Chapter 15: The Health Care Organization
and Patterns of Nursing Care Delivery
MULTIPLE CHOICE
1. A nurse is interested in case management. Which statement indicates an
understanding of the primary work environment of case managers?
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.” .
ANS: D
Nurses who are case managers work in all types of health care institutions. They may
also work for insurance or utilization review companies or in health-related areas of
various types of large businesses. Registered nurses, social workers, and therapists
may all be case managers, but how they perform their role depends on the scope of
practice of their discipline. All case managers must be skilled at communication,
critical thinking, negotiation, and collaboration. They must be knowledgeable about
resources available to patients. The case manager not only deals with individual
patients but also with family and other support systems of the patient; however, a case
manager’s work is not focused on just the community. .
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 329 OBJ: Trace the history of the use of nursing care delivery
models. TOP: Case managers MSC: NCLEX®: Not applicable.
,2. 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 have been used to determine the number of nurses needed on a unit
at any one time.
ANS: D.
A patient classification or acuity system is used in many acute care hospitals to
estimate the intensity of nursing care required to meet patient needs. This system does
not measure the needs of all patients, is not used an as absolute formula for unit
staffing, and is not used to make patient assignments. Patient acuity is the measure of
categorizing patients based on their nursing care requirements.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering REF: p. 347
OBJ: Describe challenges facing health care that impact the delivery of
nursing care.
TOP: Coordination of care and cost control MSC: NCLEX®: Not applicable
3. 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.
ANS: D
, The IOM reported that it took 17 years for research to be reflected into daily practice.
Evidence-based practice is the use of the current best evidence to provide care and
make decisions regarding patient care. Evidence-based practice is not a method of
improving nursing care and maintaining cost containment. Insurance companies do
not review the evidence of health care practice for reimbursement. Evidence-based
practice does not achieve large-scale economics while providing cost-effective care.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering REF: p. 332
OBJ: Describe challenges facing health care that impact the delivery of
nursing care.
TOP: Evidence-based practice MSC: NCLEX®: Not applicable.
4. 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
ANS: B
This is an example of primary care nursing, in which the nurse is the principal or
primary person to manage and coordinate the patient’s care around the clock. Patient-
focused care is an interdisciplinary approach to patient care. Functional care is the
provision of care by nursing and nursing ancillary staff rather than by an all-nursing
staff as seen in primary care nursing. Case management is a model of care delivery in
which a nurse case manager coordinates and collaborates with other health services
when a patient has complicated health care needs, but the case manager may not be
involved in the daily care activities of the patient. .
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
and Patterns of Nursing Care Delivery
MULTIPLE CHOICE
1. A nurse is interested in case management. Which statement indicates an
understanding of the primary work environment of case managers?
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.” .
ANS: D
Nurses who are case managers work in all types of health care institutions. They may
also work for insurance or utilization review companies or in health-related areas of
various types of large businesses. Registered nurses, social workers, and therapists
may all be case managers, but how they perform their role depends on the scope of
practice of their discipline. All case managers must be skilled at communication,
critical thinking, negotiation, and collaboration. They must be knowledgeable about
resources available to patients. The case manager not only deals with individual
patients but also with family and other support systems of the patient; however, a case
manager’s work is not focused on just the community. .
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 329 OBJ: Trace the history of the use of nursing care delivery
models. TOP: Case managers MSC: NCLEX®: Not applicable.
,2. 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 have been used to determine the number of nurses needed on a unit
at any one time.
ANS: D.
A patient classification or acuity system is used in many acute care hospitals to
estimate the intensity of nursing care required to meet patient needs. This system does
not measure the needs of all patients, is not used an as absolute formula for unit
staffing, and is not used to make patient assignments. Patient acuity is the measure of
categorizing patients based on their nursing care requirements.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering REF: p. 347
OBJ: Describe challenges facing health care that impact the delivery of
nursing care.
TOP: Coordination of care and cost control MSC: NCLEX®: Not applicable
3. 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.
ANS: D
, The IOM reported that it took 17 years for research to be reflected into daily practice.
Evidence-based practice is the use of the current best evidence to provide care and
make decisions regarding patient care. Evidence-based practice is not a method of
improving nursing care and maintaining cost containment. Insurance companies do
not review the evidence of health care practice for reimbursement. Evidence-based
practice does not achieve large-scale economics while providing cost-effective care.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering REF: p. 332
OBJ: Describe challenges facing health care that impact the delivery of
nursing care.
TOP: Evidence-based practice MSC: NCLEX®: Not applicable.
4. 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
ANS: B
This is an example of primary care nursing, in which the nurse is the principal or
primary person to manage and coordinate the patient’s care around the clock. Patient-
focused care is an interdisciplinary approach to patient care. Functional care is the
provision of care by nursing and nursing ancillary staff rather than by an all-nursing
staff as seen in primary care nursing. Case management is a model of care delivery in
which a nurse case manager coordinates and collaborates with other health services
when a patient has complicated health care needs, but the case manager may not be
involved in the daily care activities of the patient. .
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
