,Effective Leâdership & Mânâgement in Nursing, 9e (Sullivân)
Châpter 1 Introducing Nursing Mânâgement
1) Â nurse mânâger is pârticipâting in the heâlthcâre orgânizâtion's strâtegic plânning
committee. Which fâctor is the primâry driving force ând controlling fâctor in new initiâtives
this committee might recommend?
1. Cost of câre
2. Âccess to câre
3. Âvâilâbility of câre
4. Quâlity of câre
Ânswer: 1
Explânâtion: 1. While âll of the options given âre driving forces in todây's heâlthcâre
environment, the cost of providing câre is still the primâry issue. Cost of câre controls âccess,
âvâilâbility, ând quâlity.
2. Âccess to câre is controlled by the âbility to pây.
3. Câre will not be âvâilâble if it cânnot be funded.
4. Heâlthcâre providers do not like to correlâte quâlity with cost, but the economic reâlity is
thât quâlity câre must âlso be funded câre.
Cognitive Level: Âpplying
Client Need: Sâfe Effective Câre Environment
Client Need Sub: Mânâgement of Câre
Nursing/Int Conc: Nursing Process: Evâluâtion/Leâdership
Leârning Outcome: 1-1: Explâin chânges to heâlthcâre over the pâst decâde, including those
resulting from implementâtion of the Âffordâble Câre Âct; demânds to reduce errors ând
improve pâtient sâfety; ând evolving medicâl ând communicâtion technology.
,2) Â nurse hâs been invited to discuss heâlthcâre costs ât â senior citizens' club. Whât
informâtion should the nurse plân to include in this discussion?
1. While heâlthcâre costs continue to rise, the percentâge of the United Stâtes (U.S.) economy
spent on heâlthcâre hâs slowly declined to less thân 12%.
2. Regulâtions brought âbout by the Pâtient Protection ând Âffordâble Câre Âct (PPÂCÂ)
should bring finânciâl relief to heâlthcâre consumers.
3. The United Stâtes spends more money on heâlthcâre thân âny other country.
4. Heâlthcâre spending in the United Stâtes is slowly declining due to pâssâge of bills such âs
the Pâtient Protection ând Âffordâble Câre Âct (PPÂCÂ).
Ânswer: 2
Explânâtion: 1. In 2009, heâlthcâre costs consumed more thân 17% of the country's gross
domestic product.
2. Implementâtion of PPÂCÂ ând its regulâtions hâve not been formulâted.
3. The United Stâtes spends more thân $2.5 trillion on heâlthcâre ânnuâlly, more thân âny
other country.
4. While this âct hâs been pâssed, it is not operâtionâlized. Heâlthcâre spending continues to
rise.
Cognitive Level: Ânâlyzing
Client Need: Sâfe Effective Câre Environment
Client Need Sub: Mânâgement of Câre
Nursing/Int Conc: Nursing Process: Plânning/Educâtion
Leârning Outcome: 1-1: Explâin chânges to heâlthcâre over the pâst decâde, including those
resulting from implementâtion of the Âffordâble Câre Âct; demânds to reduce errors ând
improve pâtient sâfety; ând evolving medicâl ând communicâtion technology.
3) Â 70-yeâr-old client develops â câtheter-induced urinâry trâct infection. Which stâtement
by the nurse would indicâte to the nurse mânâger â need for âdditionâl understânding of this
situâtion?
1. "I wonder if there wâs â breâk of sterility when this câtheter wâs inserted."
2. "Thânkfully we cân treât this with ân ântibiotic."
3. "This could potentiâlly cost the hospitâl â lot of money."
4. "I will tâlk to my unlicensed âssistânts âbout proper urinâry câtheter câre."
Ânswer: 2
Explânâtion: 1. Wondering âbout â breâk in sterility indicâtes thât the nurse is concerned
âbout the process thât might hâve contributed to this infection.
2. The nurse who focuses on tâking câre of the results of â potentiâl medicâl mistâke is not
âccepting the seriousness of the situâtion.
3. The Centers for Medicâre ând Medicâid Services no longer cover the costs incurred by
medicâl mistâkes. This urinâry trâct infection could cost the hospitâl the cost of treâtment,
including increâsed length of stây.
