Sullivan, Effective Leadership and Management, 8/e
Chapter 1
Question 1
Type: MCSA
A nurse manager is participating in the health care organization’s strategic planning committee. Which factor is
the primary driving force and controlling factor in new initiatives this committee might recommend?
1. Cost of care
2. Access to care
3. Availability of care
4. Quality of care
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1-1: Describe the forces that are changing the health care system.
Question 2
Type: MCSA
A nurse has been invited to discuss health care costs at a senior citizens’ club. What information should the nurse
plan to include in this discussion?
1. While health care costs continue to rise, the percentage of the U.S. economy spent on health care has slowly
declined to less than 12%.
Sullivan, Effective Leadership and Management, 8/e Test Bank
2. Regulations brought about by the Patient Protection and Affordable Care Act (PPACA) should bring financial
relief to health care consumers.
3. The United States spends more money on health care than any other country.
4. Health care spending in the United States is slowly declining due to passage of bills such as the Patient
Protection and Affordable Care Act (PPACA).
Rationale 3: The Centers for Medicare and Medicaid Services no longer cover the costs incurred by medical
mistakes. This urinary tract infection could cost the hospital the cost of treatment, including increased length of
stay.
Rationale 4: The nurse has identified that improper care may result in poor outcomes for the client.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 1-2: Discuss changes in paying for health care.
Question 4
Type: MCMA
Which health care situations reflect the philosophy of quality management as designed by Deming?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. A nurse asks visitors to leave because it is after visiting hours.
2. At 2:00 p.m. the nurse orders a lunch tray for a client who has just been removed from NPO status.
3. A nurse tells the manager that a housekeeper’s work is not up to standards.
4. A nurse volunteers to take a Spanish language class to be able to communicate with clients.
5. A nurse who has not made a medication error in two years asks for a salary increase.
Rationale 5: Salary increases can be tied to quality improvement initiatives, but just asking for an increase is not
quality management.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1-3: Explain how quality initiatives can reduce medical errors.
Question 5
Type: MCMA
A client who was discharged yesterday is very upset about the quality of care received during hospitalization for
gastric surgery. What options for reporting concerns does this client have?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. There is no mechanism for complaint as the client is no longer hospitalized.
2. The client can indicate dissatisfaction on the survey often sent to clients after discharge.
3. The client can call the hospital administration.
4. The client can make a formal complaint through the American Nursing Association.
5. The client can make a public report through the Agency for Healthcare Research and Quality.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1-3: Explain how quality initiatives can reduce medical errors.
Question 6
Type: MCSA
A client needs a high-risk surgical procedure. According to the Leapfrog Group, the client should choose which
hospital for care during this procedure?
1. The hospital closest to the client’s home
2. The hospital that has done the greatest number of these surgeries in the last two years
3. The hospital chosen by the client’s primary care physician
4. The hospital with the highest performance ratings for this procedure
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1-3: Explain how quality initiatives can reduce medical errors.
Question 7
Type: MCSA
The quality management director of a large health care conglomerate wishes to initiate benchmarking strategies to
assess care. Which directive should this manager publish?
1. We will compare outcome indicators with other health care conglomerates of similar size and organization.
Sullivan, Effective Leadership and Management, 8/e Test Bank
2. Outcome data of hospitals within the organization will be compared to assess quality.
3. Each client care unit in the organization will establish specific unit goals for quality.
4. Each unit in the organization will create a quality monitor to assess how well unit policies are followed.
Rationale 4: Acquiring the evidence to answer the question is step 2.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1-4: Describe how evidence-based practice is changing nursing.
Question 9
Type: MCSA
The nurse manager asks a staff nurse why a procedure is done in a certain manner. The nurse replies, “I don’t
know why I started doing it this way. I’ve never read any research on it, but this technique always works for me.”
The manager would place this technique into which category of evidence?
1. Case study
2. Anecdotal
3. Nonexperimental design research
4. Statistical
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1-4: Describe how evidence-based practice is changing nursing.
Question 10
Type: MCMA
Sullivan, Effective Leadership and Management, 8/e Test Bank
A nurse manager is directing a team of staff nurses working to solve a clinical problem using evidence-based
practice (EBP). Which manager statements would direct these nurses to the forms of strongest clinical evidence?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. “We may find studies that use only one group of subjects.”
2. “Look for articles that report on how to use evidence in other clinical situations.”
3. “The studies we want are built around the scientific approach to solving problems.”
4. “Our focus should be on studies that use both experimental and control groups to determine intervention
effectiveness.”
5. “Many articles will have information reported by someone who is an expert in the field.”
A health care system is considering applying to the Magnet Recognition Program. The leaders of this health
system should prepare to address ________ qualities or “Forces of Magnetism.”
Standard Text:
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
Learning Outcome: 1-5: Explain how to become a Magnet-certified hospital.
Question 13
Type: MCSA
A graduating nurse student is deciding which nursing specialty would be a good place to begin a nursing career
and ensure long-term stability. Which specialty is most likely to have the greatest growth in need?
1. Pediatric nursing
2. Psychiatric nursing
3. Geriatric nursing
4. Maternity nursing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1-9: Discuss the changes and challenges that nurses face now and into the future.
Question 14
Type: MCSA
The nurse manager overhears staff discussing the shortage of nurses. Which statement by a staff member would
the manager evaluate as misinformation?
1. “There are more nurses retiring than are entering the profession.”
2. “The demand for nurses is declining because of fewer hospital admissions.”
3. “There are insufficient numbers of nursing faculty to teach interested students.”
Sullivan, Effective Leadership and Management, 8/e Test Bank