The Health Care Organization and Patterns of Nursing Care Delivery
Zerwekh: Nursing Today: Transition and Trends, 10th Edition
MULTIPLE CHOICE
1. How
... [Show More] does managed care affect the economics of health care delivery?
a. Provides incentives for smaller private or individual hospitals
b. Increases the tax base for the community
c. Uses corporate economics to achieve a profit
d. Care is paid for at a prearranged rate
ANS: D
Under a managed care system, care is paid for at a prearranged rate, rather than at the billed rate. This was the start of efforts to
reduce health care costs. Managed care does not increase the community tax base because the costs are paid by the patients and
their insurance. Managed care is more of an incentive for larger hospitals and corporations. The focus is to reduce duplication of
services and not to use corporate economics to achieve a profit.
DIF: Cognitive Level: Knowledge/Remembering
OBJ: Describe the challenges facing health care that impact the delivery of nursing care, including reduction of cost. TOP:
Organizational structure MSC: NCLEX®: Not applicable
2. Which statement regarding characteristics of clinical pathways shows the nurse’s lack of understanding?
a. “Clinical pathways focus on patient outcomes.”
b. “Clinical pathways use a timeline with sequenced interventions.”
c. “Clinical pathways collaborate efforts by health care professionals.”
d. “Clinical pathways involve nurse-centered orientation.”
ANS: D
Clinical pathways help reduce expensive variations in care. Clinical pathways are interdisciplinary plans of care that outline the
optimal sequencing and timing of interventions for patients with a particular diagnosis, procedure, or symptom. Clinical pathways
are not a nurse-centered orientation.
DIF: Cognitive Level: Evaluation/Evaluating
OBJ: Describe the challenges facing health care that impact the delivery of nursing care, including reduction of cost. TOP: Patterns of
nursing care delivery MSC: NCLEX®: Not applicable
3. Which statement shows the nurse’s understanding of patient-focused care?
a. “Patient-focused care is a nursing care delivery system.”
b. “Patient-focused care is a model for a health care organization.”
c. “Patient-focused care is a clinical pathway within an institution.”
d. “Patient-focused care is an institutional value and philosophy.”
ANS: A
Patient-focused care is another type of delivery system. The level of productivity is increased through centralization of functions
(e.g., phlebotomy, diet instruction, and respiratory therapy) on the unit under the direction of the nurse and cross-training ancillary
workers to do more than one function. The patient comes into contact with fewer people under this organizational framework.
DIF: Cognitive Level: Evaluation/Evaluating
OBJ: Trace the history of the use of nursing care delivery models.
TOP: Trends in health care MSC: NCLEX®: Not applicable
4. Which statement by the nurse manager is inaccurate regarding the forces of magnetism? “Forces of magnetism include
a. professional models of care.”
b. consultation and resources.”
c. cost reduction and sound budgets.”
d. nurses as teachers.”
ANS: C
The forces of magnetism include professional models of care, consultation and resources, and nurses as teachers among several
others. Budgets are not included.
DIF: Cognitive Level: Comprehension/Understanding REF: Box 15.1
OBJ: Describe the challenges facing health care that impact the delivery of nursing care.
TOP: Patterns of nursing care delivery MSC: NCLEX®: Not applicable
5. A nurse manager is training a new hire. Which statement shows an understanding of functional nursing?
a. “Functional nursing is organized around tasks.”
b. “Functional nursing is patient led.”
c. “Functional nursing is physician led.”
d. “Functional nursing is unorganized.”
ANS: A
Functional nursing is where nursing care is broke into a series of tasks performed by many people, which results in a fragmented,
impersonal kind of care. Fragmentation of care caused patient problems to be overlooked because they did not fit into a defined
assignment. Aides, vocational nurses, and licensed practical nurses are allowed to perform specific functions. None of the other
statements is correct.
DIF: Cognitive Level: Comprehension/Understanding
OBJ: Discuss the history of the use of nursing care delivery models.
TOP: Patterns of nursing care delivery MSC: NCLEX®: Not applicable
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6. Which of the following statements shows the nurse’s understanding of primary nursing?
a. “One nurse plans and directs patient care over 24 hours.”
b. “Involves care for 48 hours or more”
c. “Includes only one nurse planning care for the patient”
d. “Is the only method of care used today”
ANS: C
In primary nursing, the fragmentation between shifts and nurses [Show Less]