Test Bank
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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.
https://www.stuvia.com/user/angelinas
,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?
https://www.stuvia.com/user/angelinas
,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 lunch 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 up 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 focus 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 quality
management.
5. Salary increases can be tied to quality improvement initiatives, but 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.
https://www.stuvia.com/user/angelinas
,5) A nclient nwho nwas ndischarged nyesterday nis nvery nupset nabout nthe nquality nof ncare
nreceived nduring nhospitalization nfor ngastric nsurgery. nWhat noptions nfor nreporting nconcerns
ndoes nthis nclient nhave?
Note: nCredit nwill nbe ngiven nonly nif nall ncorrect nchoices nand nno nincorrect nchoices nare nselected.
Select nall nthat napply.
1. There nis nno nmechanism nfor ncomplaint nbecause nthe nclient nis nno nlonger nhospitalized.
2. The nclient ncan nindicate ndissatisfaction non nthe nsurvey noften nsent nto nclients nafter ndischarge.
3. The nclient ncan ncall nthe nhospital nadministration.
4. The nclient ncan nmake na nformal ncomplaint nthrough nthe nAmerican nNursing
nAssociation n(ANA).
5. The nclient ncan nmake na npublic nreport nthrough nthe nAgency nfor nHealthcare nResearch
nand nQuality n(AHRQ).
Answer: n 2, n3, n5
Explanation: n 1. nThe nclient ncan nstill nvoice nconcerns neven nafter ndischarge.
2. These nclient nsatisfaction nsurveys nare na ngood nmechanism nfor ndiscussing ncare nissues.
3. Telephone ncalls nare na nmeans nof ndiscussing nclient ncare nissues.
4. ANAnis nnot na nforum nfor ncomplaints nabout ncare nin na nspecific nhospitalization.
5. The nAHRQ nhas na nmechanism nfor nreporting ncare
nissues. nCognitive nLevel: n Analyzing
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nImplementation/Quality nof nPractice
Learning nOutcome: n1-1: nExplain nchanges nto nhealthcare nover nthe npast ndecade, nincluding
nthose nresulting nfrom nimplementation nof nthe nAffordable nCare nAct; ndemands nto nreduce
nerrors nand nimprove npatient nsafety; nand nevolving nmedical nand ncommunication ntechnology.
6) A nclient nneeds na nhigh-risk nsurgical nprocedure. nAccording nto nthe nLeapfrog nGroup, nthe
nclient nshould nchoose nwhich nhospital nfor ncare nduring nthis nprocedure?
1. The nhospital nclosest nto nthe nclient's nhome
2. The nhospital nthat nhas ndone nthe ngreatest nnumber nof nthese nsurgeries nin nthe nlast ntwo nyears
3. The nhospital nchosen nby nthe nclient's nprimary nhealthcare nprovider
4. The nhospital nwith nthe nhighest nperformance nratings nfor nthis
nprocedure nAnswer: n4
Explanation: n 1. nThis nmay nor nmay nnot nbe nthe nbest nchoice nof nhospital nfor nthis n procedure.
2. Just nbecause na nhospital nis nhigh nvolume ndoes nnot nmean nit nis nhigh nquality.
3. This nmay nor nmay nnot nbe nthe nbest nhospital nfor nthis nprocedure.
4. The nLeapfrog nGroup nfocuses non nquality nindicators nincluding nthe nuse nof nhigher-
performing nhospitals nfor nhigh-risk nprocedures.
Cognitive nLevel: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nImplementation/Coordination nof nCare
Learning nOutcome: n1-1: nExplain nchanges nto nhealthcare nover nthe npast ndecade, nincluding
nthose nresulting nfrom nimplementation nof nthe nAffordable nCare nAct; ndemands nto nreduce
nerrors nand nimprove npatient nsafety; nand nevolving nmedical nand ncommunication ntechnology.
