low-risk pregnancy are all examples of harm resulting from medical care

6. B Death, permanent harm, or severe temporary harm and life-sustaining intervention resulting from a patient safety event that reaches a patient

7. B Available resources and supplies, such as nurse-to-patient ratios, the skill mix of staff, technology, and policies and guidelines for care

8. B Handwashing. Process measures monitor if the intervention is being followed. The intervention was education to promote handwashing. 

9. A Surgical site infection rates. Outcome measures reflect the impact on the patient (here, infection rates). Handwashing is an intervention to reduce all hospital acquired infections - examples surgical site, central line associated bloodstream infections (CLABSI)

10. C Both individuals and organizations

11. C Availability bias- when clinical decision making is based on recent adverse events

*If this content interests you, you may also enjoy my book titled: Obstetric and Neonatal Quality and Safety (C-ONQS) Study Guide: A Practical Resource for Perinatal Nurses, available on amazon: Amazon_obneonatalstudyguide

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Copyright by Jeanette Zocco MSN, RNC-OB, C-EFM, C-ONQS