CHAPTER 13 EXAM QUESTIONS WITH
CORRECT ANSWERS
1. The nurse manager at a cardiac rehabilitation unit was asked to select a care delivery
model. Which of the following methods would be the most cost-effective?
a. Functional method
b. Case management method
c. Primary care method
d. Team method - Answer-ANS: B
2. Complex care of acutely ill patients is required on a surgical unit, which utilizes
differentiated nursing practice as its model of care delivery. The concept of
differentiated nursing practice is based on:
a. Licensure status.
b. Experience in the agency.
c. Leadership capabilities.
d. Education and expertise. - Answer-ANS: D
Differentiated nursing practice models are models of clinical nursing practice that are
defined or differentiated by level of education, expected clinical skills or competencies,
job descriptions, pay scales, and participation in decision making.
3. The relief charge nurse has assigned a newly licensed baccalaureate-prepared nurse
to be one of the team leaders for the 3-11 shift. In making this decision, the charge
nurse has overlooked this nurse's:
a. Clinical expertise.
b. Leadership ability.
c. Communication style.
d. Conflict-resolution skills. - Answer-ANS: A
Because the basic education of baccalaureate-prepared RNs emphasizes critical-
thinking, clinical reasoning, and leadership concepts, they are likely candidates for such
roles. Benner (2001), however, identified five stages of clinical competence for nurses:
novice, advanced beginner, competent, proficient, and expert. She suggests that
competence is typified by a nurse who has been on the job in the same or similar
situation 2 to 3 years. Nurses who are at the novice or advanced beginner stage would
be less likely than their more experienced counterparts to implement any type of
delivery model effectively and thus, this assignment overlooks the nurse's level of
clinical expertise and leadership experience.
4. When interviewing an applicant for a position, the nurse manager describes the unit's
care delivery system as one in which each nursing assistant is cross-trained to perform
, specific tasks, and the RNs do all treatment, medication administration, and discharge
teaching. The nurse applicant knows this nursing care delivery strategy to be:
a. The case method.
b. Functional nursing.
c. Primary nursing.
d. Nurse case management. - Answer-ANS: B
The functional model of nursing is a method of providing patient care by which each
licensed and unlicensed staff member performs specific tasks for a large group of
patients.
5. You are the nurse manager of a nursing service organization that provides around-
the-clock care to clients in their homes. To achieve maximum reimbursement for a client
who is recovering from a hip replacement, the nursing staff most likely will follow the
nursing care guidelines presented in the:
a. Nursing care plan.
b. Physician's orders.
c. Critical pathway.
d. Clinical practice guidelines. - Answer-ANS: C
A critical pathway outlines outcomes, clinical standards, and interventions for a patient
in each phase of treatment. The goal of critical pathways is effective coordination of
care across various staff and levels of care.
6. The nurse case manager is working with a client admitted for end-stage renal
disease. The case manager's major goal during this hospitalization is to:
a. Implement the care pathway on admission.
b. Provide direct nursing care throughout the hospitalization.
c. Supervise the nursing staff members who implement the care map.
d. Prevent additional hospitalizations resulting from complications of the client's disease.
- Answer-ANS: D
The goals and outcomes established in a critical pathway are designed to support the
aims of case management, which are shortened hospital stays and prevention of
hospital readmissions.
Team nursing, functional nursing, and case management are all considered efficient,
cost-effective methods of care delivery because they enable utilization of various types
of healthcare providers (rather than baccalaureate nurses in direct care, which is the
primary nursing method). Case management is considered particularly cost-effective in
patient care settings because it maintains quality care while streamlining costs for high-
risk, high-volume, high-cost patient populations and seeks the active involvement of the
patient, the family, and diverse healthcare professionals.
7. In an acute care unit, the nurse manager utilizes the functional nursing method as the
care delivery model. The nurse manager's main responsibility is the needs of the:
a. Department.
CORRECT ANSWERS
1. The nurse manager at a cardiac rehabilitation unit was asked to select a care delivery
model. Which of the following methods would be the most cost-effective?
a. Functional method
b. Case management method
c. Primary care method
d. Team method - Answer-ANS: B
2. Complex care of acutely ill patients is required on a surgical unit, which utilizes
differentiated nursing practice as its model of care delivery. The concept of
differentiated nursing practice is based on:
a. Licensure status.
b. Experience in the agency.
c. Leadership capabilities.
d. Education and expertise. - Answer-ANS: D
Differentiated nursing practice models are models of clinical nursing practice that are
defined or differentiated by level of education, expected clinical skills or competencies,
job descriptions, pay scales, and participation in decision making.
3. The relief charge nurse has assigned a newly licensed baccalaureate-prepared nurse
to be one of the team leaders for the 3-11 shift. In making this decision, the charge
nurse has overlooked this nurse's:
a. Clinical expertise.
b. Leadership ability.
c. Communication style.
d. Conflict-resolution skills. - Answer-ANS: A
Because the basic education of baccalaureate-prepared RNs emphasizes critical-
thinking, clinical reasoning, and leadership concepts, they are likely candidates for such
roles. Benner (2001), however, identified five stages of clinical competence for nurses:
novice, advanced beginner, competent, proficient, and expert. She suggests that
competence is typified by a nurse who has been on the job in the same or similar
situation 2 to 3 years. Nurses who are at the novice or advanced beginner stage would
be less likely than their more experienced counterparts to implement any type of
delivery model effectively and thus, this assignment overlooks the nurse's level of
clinical expertise and leadership experience.
4. When interviewing an applicant for a position, the nurse manager describes the unit's
care delivery system as one in which each nursing assistant is cross-trained to perform
, specific tasks, and the RNs do all treatment, medication administration, and discharge
teaching. The nurse applicant knows this nursing care delivery strategy to be:
a. The case method.
b. Functional nursing.
c. Primary nursing.
d. Nurse case management. - Answer-ANS: B
The functional model of nursing is a method of providing patient care by which each
licensed and unlicensed staff member performs specific tasks for a large group of
patients.
5. You are the nurse manager of a nursing service organization that provides around-
the-clock care to clients in their homes. To achieve maximum reimbursement for a client
who is recovering from a hip replacement, the nursing staff most likely will follow the
nursing care guidelines presented in the:
a. Nursing care plan.
b. Physician's orders.
c. Critical pathway.
d. Clinical practice guidelines. - Answer-ANS: C
A critical pathway outlines outcomes, clinical standards, and interventions for a patient
in each phase of treatment. The goal of critical pathways is effective coordination of
care across various staff and levels of care.
6. The nurse case manager is working with a client admitted for end-stage renal
disease. The case manager's major goal during this hospitalization is to:
a. Implement the care pathway on admission.
b. Provide direct nursing care throughout the hospitalization.
c. Supervise the nursing staff members who implement the care map.
d. Prevent additional hospitalizations resulting from complications of the client's disease.
- Answer-ANS: D
The goals and outcomes established in a critical pathway are designed to support the
aims of case management, which are shortened hospital stays and prevention of
hospital readmissions.
Team nursing, functional nursing, and case management are all considered efficient,
cost-effective methods of care delivery because they enable utilization of various types
of healthcare providers (rather than baccalaureate nurses in direct care, which is the
primary nursing method). Case management is considered particularly cost-effective in
patient care settings because it maintains quality care while streamlining costs for high-
risk, high-volume, high-cost patient populations and seeks the active involvement of the
patient, the family, and diverse healthcare professionals.
7. In an acute care unit, the nurse manager utilizes the functional nursing method as the
care delivery model. The nurse manager's main responsibility is the needs of the:
a. Department.
