TEST BANK FOR NURSING DELEGATION AND MANAGEMENT OF PATIENT CARE 2ND EDITION BY MOTACKI

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ANS: A Primary nursing allows the nurse to practice autonomously and make most bedside decisions. The other options are incorrect because they may not allow for the autonomy required for “point- ... of-care” decisions. DIF: Cognitive Level: Application REF: page 21 5. A nurse has accepted a position on a nursing unit where the nurse manager promotes autonomy and staff involvement in decision making. What would the nurse expect to observe on this unit? a. Nurse manager mandates changes. b. Staff takes responsibility for assignments. c. Staff participates on hospital committees. d. Nurses are recognized for excellence in practice. ANS: C Work environments that promote autonomy and decision making encourage participation on hospital committees so that staff may become involved in the decisions that are made. Option A is incorrect because this is not an environment in which staff are encouraged to participate in decision making. Option B is incorrect because it should be seen in all environments regardless of autonomy. Option D is incorrect because it is not seen solely in autonomous environments. DIF: Cognitive Level: Analysis REF: page 16 6. Leadership structures in health care can be centralized or decentralized. The nurse understands that she is working in a centralized structured environment when which of the following occurs? a. All organizational decisions must be approved by the CEO. b. Changes can be made rapidly based on immediate needs. c. Nurses must work under a dual-authority structure. d. Decisions can be made at the “point of care.” ANS: A In a centralized leadership structured environment, all decisions are made from the top down, usually without input from staff. The other options are examples of a decentralized environment in which decisions can be made more quickly as needed. DIF: Cognitive Level: Application REF: page 16 7. What should the nurse expect when working in a product-line leadership structured environment? a. Coordination of all services within the specialty b. Slow organizational response to environmental changes c. Individual service goals d. Each service area autonomous to the others ANS: A In product- or service-line leadership structures, it is necessary to have coordination of services. The other examples are not examples of product-line leadership and is an example of leadership without coordination. DIF: Cognitive Level: Application REF: page 17 8. The fundamental element of any patient care delivery combines work allocation with a. patient acuity. b. leadership. c. clinical decision making. d. delegation. ANS: C Work allocation is necessary in any patient care delivery system. The other options are incorrect because they are not necessarily useful in determining the appropriate patient care delivery systems needed. DIF: Cognitive Level: Analysis REF: page 19 9. A nurse who is interested in developing clinical decision-making skills would look for a unit that practices which model for health care delivery? a. Primary nursing b. Team nursing c. Functional nursing d. Case management ANS: A Clinical nursing skills are enhanced in a primary nursing environment because of the autonomy nurses receive. The other options do not necessarily promote the development of decision- making skills. DIF: Cognitive Level: Application REF: page 21 10. A nurse would expect to see which action on a unit that uses the team nursing model of health care delivery? a. The nurse makes patient care decisions at the bedside. b. The nurse delegates patient care to other team members. c. The nurse works on discharge plans on admission. d. The UAP takes vital signs on the patients on one hallway. ANS: B The nurse delegates and works collaboratively with the members of the team in team nursing. Option A is an example of primary nursing. Option C is an example of case management nursing. Option D is an example of functional nursing. DIF: Cognitive Level: Application REF: page 10 11. A nurse working on a unit using the primary care delivery model would expect to observe which practice specific to primary care delivery? a. The UAP measures blood sugar levels on all patients. b. The RN administers medications to a team of patients. c. The RN verifies a new order for patient started on an antihypertensive with a blood pressure of 100/60 mm Hg. d. The RN holds the morning dose of insulin for a patient scheduled for surgery later that day. ANS: D In a primary nursing environment, nurses function autonomously and make clinical decisions at the bedside. Option A is an example of functional nursing. Option B is seen in team nursing. Option C is seen in all patient care delivery models. DIF: Cognitive Level: Analysis REF: page 21 12. Which action by the nurse indicates a primary care delivery model environment? a. Development of the plan of care by primary RN to be used on all shifts b. Calling the physician for clarification after an illegible order is written c. The unit secretary takes off all orders initially. d. The charge nurse makes all patient care assignments. ANS: A The nurse develops the plan of care on admission for the remainder of the admission. The other actions are seen in many delivery care models. DIF: Cognitive Level: Analysis REF: page 21 13. In a team nursing health care delivery model environment, the nurse would observe for which action by the staff? a. The UAPs answer all call lights. b. The charge nurse is notified when there are patient complaints about care. c. The UAPs answer their patients’ call lights. d. The RN is notified when there are patient care complaints. ANS: D Nurses are completely responsible for the needs of their patients in a primary care delivery model. Option A is seen in functional nursing. Option B can be seen in models other than primary nursing. Option C is seen