,TESTBANK FOR Penner’s Economics and Financial
Management for Nurses and Nurse Leaders, 4th
Edition Knighten
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
,PENNER’S ECONOMICS AND FINANCIAL
MANAGEMENT FOR NURSES AND NURSE LEADERS
Fourth Edition
Mary Lynne Knighten, DNP, RN, NEA-BC, and
KT Waxman, DNP, MBA, RN, CNL, CENP, CHSE,
FSSH, FAONL, FAAN
Copyright © Springer Publishing Company
,Copyright © 2024 Springer Publishing Company, LLC
All rights reserved.
No part of this publication may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means, electronic, mechanical, photocopying,
recording, or otherwise, without the prior permission of Springer Publishing Company,
LLC, or authorization through payment of the appropriate fees to the Copyright
Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax
978-646-8600, or on the Web at www.copyright.com.
Springer Publishing Company, LLC
11 West 42nd Street
New York, NY 10036
www.springerpub.com
ISBN: 978-0-8261-7916-6
The authors and the publisher of this Work have made every effort to use sources
believed to be reliable to provide information that is accurate and compatible with the
standards generally accepted at the time of publication. Because medical science is
continually advancing, our knowledge base continues to expand. Therefore, as new
information becomes available, changes in procedures become necessary. We
recommend that the reader always consult current research and specific institutional
policies before performing any clinical procedure. The author and publisher shall not be
liable for any special, consequential, or exemplary damages resulting, in whole or in
part, from the readers’ use of, or reliance on, the information contained in this book. The
publisher has no responsibility for the persistence or accuracy of URLs for external or
third-party Internet websites referred to in this publication and does not guarantee that
any content on such websites is, or will remain, accurate or appropriate.
,Contents
Chapter 1: Economics of Healthcare 1
Chapter 2: Healthcare Reimbursement and Insurance 3
Chapter 3: Quantifying Nursing Care, Staffing, and Productivity 5
Chapter 4: Budget Planning 7
Chapter 5: Reporting and Managing Budgets 9
Chapter 6: Special Purpose, Capital, and Other Budgets 11
Chapter 7: Cost–Benefit Analysis 13
Chapter 8: Assessing Financial Health 15
Chapter 9: Building a Business Case 17
Chapter 10: Entrepreneurship, Contract Negotiation, and Practice Management 19
Chapter 11: Grant Writing for Health Program 21
Chapter 12: Ethical Issues and Financial Issues in International Healthcare Systems 23
Chapter 13: Health Policy and Future Trends 25
,CHAPTER 1: ECONOMICS OF HEALTHCARE
1. Healthcare is an important segment of the U.S. economy because:
a. The greater the quantity of hip replacements, the fewer the automobiles supplied.
b. Nurses keep fighting for higher and higher wages.
c. Healthcare costs have been completely controlled by managed care.
*d. National healthcare expenditures are an increasing portion of the GDP.
2. Two influences that increase the quantity of healthcare demanded include:
*a. income and insurance.
b. ancient history and monopsony.
c. hospital revenue and transparency.
d. market power and market failure.
3. Which of the following is NOT a characteristic of a market surplus?
a. The product’s market price is higher than the equilibrium price.
b. Producers reduce the product’s price to bring the market to competitive equilibrium.
*c. The quantity demanded for the product exceeds the quantity supplied.
d. The quantity supplied exceeds the quantity demanded by consumers.
4. There are three key principles integrated in the definition of economics (how resource allocation
occurs).
*a. Resources are scarce or finite, resources can be used for multiple reasons, and each person has
different preferences, wants, and needs.
b. Resources are expensive, resources can be used for multiple reasons, and each person has
different preferences, wants, and needs.
c. Resources are scarce or finite, resources can be used for multiple reasons, and individual
preferences are less important than population needs.
d. Resources are infinitely renewable, resources can be used for multiple reasons, and each person
has different preferences, wants, and needs.
5. One effective way to resolve a nursing shortage in a labor market with a monopsony is:
a. replace all RNs with nurse assistants.
b. ask physicians to write fewer orders.
*c. increase nurses’ wages.
d. close hospitals.
6. Concerns about healthcare costs arose:
*a. soon after the passage of Title XVIII and Title XIX of the Social Security Act of 1965 Medicare
and Medicaid programs.
b. at the dawn of human history.
c. as a result of World War II shortages.
d. when the U.S. healthcare costs surpassed 15% of GDP.
7. The price for a good or service falls. What likely happens to the quantity supplied?
a. increases
b. levels off
© Springer Publishing Company, LLC 1
, c. is not affected by price
*d. decreases
8. A good example of an input is:
a. a nurse giving care to a patient who is hospitalized.
