Deck 4: Nursing Care Delivery Systems

Question 1

The nurse administrator is considering employing an advanced practice nurse. The administrator would refer to which documents to determine this nurse's role in the hospital's nursing care delivery model?

A) The State Board of Nursing scope of practice information
B) The job description for the advanced practice nurse
C) The Joint Commission standards for nursing practice
D) The curriculum of the advanced practice nurse's educational program

Answer 1

The State Board of Nursing scope of practice information

Question 2

The nurse's chief function is to collaboratively plan, coordinate, and evaluate services in a cost-effective manner. The nurse fulfills which role within the care delivery system?

A) Nurse practitioner
B) Clinical nurse specialist
C) Clinical nurse leader
D) Case manager

Answer 2

Case manager

Question 3

Which characteristics of the primary nursing model make it a good match with the goals of the IOM and National Quality Forum? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) There are fewer RNs, so care is less expensive.
B) Primary nursing creates new possibilities for collaborative success.
C) Primary nursing supports efforts to make patient care safer.
D) The model allows the nurse to coordinate care across many disciplines.
E) Primary nursing reduces the need for communication and documentation.

Answer 3

Primary nursing creates new possibilities for collaborative success.
Primary nursing supports efforts to make patient care safer.
The model allows the nurse to coordinate care across many disciplines.

Question 4

A hospital utilizes the functional nursing care delivery system, and patient satisfaction scores have been falling in each quarter of the past year. What is a likely reason for this decrease? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Utilization of advanced practice nurses on the unit
B) Efficient nursing staff
C) Lack of confidence in the caregivers
D) Lower health care costs
E) Fragmentation of the nursing care

Question 5

A hospital's nursing administration is considering moving to a patient-centered care model. What are the benefits of this model?

A) It is less expensive as it requires fewer registered nurses.
B) Care can be provided more efficiently.
C) This care delivery method increases patient satisfaction.
D) It standardizes care, therefore reducing the need for large supply or medication inventories.

Question 6

The nurse manager has been charged with evaluating whether the current system of team nursing is efficient and cost-effective for the unit. Which statement supports the cost-effectiveness of team nursing on this unit?

A) Team nursing is cost-effective because it allows for the use of unlicensed assistive personnel to provide care delegated by the registered nurse.
B) Research concludes that team nursing is the most cost-effective care delivery system.
C) Managed care organizations provide financial incentives to institutions that use team nursing as a means to decrease the high cost of registered nurse salaries.
D) The Institute of Medicine's 2004 report Keeping Patients Safe identified team nursing as the most cost-effective care delivery system.

Question 7

A registered nurse desires to work at a hospital close to her home. A nurse who works at the hospital tells her that he spends much of his day delegating to unlicensed assistive personnel UAPs). The nurse realizes that the hospital practices one of which types of care delivery? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Functional nursing
B) Primary nursing
C) Team nursing
D) Case method
E) Relationship-based care

Question 8

A registered nurse RN) wants to delegate the insertion of an intravenous catheter IV) to a licensed practical nurse LPN/LVN). The RN bases the decision to delegate on which factor?

A) The RN does not have time to start the IV.
B) Inserting an IV catheter is within the scope of the LPN/LVN role according to the state's nurse practice act.
C) The RN has not started an IV since nursing school.
D) The RN does not have time to evaluate the outcome of the procedure.

Question 9

A nurse executive is writing the job description for the hospital's newly created case manager position. Which job responsibilities should the executive include? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Collaborating across disciplines to plan patient care
B) Coordinating care to increase cost-effectiveness
C) Developing nursing service work schedules
D) Reducing fragmentation of care
E) Determining when the patient can be discharged from the facility

Question 10

How would the nurse explain how acute care nursing is different from community-based care?

A) Acute care focuses on short-term nursing interventions.
B) In acute care, illness is seen as a part of living.
C) The purpose of acute care is to improve functional capacity and quality of life.
D) Nursing autonomy is greater in acute care practice.

Question 11

A clinic has instituted a program of disease management. The nurse administrator would describe the clinic's work using which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) The clinic will address high-cost chronic illnesses.
B) Proactive case management will be a part of the clinic's work.
C) Prevention will be a major focus.
D) Patient anonymity will be protected by clinic regulations.
E) Early detection and early intervention are among the clinic's goals.

Question 12

The nurse is aware that skill in collaboration will be necessary for success as changes occur in the delivery of health care. The nurse should develop which skills in preparation for these changes? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Effective communication
B) Knowledge of the history of nursing
C) A reputation for mutual respect and trust with colleagues across disciplines
D) Good decision-making skills
E) Ability to influence people and change their point of view

Question 13

The nurse is uncomfortable with the technical skills demonstrated by a newly employed licensed practical nurse LPN/LVN). A patient is to have an indwelling urinary catheter placed. How should the nurse proceed?

A) Insert the catheter without involving the LPN/LVN.
B) Delegate the task to the LPN/LVN and hope that all goes well.
C) Have the LPN/LVN observe the nurse placing the catheter.
D) Observe as the LPN/LVN completes the task.

Question 14

The nurse works in a hospital that practices functional care delivery. Which statements represent common perceptions about this system? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) "My job is so boring."
B) "My job is very satisfying."
C) "Knowing that I am instrumental in my patient's return to health is very joyful."
D) "It is hard for me to see the impact of my work in helping patients get better."
E) "As long as I do my job correctly, I am not responsible for when or how the patient gets better."

Question 15

A state has experienced an economic downturn and a shortage of registered nurses. Which nursing care delivery model would hospital administrators be likely to avoid?

A) Case method
B) Team nursing
C) Primary care nursing
D) Functional nursing

Question 16

Which scenario is an example of correct delegation?

A) The nurse asks the unlicensed assistant to bathe a patient before surgery.
B) The nurse asks the unlicensed assistant if a patient tolerated ambulating in the hall.
C) The nurse instructs the unlicensed assistant to check the patient's lung sounds for crackles.
D) The nurse asks the unlicensed assistant to see if the patient's hourly urine output is adequate.

Question 17

A registered nurse is seeking employment at a hospital with magnet status after hearing about the high nurse satisfaction at this hospital. High nursing satisfaction in a hospital with magnet status rating is a result of which commonality?

A) Unlicensed assistive personnel are used to perform direct patient care such as hygiene.
B) Charge nurses direct all care by tight control of nursing services.
C) Responsibility for care of the patient rests with the primary health care provider rather than the nurse.
D) Nurses have a great deal of professional autonomy.

Question 18

The nurse is considering returning to school to become a clinical nurse leader CNL). The nurse would prepare for which characteristics of the new position? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Spending the majority of time away from the bedside educating other nurses
B) Having patient safety as a focus of the work
C) Serving as the director of nursing services
D) Having quality improvement as a focus of the work
E) Helping to coordinate the care provided by unit nurses

Question 19

Which statement describes a nurse providing community-based care?

A) A nurse who develops curriculum for use in elementary schools across the United States
B) A nurse who monitors steel industry compliance with government health regulations
C) A nurse who establishes policy for a state's homeless shelters
D) A nurse who performs physical examinations in a free clinic

Question 20

The nurse is providing care to patients for whom she has 24-hour accountability and responsibility. How would the nurse describe this care delivery system?

A) Team nursing
B) Functional nursing
C) Case method
D) Primary nursing