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,7) The nquality nmanagement ndirector nof na nlarge nhealthcare nconglomerate nwishes nto
ninitiate nbenchmarking nstrategies nto nassess ncare. nWhich ndirective nshould nthis nmanager
npublish?
1. We nwill ncompare noutcome nindicators nwith nother nhealthcare nconglomerates nof nsimilar
nsize nand norganization.
2. Outcome ndata nof nhospitals nwithin nthe norganization nwill nbe ncompared nto nassess nquality.
3. Each nclient ncare nunit nin nthe norganization nwill nestablish nspecific nunit ngoals nfor nquality.
4. Each nunit nin nthe norganization nwill ncreate na nquality nmonitor nto nassess nhow nwell nunit
npolicies nare nfollowed.
Answer: n 1
Explanation: n 1. nBenchmarking nuses nan norganization's noutcome ndata nand ncompares nit nwith
nthat nof na nsimilar norganization nto naddress nstrengths nand nchallenges.
2. Because nthe nhospitals nwith nthe norganization nare nlikely nmanaged nin na nsimilar nmanner,
nthis nis nnot nan nexample nof nbenchmarking.
3. While nestablishing ngoals nis na npart nof nquality nmanagement, nit nis nnot nbenchmarking.
4. Setting nup na nquality nmonitor nis na nquality ninitiative, nbut nit nis nnot
nbenchmarking. nCognitive n Level: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nImplementation/Quality nof nPractice
Learning nOutcome: n1-1: nExplain nchanges nto nhealthcare nover nthe npast ndecade, nincluding
nthose nresulting nfrom nimplementation nof nthe nAffordable nCare nAct; ndemands nto nreduce
nerrors nand nimprove npatient nsafety; nand nevolving nmedical nand ncommunication ntechnology.
8) The nnurse nmanager nhas ndecided nto nuse nevidence-based npractice n(EBP) nto nsolve nan nissue
nand nhas ncalled nstaff nnurses ntogether nfor ninput. nWhich nquestion, nas nposed nby nthe nmanager,
nreflects nthe nfirst nstep nof nthe nEBP nprocess?
1. "What noutcomes nare nwe nexpecting nfrom nthis nwork?"
2. "Is nanyone nprepared nto nevaluate nthe nstatistics nwe nwill nfind?"
3. "What nis nthe nexact nclinical nissue nwith nwhich nwe nare ndealing?"
4. "Where ncan nwe nlook nfor
ninformation?" nAnswer: n3
Explanation: n 1. nAssessing noutcomes nis nthe nlast nstep nof nthe nEBP nprocess.
2. Evaluation nof nthe nevidence nis nstep n3.
3. Identifying nthe nclinical nquestion nis nthe nfirst nstep nin nthe nEBP nprocess.
4. Acquiring nthe nevidence nto nanswer nthe nquestion nis nstep
n2. nCognitive n Level: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nPlanning/Leadership
Learning nOutcome: n1-2: nDescribe nhow nnursing nmanagement nis ninfluenced nby nchanges nin
nsociety.
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,9) The nnurse nmanager nasks na nstaff nnurse nwhy na nprocedure nis ndone nin na ncertain nmanner.
nThe nnurse nreplies, n"I ndon't nknow nwhy nI nstarted ndoing nit nthis nway. nI've nnever nread nany
nresearch non nit, nbut nthis ntechnique nalways nworks nfor nme." nThe nmanager nwould nplace nthis
ntechnique ninto nwhich ncategory nof nevidence?
1. Case nstudy
2. Anecdotal
3. Nonexperimental ndesign nresearch
4. Statistical
Answer: n 2
Explanation: n1. nA ncase nstudy nis nan nin-depth nanalysis nused nto ntranslate nevidence ninto nother
nclinical nsituations.
