,Effective#Leadership#&#Management#in#Nursing,#9e#(Sullivan)#Chapt
er#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#environmen
t,#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#q
uality#care#must#also#be#funded#care.
Cognitive#Level:# Applying
Client#Need:# Safe#Effective#Care#Environment#Cli
ent#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#implementat
ion#of#the#Affordable#Care#Act;#demands#to#reduce#errors#and#improve#patient#safety;#and#evolvin
g#medical#and#communication#technology.
,2) A#nurse#has#been#invited#to#discuss#healthcare#costs#at#a#senior#citizens'#club.#What#i
nformation#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#s
pent#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#P
atient#Protection#and#Affordable#Care#Act#(PPACA).
Answer:# 2
Explanation:# 1.#In#2009,#healthcare#costs#consumed#more#than#17%#of#the#country's#gross#domesti
c#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#c
ountry.
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#Cli
ent#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#implementat
ion#of#the#Affordable#Care#Act;#demands#to#reduce#errors#and#improve#patient#safety;#and#evolvin
g#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#manag
er#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#th
e#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#a
ccepting#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,#i
ncluding#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#Cli
ent#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#implementat
ion#of#the#Affordable#Care#Act;#demands#to#reduce#errors#and#improve#patient#safety;#and#evolvin
g#medical#and#communication#technology.
4) Which#healthcare#situations#reflect#the#philosophy#of#quality#management#as#designed#by
, Deming?
Note:#Credit#will#be#given#only#if#all#correct#choices#and#no#incorrect#choices#are#selected.
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#b
y#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#clien
t#need.
2. Even#though#2:00#p.m.#is#after#"lunchtime,"#this#nurse#is#focused#on#the#client's#needs.#This#is#a
n#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#i
s#not#quality#management.
Cognitive#Level:# Applying
Client#Need:# Safe#Effective#Care#Environment#Cli
ent#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#implementat
ion#of#the#Affordable#Care#Act;#demands#to#reduce#errors#and#improve#patient#safety;#and#evolvin
g#medical#and#communication#technology.
er#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#environmen
t,#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#q
uality#care#must#also#be#funded#care.
Cognitive#Level:# Applying
Client#Need:# Safe#Effective#Care#Environment#Cli
ent#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#implementat
ion#of#the#Affordable#Care#Act;#demands#to#reduce#errors#and#improve#patient#safety;#and#evolvin
g#medical#and#communication#technology.
,2) A#nurse#has#been#invited#to#discuss#healthcare#costs#at#a#senior#citizens'#club.#What#i
nformation#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#s
pent#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#P
atient#Protection#and#Affordable#Care#Act#(PPACA).
Answer:# 2
Explanation:# 1.#In#2009,#healthcare#costs#consumed#more#than#17%#of#the#country's#gross#domesti
c#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#c
ountry.
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#Cli
ent#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#implementat
ion#of#the#Affordable#Care#Act;#demands#to#reduce#errors#and#improve#patient#safety;#and#evolvin
g#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#manag
er#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#th
e#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#a
ccepting#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,#i
ncluding#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#Cli
ent#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#implementat
ion#of#the#Affordable#Care#Act;#demands#to#reduce#errors#and#improve#patient#safety;#and#evolvin
g#medical#and#communication#technology.
4) Which#healthcare#situations#reflect#the#philosophy#of#quality#management#as#designed#by
, Deming?
Note:#Credit#will#be#given#only#if#all#correct#choices#and#no#incorrect#choices#are#selected.
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#b
y#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#clien
t#need.
2. Even#though#2:00#p.m.#is#after#"lunchtime,"#this#nurse#is#focused#on#the#client's#needs.#This#is#a
n#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#i
s#not#quality#management.
Cognitive#Level:# Applying
Client#Need:# Safe#Effective#Care#Environment#Cli
ent#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#implementat
ion#of#the#Affordable#Care#Act;#demands#to#reduce#errors#and#improve#patient#safety;#and#evolvin
g#medical#and#communication#technology.
