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Which of the following is a step in the Journey to Magnet Excellence? Select all that apply A. Analyze gaps B. Develop nursing leadership C. Transform culture D. Demonstrate efficacy E. Access assistance

A. Analyze gaps C. Transform culture E. Access assistance

Which of the following are examples of models of and approaches to care spawned by the Affordable Care Act (ACA)? Select all that apply A. Care coordination among previously separated areas B. Greater consumer engagement C. Restriction of care D. Development of death panels E. Telemonitoring F. Patient centered care in ambulatory settings

A. Care coordination among previously separated areas B. Greater consumer engagement E. Telemonitoring F. Patient centered care in ambulatory settings

Which of the following is a component of a Patient Centered Medical Home? A. Care is proactive in order to meet healthcare needs, with or without a visit B. Care is provided based on time available and the presenting problem C. Quality is determined by the credentials and experience of the providers and nurses D. Patients are responsible for coordinating their own care

A. Care is proactive in order to meet healthcare needs, with or without a visit

Rafael is a nurse in a busy outpatient clinic. He has noticed over time that some lab, procedure, and medication orders seem unnecessary. Which of the following provide a possible reason for this type of unnecessary care? Select all that apply. A. Financial incentives in a fee-for-service model drive overuse B. More confident clinicians tend to order more tests than less confident clincians C. Patients can request unnecessary services and providers sometimes placate them D. Fear of missing a diagnosis and the risk of medical liability drive overuse E. A clinician's competence could affect the number of tests ordered

A. Financial incentives in a fee-for-service model drive overuse C. Patients can request unnecessary services and providers sometimes placate them D. Fear of missing a diagnosis and the risk of medical liability drive overuse E. A clinician's competence could affect the number of tests ordered

The Joint Commission is on site at University Medical Center where Matthew is a nurse. A surveyor is likely to be unhappy if Matthew states which of the following is a National Patient Safety Goal for hospitals like his? A. Identify patient safety risks by finding out which ones are most likely to be violent to others B. Use the CDC guidelines for hand washing in order to reduce infections C. Identify patients correctly, using two identifiers D. Prevent mistakes in surgery by identifying the site correctly

A. Identify patient safety risks by finding out which ones are most likely to be violent to others

Sarah is a nurse working on health policy at a non-profit advocacy group, Healthy Now. In developing her organization's strategic plan, she wants to include proven approaches to decreasing health disparity. On which of the following areas should she focus? A. Increasing access to insurance coverage B. Improving the quality of care provided C. Revising SNAP and WIC benefits to promote healthy diets D. Expanding educational opportunities for minorities E. Advocating for a community focus by health care providers F. Promoting preventative care

A. Increasing access to insurance coverage B. Improving the quality of care provided E. Advocating for a community focus by health care providers F. Promoting preventative care

The ACA has been called pluralistic in its approach to healthcare financing. Which of the following financing elements did the ACA include? Select all that apply. A. Individual mandate to purchase insurance B. Medicaid expansion C. Payment system reform / insurance market regulation D. Employer mandate to provide insurance E. Medicare expansion F. Private pay expansion

A. Individual mandate to purchase insurance B. Medicaid expansion C. Payment system reform / insurance market regulation D. Employer mandate to provide insurance

In what ways does the healthcare market differ from other markets, according to Nichols (2016)? Select all that apply. A. Information asymmetry, where the seller has more information than the buyer B. A fee structure incompatible with demand C. The existence and importance of third party payers D. Government subsidies for many consumers E. Services are sometimes a matter of life and death

A. Information asymmetry, where the seller has more information than the buyer C. The existence and importance of third party payers E. Services are sometimes a matter of life and death

Abe, a nurse at Mountain Shadows Hospital, has just admitted D'lynne Jones for GI pain of unknown origin. Ms. Jones is worried about the cost of her care, as she is unemployed and uninsured. Which of the following statements below could Abe make that would accurately educate Ms. Jones about Medicaid? Select all that apply. A. Ms. Jones, you might qualify for Medicaid, a public insurance program paid for by the federal and state governments. B. Ms. Jones, Medicaid covers hospitalization, which would help, bu you'd still be responsible for lab services, radiology studies, and any home health after you're discharged from here. C. Ms. Jones, the Affordable Care Act, or Obamacare, lifted the restrictions on who could qualify for Medicaid. While not every state expanded Medicaid, those that did allow any legal resident under the age of 65 years with an income of 138% of federal poverty level to be eligible for the program. So you might qualify. D. Ms. Jones, Medicaid might be an option for you, but you'd need to be on Supplemental Social Security Income, or receive Temporary Assistance to Needy Families, or be pregnant and have a family income of less than 133% of federal poverty level. Do you meet any of those criteria? E. Ms. Jones, you might qualify for Medicaid. If you do, it will cover your hospitalization, lab services, radiology studies, physician care, prenatal care, preventive services, nursing home and home health care, and medically necessary transportation. F. Medicaid might be an option for you. While it would cover everything for you during your hospitalization, if you were transferred from here to a nursing home, it wouldn't cover that level of care.

