,Effective Leadership & Management in Nursing,
̦̣ 9e (Sullivan)
̦̣
Chapter 1 Introducing
̦̣ Nursing
̦̣ Management
1) A nurse ̦̣ manager is participating in the healthcare organization's strategic planning
committee. Which factor is the primary driving force and controlling factor in new initiatives
this committee might recommend?
1. Cost of care
2. Access to care
3. Availability of care
4. Quality̦̣ of care
Answer: 1
Explanation: 1. While all of the options given are driving forces in today's healthcare
environment, the cost of providing care is still the primary issue. ̦̣ Cost of care controls access,
availability, and quality. ̦̣
2. Access to care is controlled by the ability to pay.
3. Care will not be available if it cannot be funded. ̦̣
4. Healthcare providers do not like to correlate quality ̦̣ with cost, buț̣ the economic reality is
that quality ̦̣ care mu st
̦̣ also be fu nded
̦̣ care.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: ̦̣ Management of Care
Nursing/Int
̦̣ Conc: Nursing ̦̣ Process: Evaluation/Leadership
̦̣
Learning Outcome: ̦̣ 1-1: Explain changes to healthcare over the past decade, including
̦̣ those
resulting
̦̣ from implementation of the Affordable Care Act; demands to reduce ̦̣ errors and
improve patient safety; and evolving medical and communication ̦̣ technology.
,2) A nurse ̦̣ has been invited to discuss ̦̣ healthcare costs at a senior citizens' club. ̦̣ What
information should ̦̣ the nurse
̦̣ plan to include̦̣ in this discussion?
̦̣
1. While healthcare costs continue̦̣ to rise, the percentage of the United States (U.S.) economy
spent on healthcare has slowly declined to less than 12%.
2. Regulations ̦̣ brought ̦̣ abouț̣ by the Patient Protection and Affordable Care Act (PPACA)
should ̦̣ bring financial relief to healthcare consumers. ̦̣
3. The United States spends more money on healthcare than any other country. ̦̣
4. Healthcare spending in the United States is slowly declining due̦̣ to passage of bills such ̦̣ as
the Patient Protection and Affordable Care Act (PPACA).
Answer: 2
Explanation: 1. In 2009, healthcare costs consumed ̦̣ more than 17% of the country's ̦̣ gross
domestic product. ̦̣
2. Implementation of PPACA and its regulations ̦̣ have not been formulated.
̦̣
3. The United States spends more than $2.5 trillion on healthcare annually, ̦̣ more than any
other country. ̦̣
4. While this act has been passed, it is not operationalized. Healthcare spending continues ̦̣ to
rise.
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: ̦̣ Management of Care
Nursing/Int
̦̣ Conc: Nursing
̦̣ Process: Planning/Education ̦̣
Learning Outcome: ̦̣ 1-1: Explain changes to healthcare over the past decade, including ̦̣ those
resulting
̦̣ from implementation of the Affordable Care Act; demands to redu ce
̦̣ errors and
improve patient safety; and evolving medical and communication ̦̣ technology.
3) A 70-year-old client develops a catheter-induced ̦̣ urinary
̦̣ tract infection. Which statement
by the nurse ̦̣ would ̦̣ indicate to the nurse ̦̣ manager a need for additional understanding ̦̣ of this
situation?
̦̣
1. "I wonder if there was a break of sterility when this catheter was inserted."
2. "Thankfully ̦̣ we can treat this with an antibiotic."
3. "This could ̦̣ potentially cost the hospital a lot of money."
4. "I will talk to my unlicensed ̦̣ assistants abouț̣ proper urinary ̦̣ catheter care."
Answer: 2
Explanation: 1. Wondering abouț̣ a break in sterility indicates that the nurse ̦̣ is concerned
abouț̣ the process that might have contributed ̦̣ to this infection.
2. The nurse ̦̣ who focuses ̦̣ on taking care of the results ̦̣ of a potential medical mistake is not
accepting the seriousness ̦̣ of the situ ation.
̦̣
3. The Centers for Medicare and Medicaid Services no longer cover the costs incurred ̦̣ by
medical mistakes. This urinary ̦̣ tract infection cou ld
̦̣ cost the hospital the cost of treatment,
including ̦̣ increased length of stay.
4. The nurse ̦̣ has identified that improper care may resulț̣ in poor outcomes ̦̣ for the client.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: ̦̣ Management of Care
Nursing/Int
̦̣ Conc: Nursing ̦̣ Process: Evaluation/Edu
̦̣ cation
̦̣
Learning Outcome: ̦̣ 1-1: Explain changes to healthcare over the past decade, including ̦̣ those
resulting ̦̣ from implementation of the Affordable Care Act; demands to reduce ̦̣ errors and
improve patient safety; and evolving medical and communication ̦̣ technology.
