(Leading and Managing in Nursing)
Complex care of acutely ill patients is required on a surgical unit, which utilizes differentiated nursing
practice as its model of care delivery. On what is the concept of differentiated nursing practice is based?
a. Licensure status
b. Experience in the agency
c. Leadership capabilities
d. Education and expertise - ANS: D
Differentiated nursing practice models are models of clinical nursing practice that are defined or
differentiated by level of education, expected clinical skills or competencies, job descriptions, pay scales,
and participation in decision making.
The relief charge nurse has assigned a newly licensed baccalaureate-prepared nurse to be one of the
team leaders for the 3-11 shift. In making this decision, the charge nurse has overlooked this nurse's:
a. clinical expertise.
b. leadership ability.
c. communication style.
d. conflict-resolution skills. - ANS: A
Because the basic education of baccalaureate-prepared RNs emphasizes critical-thinking, clinical
reasoning, and leadership concepts, they are likely candidates for such roles. Benner (2001), however,
identified five stages of clinical competence for nurses: novice, advanced beginner, competent,
proficient, and expert. She suggests that competence is typified by a nurse who has been on the job in
the same or similar situation 2 to 3 years. Nurses who are at the novice or advanced beginner stage
would be less likely than their more experienced counterparts to implement any type of delivery model
effectively and thus, this assignment overlooks the nurse's level of clinical expertise and leadership
experience.
, When interviewing an applicant for an RN position, the nurse manager describes the unit's care delivery
system as one in which the nursing assistants are cross-trained to perform specific tasks and the RNs
complete all treatment, medication administration, and discharge teaching. The nurse applicant knows
this nursing care delivery strategy to be:
a. the case method.
b. functional nursing.
c. primary nursing.
d. nurse case management. - ANS: B
The functional model of nursing is a method of providing patient care by which each licensed and
unlicensed staff member performs specific tasks for a large group of patients.
You are the nurse manager of a nursing service organization that provides around-the-clock care to
clients in their homes. To achieve maximum reimbursement for a client who is recovering from a hip
replacement, the nursing staff most likely will follow the nursing care guidelines presented in the:
a. nursing care plan.
b. physician's orders.
c. critical pathway.
d. clinical practice guidelines. - ANS: C
A critical pathway outlines outcomes, clinical standards, and interventions for a patient in each phase of
treatment. The goal of critical pathways is effective coordination of care across various staff and levels of
care.
The nurse case manager is working with a client admitted for end-stage renal disease. The case
manager's major goal during this hospitalization for this patient is to:
a. implement the care pathway on admission.
b. provide direct nursing care throughout the hospitalization.