Zerwekh: Nursing Today: Transition and Trends, 10th Edition Test Bank All Chapters

Zerwekh: Nursing Today: Transition and Trends, 10th Edition Chapter 15: The Health Care Organization and Patterns of Nursing Care Delivery . . MULTIPLE CHOICE 1. How does managed care affect the economics of health care delivery? . a. Provides incentives for smaller private or individual hospitals b. Increases the tax base for the community c. Uses corporate economics to achieve a profit . d. Care is paid for at a prearranged rate ANS: D Under a managed care system, care is paid for at a prearranged rate, rather that at the billed . rate. This was the start of efforts to reduce health care costs. Managed care does not increase the community tax base because the costs are paid by the patients and their insurance. Managed care is more of an incentive for larger hospitals and corporations. The focus is to . reduce duplication of services and not to use corporate economics to achieve a profit. PTS: 1 DIF: Cognitive Level: Knowledge/Remembering REF: p. 235 . OBJ: Describe the challenges facing health care that impact the delivery of nursing care, including reduction of cost. TOP: Organizational structure MSC: NCLEX®: Not applicable . 2. Which statement regarding characteristics of clinical pathways shows the nurse’s lack of understanding? a. “Clinical pathways focus on patient outcomes.” . b. “Clinical pathways use a timeline with sequenced interventions.” c. “Clinical pathways collaborate efforts by health care professionals.” d. “Clinical pathways involve nurse-centered orientation.” . ANS: D Clinical pathways help reduce expensive variations in care. Clinical pathways are interdisciplinary plans of care that outline the optimal sequencing and timing of . interventions for patients with a particular diagnosis, procedure, or symptom. Clinical pathways are not a nurse-centered orientation. PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating . REF: p. 331 OBJ: Describe the challenges facing health care that impact the delivery of nursing care, including reduction of cost. TOP: Patterns of nursing care delivery . MSC: NCLEX®: Not applicable 3. Which statement shows the nurse’s understanding of patient-focused care? a. “Patient-focused care is a nursing care delivery system.”. b. “Patient-focused care is a model for a health care organization.” c. “Patient-focused care is a clinical pathway within an institution.” d. “Patient-focused care is an institutional value and philosophy.”. ANS: A Patient-focused care is another type of delivery system. The level of productivity is increased through centralization of functions (e.g., phlebotomy, diet instruction, respiratory . therapy) on the unit under the direction of the nurse and cross training ancillary workers to do more than one function. The patient comes into contact with fewer people under this organizational framework. . PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating REF: p. 344 OBJ: Trace the history of the use of nursing care delivery models. TOP: Trends in health care MSC: NCLEX®: Not applicable. 4. Which statement by the nurse manager is inaccurate regarding the forces of magnetism? “Forces of magnetism include . a. professional models of care.” b. consultation and resources.” c. cost reduction and sound budgets.” d. nurses as teachers.” . ANS: C The forces of magnetism include professional models of care, consultation and resources, and nurses as teachers among several others. Budgets are not included.. PTS: 1 DIF: Cognitive Level: Comprehension/Understanding REF: Box 15.1 . OBJ: Describe challenges facing health care that impact the delivery of nursing care. TOP: Patterns of nursing care delivery MSC: NCLEX®: Not applicable 5. A nurse manager is training a new hire. Which statement shows an understanding of . functional nursing? a. “Functional nursing is organized around tasks.” b. “Functional nursing is patient led.” . c. “Functional nursing is physician led.” d. “Functional nursing is unorganized.” ANS: A . Functional nursing is where nursing care is broke into a series of tasks performed by many people, which results in a fragmented, impersonal kind of care. Fragmentation of care caused patient problems to be overlooked because they did not fit into a defined assignment. Aides, vocational nurses, and licensed practical nurses are allowed to perform functions . such as administration of medication and treatments. None of the other statements is correct. PTS: 1 DIF: Cognitive Level: Comprehension/Understanding . REF: p. 341 OBJ: Discuss the history of the use of nursing care delivery models. TOP: Patterns of nursing care delivery MSC: NCLEX®: Not applicable 6. Which of the following statements shows the nurse’s understanding of primary nursing? . a. “One nurse plans and directs patient care over 24 hours.” b. “Involves care for 48 hours or more” c. “Includes only one nurse planning care for the patient”. d. “Is the only method of care used today” ANS: C In primary nursing, the fragmentation between shifts and nurses is eliminated because one nurse is accountable for planning the care of the patient around the clock. In primary . nursing, an associate nurse takes over when then primary is not working. There are many models of nursing care delivery systems in use today. . PTS: 1 DIF: Cognitive Level: Comprehension/Understanding REF: p. 343 OBJ: Trace the history of the use of nursing care delivery models. TOP: Patterns of nursing care delivery MSC: NCLEX®: Not applicable . 