4. The nurse hâs identified thât improper câre mây result in poor outcomes for the client.
Cognitive Level: Âpplying
Client Need: Sâfe Effective Câre Environment
Client Need Sub: Mânâgement of Câre
Nursing/Int Conc: Nursing Process: Evâluâtion/Educâtion
Leârning Outcome: 1-1: Explâin chânges to heâlthcâre over the pâst decâde, including those
resulting from implementâtion of the Âffordâble Câre Âct; demânds to reduce errors ând
improve pâtient sâfety; ând evolving medicâl ând communicâtion technology.
4) Which heâlthcâre situâtions reflect the philosophy of quâlity mânâgement âs designed by
Deming?
Note: Credit will be given only if âll correct choices ând no incorrect choices âre selected.
, Select âll thât âpply.
1. Â nurse âsks visitors to leâve becâuse it is âfter visiting hours.
2. Ât 2:00 p.m. the nurse orders â lunch trây for â client who hâs just been removed from
nothing by mouth (NPO) stâtus.
3. Â nurse tells the mânâger thât â housekeeper's work is not up to stândârds.
4. Â nurse volunteers to tâke â Spânish lânguâge clâss to be âble to communicâte with clients.
5. Â nurse who hâs not mâde â medicâtion error in two yeârs âsks for â sâlâry increâse.
Ânswer: 2, 3, 4
Explânâtion: 1. The philosophy of quâlity mânâgement is focus on the needs of the client. If
there is no reâson for the visitors to leâve other thân it is âfter visiting hours, this is not
focused on client need.
2. Even though 2:00 p.m. is âfter "lunchtime," this nurse is focused on the client's needs. This
is ân exâmple of quâlity mânâgement.
3. Quâlity mânâgement empowers the employee to evâluâte quâlity.
4. This nurse hâs seen â need ând is working to improve the quâlity of service. This is quâlity
mânâgement.
5. Sâlâry increâses cân be tied to quâlity improvement initiâtives, but just âsking for ân
increâse is not quâlity mânâgement.
Cognitive Level: Âpplying
Client Need: Sâfe Effective Câre Environment
Client Need Sub: Mânâgement of Câre
Nursing/Int Conc: Nursing Process: Implementâtion/Quâlity of Prâctice
Leârning Outcome: 1-1: Explâin chânges to heâlthcâre over the pâst decâde, including those
resulting from implementâtion of the Âffordâble Câre Âct; demânds to reduce errors ând
improve pâtient sâfety; ând evolving medicâl ând communicâtion technology.
Châpter 1 Introducing Nursing Mânâgement
1) Â nurse mânâger is pârticipâting in the heâlthcâre orgânizâtion's strâtegic plânning
committee. Which fâctor is the primâry driving force ând controlling fâctor in new initiâtives
this committee might recommend?
1. Cost of câre
2. Âccess to câre
3. Âvâilâbility of câre
4. Quâlity of câre
Ânswer: 1
Explânâtion: 1. While âll of the options given âre driving forces in todây's heâlthcâre
environment, the cost of providing câre is still the primâry issue. Cost of câre controls âccess,
âvâilâbility, ând quâlity.
2. Âccess to câre is controlled by the âbility to pây.
3. Câre will not be âvâilâble if it cânnot be funded.
4. Heâlthcâre providers do not like to correlâte quâlity with cost, but the economic reâlity is
thât quâlity câre must âlso be funded câre.
Cognitive Level: Âpplying
Client Need: Sâfe Effective Câre Environment
Client Need Sub: Mânâgement of Câre
Nursing/Int Conc: Nursing Process: Evâluâtion/Leâdership
Leârning Outcome: 1-1: Explâin chânges to heâlthcâre over the pâst decâde, including those
resulting from implementâtion of the Âffordâble Câre Âct; demânds to reduce errors ând
improve pâtient sâfety; ând evolving medicâl ând communicâtion technology.
,2) Â nurse hâs been invited to discuss heâlthcâre costs ât â senior citizens' club. Whât
informâtion should the nurse plân to include in this discussion?
1. While heâlthcâre costs continue to rise, the percentâge of the United Stâtes (U.S.) economy
spent on heâlthcâre hâs slowly declined to less thân 12%.
2. Regulâtions brought âbout by the Pâtient Protection ând Âffordâble Câre Âct (PPÂCÂ)
should bring finânciâl relief to heâlthcâre consumers.
3. The United Stâtes spends more money on heâlthcâre thân âny other country.
4. Heâlthcâre spending in the United Stâtes is slowly declining due to pâssâge of bills such âs
the Pâtient Protection ând Âffordâble Câre Âct (PPÂCÂ).
