Deck 4: Organizational Structure for Effective Care Delivery

Question 1

The director of nursing education for a hospital has been asked to provide continuing education on safety precautions to physicians, nurses, and all other disciplines providing patient care. Although the director is responsible for providing this education, the director is not responsible for assuring that physicians and healthcare managers adhere to the procedures. What type of healthcare organizational structure is present in this hospital?

A) Vertical structure
B) Staff authority
C) Span of control
D) Horizontal structure

Answer 1

Staff authority

Question 2

The primary physician identifies a healthcare provider to manage the care of a patient on the general medical unit of a hospital. Depending upon the facility, which healthcare provider may fill this role? Select all that apply.

A) Nurse Practitioner Hospitalist
B) Physician Intensivist
C) Physician Hospitalist
D) Registered nurse
E) Clinical Nurse Specialist Intensivist

Answer 2

Nurse Practitioner Hospitalist
Physician Hospitalist

Question 3

The nursing student clinical group is attending the first clinical session of the semester. What nursing care delivery model do students usually expect to follow?

A) Total patient care model
B) Functional nursing model
C) Primary nursing model
D) Care management model

Answer 3

Total patient care model

Question 4

This morning, the RN is assigned to administer medications to all of the patients on the medical-surgical unit. From this assignment, the RN knows that this organization adheres to which type of patient care delivery model?

A) Total patient care model
B) Functional nursing model
C) Primary nursing model
D) Care management model

Question 5

The nurse is interviewing for a position in a newly opened hospital. Which observation would best indicate to this nurse that the organization follows a shared governance model?

A) Among the documents provided by the human resources department is an organizational chart of the nursing department, indicating that the director is the highest-ranking member.
B) Conversation with a staff nurse reveals that the nurse feels empowered in making patient care decisions.
C) The mission statement of the hospital describes centralized power.
D) A staff nurse mentions that each individual staff member has complete autonomy.

Question 6

What has caused some of the concern about the use of unlicensed assistive personnel (UAP)?

A) Supervision is provided by the registered nurse.
B) UAPs do not provide quality care.
C) Home health aides are not supervised.
D) There is variability of education and training of all types of UAPs.

Question 7

Choose the statements that are correct about not-for-profit healthcare organizations. Select all that apply.

A) There are stockholders who own stock in the organization.
B) These organizations do not have to make a profit to survive.
C) Typically, these organizations are funded by charitable institutions, the government, or churches, as well as by the typical reimbursement sources.
D) These organizations experience more ethical and legal problems.
E) Organizations are called voluntary or public health organizations.

Question 8

The obstetrics department, which is composed of labor and delivery, postpartum, nurseries, and the neonatal intensive care unit, operates under what organizational structure?

A) Decentralized structure
B) Matrix organizational structure
C) Departmentalization
D) Line authority

Question 9

The nurse is organizing a smoking cessation group for the residents of a retirement center. 8What level of healthcare services does this represent?

A) Primary care
B) Secondary care
C) Tertiary care
D) Rehabilitation care

Question 10

Compare and contrast input, process, and output in systems organizational theory by selecting the options that represent process. Select all that apply.

A) The physician admits a patient to the hospital.
B) The nurse provides excellent care to a patient postoperatively.
C) The dietary manager orders supplies based upon cost-effectiveness.
D) The patient delivers a healthy infant.
E) The nursing unit secretary identifies a potential medical error before it occurs.

Question 11

The patient is being discharged from the hospital after having a coronary artery bypass graft (CABG). Which level of the healthcare system will best serve the needs of this patient at this point?

A) Primary care
B) Secondary care
C) Tertiary care
D) Public healthcare

Question 12

The organizational analysis documentation describes the organization as one with centralized leadership with a clearly defined organization chart hierarchy. The organization is divided into departments and follows detailed rules and regulation. This organization follows which theories? Select all that apply.

A) Classical
B) Systems
C) Integrated delivery system
D) Vertical integration theory
E) Bureaucratic

Question 13

An outside accreditation team is evaluating the organization's mission statement. Which action, taken by the organization, is the most important in regard to this statement?

A) The organization must provide a current copy of the mission statement.
B) The organization must be certain that the mission statement is prominently displayed in public access areas.
C) The organization must provide the team with a written plan about how the mission statement will be followed.
D) The organization must provide evidence of how the mission statement is being followed.

Question 14

Several small rural hospitals have been acquired by a large nationwide healthcare organization. Six months after the acquisition, the rural hospitals remain in conflict with the management team and with one another. Choose the questions that the management team should ask in order to identify the reasons for this continued discord. Select all that apply.