A. Ms. Jones, you might qualify for Medicaid, a public insurance program paid for by the federal and state governments. C. Ms. Jones, the Affordable Care Act, or Obamacare, lifted the restrictions on who could qualify for Medicaid. While not every state expanded Medicaid, those that did allow any legal resident under the age of 65 years with an income of 138% of federal poverty level to be eligible for the program. So you might qualify. E. Ms. Jones, you might qualify for Medicaid. If you do, it will cover your hospitalization, lab services, radiology studies, physician care, prenatal care, preventive services, nursing home and home health care, and medically necessary transportation.

The U.S. healthcare system has been described as a paradox of excess and deprivation. Which phrase below best explains what is meant by this description? A. Individuals with access to care are often treated unnecessarily while millions lack either financial or geographical access to even the most basic of services B. The overwhelming majority of Americans have both financial and geographical access to healthcare with a small population lacking both C. The overwhelming majority of Americans cannot afford to access the geographically dispersed, highly rated health care system in the U.S. D. Individuals who receive significantly more healthcare services have much better outcomes than those with more limited access to healthcare

A.Individuals with access to care are often treated unnecessarily while millions lack either financial or geographical access to even the most basic of services

Clarence McDermott is a white male who owns a very successful business. Mariah Chandler, an African American female, is one of his warehouse employees. Although they both have insurance through Mr. McDermott's company, select the best explanation for why Mr. McDermott will likely have better health than Ms. Chandler. A.The health of an individual is influenced less by medical care than by broader socioeconomic factors such as income, education, and race. B. Mr. McDermott likely has less stress than does Mrs. Chandler. C. African Americans tend to take worse care of themselves than white Americans do. D. Mr. McDermott likely receives better medical care than does Mrs. Chandler.

A.The health of an individual is influenced less by medical care than by broader socioeconomic factors such as income, education, and race.

To maximize the coordination of care, provide seamless transitions, and improve quality of care, organizations are increasingly turning to which organization type?

Accountable Care Organizations

Which of the following is not a focus are of the Robert Wood Johnson Foundation? A. Health system improvement B. Health professional wellbeing C. Healthy communities D. Healthy weight

B. Health professional wellbeing

What authority does the Centers for Medicare & Medicaid Services have related to healthcare? A. It regulates services by setting standards of care, called conditions of participation, which indicate what organizations must accomplish to be eligible for Medicare and Medicaid reimbursement. B. It both regulates healthcare organizations by establishing conditions of participation, and accredits healthcare organizations through survey processes conducted on CMS's behalf C. It accredits agencies so the agencies can be reimbursed by any payor with whom the agency is contracted D. Its authority is limited to overseeing nursing care provided in healthcare organizations that receive Medicare and Medicaid funding

B. It both regulates healthcare organizations by establishing conditions of participation, and accredits healthcare organizations through survey processes conducted on CMS's behalf

As a nurse manager in a hospital, you would expect which of the following to be the major contributor to funding and revenues in your organization? A. Blue Cross/Blue Shield B. The federal government C. Medicaid D. Medicare

B. The federal government

Medical Cannabis Access Now is actively working to expand medical use of cannabis. As a special interest group, it wants to directly influence public officials and their decisions Which of the following methods of influence best reflects its desires? A. Litigation B. Shaping public opinion C. Lobbying D. Grassroots mobilization

C. Lobbying

Match the following era with its descriptor. 1. 1945 -1970 2. The 1970s 3. 1980s 4. 1990s 5. The New Millennium 6. 2nd decade of New Millennium A.Purchasers, especially government, become concerned about costs of healthcare and insurers begin to question generous payments to providers B.Purchasers become very concerned with costs of care and attempts are made to contain those costs through DRGs, fee schedules, capitulated HMOs, and selective contracting C. The provider-insurer pact, this era is characterized by independent hospitals and small private practices, many private insurers who were dominated by providers, purchasers had little power, and payments for providers were generous D.Selective contracting spreads, price competition is introduced, large integrated healthcare systems form, large physician practices emerge, insurance companies dominate several managed care markets, for-profit institutes rise in importance, and insurers gain power over providers E. HMOs fade in importance, hospitals consolidate, insurers consolidate, specialists form groups and move their procedures out of hospitals and into specialist -owned centers, crisis worsens in primary care, pharmaceutical companies come under attack F. ACA forms to create less underinsurance and less uninsurance, fee-for-service comes under attack, ACOs develop, and primary care strives to be more patient focused

1. C 2. A 3. B 4. D 5. E 6. F

Amber wants to improve the rate of nosocomial infections on her unit. In what order should she follow the steps of quality improvement be low?