2. Anecdotal nevidence nis nderived nfrom nexperience.
3. Nonexperimental ndesign nresearch nincludes ngathering nfactors nrelated nto na nclinical ncondition.
4. Statistical nevidence nis nbuilt nfrom na nscientific
napproach. nCognitive nLevel: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nImplementation/Quality nof nPractice
Learning nOutcome: n1-3: nIdentify nthe nchanges nand nchallenges nthat nnurses nface nnow nand nin
nthe nfuture.
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,10) A nnurse nmanager nis ndirecting na nteam nof nstaff nnurses nworking nto nsolve na nclinical
nproblem nusing nevidence-based npractice n(EBP). nWhich nof nthe nfollowing nstatements nwould
ndirect nthese nnurses nto nthe nforms nof nstrongest nclinical nevidence?
Note: nCredit nwill nbe ngiven nonly nif nall ncorrect nchoices nand nno nincorrect nchoices nare nselected.
Select nall nthat napply.
1. "We nmay nfind nstudies nthat nuse nonly none ngroup nof nparticipants."
2. "Look nfor narticles nthat nreport non nhow nto nuse nevidence nin nother nclinical n situations."
3. "The nstudies nwe nwant nare nbuilt naround nthe nscientific napproach nto nsolving nproblems."
4. "Our nfocus nshould nbe non nstudies nthat nuse nboth nexperimental nand ncontrol
ngroups nto ndetermine nintervention neffectiveness."
5. "Many narticles nwill nhave ninformation nreported nby nsomeone nwho nis nan nexpert nin nthe
nfield." nAnswer: n3, n4
Explanation: n1. nStudies nusing nonly none ngroup nof nparticipants nare ndone nin na nquasi-experimental
ndesign. nThis nis nnot none nof nthe ntwo nstrongest nforms nof nevidence.
2. An nin-depth nanalysis nused nto ntranslate ninformation nto nother nclinical nsituations nis na ncase
nstudy napproach. nThis nis nnot none nof nthe ntwo nstrongest nforms nof nevidence.
3. Using nthe nscientific napproach nresults nin nstatistical nevidence, nwhich nis none nof nthe
ntwo nstrongest nforms.
4. Studies nthat nuse nboth nexperimental nand ncontrol ngroups nare nrandomized ncontrol ntrials.
nThis nis none nof nthe ntwo nstrongest nforms nof nevidence.
5. Evidence nreported nby nan nexpert nin nthe nfield nis ntestimonial nevidence. nIt nis nnot none nof nthe
ntwo nstrongest nforms nof nevidence.
Cognitive nLevel: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nPlanning/Leadership
Learning nOutcome: n1-3: nIdentify nthe nchanges nand nchallenges nthat nnurses nface nnow nand nin
nthe nfuture.
11) A nhealthcare nsystem nis nconsidering napplying nto nthe nMagnet nRecognition nProgram.
nThe nleaders nof nthis nhealth nsystem nshould nprepare nto naddress qualities nor n"Forces nof
nMagnetism."
Answer: n 14
Explanation: n There nare n14 nqualities nor n"Forces nof nMagnetism" nthat nmust nbe ndemonstrated
nto nachieve nMagnet nstatus.
Cognitive nLevel: n Understanding
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nPlanning/Quality nof nPractice
Learning nOutcome: n1-2: nDescribe nhow nnursing nmanagement nis ninfluenced nby nchanges nin
nsociety.
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, 12) Which norganization nwould nthe nhospital nmanagement nteam ncontact nto npursue
ncertification nas na nMagnet nhospital?
1. Magnet nRecognition nProgram
2. American nNational nMagnet nCommission
3. The nJoint nCommission
4. American nMedical nAssociation
n(AMA) n Answer: n1
Explanation: n1. nThe nMagnet nRecognition nProgram, ndeveloped nby nthe nAmerican nNurses
nCredentialing nCenter, ndesignates nhealthcare norganizations nthat nprovide nnursing nexcellence.
