Chapter 3 Effective Leadership and Management in Nursing 8th Edition

Chapter 3  Effective Leadership and Management in Nursing 8th Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
The nurse manager tells a newly hired nurse that the unit practices functional nursing. What should the new nurse expect?
1. One nurse has responsibility for all the medications on the unit.
2. One nurse has responsibility for all the needs of three clients.
3. One charge nurse and one respiratory therapist have responsibility for all clients.
4. One nurse and one nursing assistant have responsibility for ten clients.
Correct Answer: 1
Rationale 1: Functional nursing breaks down client care into tasks assigned to the appropriate professional or skilled caregivers. This may result in one nurse (the “med nurse”) administering all the medications on the unit.
Rationale 2: Total patient care is given by one nurse assigned to a few clients.
Rationale 3: Team or modular nursing uses a variety of skilled caregivers to provide care to an assigned group of clients.
Rationale 4: Team or modular nursing uses a variety of skilled caregivers to provide care to an assigned group of clients.
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: 3-2: Describe what types of nursing care delivery systems exist.

Question 2
Type: MCMA
A large metropolitan hospital uses differentiated practice as part of the structure of nursing services. Following this plan, nursing responsibilities are assigned based on which criteria?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Seniority
2. Educational level
3. Experience
4. Nurse preference
5. Affordability
Correct Answer: 2,3,4
Rationale 1: Seniority does not mean competence.
Rationale 2: Differentiated practice takes education (primarily associate’s degree and bachelor’s degree) into consideration when determining nursing responsibilities.
Rationale 3: Experience is considered in differentiated practice.
Rationale 4: Nurse preference is taken into consideration in differentiated practice.
Rationale 5: While cost containment is always an issue, in true differentiated practice it is not a primary determinant of responsibilities.
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: 3-5: Explain characteristics of effective delivery systems.

Question 3
Type: MCSA
The RN receives reports on eight clients in the morning. Client assignments are then delegated to an LPN and two nursing assistants. The morning is busy, with physician visits and new client orders, and the RN communicates these new orders to the LPN and nursing assistants. The RN also meets with the case manager to discuss nursing home placement for a client. What type of nursing care delivery system is in place in this hospital?
1. Critical pathways
2. Total patient care
3. Team nursing
4. Functional nursing
Correct Answer: 3
Rationale 1: Critical pathways are a set of strategies used by health care providers to attain expected outcomes. Critical pathways are not a nursing care delivery system, and there are insufficient data to determine if they are used in this scenario.
Rationale 2: Total patient care is given by one nurse.
Rationale 3: The RN in this case is leading a team. A variety of skilled caregivers cares for a group of clients.
Rationale 4: Functional nursing breaks down the assignments into tasks.
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: 3-2: Describe what types of nursing care delivery systems exist.

Question 4
Type: MCMA
As the RN team leader, identify potential disadvantages of using team nursing to deliver care to assigned clients.

Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Continuity of care may suffer.
2. Client/staff communication may be an issue.
3. There is little cost savings to the institution.
4. Delegation is necessary.
5. Not as many professional staff are required.
Correct Answer: 1,2,4
Rationale 1: Continuity of care may suffer when care is given by more than one person.
Rationale 2: Team nursing requires excellent communication skills in all team members, who must communicate with clients, families, and each other.
Rationale 3: Team nursing does save on personnel costs.
Rationale 4: The RN must be careful to delegate only tasks that are appropriate for the skill level and licensure of the designated personnel. The RN is ultimately responsible for all client care.
Rationale 5: Team nursing does reduce the numbers of professional staff required.
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: 3-3: Discuss the positive and negative aspects of different systems.

Question 5
Type: MCSA
The hospital is opening its first intensive care unit. The nurse executive should plan to staff this unit according to which model of care?
1. Functional nursing
2. Team nursing
3. Total patient care
4. Modular nursing
Correct Answer: 3
Rationale 1: Functional nursing has the disadvantages of less continuity of care and potentially less skilled personnel caring for the client.
Rationale 2: Team nursing has the disadvantage of not having a professional nurse attending to all client care needs.
Rationale 3: In total patient care, one nurse cares for a client and, being totally accountable for the client, can give continuous, holistic, and expert care.
Rationale 4: Modular nursing is somewhat synonymous with team nursing and has the disadvantage of not having a professional nurse to attend to all client care needs.
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: 3-5: Explain characteristics of effective delivery systems.