TEST BANK FOR
EFFECTIVE
LEADERSHIP AND
MANAGEMENT IN
NURSING, 9TH
EDITION, ELEANOR
J. SULLIVAN
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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 initiatives
this 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) Whi ch health care situations refle ct the philosophy of quality management as designed by
Deming?
Note: Credit will be given only if all corre ct choi ces and no in corre ct choi ces are sele cted.
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Sele ct all that apply.
1. A nurse asks visitors to leave be cause it is after visiting hours.
2. At 2:00 p.m. the nurse orders a lun ch 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 communi cate with clients.
5. A nurse who has not made a medi cation error in two years asks for a salary in crease.
Answer: 2, 3, 4
Explanation: 1. The philosophy of quality management is fo cus 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 fo
cused on client need.
2. Even though 2:00 p.m. is after "lun chtime," this nurse is fo cused 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 servi ce. This is quality
management.
5. Salary in creases can be tied to quality improvement initiatives, but just asking for an
in crease is not quality management.
Cognitive Level: Applying
Client Need: Safe Effe ctive Care Environment
Client Need Sub: Management of Care
Nursing/Int Con c: Nursing Pro cess: Implementation/Quality of Pra cti ce
Learning Out come: 1-1: Explain changes to health care over the past de cade, in cluding those
resulting from implementation of the Affordable Care A ct; demands to redu ce errors and
improve patient safety; and evolving medi cal and communi cation te chnology.
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