Deck 15: The Health Care Organization and Patterns of Nursing Care Delivery

Question 1

How does managed care affect the economics of health care delivery?

A) Provides incentives for smaller private or individual hospitals
B) Increases the tax bases for the community
C) Uses corporate economics to achieve a profit
D) Decreases duplicate processes and redundant facilities

Answer 1

Decreases duplicate processes and redundant facilities

Question 2

Which statement regarding characteristics of clinical pathways shows the nurses understanding?

A) "Clinical pathways focus on patient outcomes."
B) "Clinical pathways use a timeline with sequenced interventions."
C) "Clinical pathways collaborate efforts by health care professionals."
D) "Clinical pathways involve nurse-centered orientation."

Answer 2

"Clinical pathways involve nurse-centered orientation."

Question 3

A female patient is admitted to the labor and delivery unit,where she is assigned a registered nurse who will manage her care for the duration of her hospitalization.What type of nursing care delivery model is represented in this nursing unit?

A) Functional care
B) Primary care
C) Patient-focused care
D) Case management

Answer 3

Primary care

Question 4

Which of the following best describes the concept of evidence-based practice?

A) It is a method of improving nursing care and effectively maintaining cost containment.
B) Insurance companies review the evidence of the health care practice for reimbursement.
C) It achieves large-scale economics while providing cost-effective care.
D) It provides for the use of recent research in current nursing practice.

Question 5

Which type of nursing delivery models would be appropriate in a rural area that would require fewer numbers of registered nurses? (Select all that apply.)

A) Functional nursing
B) Team nursing
C) Primary care nursing
D) Patient-focused care
E) Transitional care

Question 6

Which action by the case manager would be required under the full immersion model?

A) The case manager would see only the patients with the most extensive health care needs.
B) The case manager would see all patients that come into the hospital.
C) The case manager would only see the patients with health insurance.
D) The case manager would conduct a daily chart review of patients he or she is assigned to.

Question 7

The nurse assesses the quality of patient care to be higher in the Total Patient Care model because:

A) Patients are able to perform the majority of their own care.
B) Nurses are required to perform less care.
C) Nurses are able to focus all of their care on one patient.
D) Nurses are hired to care for two patients.

Question 8

Which statement shows the nurses understanding of patient-focused care?

A) "Patient-focused care is a nursing care delivery system."
B) "Patient-focused care is a model for a health care organization."
C) "Patient-focused care is a clinical pathway within an institution."
D) "Patient-focused care is an institutional value and philosophy."

Question 9

A nurse is covering for a coworker who is on a lunch break.While administering medications,the nurse notices a bag of antibiotic hanging with another patient's name on it.The nurse immediately stops the infusion.What should the next step be?

A) Say nothing about the error because the patient is fine.
B) Speak with the coworker about the error and fill out the proper paperwork for documentation.
C) Tell the other coworkers about the error.
D) Tell the patient about the error.

Question 10

Which statement by the nurse manager is accurate regarding case management? The two tools that support case management are

A) "clinical pathways and patient classifications."
B) "clinically oriented and business-oriented pathways."
C) "clinical pathways and disease management protocols."
D) "centralized and decentralized system models."

Question 11

Which statement is true about case management?

A) There are two models-traditional and full immersion.
B) It is used to reduce resource utilization only.
C) To be effective,it requires case managers to provide direct patient care.
D) It eliminates the need for other caregivers (LPN,LVNs,nursing assistants).

Question 12

A nurse manager is training a new hire.Which statement shows an understanding of functional nursing?

A) "Functional nursing is organized around tasks."
B) "Functional nursing is patient led."
C) "Functional nurses is physician led."
D) "Functional nursing is unorganized."

Question 13

A nurse is interested in case management.Which statement indicates an understanding of the primary work environment of case manager?

A) "They work most often in acute care institutions."
B) "Their work is focused on community activities and is based within the community."
C) "They typically work for insurance companies,providing coordination of care."
D) "All types of health care organizations,as well as organizations with health-related functions,hire case managers."