1. Identify the needs most important to the consumer of healthcare 2. Assemble an interprofessional team to review the identified consumer needs 3. Collect data to measure the current status of services 4. Establish measurable outcomes and quality indicators 5. Select and implement a plan to meet the outcomes 6. Collect data to evaluate the implemented plan and achievement of outcomes

Match each of the following nations with its healthcare system. A. Canada B. Germany C. United Kingdom D. Japan E. United States 1. A public single payer system financed from federal and regional taxes; there is no link between employment and health insurance; services are broad, and private insurance is prohibited for coverage of services provided by the public plan 2.Funded by contributions to non-profit sickness funds that are organized geographically, by employer, by occupation, or by nation. Outpatient care and inpatient are are strictly separated. Providers are paid according to rates set by a Concerted Action group. 3. A tax-funded single national health service that covers a range of services. Private insurers are permitted to cover services at private hospitals but not in national health service facilities. The nation relies chiefly on capitation and salary limits to contain costs, but has paid physicians for performance. 4. Insurance is rooted in employment-linked social insurance program, There are social insurance and national insurance plans as well to cover those not part of a large employer plan. Many physicians own outpatient practices and small hospitals. Rates are set by the government. 5. Dispersed with multiple payers, including private and publicly funded. Providers set their own rates with private payers but publicly funded plans set the rates for services they cover. Many individuals lack healthcare coverage.

1.A 2. B 3. C 4.D 5. E

Match the policy concept with its descriptor. 1. Longest's Cycle Model 2. Kingdon's Policy Streams Model A. Health policy is cyclical, with phases that include policy formulation, policy implementation, and policy modification B. Health policy occurs when the political, policy, and problem stream flow through a policy window simultaneously

1:A 2:B

The U.S. healthcare system is comprised of four actors. Match the actor type with its example: A. Supplier B. Provider C. Purchaser D. Insurers 1.Pharmaceutical company, medical supply company, computer industry, food services vendor 2. Hospitals, physicians, ACOs, nurses, pharmacies, home care agencies 3. Individuals, businesses, and governments that pay for health insurance 4. Pay providers for medical services, receive premiums from policy holders

1:A 2:B 3:C 4:D

Melanie is a nurse at the Robert Wood Johnson Foundation. She is working on advancing federal policies that promote health outcomes and increase patient satisfaction while decreasing costs, medical errors, and waste. On which of the following cornerstone of reform is Melanie focusing? A. Creating value, because payers will spend money on higher quality, more efficient care. B. Expanding access to care, because care will become higher in quality because of her work. C. Coordinating care, because these steps requires the coordination of private and governmental entities. D. Payment reform, because she wants to change the way providers are paid.

A. Creating value, because payers will spend money on higher quality, more efficient care.

There are several reasons for overuse of healthcare. Select all that apply. A. Fee for service B. A provider's lack competence C. A provider's high competence D. Risk of medical liability E. Clinician's belief rather than knowledge F. Provider's expectations of each other G. Patient's expectations H. Legal mandates

A. Fee for service B. A provider's lack competence D. Risk of medical liability E. Clinician's belief rather than knowledge F. Provider's expectations of each other G. Patient's expectations

Ali knows her organization must accomplish which of the following for it to evolve? Select all that apply. A. Foster openness in the face of change. B. Appreciate that it is a complex entity whose various parts can influence outcomes. C. Help individuals to become self-aware about their thoughts and values. D. Promote teams working collaboratively. E. Eliminate negative thinking about proposed changes. F. Emphasize its past successes brought about by stable leadership. G. Develop and communicate a shared vision of where the organization is going.

A. Foster openness in the face of change. B. Appreciate that it is a complex entity whose various parts can influence outcomes. C. Help individuals to become self-aware about their thoughts and values. D. Promote teams working collaboratively. G. Develop and communicate a shared vision of where the organization is going.

Which of the following is true regarding the U.S. Military Health Service? (select all that apply) A. Funding for the MHS is approved annually by Congress when it passes the National Defense Authorization Act. B. Although the budget is nearly $50 billion annually, increases in expenses for the MHS have kept pace with inflation. C. The MHS has three missions:supporting wartime and other deployments, providing services to its recipients, and innovating care delivery. D. The MHS places great importance on advanced nursing education. E. Private sector civilian providers comprise part of the delivery system for the MHS.

A. Funding for the MHS is approved annually by Congress when it passes the National Defense Authorization Act. D. The MHS places great importance on advanced nursing education. E. Private sector civilian providers comprise part of the delivery system for the MHS.

Maria Herrera poorly controls her hypertension and diabetes by not taking her medications consistently, not eating her recommended diet, and not exercising as her nurse advised. Which of the following factors are most likely to explain her non-adherence? A. Maria lives in a part of town without healthy food options or public spaces to exercise, can barely afford her medications, and cannot always take the time off work to keep her endocrinologist appointments. B. Maria is genetically predisposed to her conditions and this healthcare risk is nearly impossible to overcome. C. Maria lacks the discipline to diet and exercise and does not understand the benefits of either. D. Maria's culture promotes unhealthy life choices.

A. Maria lives in a part of town without healthy food options or public spaces to exercise, can barely afford her medications, and cannot always take the time off work to keep her endocrinologist appointments.