2. The nAmerican nNational nMagnet nCommission nis nfictitious.
3. The nJoint nCommission naccredits nhealthcare norganizations, nbut ndoes nnot naward
nMagnet nstatus.
4. The nAMA ndoes nnot naward nMagnet nstatus. nMagnet nstatus nis nfocused non nnursing
nexcellence. nCognitive n Level: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nImplementation/Leadership
Learning nOutcome: n1-2: nDescribe nhow nnursing nmanagement nis ninfluenced nby nchanges nin
nsociety.
13) A ngraduating nnurse nis ndeciding nwhich nnursing nspecialty nwould nbe na ngood nplace nto
nbegin na nnursing ncareer nand nensure nlong-term nstability. nWhich nspecialty nis nmost nlikely nto
nhave nthe ngreatest ngrowth nin nneed?
1. Pediatric nnursing
2. Psychiatric nnursing
3. Geriatric nnursing
4. Maternitynnursing
Answer: n3
Explanation: n 1. nPediatric nnursing nis nnot nlikely nto nsee nas nmuch ngrowth nas nanother nspecialty.
2. Psychiatric nnursing nis nnot nlikely nto nsee nas nmuch ngrowth nas nanother nspecialty.
3. As nbaby nboomers nage, ngeriatric nnursing nwill nbe nneeded nmore nthan nany nother nspecialty.
nNot nonly nare nthe nbaby nboomers na nlarge nsegment nof nthe npopulation, nbut nbetter nhealth
npractices nare nresulting nin npeople nliving nlonger.
4. Maternity nnursing nis nnot nlikely nto nsee nas nmuch ngrowth nas nanother
nspecialty. nCognitive n Level: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nPlanning/Professional nPractice nEvaluation
Learning nOutcome: n1-3: nIdentify nthe nchanges nand nchallenges nthat nnurses nface nnow nand nin
nthe nfuture.
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https://www.stuvia.com/user/angelinas
,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.
https://www.stuvia.com/user/angelinas
,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?
https://www.stuvia.com/user/angelinas
,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 lunch 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 up 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 focus 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 quality
management.
5. Salary increases can be tied to quality improvement initiatives, but 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.
https://www.stuvia.com/user/angelinas
,5) A nclient nwho nwas ndischarged nyesterday nis nvery nupset nabout nthe nquality nof ncare
nreceived nduring nhospitalization nfor ngastric nsurgery. nWhat noptions nfor nreporting nconcerns
ndoes nthis nclient nhave?
Note: nCredit nwill nbe ngiven nonly nif nall ncorrect nchoices nand nno nincorrect nchoices nare nselected.
Select nall nthat napply.
1. There nis nno nmechanism nfor ncomplaint nbecause nthe nclient nis nno nlonger nhospitalized.
2. The nclient ncan nindicate ndissatisfaction non nthe nsurvey noften nsent nto nclients nafter ndischarge.
3. The nclient ncan ncall nthe nhospital nadministration.
4. The nclient ncan nmake na nformal ncomplaint nthrough nthe nAmerican nNursing
nAssociation n(ANA).
5. The nclient ncan nmake na npublic nreport nthrough nthe nAgency nfor nHealthcare nResearch
nand nQuality n(AHRQ).
Answer: n 2, n3, n5
Explanation: n 1. nThe nclient ncan nstill nvoice nconcerns neven nafter ndischarge.
2. These nclient nsatisfaction nsurveys nare na ngood nmechanism nfor ndiscussing ncare nissues.
3. Telephone ncalls nare na nmeans nof ndiscussing nclient ncare nissues.
4. ANAnis nnot na nforum nfor ncomplaints nabout ncare nin na nspecific nhospitalization.
5. The nAHRQ nhas na nmechanism nfor nreporting ncare
nissues. nCognitive nLevel: n Analyzing
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nImplementation/Quality nof nPractice
Learning nOutcome: n1-1: nExplain nchanges nto nhealthcare nover nthe npast ndecade, nincluding
nthose nresulting nfrom nimplementation nof nthe nAffordable nCare nAct; ndemands nto nreduce
nerrors nand nimprove npatient nsafety; nand nevolving nmedical nand ncommunication ntechnology.