A) How are the hospitals communicating with the organization and with one another?
B) Are the goals of the hospitals aligned with those of the organization?
C) Are the rural hospitals too focused on patient-centered care and safety?
D) How is the organization handling decision making with the hospitals?
E) Aren't buyouts always this way?

Question 15

The nurse manager supervises the neurologic intensive care unit, surgical intensive care unit, and cardiac intensive care unit. Each unit employs 35 nurses and 15 support staff. The span of control for this manager is ________. Record your answer rounding to the nearest whole number.

Question 16

Which statement should be included in a classroom discussion about organizational process?

A) It is a philosophy that becomes the basis for operationalizing the mission of the institution.
B) It answers the questions of "what does the organization look like."
C) It directs staff as to whom they report.
D) It is a graphical representation of an organization's flow of responsibility.

Question 17

Which factor would least likely be included in the analysis of an organization?

A) Whether the organization's mission and vision match staff performance
B) Results from a staff opinion survey regarding the organization's decision-making processes
C) How the organization's communication patterns have affected the change process
D) The turnover rate of nursing personnel in a given unit

Question 18

The healthcare organization is undergoing reorganization to a service-line structure. What are the benefits of this structure? Select all that apply.

A) There is a clear delineation of the organization's rules.
B) Each staff member reports to only one supervisor.
C) Staff members are not encouraged to use creative problem solving.
D) Departments are less likely to place blame on one another.
E) The nursing presence is strong and unified.

Question 19

What is a primary factor in the increasing interest in the use of chiropractic care?

A) There are more chiropractors available.
B) Chiropractors have been given medical doctor credentials.
C) Use of nontraditional medical interventions
D) Chiropractors can now perform surgical procedures to reduce pain.

Question 20

What is a disadvantage of using the team approach for care delivery?

A) The team leader might not have the necessary leadership skills required to successfully lead the team.
B) There is a risk that care will be fragmented.
C) This approach often leads to greater staff dissatisfaction, with staff members feeling they are just grinding out tasks.
D) This approach may lead to decreased collaboration and redundancy in patient care.

Question 21

A nurse who has the ability to make decisions and has competence to do so is best described as demonstrating which of the following?

A) Responsibility
B) Delegation
C) Autonomy
D) Accountability

Question 22

The patient who had a colonoscopy one hour ago suddenly experiences bright red rectal bleeding, becomes diaphoretic, and is short of breath. The nurse decides to implement standing emergency orders and initiates oxygen per mask and increases the patient's IV rate, while a colleague contacts the patient's physician. Which critical element of nursing is this nurse demonstrating? Select all that apply.

A) Autonomy
B) Responsibility
C) Delegation
D) Accountability
E) Relevance

Question 23

What are the responsibilities of the nurse manager in most shared governance models? Select all that apply.

A) Staffing
B) Direct patient care
C) Program evaluation
D) Allocation of resources
E) Long-range planning

Question 24

Which options are included in the six dimensions of shared governance? Select all that apply.

A) Informal authority base
B) Access to information about the organization
C) Delegation of care to others
D) Ability to set goals and negotiate conflict
E) Control over professional practice

Question 25

What is the oldest of the nursing care models?

A) Total patient care
B) Functional nursing
C) Team nursing
D) Primary nursing

Question 26

These four principles of marketing are used to guide development of a marketing plan, focusing on the critical elements of the plan. Select all that apply.

A) Place
B) People
C) Product
D) Pricing
E) Promotion

Question 27

The American Organization of Nurse Executives (AONE) emphasizes "the core of nursing is knowledge and caring." To which portions of the Institute of Medicine core competencies does this statement relate? Select all that apply.

A) Use of interprofessional teams
B) Informatics
C) Evidence-based practice
D) Quality improvement
E) Patient-centered care

Question 28

You are orienting a new staff nurse to the unit's nursing model, which is the Synergy Model for Patient Care™. As you describe the model, you make a mistake and another nurse points out your error. What would that nurse identify?

A) The model matches nurses' competencies with patient characteristics, needs, and the unit.
B) The model is for critical-care units.
C) The model supports the healthcare professions core competency to use patient-centered care.
D) Nurses are expected to be competent in clinical inquiry.

Question 29

What is the most significant change today in healthcare providers that impacts all types of healthcare settings?

A) Use of hospitalist
B) Increased emphasis on interprofessional teams
C) Development of the Doctor of Nursing Practice degree
D) Use of unlicensed assistive personnel

Question 30

The marketing process includes which three elements listed below? Select all that apply.

A) A determination of what is wanted needed
B) A method(s) for reaching what is wanted or needed
C) A description of the cost and quality of what is needed
D) A specific plan to evaluation the service needed
E) An understanding of the patient, customer, or consumer and service needed