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,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
initiativesthis committee might recommend?
1. Cost of care
2. Access to care
3. Availability of care
4. Quality 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, but the economic reality is
that quality care must also be funded 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.
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,2) A nurse has been invited to discuss healthcare costs at a senior citizens' club. What
information should the nurse plan to include in this discussion?
1. While healthcare costs continue to rise, the percentage of the United States (U.S.) economy
spent on healthcare has slowly declined to less than 12%.
2. Regulations brought about 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 due 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 reduce 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 about proper urinary catheter care."
Answer: 2
Explanation: 1. Wondering about a break in sterility indicates that the nurse is concerned
about 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 situation.
3. The Centers for Medicare and Medicaid Services no longer cover the costs incurred by
medical mistakes. This urinary tract infection could cost the hospital the cost of treatment,
including increased length of stay.
4. The nurse has identified that improper care may result 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/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 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?
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, Select iall ithat iapply.
1. A inurse iasks ivisitors ito ileave ibecause iit iis iafter ivisiting ihours.
2. At i2:00 ip.m. ithe inurse iorders ia ilunch itray ifor ia iclient iwho ihas ijust ibeen iremoved
ifrom inothing iby imouth i(NPO) istatus.
3. A inurse itells ithe imanager ithat ia ihousekeeper's iwork iis inot iup ito istandards.
4. A inurse ivolunteers ito itake ia iSpanish ilanguage iclass ito ibe iable ito icommunicate iwith iclients.
5. A inurse iwho ihas inot imade ia imedication ierror iin itwo iyears iasks ifor ia isalary
iincrease. iAnswer: i2, i3, i4
Explanation: i 1. iThe iphilosophy iof iquality imanagement iis ifocus ion ithe ineeds iof ithe iclient.
iIf ithere iis ino ireason ifor ithe ivisitors ito ileave iother ithan iit iis iafter ivisiting ihours, ithis iis
inot ifocused ion iclient ineed.
2. Even ithough i2:00 ip.m. iis iafter i"lunchtime," ithis inurse iis ifocused ion ithe iclient's ineeds.
iThis iis ian iexample iof iquality imanagement.
3. Quality imanagement iempowers ithe iemployee ito ievaluate iquality.
4. This inurse ihas iseen ia ineed iand iis iworking ito iimprove ithe iquality iof iservice. iThis iis
iquality imanagement.
5. Salary iincreases ican ibe itied ito iquality iimprovement iinitiatives, ibut ijust iasking ifor
ian iincrease iis inot iquality imanagement.
Cognitive iLevel: i Applying
Client iNeed: i Safe iEffective iCare iEnvironment
iClient iNeed iSub: i Management iof iCare
Nursing/Int iConc: i Nursing iProcess: iImplementation/Quality iof iPractice
Learning iOutcome: i1-1: iExplain ichanges ito ihealthcare iover ithe ipast idecade, iincluding
ithose iresulting ifrom iimplementation iof ithe iAffordable iCare iAct; idemands ito ireduce
ierrors iand iimprove ipatient isafety; iand ievolving imedical iand icommunication itechnology.
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