Test Bank: Effective Leadership and Management in Nursing 9th Edition by Sullivan - Ch. 1-28, 9780134153117, with Rationales

TEST BANK
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,chapter 1 2p 2 p Introducing Nursing Management 2p 2p




1) A nurse manager is participating in the healthcare organization's strategic planning com
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mittee. Which factor is the primary driving force and controlling factor in new initiatives t
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his committee might recommend?
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1. Cost of care 2p 2p


2. Access to care 2p 2p


3. Availability of care 2p 2p


4. Quality of care 2p 2p


2pAnswer: 1 2 p


Explanation: 1. While all of the options given are driving forces in today's healthcare envi
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ronment, the cost of providing care is still the primary issue. Cost of care controls access, a
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vailability, and quality. 2p 2p


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
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pis that quality care must also be funded care.
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Cognitive Level: Applying 2p 2 p


Client Need: Safe Effective Care Environment Cli
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ent Need Sub: Management of Care
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Nursing/Int Conc: Nursing Process: Evaluation/Leadership
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Learning Outcome: 1- 2p 2 p


1: Explain changes to healthcare over the past decade, including those resulting from imple
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mentation of the Affordable Care Act; demands to reduce errors and improve patient safety
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; 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. Wh
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at 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.) econo
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my 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
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pas the Patient Protection and Affordable Care Act (PPACA).
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Answer: 2 2 p


Explanation: 1. In 2009, healthcare costs consumed more than 17% of the country's gross d
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omestic product. 2p


2. Implementation of PPACA and its regulations have not been formulated. 2p 2p 2p 2p 2p 2p 2p 2p 2p


3. The United States spends more than $2.5 trillion on healthcare annually, more than a
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ny other country.
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4. While this act has been passed, it is not operationalized. Healthcare spending continues
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to rise. 2p


Cognitive Level: Analyzing 2p 2 p


Client Need: Safe Effective Care Environment Cli
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ent Need Sub: Management of Care
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Nursing/Int Conc: Nursing Process: Planning/Education
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Learning Outcome: 1- 2p 2 p


1: Explain changes to healthcare over the past decade, including those resulting from imple
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mentation of the Affordable Care Act; demands to reduce errors and improve patient safety
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; and evolving medical and communication technology.
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3) A 70-year-old client develops a catheter-
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induced urinary tract infection. Which statement by the nurse would indicate to the nurse
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manager a need for additional understanding of 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." 2p 2p 2p 2p 2p 2p 2p


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 a
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bout 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 treat
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ment, including increased length of stay.
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4. The nurse has identified that improper care may result in poor outcomes for the clie
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nt. Cognitive Level: Applying
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Client Need: Safe Effective Care Environment Cli
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ent Need Sub: Management of Care
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Nursing/Int Conc: Nursing Process: Evaluation/Education
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Learning Outcome: 1- 2p 2 p


1: Explain changes to healthcare over the past decade, including those resulting from imple
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mentation of the Affordable Care Act; demands to reduce errors and improve patient safety
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; and evolving medical and communication technology.
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4) Which healthcare situations reflect the philosophy of quality management as designed
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by Deming? 2p


Note: Credit will be given only if all correct choices and no incorrect choices are selected.
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, Select all that apply. 2p 2p 2p


1. A nurse asks visitors to leave because it is after visiting hours.
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2. At 2:00 p.m. the nurse orders a lunch tray for a client who has just been removed fr
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om nothing by mouth (NPO) status.
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3. A nurse tells the manager that a housekeeper's work is not up to standards.
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4. A nurse volunteers to take a Spanish language class to be able to communicate with clien
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ts.
5. A nurse who has not made a medication error in two years asks for a salary increa
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se. Answer: 2, 3, 4
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Explanation: 1. The philosophy of quality management is focus on the needs of the client. I
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f there is no reason for the visitors to leave other than it is after visiting hours, this is not f
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ocused on client need. 2p 2p 2p


2. Even though 2:00 p.m. is after "lunchtime," this nurse is focused on the client's needs. T
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his is an example of quality management.
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3. Quality management empowers the employee to evaluate quality.
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4. This nurse has seen a need and is working to improve the quality of service. This is qual
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ity management.
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5. Salary increases can be tied to quality improvement initiatives, but just asking for
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an increase is not quality management.
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Cognitive Level: Applying 2p 2 p


Client Need: Safe Effective Care Environment Cli
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ent Need Sub: Management of Care
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Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
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Learning Outcome: 1- 2p 2 p


1: Explain changes to healthcare over the past decade, including those resulting from imple
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mentation of the Affordable Care Act; demands to reduce errors and improve patient safety
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; and evolving medical and communication technology.
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