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1) A nurse manager is participating in the healthcare organization's strategic planning
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committee. Which factor is the primary driving force and controlling factor in new initiatives
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this committee might recommend?
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,1. Cost of care zz zz
2. Access to care zz zz
3. Availability of care zz zz
4. Quality of care zz zz
Answer: 1
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Explanation: 1. While all of the options given are driving forces in today's healthcare
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environment, the cost of providing care is still the primary issue. Cost of care controls access,
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availability, and quality.
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2. Access to care is controlled by the ability to pay.
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3. Care will not be available if it cannot be funded.
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4. Healthcare providers do not like to correlate quality with cost, but the economic reality is
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that quality care must also be funded care.
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Cognitive Level: Applying zz z z
Client Need: Safe Effective Care Environment
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Client Need Sub: Management of Care
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Nursing/Int Conc: Nursing Process: Evaluation/Leadership
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Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
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resulting from implementation of the Affordable Care Act; demands to reduce errors and
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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
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information should the nurse plan to include in this discussion?
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1. While healthcare costs continue to rise, the percentage of the United States (U.S.) economy
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spent on healthcare has slowly declined to less than 12%.
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2. Regulations brought about by the Patient Protection and Affordable Care Act (PPACA)
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should bring financial relief to healthcare consumers.
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3. The United States spends more money on healthcare than any other country.
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4. Healthcare spending in the United States is slowly declining due to passage of bills such as
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the Patient Protection and Affordable Care Act (PPACA).
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Answer: 2 z z
Explanation: 1. In 2009, healthcare costs consumed more than 17% of the country's gross
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domestic product.
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2. Implementation of PPACA and its regulations have not been formulated. zz zz zz zz zz zz zz zz zz
3. The United States spends more than $2.5 trillion on healthcare annually, more than any
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other country.
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4. While this act has been passed, it is not operationalized. Healthcare spending continues to
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rise.
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Cognitive Level: Analyzing zz z z
Client Need: Safe Effective Care Environment
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Client Need Sub: Management of Care
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Nursing/Int Conc: Nursing Process: Planning/Education zz z z zz zz
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
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resulting from implementation of the Affordable Care Act; demands to reduce errors and
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improve patient safety; and evolving medical and communication technology.
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3) A 70-year-old client develops a catheter-induced urinary tract infection. Which statement
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by the nurse would indicate to the nurse manager a need for additional understanding of
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this situation?
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1. "I wonder if there was a break of sterility when this catheter was inserted."
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2. "Thankfully we can treat this with an antibiotic." zz zz zz zz zz zz zz
3. "This could potentially cost the hospital a lot of money."
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4. "I will talk to my unlicensed assistants about proper urinary catheter care."
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Answer: 2
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Explanation: 1. Wondering about a break in sterility indicates that the nurse is concerned
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about the process that might have contributed to this infection.
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2. The nurse who focuses on taking care of the results of a potential medical mistake is
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not accepting the seriousness of the situation.
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3. The Centers for Medicare and Medicaid Services no longer cover the costs incurred
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by medical mistakes. This urinary tract infection could cost the hospital the cost of
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treatment, including increased length of stay.
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4. The nurse has identified that improper care may result in poor outcomes for the client.
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Cognitive Level: Applying
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Client Need: Safe Effective Care Environment
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Client Need Sub: Management of Care
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Nursing/Int Conc: Nursing Process: Evaluation/Education zz z z zz zz
Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those
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resulting from implementation of the Affordable Care Act; demands to reduce errors and
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improve patient safety; and evolving medical and communication technology.
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4) Which healthcare situations reflect the philosophy of quality management as designed by
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Deming?
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Note: Credit will be given only if all correct choices and no incorrect choices are selected.
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