6) A nclient nneeds na nhigh-risk nsurgical nprocedure. nAccording nto nthe nLeapfrog nGroup, nthe
nclient nshould nchoose nwhich nhospital nfor ncare nduring nthis nprocedure?
1. The nhospital nclosest nto nthe nclient's nhome
2. The nhospital nthat nhas ndone nthe ngreatest nnumber nof nthese nsurgeries nin nthe nlast ntwo nyears
3. The nhospital nchosen nby nthe nclient's nprimary nhealthcare nprovider
4. The nhospital nwith nthe nhighest nperformance nratings nfor nthis
nprocedure nAnswer: n4
Explanation: n 1. nThis nmay nor nmay nnot nbe nthe nbest nchoice nof nhospital nfor nthis n procedure.
2. Just nbecause na nhospital nis nhigh nvolume ndoes nnot nmean nit nis nhigh nquality.
3. This nmay nor nmay nnot nbe nthe nbest nhospital nfor nthis nprocedure.
4. The nLeapfrog nGroup nfocuses non nquality nindicators nincluding nthe nuse nof nhigher-
performing nhospitals nfor nhigh-risk nprocedures.
Cognitive nLevel: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nImplementation/Coordination nof nCare
Learning nOutcome: n1-1: nExplain nchanges nto nhealthcare nover nthe npast ndecade, nincluding
nthose nresulting nfrom nimplementation nof nthe nAffordable nCare nAct; ndemands nto nreduce
nerrors nand nimprove npatient nsafety; nand nevolving nmedical nand ncommunication ntechnology.
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,7) The nquality nmanagement ndirector nof na nlarge nhealthcare nconglomerate nwishes nto
ninitiate nbenchmarking nstrategies nto nassess ncare. nWhich ndirective nshould nthis nmanager
npublish?
1. We nwill ncompare noutcome nindicators nwith nother nhealthcare nconglomerates nof nsimilar
nsize nand norganization.
2. Outcome ndata nof nhospitals nwithin nthe norganization nwill nbe ncompared nto nassess nquality.
3. Each nclient ncare nunit nin nthe norganization nwill nestablish nspecific nunit ngoals nfor nquality.
4. Each nunit nin nthe norganization nwill ncreate na nquality nmonitor nto nassess nhow nwell nunit
npolicies nare nfollowed.
Answer: n 1
Explanation: n 1. nBenchmarking nuses nan norganization's noutcome ndata nand ncompares nit nwith
nthat nof na nsimilar norganization nto naddress nstrengths nand nchallenges.
2. Because nthe nhospitals nwith nthe norganization nare nlikely nmanaged nin na nsimilar nmanner,
nthis nis nnot nan nexample nof nbenchmarking.
3. While nestablishing ngoals nis na npart nof nquality nmanagement, nit nis nnot nbenchmarking.
4. Setting nup na nquality nmonitor nis na nquality ninitiative, nbut nit nis nnot
nbenchmarking. nCognitive n Level: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nImplementation/Quality nof nPractice
Learning nOutcome: n1-1: nExplain nchanges nto nhealthcare nover nthe npast ndecade, nincluding
nthose nresulting nfrom nimplementation nof nthe nAffordable nCare nAct; ndemands nto nreduce
nerrors nand nimprove npatient nsafety; nand nevolving nmedical nand ncommunication ntechnology.
8) The nnurse nmanager nhas ndecided nto nuse nevidence-based npractice n(EBP) nto nsolve nan nissue
nand nhas ncalled nstaff nnurses ntogether nfor ninput. nWhich nquestion, nas nposed nby nthe nmanager,
nreflects nthe nfirst nstep nof nthe nEBP nprocess?