in team nursing. DIF: Cognitive Level: Analysis REF: page 21 MULTIPLE RESPONSE 1. The patient care delivery system used by an institution should be based on which fundamental elements? (Select all that apply.) a. Work allocation b. Accountability c. Allocation of resources d. Mission statement e. Leadership style f. Cultural diversity of patients ANS: A, B, D According to the text, work allocation, accountability, and mission statement are fundamental elements of any patient care delivery system. The other options are not fundamental elements of a patient care delivery system. DIF: Cognitive Level: Application REF: pages 18-19 Chapter 03: Strategic Management and Planning Motacki: Nursing Delegation and Management of Patient Care, 2nd Edition MULTIPLE CHOICE 1. When applying for a management position, the nurse should ask about the goals and plans of the hospital. Strategic plans must be developed around a. the mission statement. b. patient population. c. staff input. d. infection rates. ANS: A The strategic plan of an organization must comply with the mission statement. The other factors are incorrect because although they may influence the overall plan, the plan can never stray from the mission statement. DIF: Cognitive Level: Application REF: page 28 2. The strategic plan of an organization includes all stakeholders of the organization, including nurse managers. Which explains the benefit of including nurse managers in developing plans for the organization? a. Nurse managers own stock in the business. b. Nurse managers understand the clinical areas. c. Nurse managers will be involved in implementing the changes. d. Nurse managers have had business courses. ANS: C Nurse managers will be important in the implementation of the plan at the unit level. Option A is not true. Option B is not a reason for including nurse managers. Option D is not a reason for including nurse managers. DIF: Cognitive Level: Analysis REF: page 28 3. Nurse managers are included in strategic planning for the institution because of which principle? a. Nurse managers have the authority to terminate employees. b. Nurse managers encourage “buy-in” from staff. c. Nurse managers understand the need for the plan. d. Nurse managers understand the financial aspects of the organization. ANS: B Nurse managers ensure “buy-in” of the project from staff. The other options are not the reason for including nurse managers in the planning. DIF: Cognitive Level: Analysis REF: page 28 4. When interviewing for a position at a new facility, the nurse managers ask to review the mission, vision, and values statements because they understand that these statements provide information about the organization’s a. fiscal responsibility. b. direction and purpose. c. concern for uninsured. d. specific actions to be taken. ANS: B These statements are usually generalized around the direction and purpose of the organization. Mission, vision, and value statements do not address specific areas listed in the other options. DIF: Cognitive Level: Analysis REF: page 28 5. A health care organization incorporates information from which group into their strategic plan? a. Local community b. Nursing research c. Pharmaceutical research d. Insurance companies ANS: A Information from stakeholders, which would include the members of the local community, should be incorporated into their strategic plan. The other groups are not generally a source for direction that is incorporated into the strategic plan. DIF: Cognitive Level: Application REF: page 28 6. In developing mission and values statements, health care facilities incorporate tools to describe desirable behaviors of the organization. These tools describe behaviors such as a. patient risks. b. nurse/patient ratios. c. organizational direction. d. desired outcomes. ANS: C Most tools used to describe mission and values incorporate actions that are measurable. The other behaviors are not included in organizational statements. DIF: Cognitive Level: Application REF: page 28 7. Sometimes organizations use measurable critical success factors (CSFs) when developing their strategic plan. The CSFs include People, Service, Quality, Financial, Growth, and sometimes Community. Which of the definitions indicates the meaning of the term People? a. The term People represents the patients served. b. The term People represents the nurses and physicians who provide the care. c. The term People represents the community served. d. The term People represents the upper-level management. ANS: B The term People, when used as a CSF, represents those who are attracted to an environment conducive for nurturing the best in their practice. The other definitions do not represent the meaning of the term People as a CSF. DIF: Cognitive Level: Analysis REF: page 32 8. Strategic goals are developed as a result of which information source? a. Environmental scan b. Electronic medical record c. Changes in nursing practice d. Changes in staff ratios ANS: A The environmental scan is a major source for developing strategic goals and includes the competition, economic trends, etc. The other goals do not impact strategic goal development. DIF: Cognitive Level: Analysis REF: page 28 9. When referring to the critical success factors (CSFs) that organizations use for developing their strategic plans, the term Quality best describes which characteristic? a. Quality is a measurement of the product produced. b. Quality is the value of the service. c. Quality is the outcome provided when the best people are providing the best service. d. Quality is a characteristic of the service. ANS: C Quality represents the outcome of the care being provided by the best people in an institution with the best service. The other characteristics can be a definition of the term Quality but do not apply when used as a CSF. DIF: Cognitive Level: Analysis REF: page 32 10. When referring to the critical success factors (CSFs) that