Question 14

A nurse has been assigned as team leader for the day and is working with two LPNs and two unlicensed personnel.What should the nurse do to ensure success in caring for patients?

A) Give the assignments for the day out to the team and plan to meet right before the end of shift.
B) Continuously communicate with the members of the team throughout the entire day.
C) Report changes in a patient's condition to the health care provider only.
D) Revise each patient's plan of care once a shift.

Question 15

A new nurse is determining which hospital to apply for.The nurse has heard a lot about magnet hospitals from friends that are nurses and knows that working for a magnet hospital would mean

A) the nurse would likely experience high job satisfaction.
B) the nurse would likely experience poor job satisfaction.
C) the nurse would have to have a BSN before being able to apply.
D) the nurse would be hired after having a year of nursing experience.

Question 16

Which statement is true about patient classification systems?

A) They measure all the needs of patients.
B) They provide an absolute formula for unit staffing.
C) They should not be used to make patient care assignments because acuity systems are more accurate.
D) They provide historical data of the usage of nursing time,which is helpful when developing the department budget.

Question 17

Which of the following statements shows the nurses understanding of primary nursing?

A) "Primary nursing involves planning and directing of patient care over 24 hours."
B) "Primary nursing involves care for 48 hours or more."
C) "Primary nursing involves one nurse planning care for the patient."
D) "Primary nursing is the only method of care used today."

Question 18

Which of the following statements about evidence-based practice shows that the nurse has an adequate understanding?

A) "Evidence-based practice is the hospital's protocol for providing care."
B) "Evidence-based practice is based on community need."
C) "Evidence-based practice is a set of guidelines determined by each hospital unit."
D) "Evidence-based practice is the use of current best evidence in making decisions about patient care."

Question 19

The nurse is reviewing upcoming discharges.Which patient would a case manager be assigned to?

A) A 55-year-old woman post hysterectomy,who has adequate support from family
B) A 42-year-old man post appendectomy,who is able to change his own dressing
C) A 60-year-old man post sepsis,in need of nursing home placement
D) A 38-year-old woman,post shoulder repair,who needs to follow up with the orthopedic surgeon

Question 20

The nurse has an adequate understanding of patient-focused care when stating which of the following?

A) "Patient-focused care includes the physician,who supervises care."
B) "Patient-focused care decreases productivity."
C) "In patient-focused care,the nurse supervises delivery of care."
D) "The patient is not an active participant in patient-focused care."

Question 21

The nurse judges that the disease management program has been successful when the patient (Select all that apply.)

A) assumes responsibility for their own health.
B) learns how to maintain good health.
C) can state how to manage their chronic condition.
D) relies on the health care team for maintenance of health.
E) can state how to avoid worsening of health.

Question 22

Which action can the hospital administrator take to reduce health care costs? (Select all that apply.)

A) Hire case managers to see all patients who have extensive medical needs.
B) Reduce the number of patients the hospital can accommodate.
C) Ensure that appropriate staff is available.
D) Encourage the use of evidence-based practice.
E) Accept only patients with health insurance.

Question 23

The nursing shortage is projected to reach 1.2 million by 2020.Which actions can hospitals take to retain nurses? (Select all that apply.)

A) Create a health care system that supports nursing advancement.
B) Encourage a work environment that fosters workgroup cohesion.
C) Allow nurses to have autonomy.
D) Reduce the number of managers within the health care system.
E) Allow nurses a variety of specialties to choose from.

Question 24

The nurse understands cost containment when stating which of the following? Major elements of the law that support cost containment include (Select all that apply.)

A) "increased governmental regulation of insurers."
B) "less use of technology."
C) "increasing incentives for coordination of care."
D) "emphasis on physician centered care."
E) "decreasing consumer out of pocket costs."

Question 25

Which statement by the nurse indicates understanding of the case manager's role? The case manager (Select all that apply.)

A) "guides patients through the health care delivery process."
B) "ensures quicker discharge for patients without insurance."
C) "coordinates care for the patient."
D) "assists patients in achieving goals effectively and efficiently."
E) "collaborates with the health care team."