1. "What noutcomes nare nwe nexpecting nfrom nthis nwork?"
2. "Is nanyone nprepared nto nevaluate nthe nstatistics nwe nwill nfind?"
3. "What nis nthe nexact nclinical nissue nwith nwhich nwe nare ndealing?"
4. "Where ncan nwe nlook nfor
ninformation?" nAnswer: n3
Explanation: n 1. nAssessing noutcomes nis nthe nlast nstep nof nthe nEBP nprocess.
2. Evaluation nof nthe nevidence nis nstep n3.
3. Identifying nthe nclinical nquestion nis nthe nfirst nstep nin nthe nEBP nprocess.
4. Acquiring nthe nevidence nto nanswer nthe nquestion nis nstep
n2. nCognitive n Level: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nPlanning/Leadership
Learning nOutcome: n1-2: nDescribe nhow nnursing nmanagement nis ninfluenced nby nchanges nin
nsociety.
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,9) The nnurse nmanager nasks na nstaff nnurse nwhy na nprocedure nis ndone nin na ncertain nmanner.
nThe nnurse nreplies, n"I ndon't nknow nwhy nI nstarted ndoing nit nthis nway. nI've nnever nread nany
nresearch non nit, nbut nthis ntechnique nalways nworks nfor nme." nThe nmanager nwould nplace nthis
ntechnique ninto nwhich ncategory nof nevidence?
1. Case nstudy
2. Anecdotal
3. Nonexperimental ndesign nresearch
4. Statistical
Answer: n 2
Explanation: n1. nA ncase nstudy nis nan nin-depth nanalysis nused nto ntranslate nevidence ninto nother
nclinical nsituations.
2. Anecdotal nevidence nis nderived nfrom nexperience.
3. Nonexperimental ndesign nresearch nincludes ngathering nfactors nrelated nto na nclinical ncondition.
4. Statistical nevidence nis nbuilt nfrom na nscientific
napproach. nCognitive nLevel: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nImplementation/Quality nof nPractice
Learning nOutcome: n1-3: nIdentify nthe nchanges nand nchallenges nthat nnurses nface nnow nand nin
nthe nfuture.
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,10) A nnurse nmanager nis ndirecting na nteam nof nstaff nnurses nworking nto nsolve na nclinical
nproblem nusing nevidence-based npractice n(EBP). nWhich nof nthe nfollowing nstatements nwould
ndirect nthese nnurses nto nthe nforms nof nstrongest nclinical nevidence?
Note: nCredit nwill nbe ngiven nonly nif nall ncorrect nchoices nand nno nincorrect nchoices nare nselected.
Select nall nthat napply.
1. "We nmay nfind nstudies nthat nuse nonly none ngroup nof nparticipants."
2. "Look nfor narticles nthat nreport non nhow nto nuse nevidence nin nother nclinical n situations."
3. "The nstudies nwe nwant nare nbuilt naround nthe nscientific napproach nto nsolving nproblems."
4. "Our nfocus nshould nbe non nstudies nthat nuse nboth nexperimental nand ncontrol
ngroups nto ndetermine nintervention neffectiveness."
5. "Many narticles nwill nhave ninformation nreported nby nsomeone nwho nis nan nexpert nin nthe
nfield." nAnswer: n3, n4
Explanation: n1. nStudies nusing nonly none ngroup nof nparticipants nare ndone nin na nquasi-experimental
ndesign. nThis nis nnot none nof nthe ntwo nstrongest nforms nof nevidence.
2. An nin-depth nanalysis nused nto ntranslate ninformation nto nother nclinical nsituations nis na ncase
nstudy napproach. nThis nis nnot none nof nthe ntwo nstrongest nforms nof nevidence.
3. Using nthe nscientific napproach nresults nin nstatistical nevidence, nwhich nis none nof nthe
ntwo nstrongest nforms.