Jacob is a college student studying political science. He understands that there must be multiple forces that shape health policy, but he's confused about what these forces are. Daniel helps Jacob out by correctly identifying the forces that shape health policy. Which of the following forces did Daniel correctly identify for Jacob? Select all that apply. A. Policy analysis and analysts B. Interest groups C. The media D. Presidential power E. Values F. Science and research G. Healthcare workforce H. Advocacy and activism I. Money

A. Policy analysis and analysts B. Interest groups C. The media D. Presidential power E. Values F. Science and research H. Advocacy and activism

What is the difference between regulating and accrediting? A. Regulating sets the standards of care for a healthcare organization and accrediting monitors whether a healthcare organization complies with the standards B.Regulating occurs for healthcare entities providing primary care and accrediting occurs for healthcare entities providing secondary and tertiary care C. Regulating sets standards of care that a healthcare organization must meet while accrediting sets standards of care that only long-term care facilities must meet D. Regulating and accrediting are the same process; the federal government performs regulate healthcare organizations and private entities alone accredit health care organizations

A. Regulating sets the standards of care for a healthcare organization and accrediting monitors whether a healthcare organization complies with the standards

Carolyn is a nurse at Sandia Vista Rehab. She has just been promoted to Assistant Director of Nursing, and she is eager to be effective in her new role. According to Evans, what tasks should she undertake to be effective? Select all that apply A. Select a mentor who will help coach her B. Pursue higher education so she understands her role C. Be willing to grow by planning, investing, and working to hone her skills D. Accept responsibility, owning what went wrong if outcomes fall short of goals E. Lead by example, demonstrating the behaviors she wants to see in her team members F. Write effective policy that guides the team to better performance G. Share the rewards, recognizing her team members for their contributions H. Have a clear vision that she shares with her team

A. Select a mentor who will help coach her C. Be willing to grow by planning, investing, and working to hone her skills D. Accept responsibility, owning what went wrong if outcomes fall short of goals E. Lead by example, demonstrating the behaviors she wants to see in her team members G. Share the rewards, recognizing her team members for their contributions H. Have a clear vision that she shares with her team

What does the term 'paradox of excess and deprivation' attempt to explain? A. Some Americans enjoy access to robust, high quality healthcare while others lack access to even the most basic of services. B. Insurance companies charge an excess of premiums yet deprive members of access to needed care. C. The American healthcare system is characterized by an excess of providers while citizens of other nations are deprived much needed care. D. The Patient Protection and Affordable Care Act moved the American healthcare system from one of deprivation to one of excess.

A. Some Americans enjoy access to robust, high quality healthcare while others lack access to even the most basic of services.

Sarah is a nurse at Mountain West Hospital. Her neighbor asks her how the ACA impacted nursing. Which of the following statements best illustrates that Sarah correctly explains how the ACA impacts nursing? Select all that apply. A. The ACA called for the modernizing of the scope of practice for Advanced Practice Registered Nurses so they can contribute more significantly to primary care services B. The ACA expanded capacity for the primary work force, including nurses, through a variety of financial supports such as loans, loan forgiveness programs, and scholarhsips C. The ACA established a successful National Healthcare Workforce Commission led by nurses since its inception in 2012. D. The ACA focused primarily on medical education rather than nursing education because the shortage of doctors is more acute than the shortage of nurses

A. The ACA called for the modernizing of the scope of practice for Advanced Practice Registered Nurses so they can contribute more significantly to primary care services B. The ACA expanded capacity for the primary work force, including nurses, through a variety of financial supports such as loans, loan forgiveness programs, and scholarhsips

Which of the following statements is true regarding cost controls and rationing? Select all that apply. A. The extent of unnecessary care and administrative waste strongly suggest that the U.S. need not ration effective medical treatment. B. Rationing care means that not all care that is beneficial will reach all of those in need of the care and the fair distribution of the care that is available C. Cost controls that require no limitation in medical care that is expected to be beneficial are considered painful D. Cost controls necessitate rationing of care

A. The extent of unnecessary care and administrative waste strongly suggest that the U.S. need not ration effective medical treatment. B. Rationing care means that not all care that is beneficial will reach all of those in need of the care and the fair distribution of the care that is available

Adam is a nurse on the post op unit at Desert Shadows Hospital. He is going to a Magnet meeting and assigns the care of his patients to Susan for the period he is away. Which of the following best reflects what Adam accomplished by assigning the care of his patients to Susan? A. Transferred both the responsibility of care and the accountability of care to Susan B. Transferred the accountability of care but not the responsibility of care to Susan C. Directed, guided, and influenced the outcome of care D. Transferred the responsibility but not the accountability of care

A. Transferred both the responsibility of care and the accountability of care to Susan

Randy's nurse manager attends to his needs and motivates him and his team by having a "can do" attitude, encouraging the team to creatively solve problems, and provides weekly quizzes to pique their intellectual curiosity to help improve processes. What type of leadership theory is Randy's nurse manager manifesting? A. Transformational B. Hierarchy of needs C. Two factor D. Situational Contingency