organizations use for developing their strategic plans, the term Financial best describes which characteristic? a. Financial indicates the economic benefits achieved. b. Financial indicates the expertise of the financial manager. c. Financial indicates the cost to the patient. d. Financial indicates the cost to the community. ANS: A The term Financial when used as a CSF indicates the economic benefits derived from the quality of the service provided by the best people. The other options do not represent the meaning of the term Financial when used as a CSF. DIF: Cognitive Level: Analysis REF: page 32 11. When referring to the critical success factors (CSFs) that organizations use for developing their strategic plans, the term Growth best describes which characteristic? a. Growth is the expansion of the specific disease. b. Growth is the aging of the population served. c. Growth is difficult-to-access health care. d. Growth is the expansion of the organization. ANS: D Growth refers to the expansion of the organization as a result of the financial benefits received from the quality outcome resulting from the service provided by the best people. The other options do not represent the meaning of the term Growth when used as a CSF. DIF: Cognitive Level: Analysis REF: page 32 12. When referring to the critical success factors (CSFs) that organizations use for developing their strategic plans, the term Community best describes which characteristic? a. Community is society. b. Community is the neighborhood surrounding the organization. c. Community identifies the people served. d. Community is the group of people working within the organization. ANS: C The Community is the end beneficiary of the growth from the financial benefits due to the quality outcomes from the service provided by the best people. The other options represent the meaning of the term Community when used as a CSF. DIF: Cognitive Level: Analysis REF: page 32 13. Which of the following could have an impact on strategic planning for a community hospital? a. Change in primary orthopedic surgeon b. Increased availability of flu shots c. Health promotion by the local nursing school d. Community health fairs ANS: A Each surgeon has their own patient load in their practice and this would change the strategic plan. The other options reduce admissions to the hospital by reducing patient illnesses or aid in identifying diseases early. DIF: Cognitive Level: Application REF: page 29 14. A community hospital has assessed the need for an automatic internal cardiac defibrillator for special procedures. Because of the reimbursement allowed from Medicare, which of the following best explains the decision made? a. An environmental scan showed no interest in the community for having these placed. b. An environmental scan showed the need for this procedure in only a few patients in the community. c. An environmental scan showed that the cost to the patient was prohibitive. d. An environmental scan showed the device has a high malfunction rate. ANS: B This hospital determined that the cost-benefit to the hospital did not make it financially beneficial to perform these procedures. The other options would not have been determined by an environmental scan. DIF: Cognitive Level: Analysis REF: page 29 15. Which of the following represents a short-term goal for an organization? a. Health education to prevent the incidence of accidents due to drunk drivers b. Heart failure education provided to every patient admitted with that diagnosis- related group c. Building a new emergency department d. Renovation of the intensive care unit ANS: B Providing education to a specific population is achievable as a short-term goal. The other options are long-term goals. DIF: Cognitive Level: Application REF: page 30 16. Action planning is a process by which organizations develop and implement both short-term and long-term goals. What would be expected in these plans? a. Identification of the strengths and weaknesses for each objective b. Identification of the impact on the community c. Specific responsibilities and timelines for each objective d. Specific patient population for each objective ANS: C Responsibilities and timelines are set for each objective. Options A and B are incorrect because they are not part of the action planning process. Option D is incorrect because action planning usually has a more global focus. DIF: Cognitive Level: Application REF: page 30 17. When identifying the objectives in an organization’s action plan, what would be an essential tool to use to improve performance? a. Benchmarking to “best in class performers” b. Patient satisfaction survey results c. Employee satisfaction survey results d. Patient population ANS: A Most objectives will identify benchmarks that they want to reach. The other options may be used but not for every objective and therefore is not essential. DIF: Cognitive Level: Analysis REF: page 30 18. Nurse managers involved in the development of the action plan for a unit understand that each objective is individualized such that a. each objective has an identified population. b. each objective has an identified resource. c. each objective has an identified goal. d. each objective has been identified by the CEO. ANS: C Each objective has a target goal or benchmark. The other options do not apply. DIF: Cognitive Level: Application REF: page 30 19. When establishing a unit action plan, the nurse manager identifies steps to be taken to accomplish the goal. What is most important for achieving the goal? a. Regularly scheduled meetings b. Administration attendance at meetings c. Staff involvement in decisions and actions d. Involvement of other departments ANS: C Without “buy-in” from staff, the likelihood of success in the plan is remote. The other options may be necessary for success but are not the most important fact [Show More]

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