4) Which healthcare situations
̦̣ reflect the philosophy of quality
̦̣ management as designed by
Deming?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
, Select all that apply.
1. A nurse ̦̣ asks visitors to leave because ̦̣ it is after visiting hours. ̦̣
2. At 2:00 p.m. the nurse ̦̣ orders a lu nch̦̣ tray for a client who has just
̦̣ been removed from
nothing by mouth ̦̣ (NPO) status.̦̣
3. A nurse ̦̣ tells the manager that a housekeeper's ̦̣ work is not up̦̣ to standards.
4. A nurse ̦̣ volunteers ̦̣ to take a Spanish language ̦̣ class to be able to communicate ̦̣ with clients.
5. A nurse ̦̣ who has not made a medication error in two years asks for a salary increase.
Answer: 2, 3, 4
Explanation: 1. The philosophy of quality ̦̣ management is focuș̣ on the needs of the client. If
there is no reason for the visitors to leave other than it is after visiting hours, ̦̣ this is not
focused ̦̣ on client need.
2. Even though ̦̣ 2:00 p.m. is after "lunchtime," ̦̣ this nurse
̦̣ is focused ̦̣ on the client's needs. This
is an example of quality ̦̣ management.
3. Quality ̦̣ management empowers the employee to evaluate ̦̣ quality. ̦̣
4. This nurse ̦̣ has seen a need and is working to improve the quality ̦̣ of service. This is quality̦̣
management.
5. Salary increases can be tied to quality ̦̣ improvement initiatives, buț̣ just ̦̣ asking for an
increase is not quality ̦̣ management.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: ̦̣ Management of Care
Nursing/Int
̦̣ Conc: Nursing ̦̣ Process: Implementation/Quality ̦̣ of Practice
Learning Outcome: ̦̣ 1-1: Explain changes to healthcare over the past decade, including ̦̣ those
resulting
̦̣ from implementation of the Affordable Care Act; demands to reduce ̦̣ errors and
improve patient safety; and evolving medical and communication ̦̣ technology.
̦̣ 9e (Sullivan)
̦̣
Chapter 1 Introducing
̦̣ Nursing
̦̣ Management
1) A nurse ̦̣ manager is participating in the healthcare organization's strategic planning
committee. Which factor is the primary driving force and controlling factor in new initiatives
this committee might recommend?
1. Cost of care
2. Access to care
3. Availability of care
4. Quality̦̣ of care
Answer: 1
Explanation: 1. While all of the options given are driving forces in today's healthcare
environment, the cost of providing care is still the primary issue. ̦̣ Cost of care controls access,
availability, and quality. ̦̣
2. Access to care is controlled by the ability to pay.
3. Care will not be available if it cannot be funded. ̦̣
4. Healthcare providers do not like to correlate quality ̦̣ with cost, buț̣ the economic reality is
that quality ̦̣ care mu st
̦̣ also be fu nded
̦̣ care.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: ̦̣ Management of Care
Nursing/Int
̦̣ Conc: Nursing ̦̣ Process: Evaluation/Leadership
̦̣
Learning Outcome: ̦̣ 1-1: Explain changes to healthcare over the past decade, including
̦̣ those
resulting
̦̣ from implementation of the Affordable Care Act; demands to reduce ̦̣ errors and
improve patient safety; and evolving medical and communication ̦̣ technology.
,2) A nurse ̦̣ has been invited to discuss ̦̣ healthcare costs at a senior citizens' club. ̦̣ What
information should ̦̣ the nurse
̦̣ plan to include̦̣ in this discussion?
̦̣
1. While healthcare costs continue̦̣ to rise, the percentage of the United States (U.S.) economy
spent on healthcare has slowly declined to less than 12%.
2. Regulations ̦̣ brought ̦̣ abouț̣ by the Patient Protection and Affordable Care Act (PPACA)
should ̦̣ bring financial relief to healthcare consumers. ̦̣
3. The United States spends more money on healthcare than any other country. ̦̣
4. Healthcare spending in the United States is slowly declining due̦̣ to passage of bills such ̦̣ as
the Patient Protection and Affordable Care Act (PPACA).
