NURSING 101
questions-midterm
CHAPTER 1
Effective Leadership & Management in Nursing, 9e (Sullivan)
Chapter 1 Introducing Nursing Management
1) A nurse manager is participating in the healthcare 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 Answer: 1
Explanation: 1. While all of the options given are driving forces in today's
healthcare environment, the cost of providing care is still the primary issue.
Cost of care controls access, availability, and quality.
2. Access to care is controlled by the ability to pay.
3. Care will not be available if it cannot be funded.
4. Healthcare providers do not like to correlate quality with cost, but
the economic reality is that quality care must also be funded care.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Evaluation/Leadership
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
2) A nurse has been invited to discuss healthcare costs at a senior citizens'
club. What information should the nurse plan to include in this discussion?
1. While healthcare costs continue to rise, the percentage of the United
States (U.S.) economy spent on healthcare 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 healthcare consumers.
3. The United States spends more money on healthcare than any other
country.
4. Healthcare spending in the United States is slowly declining due to
passage of bills such as the Patient Protection and Affordable Care Act
(PPACA).
Answer: 2
Explanation: 1. In 2009, healthcare costs consumed more than 17% of the
country's gross domestic product.
,NURSING 101
questions-midterm
2. Implementation of PPACA and its regulations have not been formulated.
3. The United States spends more than $2.5 trillion on healthcare annually,
more than any other country.
4. While this act has been passed, it is not operationalized. Healthcare
spending continues to rise.
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Planning/Education
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
3) 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."
Answer: 2
Explanation: 1. Wondering about a break in sterility indicates that the nurse
is concerned about the process that might have contributed to this infection.
2. The nurse who focuses on taking care of the results of a potential medical
mistake is not accepting the seriousness of the situation.
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.
4. The nurse has identified that improper care may result in poor outcomes
for the client.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Evaluation/Education
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
4) Which healthcare 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. Select all that apply.
1. A nurse asks visitors to leave because it is after visiting hours.
,NURSING 101
questions-midterm
2. At 2:00 p.m. the nurse orders a lunch tray for a client who has just been
removed from nothing by mouth (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.
Answer: 2, 3, 4
Explanation: 1. The philosophy of quality management is focus on the needs
of the client. If there is no reason for the visitors to leave other than it is
after visiting hours, this is not focused on client need.
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.
3. Quality management empowers the employee to evaluate quality.
4. This nurse has seen a need and is working to improve the quality
of service. This is quality management.
5. Salary increases can be tied to quality improvement initiatives, but just
asking for an increase is not quality management.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
5) 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. Select all that apply.
1. There is no mechanism for complaint because 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 (ANA).
5. The client can make a public report through the Agency for Healthcare
Research and Quality (AHRQ).
Answer: 2, 3, 5
Explanation: 1. The client can still voice concerns even after discharge.
, NURSING 101
questions-midterm
2. These client satisfaction surveys are a good mechanism for discussing
care issues.
3. Telephone calls are a means of discussing client care issues.
4. ANA is not a forum for complaints about care in a specific hospitalization.
5. The AHRQ has a mechanism for reporting care issues.
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
6) A client needs a high-risk surgical procedure. According to the Leapfrog
Group, the client should choose which hospital for care during this
procedure?
1. The hospital closest to the client's home
2. The hospital that has done the greatest number of these surgeries in
the last two years
3. The hospital chosen by the client's primary healthcare provider
4. The hospital with the highest performance ratings for this procedure
Answer: 4
Explanation: 1. This may or may not be the best choice of hospital for this
procedure.
2. Just because a hospital is high volume does not mean it is high quality.
3. This may or may not be the best hospital for this procedure.
4. The Leapfrog Group focuses on quality indicators including the use of
higher-performing hospitals for high-risk procedures.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Coordination of Care
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
7) The quality management director of a large healthcare conglomerate
wishes to initiate benchmarking strategies to assess care. Which directive
should this manager publish?