A. Transformational

Which of the following is a domain of emotional intelligence? Select all that apply A.Deepening self awareness B. Being empathetic C. Delegating effectively D. Praising effortlessly E. Motivating self and others

A.Deepening self awareness B. Being empathetic E. Motivating self and others

What are the three essential components of a professional ethic? A.Its purpose, the conduct expected of the professional, and the skills and outcomes expected in professional practice B. Its purpose and the conduct expected of the professional C. Its purpose, the conduct expected of the professional, the skills and outcomes expected in professional practice, and the duty of the professional to abide by the professional licensure requirements D. Its purpose, the skills and outcomes expected in professional practice, and the duty of the professional to abide by the laws that govern practice

A.Its purpose, the conduct expected of the professional, and the skills and outcomes expected in professional practice

How can the healthcare system in the new millennium best be described? A. Physicians starting their own specialty hospitals, pharmaceutical companies lobbying heavily for favorable legislation, hospitals consolidating and replacing low-reimbursement services with more profitable care, insurers continuing to raise premiums, and individuals stuck with ever-increasing medical expenses. B. Purchasers are revolting against ever increasing insurance premiums, with many employers opting to self insure; the government introduces cost containment like DRGs, and selective contracting is becoming an industry norm (i.e., HMOs). C. The honeymoon between provider and insurer is over as American economic dominance loses ground to Asia. Insurance companies are implementing utilization review, peer review for medical appropriateness becomes the norm, and providers are denying services that are not covered by insurance. D. insurers and providers are aligned, with ever-increasing medical costs borne by employers and individuals. The economy under President Obama is recovering and employers are able to pay for higher insurance premiums for their employees.

A.Physicians starting their own specialty hospitals, pharmaceutical companies lobbying heavily for favorable legislation, hospitals consolidating and replacing low-reimbursement services with more profitable care, insurers continuing to raise premiums, and individuals stuck with ever-increasing medical expenses.

Prior to enactment of the Affordable Care Act, the number of uninsured individuals in the U.S. grew steadily. Which of the following is not a reason cited by Bodenheimer and Grumbach (2016) for the growth in the uninsured rate? A.Unions, which have historically fought for insurance coverage, have been hampered in their efforts due to conservative laws enacted by primarily Republican governors. B. Skyrocketing costs of insurance made coverage unaffordable for individuals C.There are interruptions in insurance coverage since insurance is most often obtained through employment, and when an employee leaves his or her job, the employee may not afford insurance continuance through COBRA. D. The labor force changed from one of highly-skilled manufacturing.

A.Unions, which have historically fought for insurance coverage, have been hampered in their efforts due to conservative laws enacted by primarily Republican governors.

What can be said about "dual eligibles", the population that has both Medicare and Medicaid coverage? A.Dual enrollees comprise a small portion of Medicaid and about half of Medicare enrollment, and consume a disproportionate amount of Medicaid spending B Dual enrollees comprise a small portion of both Medicaid and Medicare, and consume a disproportionate amount of Medicare spending and Medicaid spending C.Dual enrollees comprise a small portion of both Medicaid and Medicare enrollment, and consume a disproportionate amount of Medicare spending D.Dual enrollees comprise about half of both Medicaid and Medicare enrollment, and consume a disproportionate amount of Medicare spending and Medicaid spending

B Dual enrollees comprise a small portion of both Medicaid and Medicare, and consume a disproportionate amount of Medicare spending and Medicaid spending

James and Micah just disagreed about how to perform a procedure. Which of the following statements by Micah is likely to improve the situation? A. "I don't think I did anything wrong. I did it the way I was taught." B. "I got really upset. Help me understand where you're coming from." C. "Why did you yell at me in front of the patient? I was doing my best." D. "You made me really angry in there. Next time, just let me be."

B. "I got really upset. Help me understand where you're coming from."

A surveyor from The Joint Commission is exploring how New Mexico General Hospital managed to make such tremendous improvements since its last survey. Charlene explains that some of the change was actually unplanned. How did she likely explain this process? A. "Leaders really had little insight into how the change would proceed and offered almost no guidance." B. "With unplanned change, a number of individuals across the hospital influenced the process." C. "We were able to adhere to Lewin's model of unfreezing, moving, and refreezing pretty easily." D. "The late adopters here nearly derailed us, but thankfully our rejectors encouraged them to reject our dominant thinking and get on with the change."

B. "With unplanned change, a number of individuals across the hospital influenced the process."

Which of the following statements best describes a virtually integrated healthcare system? A. An ACO manages all the care delivered, regardless of the presence of contract among providers and payers, for a geographically designated population B. A health plan contracts with various services (i.e., hospitals, physician practices, pharmacies) that deliver care to the health plan's enrollees C. A single entity owns all components of the healthcare delivery system D. An HMO owns most of the components of the healthcare delivery system and enrollees pay out of pocket for services received outside the network

B. A health plan contracts with various services (i.e., hospitals, physician practices, pharmacies) that deliver care to the health plan's enrollees

In which of the following areas did the National Academies recommend redesigning health care? Select All A. Advancing the role of the nurse practitioner. B. Applying evidence to health care delivery. C. Using information technology. D. Putting the patient at the center of care. E. Aligning payment policies with quality improvement. F. Preparing the workforce.

