LEADERSHIP AND
MANAGEMENT IN
NURSING, 4TH
EDITION, MARY
ELLEN GROHAR-
MURRAY
, Chapter 1: The Health Care System: Environment for Nursing Leadership
Learning Objective 1
Identify the major forces dominating the health care system today.
1. When planning client care, the nurse must be aware that current changes in health care are
primarily driven by which force?
1. Availability of care
2. Cost of care
3. Access to care
4. Quality of care
Answer: 2
Rationale: Cost is the primary factor driving the changes in health care because rising costs
affect access to care, availability of care, and quality of care.
Nursing Process: Planning
Client Need: Safe, Effective Care Environment
Cognitive Level: Application
2. Fewer professional nurses on each unit will have which effect in the health care system of the
future?
1. Increased quality of client care
2. Cost savings passed on to the client
3. Decreased mortality rates
4. Negative outcomes with surgical clients