Answer: 2
Explanation: 1. In 2009, healthcare costs consumed ̦̣ more than 17% of the country's ̦̣ gross
domestic product. ̦̣
2. Implementation of PPACA and its regulations ̦̣ have not been formulated.
̦̣
3. The United States spends more than $2.5 trillion on healthcare annually, ̦̣ more than any
other country. ̦̣
4. While this act has been passed, it is not operationalized. Healthcare spending continues ̦̣ to
rise.
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: ̦̣ Management of Care
Nursing/Int
̦̣ Conc: Nursing
̦̣ Process: Planning/Education ̦̣
Learning Outcome: ̦̣ 1-1: Explain changes to healthcare over the past decade, including ̦̣ those
resulting
̦̣ from implementation of the Affordable Care Act; demands to redu ce
̦̣ errors and
improve patient safety; and evolving medical and communication ̦̣ technology.
3) A 70-year-old client develops a catheter-induced ̦̣ urinary
̦̣ tract infection. Which statement
by the nurse ̦̣ would ̦̣ indicate to the nurse ̦̣ manager a need for additional understanding ̦̣ of this
situation?
̦̣
1. "I wonder if there was a break of sterility when this catheter was inserted."
2. "Thankfully ̦̣ we can treat this with an antibiotic."
3. "This could ̦̣ potentially cost the hospital a lot of money."
4. "I will talk to my unlicensed ̦̣ assistants abouț̣ proper urinary ̦̣ catheter care."
Answer: 2
Explanation: 1. Wondering abouț̣ a break in sterility indicates that the nurse ̦̣ is concerned
abouț̣ the process that might have contributed ̦̣ to this infection.
2. The nurse ̦̣ who focuses ̦̣ on taking care of the results ̦̣ of a potential medical mistake is not
accepting the seriousness ̦̣ of the situ ation.
̦̣
3. The Centers for Medicare and Medicaid Services no longer cover the costs incurred ̦̣ by
medical mistakes. This urinary ̦̣ tract infection cou ld
̦̣ cost the hospital the cost of treatment,
including ̦̣ increased length of stay.
4. The nurse ̦̣ has identified that improper care may resulț̣ in poor outcomes ̦̣ for the client.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: ̦̣ Management of Care
Nursing/Int
̦̣ Conc: Nursing ̦̣ Process: Evaluation/Edu
̦̣ cation
̦̣
Learning Outcome: ̦̣ 1-1: Explain changes to healthcare over the past decade, including ̦̣ those
resulting ̦̣ from implementation of the Affordable Care Act; demands to reduce ̦̣ errors and
improve patient safety; and evolving medical and communication ̦̣ technology.
4) Which healthcare situations
̦̣ reflect the philosophy of quality
̦̣ management as designed by
Deming?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
, Select all that apply.
1. A nurse ̦̣ asks visitors to leave because ̦̣ it is after visiting hours. ̦̣
2. At 2:00 p.m. the nurse ̦̣ orders a lu nch̦̣ tray for a client who has just
̦̣ been removed from
nothing by mouth ̦̣ (NPO) status.̦̣
3. A nurse ̦̣ tells the manager that a housekeeper's ̦̣ work is not up̦̣ to standards.
4. A nurse ̦̣ volunteers ̦̣ to take a Spanish language ̦̣ class to be able to communicate ̦̣ with clients.
5. A nurse ̦̣ who has not made a medication error in two years asks for a salary increase.
Answer: 2, 3, 4
Explanation: 1. The philosophy of quality ̦̣ management is focuș̣ on the needs of the client. If
there is no reason for the visitors to leave other than it is after visiting hours, ̦̣ this is not
focused ̦̣ on client need.
2. Even though ̦̣ 2:00 p.m. is after "lunchtime," ̦̣ this nurse
̦̣ is focused ̦̣ on the client's needs. This
is an example of quality ̦̣ management.
3. Quality ̦̣ management empowers the employee to evaluate ̦̣ quality. ̦̣
4. This nurse ̦̣ has seen a need and is working to improve the quality ̦̣ of service. This is quality̦̣
management.
5. Salary increases can be tied to quality ̦̣ improvement initiatives, buț̣ just ̦̣ asking for an
increase is not quality ̦̣ management.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: ̦̣ Management of Care
Nursing/Int
̦̣ Conc: Nursing ̦̣ Process: Implementation/Quality ̦̣ of Practice
Learning Outcome: ̦̣ 1-1: Explain changes to healthcare over the past decade, including ̦̣ those
resulting
̦̣ from implementation of the Affordable Care Act; demands to reduce ̦̣ errors and
improve patient safety; and evolving medical and communication ̦̣ technology.