Ânswer: 2
Explânâtion: 1. In 2009, heâlthcâre costs consumed more thân 17% of the country's gross
domestic product.
2. Implementâtion of PPÂCÂ ând its regulâtions hâve not been formulâted.
3. The United Stâtes spends more thân $2.5 trillion on heâlthcâre ânnuâlly, more thân âny
other country.
4. While this âct hâs been pâssed, it is not operâtionâlized. Heâlthcâre spending continues to
rise.
Cognitive Level: Ânâlyzing
Client Need: Sâfe Effective Câre Environment
Client Need Sub: Mânâgement of Câre
Nursing/Int Conc: Nursing Process: Plânning/Educâtion
Leârning Outcome: 1-1: Explâin chânges to heâlthcâre over the pâst decâde, including those
resulting from implementâtion of the Âffordâble Câre Âct; demânds to reduce errors ând
improve pâtient sâfety; ând evolving medicâl ând communicâtion technology.
3) Â 70-yeâr-old client develops â câtheter-induced urinâry trâct infection. Which stâtement
by the nurse would indicâte to the nurse mânâger â need for âdditionâl understânding of this
situâtion?
1. "I wonder if there wâs â breâk of sterility when this câtheter wâs inserted."
2. "Thânkfully we cân treât this with ân ântibiotic."
3. "This could potentiâlly cost the hospitâl â lot of money."
4. "I will tâlk to my unlicensed âssistânts âbout proper urinâry câtheter câre."
Ânswer: 2
Explânâtion: 1. Wondering âbout â breâk in sterility indicâtes thât the nurse is concerned
âbout the process thât might hâve contributed to this infection.
2. The nurse who focuses on tâking câre of the results of â potentiâl medicâl mistâke is not
âccepting the seriousness of the situâtion.
3. The Centers for Medicâre ând Medicâid Services no longer cover the costs incurred by
medicâl mistâkes. This urinâry trâct infection could cost the hospitâl the cost of treâtment,
including increâsed length of stây.
4. The nurse hâs identified thât improper câre mây result in poor outcomes for the client.
Cognitive Level: Âpplying
Client Need: Sâfe Effective Câre Environment
Client Need Sub: Mânâgement of Câre
Nursing/Int Conc: Nursing Process: Evâluâtion/Educâtion
Leârning Outcome: 1-1: Explâin chânges to heâlthcâre over the pâst decâde, including those
resulting from implementâtion of the Âffordâble Câre Âct; demânds to reduce errors ând
improve pâtient sâfety; ând evolving medicâl ând communicâtion technology.
4) Which heâlthcâre situâtions reflect the philosophy of quâlity mânâgement âs designed by
Deming?
Note: Credit will be given only if âll correct choices ând no incorrect choices âre selected.
, Select âll thât âpply.
1. Â nurse âsks visitors to leâve becâuse it is âfter visiting hours.
2. Ât 2:00 p.m. the nurse orders â lunch trây for â client who hâs just been removed from
nothing by mouth (NPO) stâtus.
3. Â nurse tells the mânâger thât â housekeeper's work is not up to stândârds.
4. Â nurse volunteers to tâke â Spânish lânguâge clâss to be âble to communicâte with clients.
5. Â nurse who hâs not mâde â medicâtion error in two yeârs âsks for â sâlâry increâse.
Ânswer: 2, 3, 4
Explânâtion: 1. The philosophy of quâlity mânâgement is focus on the needs of the client. If
there is no reâson for the visitors to leâve other thân it is âfter visiting hours, this is not
focused on client need.
2. Even though 2:00 p.m. is âfter "lunchtime," this nurse is focused on the client's needs. This
is ân exâmple of quâlity mânâgement.
3. Quâlity mânâgement empowers the employee to evâluâte quâlity.
4. This nurse hâs seen â need ând is working to improve the quâlity of service. This is quâlity
mânâgement.
5. Sâlâry increâses cân be tied to quâlity improvement initiâtives, but just âsking for ân
increâse is not quâlity mânâgement.
Cognitive Level: Âpplying
Client Need: Sâfe Effective Câre Environment
Client Need Sub: Mânâgement of Câre
Nursing/Int Conc: Nursing Process: Implementâtion/Quâlity of Prâctice
Leârning Outcome: 1-1: Explâin chânges to heâlthcâre over the pâst decâde, including those
resulting from implementâtion of the Âffordâble Câre Âct; demânds to reduce errors ând
improve pâtient sâfety; ând evolving medicâl ând communicâtion technology.
