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
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
3. The family of an elderly client demonstrates understanding of diagnosis-related groups
(DRGs) when which statement is made?
1. “Since he has the same diagnosis as others who were able to be discharged early,
he has to be discharged.”
2. “Since the average length of stay for his diagnosis is exceeded, he must be
discharged from the hospital. “
3. “Medicare will continue to pay for his care for as long as he
requires hospital care.”
4. “Since he has does not have several related medical issues and diagnoses,
Medicare requires him to be discharged.”
Learning Objective 2
List the factors that contribute to the rising cost of health care.
4. Which is the United States’ largest and most expensive health care program?
1. Temporary Assistance for Needy Families (TANF)
2. Social Security
3. Medicare
4. Medicaid
5. Which factors make health care costs difficult to control? Select all that apply.
1. Technology replacement costs
2. People living longer
3. Focus on disease
4. The medically uninsured
5. Disease-prevention strategies
6. The nurse manager overhears a group of staff nurses discussing the shortage of nurses. Which
statement by a nurse indicates the need for further information?
1. “The number of women in nursing still outnumbers men and minorities.”
2. “There are insufficient numbers of nursing faculty to teach interested students.”
3. “The demand for nurses is declining because of fewer hospital admissions.”
4. “There are more nurses retiring than are entering the profession.”
7. A graduating nurse is deciding which nursing specialty would be a good place to begin a
nursing career to ensure long-term stability. Which specialty is most likely to grow in need?
1. Pediatric nursing
2. Psychiatric nursing
3. Maternity nursing
4. Geriatric nursing
8. Of which aspect of nursing in today’s health care system must an effective nurse manager be
aware? Select all that apply.
1. Consistency
2. Complicated technology
3. Adequate staffing
4. Increasing number of retirees
5. Decreasing resources
9. Which action by nurse managers and/or staff will positively impact the nursing shortage?
1. Focus on the recruitment of middle school and high school students, men, and
minorities to the nursing profession.
2. Work towards shorter hospital stays, resulting in decreasing need of nurses in
acute care settings.
3. Encourage current nursing faculty members to return to work in positions
working directly with clients instead of with students.
4. Increase nursing wages.
Learning Objective 4
Differentiate leadership from management.
10. A newly licensed registered nurse recently was hired to work in an acute care facility. Which
of the following management tasks is anticipated within the nurse’s scope of responsibility?
Select all that apply.
1. Delegate tasks to nonprofessional personnel.
2. Plan unit budget with decreasing resources.
3. Evaluate client care.
4. Supervise nonprofessional personnel.
5. Complete performance evaluations on staff.
11. Which statement explains why nurses must be leaders to be successful in client care?
1. Only nurses as leaders can function in managed care.
2. Only nurses as leaders have physician respect.
3. Nurses must direct client-care activities to reach outcomes.
4. Nurses must be effective at giving orders.
12. Which is a difference between nurses as leaders and nurses as managers?
1. Nurses as leaders are born, and nurses as managers demonstrate a learned skill.
2. Leaders have good interpersonal skills, while nurses as managers do not.
3. Leaders focus on a specific goal, and managers focus on multiple goals.
4. Good leaders are always good managers, but managers are not always good
leaders.
Learning Objective 5
Evaluate the situational-behavioral framework of leadership/management.
13. Which most accurately describes the situational-behavioral framework for nursing
leadership/management? It is based:
1. Solely on the nurse’s experience.
2. On flexibility in management behaviors.
3. On the critical nature of the incident.
4. Solely on the nurse manager’s leadership skills.
14. Which situation is most likely to lead to the highest reimbursement for health care
services used by a client?
1. A postoperative day 4 client is discharged a day earlier than expected.
2. The provider chosen is not within the provider network provided by the client’s
point-of-service managed care organization.
3. The client has insurance coverage through a health maintenance organization
(HMO), and seeks care from someone other than the primary care provider.
4. A client receives care from an extremely busy primary care provider who belongs
to a medical group receiving capitated fees.
15. When a nursing instructor is discussing health care coverage in the United States, which
description should be omitted?
1. The United States has one of the best health care systems in the world.
2. Care in the United States is available for everyone.
3. Health care spending will double in the next decade.
4. The managed care system has helped control costs.