The nurse manager reviews a unit quality-improvement cycle. Which actions require follow-up? Highlight the actions that interfere with a valid Plan-Do-Study-Act test of change.
Highlight in Table
Choose your responses, then check the answer.
Explanation
Hospital-wide rollout before study, changing several processes without tracking them, and discarding an unsuccessful cycle require follow-up. PDSA uses a defined prediction, small test, documented observations, comparison, and adaptation.
Quick answer Highlight expanding the change before examining the first cycle, altering several workflows without tracking their separate effects, and omitting an unsuccessful cycle from the record. These actions prevent the team from learning what produced the result.
Why this is correct PDSA begins with a focused plan and prediction, tests a change on a small scale, studies data and unexpected observations, then adapts the next cycle. Transparent results, including disappointing ones, are evidence for the next decision rather than failures to hide.[2]
Easy analogy or mental picture Think of adjusting a recipe one ingredient at a time and tasting each small batch. Changing the whole kitchen menu at once or throwing away a poor batch without notes hides the cause; the analogy illustrates controlled learning, not clinical outcome measurement by itself.
Memory hook Predict, test small, study honestly, adapt.
NCLEX decision rule For a quality-improvement question, prefer a measurable small test with documented observations and an explicit comparison to the prediction before wider implementation.
Why the other choices are wrong Defining a measure, testing on a single shift, recording surprises, comparing results with the prediction, and planning an adapted second cycle all preserve learning. They are expected PDSA steps, not reasons to stop the project.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
AHRQ: Plan-Do-Study-Act WorksheetAgency for Healthcare Research and Quality