Chapter 1 Effective Leadership and Management in Nursing 8th Edition

Chapter 1  Effective Leadership and Management in Nursing 8th Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
A nurse manager is participating in the health care 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
Correct Answer: 1
Rationale 1: While all of the options given are driving forces in today’s health care environment, the cost of providing care is still the primary issue. Cost of care controls access, availability, and even quality.
Rationale 2: Access to care is controlled by the ability to pay for that access.
Rationale 3: Care will not be available if it cannot be funded.
Rationale 4: Health care providers do not like to correlate quality with cost, but the economic reality is that quality care must also be funded care.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1-1: Describe the forces that are changing the health care system.

Question 2
Type: MCSA
A nurse has been invited to discuss health care costs at a senior citizens’ club. What information should the nurse plan to include in this discussion?
1. While health care costs continue to rise, the percentage of the U.S. economy spent on health care 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 health care consumers.
3. The United States spends more money on health care than any other country.
4. Health care spending in the United States is slowly declining due to passage of bills such as the Patient Protection and Affordable Care Act (PPACA).
Correct Answer: 3
Rationale 1: In 2009, health care costs consumed over 17% of the country’s gross domestic product.
Rationale 2: Implementation of PPACA and its regulations have not been formulated.
Rationale 3: The United States spends over $2.5 trillion on health care annually, more than any other country.
Rationale 4: While this act has been passed, it is not operationalized. Health care spending continues to rise.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1-1: Describe the forces that are changing the health care system.

Question 3
Type: MCSA
A 70-year-old client develops a catheter-induced urinary tract infection. Which statement by the nurse would indicate to the nurse manager 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.”
Correct Answer: 2
Rationale 1: Wondering about a break in sterility indicates that the nurse is concerned about the process that might have contributed to this infection.
Rationale 2: The nurse who focuses on taking care of the results of a potential medical mistake is not accepting the seriousness of the situation.
Rationale 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, including increased length of stay.
Rationale 4: The nurse has identified that improper care may result in poor outcomes for the client.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 1-2: Discuss changes in paying for health care.

Question 4
Type: MCMA
Which health care 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.
Standard Text: 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 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.
Correct Answer: 2,3,4
Rationale 1: The philosophy of quality management is focus on the needs of the consumer. If there is no reason for the visitors to leave other than it after visiting hours, this is not focused on client need.
Rationale 2: Even though 2:00 p.m. is after “lunchtime,” this nurse is focused on the client’s needs. This is an example of quality management.
Rationale 3: Quality management empowers the employee to evaluate quality.
Rationale 4: This nurse has seen a need and is working to improve the quality of service. This is quality management.
Rationale 5: Salary increases can be tied to quality improvement initiatives, but just asking for an increase is not quality management.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1-3: Explain how quality initiatives can reduce medical errors.

Question 5
Type: MCMA
A client who was discharged yesterday is very upset about the quality of care received during hospitalization for gastric surgery. What options for reporting concerns does this client have?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. There is no mechanism for complaint as the client is no longer hospitalized.
2. The client can indicate dissatisfaction on the survey often sent to clients after discharge.
3. The client can call the hospital administration.
4. The client can make a formal complaint through the American Nursing Association.
5. The client can make a public report through the Agency for Healthcare Research and Quality.
Correct Answer: 2,3,5
Rationale 1: The client can still voice concerns even after discharge.
Rationale 2: These client satisfaction surveys are a good mechanism for discussing care issues.
Rationale 3: Telephone calls are a means of discussing client care issues.
Rationale 4: ANA is not a forum for complaints about care in a specific hospitalization.
Rationale 5: The Agency for Healthcare Research and Quality has a mechanism for reporting care issues.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1-3: Explain how quality initiatives can reduce medical errors.