*b. a patient arriving at the emergency room needing care.
c. a patient leaving a clinic after seeing a nurse practitioner.
d. a hospital building a new surgical center.
9. One reason healthcare markets are not competitive is that:
*a. There are often no suitable substitutes.
b. Healthcare markets are based on communist theory.
c. No one can enter or leave a healthcare market.
d. The prices for medical care are too high.
10. An example of public goods is:
a. a federal holiday.
b. social security taxes.
c. market equilibrium.
*d. safe drinking water.
© Springer Publishing Company, LLC 2
,CHAPTER 2: HEALTHCARE REIMBURSEMENT AND
INSURANCE
1. What is an important characteristic of asymmetric information in healthcare markets?
a. Physicians always know more about a patient’s condition than the patient.
b. Patients always know more about their condition than the physician.
*c. One party has knowledge that the other party does not.
d. One party has to pay the other party for information.
2. Americans who do not have health insurance not only face increased health risks, but:
*a. They face financial risks such as credit problems and bankruptcy.
b. They are always poor and unemployed.
c. They should stop trying to obtain preventive care.
d. They are automatically enrolled in Medicaid.
3. Nearly a third of the U.S. health expenditures:
a. are allocated to the care of children.
*b. go to support hospital services.
c. fund public health programs.
d. are spent on pharmaceuticals.
4. An example of cost shifting is:
a. requiring health plan members to pay an annual premium.
b. finding ways to reduce waste and improve the collection of payments.
c. dropping out of one health plan because another plan seems better.
*d. charging private payers more to cover other unreimbursed costs.
5. Coinsurance represents the percent of health costs the insurer requires the consumer to pay, while:
a. deductibles have been outlawed by the ACA.
b. a lifetime cap is required to control excessive costs.
*c. a copayment is another form of cost sharing.
d. cost sharing is not a concern if the consumer is insured.
6. In managed care settings, capitation:
a. aligns incentives so that adverse selection disappears.
b. is unnecessary except for government contracts.
*c. encourages providers to reduce healthcare costs.
d. induces demand for services.
7. The ACA led to hospitals:
a. refusing to treat Medicaid patients.
b. focusing more on volume than on the quality of care.
c. increasing preventable readmissions whenever possible.
*d. participating in the value-based purchasing program.
8. ACOs are similar to MCOs, however:
a. ACOs are far more expensive.
© Springer Publishing Company, LLC 3
, b. ACOs do not provide medical homes.
*c. ACOs do not permit gatekeeping.
d. ACOs are a much older model of healthcare delivery.
9. FFS is a volume-based payment system because:
a. reimbursement is tied to a patient’s income level.
b. reimbursement is spread over the entire risk pool.
*c. reimbursement depends on utilization.
d. reimbursement depends on deductibles.
10. State regulation and accreditation requirements for quality reporting by MCOs help address potential
problems with:
a. over-care.
b. rising costs.
*c. under-care.
d. outliers.
© Springer Publishing Company, LLC 4
, CHAPTER 3: QUANTIFYING NURSING CARE, STAFFING, AND
PRODUCTIVITY
1. Major categories of indicators relevant to nursing care include:
a. FTEs, local prices, market value, and wage indicators.
*b. capacity, utilization, performance, and financial indicators.
c. revenue, expense, educational level, and income indicators.
d. educational level, income, local prices, and market value indicators.
2. Capacity that does not change if the volume of patients changes is known as:
*a. fixed capacity.
b. variable capacity.
c. intermittent capacity.
d. structural capacity.
3. Inpatient acuity influences:
a. the number of physicians who are available.
b. the contractual adjustments for revenue.
c. the number of licensed beds on the unit.
*d. the HPPD required for direct care.
4. Examples of productivity measures are:
a. patient days
b. visits
c. procedures
*d. all of the above.
5. The average daily census is calculated by dividing:
a. days in a time period by patient days.
b. the number of beds by patient days.
*c. patient days by days in a time period.
d. the number of beds by days in a time period.
6. The occupancy rate measures how closely the patient census:
*a. comes to the unit’s full capacity.
b. comes to the number of nurses staffed each shift.
c. comes to earning a profit for the hospital.
d. comes to established quality benchmarks.
7. One reason nurse staffing is important to measure is that:
a. profitability depends on keeping staffing as low as possible.
b. the structural capacity of a hospital consists of staffing.
c. the more nurses on the staff, the fewer physicians are needed.
*d. nursing costs make up a large portion of a hospital’s budget.
8. FTEs are often used to measure nurse staffing, rather than job positions:
a. because this approach makes the calculations more complicated.