1. We will compare outcome indicators with other healthcare conglomerates
of similar size and organization.
questions-midterm
CHAPTER 1
Effective Leadership & Management in Nursing, 9e (Sullivan)
Chapter 1 Introducing Nursing Management
1) A nurse manager is participating in the healthcare 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 Answer: 1
Explanation: 1. While all of the options given are driving forces in today's
healthcare environment, the cost of providing care is still the primary issue.
Cost of care controls access, availability, and quality.
2. Access to care is controlled by the ability to pay.
3. Care will not be available if it cannot be funded.
4. Healthcare providers do not like to correlate quality with cost, but
the economic reality is that quality care must also be funded care.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Evaluation/Leadership
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
2) A nurse has been invited to discuss healthcare costs at a senior citizens'
club. What information should the nurse plan to include in this discussion?
1. While healthcare costs continue to rise, the percentage of the United
States (U.S.) economy spent on healthcare 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 healthcare consumers.
3. The United States spends more money on healthcare than any other
country.
4. Healthcare spending in the United States is slowly declining due to
passage of bills such as the Patient Protection and Affordable Care Act
(PPACA).
Answer: 2
Explanation: 1. In 2009, healthcare costs consumed more than 17% of the
country's gross domestic product.
,NURSING 101
questions-midterm
2. Implementation of PPACA and its regulations have not been formulated.
3. The United States spends more than $2.5 trillion on healthcare annually,
more than any other country.
4. While this act has been passed, it is not operationalized. Healthcare
spending continues to rise.
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Planning/Education
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
3) 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."
Answer: 2
Explanation: 1. Wondering about a break in sterility indicates that the nurse
is concerned about the process that might have contributed to this infection.
2. The nurse who focuses on taking care of the results of a potential medical
mistake is not accepting the seriousness of the situation.
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.
4. The nurse has identified that improper care may result in poor outcomes
for the client.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Evaluation/Education
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
4) Which healthcare 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. Select all that apply.
1. A nurse asks visitors to leave because it is after visiting hours.
,NURSING 101
questions-midterm
2. At 2:00 p.m. the nurse orders a lunch tray for a client who has just been
removed from nothing by mouth (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.
Answer: 2, 3, 4
Explanation: 1. The philosophy of quality management is focus on the needs
of the client. If there is no reason for the visitors to leave other than it is
after visiting hours, this is not focused on client need.
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.
3. Quality management empowers the employee to evaluate quality.
4. This nurse has seen a need and is working to improve the quality
of service. This is quality management.
5. Salary increases can be tied to quality improvement initiatives, but just
asking for an increase is not quality management.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
5) 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. Select all that apply.
1. There is no mechanism for complaint because 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 (ANA).
5. The client can make a public report through the Agency for Healthcare
Research and Quality (AHRQ).
Answer: 2, 3, 5
Explanation: 1. The client can still voice concerns even after discharge.
, NURSING 101
questions-midterm
2. These client satisfaction surveys are a good mechanism for discussing
care issues.
3. Telephone calls are a means of discussing client care issues.
4. ANA is not a forum for complaints about care in a specific hospitalization.
5. The AHRQ has a mechanism for reporting care issues.
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
6) A client needs a high-risk surgical procedure. According to the Leapfrog
Group, the client should choose which hospital for care during this
procedure?
1. The hospital closest to the client's home
2. The hospital that has done the greatest number of these surgeries in
the last two years
3. The hospital chosen by the client's primary healthcare provider
4. The hospital with the highest performance ratings for this procedure
Answer: 4
Explanation: 1. This may or may not be the best choice of hospital for this
procedure.
2. Just because a hospital is high volume does not mean it is high quality.
3. This may or may not be the best hospital for this procedure.
4. The Leapfrog Group focuses on quality indicators including the use of
higher-performing hospitals for high-risk procedures.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Int Conc: Nursing Process: Implementation/Coordination of Care
Learning Outcome: 1-1: Explain changes to healthcare over the past decade,
including those resulting from implementation of the Affordable Care Act;
demands to reduce errors and improve patient safety; and evolving medical
and communication technology.
7) The quality management director of a large healthcare conglomerate
wishes to initiate benchmarking strategies to assess care. Which directive
should this manager publish?
1. We will compare outcome indicators with other healthcare conglomerates
of similar size and organization.