B. Applying evidence to health care delivery. C. Using information technology. E. Aligning payment policies with quality improvement. F. Preparing the workforce.

When Juaml educates Mrs. Garcia about her antihypertensive medication but allows her to decline it, under what ethical principle is Jumal practicing? A. Nonmaleficence, because the medication comes with too many side effects that will harm the patient. B. Autonomy, because the patient is deciding for herself whether she wants to take the medication C. Justice, because the medication can be used for someone who needs it more. D. Beneficence, because the patient will do better without the medication-- its prescription is unnecessary.

B. Autonomy, because the patient is deciding for herself whether she wants to take the medication

What observation about healthcare outcomes and costs does the graph below represent? (Graph on UHP P.98) A. To obtain better health outcomes requires higher costs B. Both C and D C. It is possible to obtain better health outcomes without increasing costs D. Shifting the curve from A to C represents a more efficient relationship between costs and health outcomes

B. Both C and D

Which of the following statements is true regarding fee for service and capitation payment systems? A. In a fee for service payment, the provider bears the financial risk of providing services B. Capitation payment provides a disincentive for providers to deliver more services C. Capitation transfers financial risk from payers to providers D. Fee for service payment contributed to the rapid rise of healthcare costs E. Fee for service payment incentivizes the provider to provide more services F. Capitation payment is the same as a salary payment system

B. Capitation payment provides a disincentive for providers to deliver more services C. Capitation transfers financial risk from payers to providers D. Fee for service payment contributed to the rapid rise of healthcare costs E. Fee for service payment incentivizes the provider to provide more services

Which of the following characterize health insurance exchanges. Select all that apply. A. Limits choice to consumers B. Designed to serve the individual market C. Designed to serve the small group market D. Designed to increase choice, transparency, and convenience for consumers E. Offers only private insurance F. An online marketplace for the sale and purchase of health insurance

B. Designed to serve the individual market C. Designed to serve the small group market D. Designed to increase choice, transparency, and convenience for consumers F. An online marketplace for the sale and purchase of health insurance

1. Michael is a nurse who has just read about health disparities in the United States. He decides to wrote a letter to the American Nurses Association to make sure the group is aware of the extent of the problem. Which of the following statements in his letter is likely to accurately reflect the degree of health disparities in the U.S.? A. Health disparities are somewhat problematic in the U.S. and affect the poor B. Health disparities are significant and reflect that racial and ethnic minorities, women, the poor, the less educated, and those living in certain areas are more likely to have poorer health than others C. Health disparities in the U.S. are minimal and only affect racial minorities D. Health disparities are minimal in the U.S. and affect primarily those living in certain areas

B. Health disparities are significant and reflect that racial and ethnic minorities, women, the poor, the less educated, and those living in certain areas are more likely to have poorer health than others

Quality Management helps to achieve financial solvency by accomplishing which of the following? A. Eliminating costly errors and events, like nosocomial infections and injuries and doing away with malpractice lawsuits. B. Higher patient satisfaction, resulting in greater volume as well as more efficient use of resources, including beds, staffs, equipment, and supplies. C. Increasing administrative time devoted to organizational restructuring towards more hierarchical cultures. D. Increased staff turnover and higher reimbursement for quality outcomes through a process called "Pay for Performance".

B. Higher patient satisfaction, resulting in greater volume as well as more efficient use of resources, including beds, staffs, equipment, and supplies.

Ali is a new manager at Sandia Regional Medical Center. Which of the following statements by Ali would best indicate that her mentor needs to go over the problems Ali is likely to face in her new role? A.I understand that some employees will have challenges with absenteeism, some will likely lack clinical competence, others may have some emotional problems, some may simply be uncooperative, and others may be challenged with chemical dependence. B. I understand that the overall goal is to remove unsuccessful employees before they negatively influence other team members and risk diminishing the quality of care we provide C.I understand that the overall goal is to help problem employees improve their performance, to maintain the highest standards for delivering patient care, and to provide a supportive environment in which we can each do our best D. I understand that I will need to address problems directly and that there is a specific process for addressing the problems I encounter

B. I understand that the overall goal is to remove unsuccessful employees before they negatively influence other team members and risk diminishing the quality of care we provide

Which of the following statements is false about medical debt in the United States? Select all that apply A. Individuals with insurance comprise the majority of those with difficulty paying medical debt B. Most people with difficulty paying medical bills incurred the debt as a result of a job loss or pay cut due to their illness. C. Medical debt is increasing in large part because salary increases have not kept pace with inflating healthcare costs. D. Bills that build up over time from chronic care are the largest contributor to medical debt E. Doctor visits, diagnostic tests, and lab fees are the most common source of medical bills of those having difficulty paying medical bills and they comprise the largest dollar amount of medical bills