© Springer Publishing Company, LLC 5
Management for Nurses and Nurse Leaders, 4th
Edition Knighten
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
,PENNER’S ECONOMICS AND FINANCIAL
MANAGEMENT FOR NURSES AND NURSE LEADERS
Fourth Edition
Mary Lynne Knighten, DNP, RN, NEA-BC, and
KT Waxman, DNP, MBA, RN, CNL, CENP, CHSE,
FSSH, FAONL, FAAN
Copyright © Springer Publishing Company
,Copyright © 2024 Springer Publishing Company, LLC
All rights reserved.
No part of this publication may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means, electronic, mechanical, photocopying,
recording, or otherwise, without the prior permission of Springer Publishing Company,
LLC, or authorization through payment of the appropriate fees to the Copyright
Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax
978-646-8600, or on the Web at www.copyright.com.
Springer Publishing Company, LLC
11 West 42nd Street
New York, NY 10036
www.springerpub.com
ISBN: 978-0-8261-7916-6
The authors and the publisher of this Work have made every effort to use sources
believed to be reliable to provide information that is accurate and compatible with the
standards generally accepted at the time of publication. Because medical science is
continually advancing, our knowledge base continues to expand. Therefore, as new
information becomes available, changes in procedures become necessary. We
recommend that the reader always consult current research and specific institutional
policies before performing any clinical procedure. The author and publisher shall not be
liable for any special, consequential, or exemplary damages resulting, in whole or in
part, from the readers’ use of, or reliance on, the information contained in this book. The
publisher has no responsibility for the persistence or accuracy of URLs for external or
third-party Internet websites referred to in this publication and does not guarantee that
any content on such websites is, or will remain, accurate or appropriate.
,Contents
Chapter 1: Economics of Healthcare 1
Chapter 2: Healthcare Reimbursement and Insurance 3
Chapter 3: Quantifying Nursing Care, Staffing, and Productivity 5
Chapter 4: Budget Planning 7
Chapter 5: Reporting and Managing Budgets 9
Chapter 6: Special Purpose, Capital, and Other Budgets 11
Chapter 7: Cost–Benefit Analysis 13
Chapter 8: Assessing Financial Health 15
Chapter 9: Building a Business Case 17
Chapter 10: Entrepreneurship, Contract Negotiation, and Practice Management 19
Chapter 11: Grant Writing for Health Program 21
Chapter 12: Ethical Issues and Financial Issues in International Healthcare Systems 23
Chapter 13: Health Policy and Future Trends 25
,CHAPTER 1: ECONOMICS OF HEALTHCARE
1. Healthcare is an important segment of the U.S. economy because:
a. The greater the quantity of hip replacements, the fewer the automobiles supplied.
b. Nurses keep fighting for higher and higher wages.
c. Healthcare costs have been completely controlled by managed care.
*d. National healthcare expenditures are an increasing portion of the GDP.
2. Two influences that increase the quantity of healthcare demanded include:
*a. income and insurance.
b. ancient history and monopsony.
c. hospital revenue and transparency.
d. market power and market failure.
3. Which of the following is NOT a characteristic of a market surplus?
a. The product’s market price is higher than the equilibrium price.
b. Producers reduce the product’s price to bring the market to competitive equilibrium.
*c. The quantity demanded for the product exceeds the quantity supplied.
d. The quantity supplied exceeds the quantity demanded by consumers.
4. There are three key principles integrated in the definition of economics (how resource allocation
occurs).
*a. Resources are scarce or finite, resources can be used for multiple reasons, and each person has
different preferences, wants, and needs.
b. Resources are expensive, resources can be used for multiple reasons, and each person has
different preferences, wants, and needs.
c. Resources are scarce or finite, resources can be used for multiple reasons, and individual
preferences are less important than population needs.
d. Resources are infinitely renewable, resources can be used for multiple reasons, and each person
has different preferences, wants, and needs.
5. One effective way to resolve a nursing shortage in a labor market with a monopsony is:
a. replace all RNs with nurse assistants.
b. ask physicians to write fewer orders.
*c. increase nurses’ wages.
d. close hospitals.
6. Concerns about healthcare costs arose:
*a. soon after the passage of Title XVIII and Title XIX of the Social Security Act of 1965 Medicare
and Medicaid programs.
b. at the dawn of human history.
c. as a result of World War II shortages.
d. when the U.S. healthcare costs surpassed 15% of GDP.
7. The price for a good or service falls. What likely happens to the quantity supplied?
a. increases
b. levels off
© Springer Publishing Company, LLC 1
, c. is not affected by price
*d. decreases
8. A good example of an input is:
a. a nurse giving care to a patient who is hospitalized.