4. Studies nthat nuse nboth nexperimental nand ncontrol ngroups nare nrandomized ncontrol ntrials.
nThis nis none nof nthe ntwo nstrongest nforms nof nevidence.
5. Evidence nreported nby nan nexpert nin nthe nfield nis ntestimonial nevidence. nIt nis nnot none nof nthe
ntwo nstrongest nforms nof nevidence.
Cognitive nLevel: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nPlanning/Leadership
Learning nOutcome: n1-3: nIdentify nthe nchanges nand nchallenges nthat nnurses nface nnow nand nin
nthe nfuture.
11) A nhealthcare nsystem nis nconsidering napplying nto nthe nMagnet nRecognition nProgram.
nThe nleaders nof nthis nhealth nsystem nshould nprepare nto naddress qualities nor n"Forces nof
nMagnetism."
Answer: n 14
Explanation: n There nare n14 nqualities nor n"Forces nof nMagnetism" nthat nmust nbe ndemonstrated
nto nachieve nMagnet nstatus.
Cognitive nLevel: n Understanding
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nPlanning/Quality nof nPractice
Learning nOutcome: n1-2: nDescribe nhow nnursing nmanagement nis ninfluenced nby nchanges nin
nsociety.
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, 12) Which norganization nwould nthe nhospital nmanagement nteam ncontact nto npursue
ncertification nas na nMagnet nhospital?
1. Magnet nRecognition nProgram
2. American nNational nMagnet nCommission
3. The nJoint nCommission
4. American nMedical nAssociation
n(AMA) n Answer: n1
Explanation: n1. nThe nMagnet nRecognition nProgram, ndeveloped nby nthe nAmerican nNurses
nCredentialing nCenter, ndesignates nhealthcare norganizations nthat nprovide nnursing nexcellence.
2. The nAmerican nNational nMagnet nCommission nis nfictitious.
3. The nJoint nCommission naccredits nhealthcare norganizations, nbut ndoes nnot naward
nMagnet nstatus.
4. The nAMA ndoes nnot naward nMagnet nstatus. nMagnet nstatus nis nfocused non nnursing
nexcellence. nCognitive n Level: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nImplementation/Leadership
Learning nOutcome: n1-2: nDescribe nhow nnursing nmanagement nis ninfluenced nby nchanges nin
nsociety.
13) A ngraduating nnurse nis ndeciding nwhich nnursing nspecialty nwould nbe na ngood nplace nto
nbegin na nnursing ncareer nand nensure nlong-term nstability. nWhich nspecialty nis nmost nlikely nto
nhave nthe ngreatest ngrowth nin nneed?
1. Pediatric nnursing
2. Psychiatric nnursing
3. Geriatric nnursing
4. Maternitynnursing
Answer: n3
Explanation: n 1. nPediatric nnursing nis nnot nlikely nto nsee nas nmuch ngrowth nas nanother nspecialty.
2. Psychiatric nnursing nis nnot nlikely nto nsee nas nmuch ngrowth nas nanother nspecialty.
3. As nbaby nboomers nage, ngeriatric nnursing nwill nbe nneeded nmore nthan nany nother nspecialty.
nNot nonly nare nthe nbaby nboomers na nlarge nsegment nof nthe npopulation, nbut nbetter nhealth
npractices nare nresulting nin npeople nliving nlonger.
4. Maternity nnursing nis nnot nlikely nto nsee nas nmuch ngrowth nas nanother
nspecialty. nCognitive n Level: n Applying
Client nNeed: n Safe nEffective nCare nEnvironment
nClient nNeed nSub: n Management nof nCare
Nursing/Int nConc: n Nursing nProcess: nPlanning/Professional nPractice nEvaluation
Learning nOutcome: n1-3: nIdentify nthe nchanges nand nchallenges nthat nnurses nface nnow nand nin
nthe nfuture.
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