B. Most people with difficulty paying medical bills incurred the debt as a result of a job loss or pay cut due to their illness. D. Bills that build up over time from chronic care are the largest contributor to medical debt E. Doctor visits, diagnostic tests, and lab fees are the most common source of medical bills of those having difficulty paying medical bills and they comprise the largest dollar amount of medical bills

Jesse is leading Banner Health Systems' main hospital along its Pathway to Excellence. In so doing, which of the following Institutes of Medicine key message to nursing is Jesse most reflecting? A. Nurses should practice to the full extent of their education and training. B. Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States C. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression D. Effective workforce planning and policy making require better data collection and information infrastructure

B. Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States

Sam is creating a budget to reflect the day to day expenses and revenues of her unit. What type of budget is she preparing? A. Capital budget, because the revenue and expenses are capital B. Operational budget, because the expenses and revenue relate to operating the unit C. Cash budget, because the unit requires cash on hand for routine budget expenses D. Fixed allocation budget, because expenses and revenues are relatively fixed

B. Operational budget, because the expenses and revenue relate to operating the unit

Petra travels to the state capital during the state's legislative session. She wants to improve the health of her fellow citizens by advocating for various policies she feels will most contribute to her cause. To have the most impact on public health improvement, for what types of policies should Petra be advocating? A. Petra should advocate for expanding insurance coverage to more citizens in her state B. Petra should advocate for policies that address upstream contributors to health inequities C. Petra should advocate for expanded healthcare access in rural areas of her state D. Petra should advocate for policies that directly address healthcare quality

B. Petra should advocate for policies that address upstream contributors to health inequities

In attempting to lower healthcare costs, there are "painful and painless" cost controls. Which of the following is not a painless cost control measure identified by Bodenheimer and Grumbach (2012)? A. Substituting less costly technologies that are equally effective. B. Rationing healthcare services. C. Controlling fees and provider incomes. D. Cutting the price of pharmaceuticals and other supplies.

B. Rationing healthcare services.

How can the cost of healthcare in the United States best be described? A. Growing at the same rate as other national, state, and local governmental expenditures B. Significantly higher per capita than other nations' expenditures C. In line with other industrialized nations' per capita expenditures D. The expenditures achieve greater health outcomes than other nations' expenditures

B. Significantly higher per capita than other nations' expenditures

In reviewing the current delivery model, the nurse manager is aware that which of the following is a demographic change that will have a significant effect on the healthcare delivery systems of the future? A. Escalations in the cost of health care. B. The increasing percentage of the population that will be over age 65. C. Increasing reports of violence in the workplace. D. Changes in staffing patterns.

B. The increasing percentage of the population that will be over age 65.

Which of the following represents a goal of the National Institutes of Health? Select all that apply A.to expand what is meant by health care consumer engagement, develop innovative methods to promote the Nation's health literacy, and advance the scientific approach to promoting patient-provider partmernships in health care settings B. To exemplify and promote the highest level of scientific integrity, public accountability, and social responsibility in the conduct of science C. To foster fundamental creative discoveries, innovative research strategies, and their applications as a basis for ultimately protecting and improving health D. To promote nursing education to the highest level of academic achievement and rigor in order to advance the public health E. To develop, maintain, and renew scientific human and physical resources that will ensure the Nation's capability to prevent disease F. To expand the knowledge base in medical and associated sciences in order to enhance the Nation's economic well-being and ensure a continued high return on the public investment in research

B. To exemplify and promote the highest level of scientific integrity, public accountability, and social responsibility in the conduct of science C. To foster fundamental creative discoveries, innovative research strategies, and their applications as a basis for ultimately protecting and improving health E. To develop, maintain, and renew scientific human and physical resources that will ensure the Nation's capability to prevent disease F. To expand the knowledge base in medical and associated sciences in order to enhance the Nation's economic well-being and ensure a continued high return on the public investment in research

Select the proper mission of the American Nurses Association (ANA) and the policy-shaping force with which it most aligns. A. Nurses advancing our profession by advancing scientific nursing knowledge; it represents science and research. B.Nurses advancing our profession to improve health for all; it is an interest group advocating for health improvement. C. Improving the reach of nurses in healthcare settings and the public domain; it best represents politics. D. Nurses promoting the value of universal health care access; it is most reflective of a value influence.

B.Nurses advancing our profession to improve health for all; it is an interest group advocating for health improvement.

As a nurse manager, you have been offered a position at a Veterans Administration hospital. In accepting the position, it is important for you to understand that the Veterans Administration hospital provides what type of services? A. Secondary care only and are publicly administered and funded. B. Services to veterans under an HMO. C. A range of services and are responsible to government and taxpayers. D. Primary care and are privately funded.

C. A range of services and are responsible to government and taxpayers.

Summit Hills Healthcare provides women's health services on an inpatient basis (average stay of less than 30 days). What type of facility would this likely be considered? A. Public care, specialized. B. Tertiary care, long-term. C. Acute care, specialized. D. Primary care, specialized.