*b. a patient arriving at the emergency room needing care.
c. a patient leaving a clinic after seeing a nurse practitioner.
d. a hospital building a new surgical center.
9. One reason healthcare markets are not competitive is that:
*a. There are often no suitable substitutes.
b. Healthcare markets are based on communist theory.
c. No one can enter or leave a healthcare market.
d. The prices for medical care are too high.
10. An example of public goods is:
a. a federal holiday.
b. social security taxes.
c. market equilibrium.
*d. safe drinking water.
© Springer Publishing Company, LLC 2
,CHAPTER 2: HEALTHCARE REIMBURSEMENT AND
INSURANCE
1. What is an important characteristic of asymmetric information in healthcare markets?
a. Physicians always know more about a patient’s condition than the patient.
b. Patients always know more about their condition than the physician.
*c. One party has knowledge that the other party does not.
d. One party has to pay the other party for information.
2. Americans who do not have health insurance not only face increased health risks, but:
*a. They face financial risks such as credit problems and bankruptcy.
b. They are always poor and unemployed.
c. They should stop trying to obtain preventive care.
d. They are automatically enrolled in Medicaid.
3. Nearly a third of the U.S. health expenditures:
a. are allocated to the care of children.
*b. go to support hospital services.
c. fund public health programs.
d. are spent on pharmaceuticals.
4. An example of cost shifting is:
a. requiring health plan members to pay an annual premium.
b. finding ways to reduce waste and improve the collection of payments.
c. dropping out of one health plan because another plan seems better.
*d. charging private payers more to cover other unreimbursed costs.
5. Coinsurance represents the percent of health costs the insurer requires the consumer to pay, while:
a. deductibles have been outlawed by the ACA.
b. a lifetime cap is required to control excessive costs.
*c. a copayment is another form of cost sharing.
d. cost sharing is not a concern if the consumer is insured.
6. In managed care settings, capitation:
a. aligns incentives so that adverse selection disappears.
b. is unnecessary except for government contracts.
*c. encourages providers to reduce healthcare costs.
d. induces demand for services.
7. The ACA led to hospitals:
a. refusing to treat Medicaid patients.
b. focusing more on volume than on the quality of care.
c. increasing preventable readmissions whenever possible.
*d. participating in the value-based purchasing program.
8. ACOs are similar to MCOs, however:
a. ACOs are far more expensive.
© Springer Publishing Company, LLC 3
, b. ACOs do not provide medical homes.
*c. ACOs do not permit gatekeeping.
d. ACOs are a much older model of healthcare delivery.
9. FFS is a volume-based payment system because:
a. reimbursement is tied to a patient’s income level.
b. reimbursement is spread over the entire risk pool.
*c. reimbursement depends on utilization.
d. reimbursement depends on deductibles.
10. State regulation and accreditation requirements for quality reporting by MCOs help address potential
problems with:
a. over-care.
b. rising costs.
*c. under-care.
d. outliers.
© Springer Publishing Company, LLC 4
, CHAPTER 3: QUANTIFYING NURSING CARE, STAFFING, AND
PRODUCTIVITY
1. Major categories of indicators relevant to nursing care include:
a. FTEs, local prices, market value, and wage indicators.
*b. capacity, utilization, performance, and financial indicators.
c. revenue, expense, educational level, and income indicators.
d. educational level, income, local prices, and market value indicators.
2. Capacity that does not change if the volume of patients changes is known as:
*a. fixed capacity.
b. variable capacity.
c. intermittent capacity.
d. structural capacity.
3. Inpatient acuity influences:
a. the number of physicians who are available.
b. the contractual adjustments for revenue.
c. the number of licensed beds on the unit.
*d. the HPPD required for direct care.
4. Examples of productivity measures are:
a. patient days
b. visits
c. procedures
*d. all of the above.
5. The average daily census is calculated by dividing:
a. days in a time period by patient days.
b. the number of beds by patient days.
*c. patient days by days in a time period.
d. the number of beds by days in a time period.
6. The occupancy rate measures how closely the patient census:
*a. comes to the unit’s full capacity.
b. comes to the number of nurses staffed each shift.
c. comes to earning a profit for the hospital.
d. comes to established quality benchmarks.
7. One reason nurse staffing is important to measure is that:
a. profitability depends on keeping staffing as low as possible.
b. the structural capacity of a hospital consists of staffing.
c. the more nurses on the staff, the fewer physicians are needed.
*d. nursing costs make up a large portion of a hospital’s budget.
8. FTEs are often used to measure nurse staffing, rather than job positions:
a. because this approach makes the calculations more complicated.
© Springer Publishing Company, LLC 5
