f
,Effective Leadership & Management in Nursing, 9e (Sullivan) Chapter 1
f f f f f f f f f
fIntroducing Nursing Management f f
1) A nurse manager is participating in the healthcare organization's strategic planning committee
f f f f f f f f f f f
. Which factor is the primary driving force and controlling factor in new initiatives this committee
f f f f f f f f f f f f f f f f
might recommend? f
1. Cost of care f f
2. Access to care f f
3. Availability of care f f
4. Quality of care f f f
Answer: 1 f
Explanation: 1. While all of the options given are driving forces in today's healthcare environment
f f f f f f f f f f f f f f
, the cost of providing care is still the primary issue. Cost of care controls access, availability, and qu
f f f f f f f f f f f f f f f f f f
ality.
2. Access to care is controlled by the ability to pay. f f f f f f f f f
3. Care will not be available if it cannot be funded.
f f f f f f f f f
4. Healthcare providers do not like to correlate quality with cost, but the economic reality is that
f f f f f f f f f f f f f f f f
quality care must also be funded care. f f f f f f
Cognitive Level: Applying f f
Client Need: Safe Effective Care Environment Client
f f f f f f f
Need Sub: Management of Caref f f f
Nursing/Int Conc: Nursing Process: Evaluation/Leadership f f f f
Learning Outcome: 1- f f
1: Explain changes to healthcare over the past decade, including those resulting from implementati
f f f f f f f f f f f f f
on of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving
f f f f f f f f f f f f f f f f
medical and communication technology. f f f
,2) A nurse has been invited to discuss healthcare costs at a senior citizens' club. What infor
f f f f f f f f f f f f f f f
mation should the nurse plan to include in this discussion?
f f f f f f f f f
1. While healthcare costs continue to rise, the percentage of the United States (U.S.) economy spen
f f f f f f f f f f f f f f
t on healthcare has slowly declined to less than 12%.
f f f f f f f f f
2. Regulations brought about by the Patient Protection and Affordable Care Act (PPACA) sho f f f f f f f f f f f f
uld bring financial relief to healthcare consumers.
f f f f f f
3. The United States spends more money on healthcare than any other country.
f f f f f f f f f f f
4. Healthcare spending in the United States is slowly declining due to passage of bills such as the P f f f f f f f f f f f f f f f f f
atient Protection and Affordable Care Act (PPACA).
f f f f f f
Answer: 2 f
Explanation: 1. In 2009, healthcare costs consumed more than 17% of the country's gross domestic f f f f f f f f f f f f f f
product.
f
2. Implementation of PPACA and its regulations have not been formulated. f f f f f f f f f
3. The United States spends more than $2.5 trillion on healthcare annually, more than any othe
f f f f f f f f f f f f f f
r country.
f
4. While this act has been passed, it is not operationalized. Healthcare spending continues to rise.
f f f f f f f f f f f f f f
Cognitive Level: Analyzing f f
Client Need: Safe Effective Care Environment Client
f f f f f f f
Need Sub: Management of Care f f f f
Nursing/Int Conc: Nursing Process: Planning/Education f f f f
Learning Outcome: 1- f f
1: Explain changes to healthcare over the past decade, including those resulting from implementati
f f f f f f f f f f f f f
on of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving
f f f f f f f f f f f f f f f f
medical and communication technology. f f f
3) A 70-year-old client develops a catheter-
f f f f f
induced urinary tract infection. Which statement by the nurse would indicate to the nurse manag
f f f f f f f f f f f f f f
er a need for additional understanding of this situation?
f f f f f f f f
1. "I wonder if there was a break of sterility when this catheter was inserted."
f f f f f f f f f f f f f
2. "Thankfully we can treat this with an antibiotic." f f f f f f f
3. "This could potentially cost the hospital a lot of money." f f f f f f f f f
4. "I will talk to my unlicensed assistants about proper urinary catheter care." An
f f f f f f f f f f f f
swer: 2 f
Explanation: 1. Wondering about a break in sterility indicates that the nurse is concerned about the f f f f f f f f f f f f f f f f
process that might have contributed to this infection. f f f f f f f
2. The nurse who focuses on taking care of the results of a potential medical mistake is not accep
f f f f f f f f f f f f f f f f f
ting the seriousness of the situation.
f f f f f
3. The Centers for Medicare and Medicaid Services no longer cover the costs incurred by medi
f f f f f f f f f f f f f f
cal mistakes. This urinary tract infection could cost the hospital the cost of treatment, including
f f f f f f f f f f f f f f f
increased length of stay. f f f
4. The nurse has identified that improper care may result in poor outcomes for the client. Cog
f f f f f f f f f f f f f f f
nitive Level: Applying f f
Client Need: Safe Effective Care Environment Client
f f f f f f f
Need Sub: Management of Care f f f f
Nursing/Int Conc: Nursing Process: Evaluation/Education f f f f
Learning Outcome: 1- f f
1: Explain changes to healthcare over the past decade, including those resulting from implementati
f f f f f f f f f f f f f
on of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving
f f f f f f f f f f f f f f f f
medical and communication technology. f f f
4) Which healthcare situations reflect the philosophy of quality management as designed by De
f f f f f f f f f f f f
ming?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
f f f f f f f f f f f f f f f
, Select all that apply. f f f
1. A nurse asks visitors to leave because it is after visiting hours.
f f f f f f f f f f f
2. At 2:00 p.m. the nurse orders a lunch tray for a client who has just been removed from nothi
f f f f f f f f f f f f f f f f f f
ng by mouth (NPO) status.
f f f f
3. Anurse tells the manager that a housekeeper's work is not up to standards.
f f f f f f f f f f f f f
4. A nurse volunteers to take a Spanish language class to be able to communicate with clients.
f f f f f f f f f f f f f f f
5. A nurse who has not made a medication error in two years asks for a salary increase. Ans
f f f f f f f f f f f f f f f f f
wer: 2, 3, 4 f f f
Explanation: 1. The philosophy of quality management is focus on the needs of the client. If there is
f f f f f f f f f f f f f f f f f
no reason for the visitors to leave other than it is after visiting hours, this is not focused on client nee
f f f f f f f f f f f f f f f f f f f f f
d.
2. Even though 2:00 p.m. is after "lunchtime," this nurse is focused on the client's needs. This is an
f f f f f f f f f f f f f f f f f f
example of quality management. f f f
3. Quality management empowers the employee to evaluate quality.f f f f f f f
4. This nurse has seen a need and is working to improve the quality of service. This is quality mana
f f f f f f f f f f f f f f f f f f
gement.
5. Salary increases can be tied to quality improvement initiatives, but just asking for an incr
f f f f f f f f f f f f f f
ease is not quality management.
f f f f
Cognitive Level: Applying f f
Client Need: Safe Effective Care Environment Client
f f f f f f f
Need Sub: Management of Care
f f f f
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice f f f f f f
Learning Outcome: 1- f f
1: Explain changes to healthcare over the past decade, including those resulting from implementati
f f f f f f f f f f f f f
on of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving
f f f f f f f f f f f f f f f f
medical and communication technology. f f f