7. Which statement is true about case management? a. It helps clients achieve goals effectively and efficiently. b. It is used to reduce resource utilization only. . c. To be effective, it requires case managers to provide direct patient care. d. It eliminates the need for other caregivers (LPNs, LVNs, nurs ing assistants). ANS: A . Case management is one of the strategies to reduce costs while ensuring coordination of care. Its main purpose is to help clients achieve goals, but also it is a cost control strategy. The case manager does not always provide direct care. Many other members of the health . care team are involved in case management. PTS: 1 DIF: Cognitive Level: Knowledge/Remembering REF: p. 329 OBJ: Trace the history of the use of nursing care delivery models. . TOP: Patterns of nursing care delivery MSC: NCLEX®: Not applicable 8. A nurse is interested in case management. Which statement indicates an understanding of . the primary work environment of case managers? a. “They work most often in acute care institutions.” b. “Their work is focused on community activities and is based within the community.” . c. “They typically work for insurance companies, providing coordination of care.” d. “All types of health care organizations, as well as organizations with health -related functions, hire case managers.” . ANS: D Nurses who are case managers work in all types of health care institutions. They may also work for insurance or utilization review companies or in health-related areas of various . types of large businesses. Registered nurses, social workers, and therapists may all be case managers, but how they perform their role depends on the scope of practice of their discipline. All case managers must be skilled at communication, critical thinking, negotiation, and collaboration. They must be knowledgeable about resources available to . patients. The case manager not only deals with individual patients but also with family and other support systems of the patient; however, a case manager’s work is not focused on just the community. . PTS: 1 DIF: Cognitive Level: Comprehension/Understanding REF: p. 329 OBJ: Trace the history of the use of nursing care delivery models. TOP: Case managers MSC: NCLEX®: Not applicable. 9. Which statement is true about patient classification systems? a. They measure all the needs of patients. . b. They provide an absolute formula for unit staffing. c. They should not be used to make patient-care assignments because acuity systems are more accurate. d. They have been used to determine the number of nurses needed on a unit at any . one time. ANS: D . A patient classification or acuity system is used in many acute care hospitals to estimate the intensity of nursing care required to meet patient needs. This system does not measure the needs of all patients, is not used an as absolute formula for unit staffing, and is not used to make patient assignments. Patient acuity is the measure of categorizing patients based on . their nursing care requirements. PTS: 1 DIF: Cognitive Level: Knowledge/Remembering . REF: p. 347 OBJ: Describe challenges facing health care that impact the delivery of nursing care. TOP: Coordination of care and cost control MSC: NCLEX®: Not applicable . 10. Which of the following best describes the concept of evidence-based practice? a. It is a method of improving nursing care and effectively maintaining cost . containment. b. Insurance companies review the evidence of the health care practice for reimbursement. c. It achieves large-scale economics while providing cost. -effective care. d. It provides for the use of recent research in current nursing practice. ANS: D The IOM reported that it took 17 years for research to be reflected into daily practice. . Evidence-based practice is the use of the current best evidence to provide care and make decisions regarding patient care. Evidence-based practice is not a method of improving nursing care and maintaining cost containment. Insurance companies do not review the . evidence of health care practice for reimbursement. Evidence-based practice does not achieve large-scale economics while providing cost-effective care. PTS: 1 DIF: Cognitive Level: Knowledge/Remembering . REF: p. 332 OBJ: Describe challenges facing health care that impact the delivery of nursing care. TOP: Evidence-based practice MSC: NCLEX®: Not applicable.