C. Acute care, specialized.

Sarah is a nurse at Desert Shadows Nursing Center. She has just completed the intake assessment on Mrs. Garcia, a 84 year old female with diabetes. She failed to inform the accepting physician about Mrs. Garcia's diabetes, and thus received no orders to check the patient's blood glucose levels or to administer any insulin. After lunch, Mrs. Garcia feels tired, has a headache, and requests several cups of water. Sarah immediately realizes her mistake, calls the physician on call, and obtains orders to check Mrs.Garcia's blood glucose and to administer insulin based on the patient's glucose levels. Mrs. Garcia's blood glucose level was 190, for which Sarah administered 2 units of insulin. Sarah stayed with Mrs. Garcia and checked her blood glucose in 30 minutes and in 90 minutes. Levels were 150 and 100, respectively. What is the likely outcome from this event? A. Sarah could be successfully sued for malpractice as all elements of malpractice have been met B. Sarah will likely be reported to the Board of Nursing in her state as her care fell below the standard of care C. Although Sarah made an error, Mrs. Garcia's family has no grounds for a malpractice suit as the harm incurred was minimal and transient D. Sarah and Desert Shadows will likely both be successfully sued as both are liable for the harm experienced by Mrs. Garcia

C. Although Sarah made an error, Mrs. Garcia's family has no grounds for a malpractice suit as the harm incurred was minimal and transient

Susan was the charge nurse on 5 west medical unit at the time Alex, a psych nurse, floated to 5 west. Alex did not set a patient's bed in the lowest position, turn on the bed alarm, or place the call light within reach of a patient already identified as being at risk for falls. The patient got out of bed, fell, and fractured his hip. He developed pneumonia and died 2 weeks later. The patient's family is suing Alex and Susan. Why is Susan being named in the suit? A. Both A & B. B. The concept of respondeat superior, which makes employers responsible for the actions of their employees. C. As the charge nurse, she has the personal liability for assigning, delegating, and supervising care on her unit. D. Susan failed to delegate to Alex correctly.

C. As the charge nurse, she has the personal liability for assigning, delegating, and supervising care on her unit.

Christen is a nurse who is passionately concerned about expanding access to prenatal care, particularly for women of color. Which of the following best identifies the steps she needs to take to effectively lobby her elected officials and the effecctive approaches she can take to lobby them? A.Christen should first contact her elected officials to identify their stance on prenatal care, identify supporters of her cause, and divy up the research needed to make sure they are ready to approach legislators through email, letters, calls, personal visits, and testifying at hearings if asked to do so. B.Christen should first identify supporters of expanding prenatal care, then research the topic more fully, and finally contact policymakers. Effective ways of influencing policymakers include making calls, visiting personally, picketing and protesting, and testifying at hearings. C.Christen should research the topic, identify supporters, and reach out to policymakers. Ways of reaching out to them include personal visits, calling, and writing letters and e-mails, and providing testimony at hearings. D.Christen should first research prenatal care, identify other like-minded individuals who are also legislators, and finally reach out to these elected officials through email, phone calls, letters, and testifying at hearings. If she gets little response, protesting is a proven last effort in impacting policy change.

C. Christen should research the topic, identify supporters, and reach out to policymakers. Ways of reaching out to them include personal visits, calling, and writing letters and e-mails, and providing testimony at hearings.

Mr. Khalsa visited his nurse practitioner with a complaint of shortness of breath, pressure in his chest, and fatigue. His NP diagnosed him with the flu, prescribed guaifenesin, and recommended bed rest and fluids. Three days later, Mr. Khalsa was admitted to the hospital for congestive heart failure and expired two days later. His hospitalist was concerned that Mr. Khalsa had not received high quality health care. Which of the following component of high quality healthcare did Mr. Khalsa not experience? A. Separation of financial and clinical decisions, because his NP elected to treat him on an outpatient basis. B. Adequate scientific knowledge, because it is hard to distinguish CHF from the flu. C. Competent health care provider, as his condition was misdiagnosed. D. Access to care as he should have been admitted sooner.

C. Competent health care provider, as his condition was misdiagnosed.

Nicki is leading her unit's preparation for a survey by The Joint Commission. She wants to make a poster about the National Patient Safety Goals to remind her team what they are. Which of the following should she include on her poster? Select all that apply. A. Identify patient safety risks by finding out which patients are most likely to be violent B. Promote patient communication by being culturally competent C. Identify patients correctly, using at least two identifiers D. Use the CDC guidelines for handwashing E. Prevent mistakes in surgery by identifying correct surgical sites

C. Identify patients correctly, using at least two identifiers D. Use the CDC guidelines for handwashing E. Prevent mistakes in surgery by identifying correct surgical sites

Elena and Joe are nurses at Mountain Shadows Hospital. Two patients on their unit are on the liver transplant waiting list. A liver just came available, and surprisingly, both patients are a match. Elena feels that one patient, an alcoholic, should not get a liver. Joe feels that because this patient has insurance while the other does not, that she should get a liver. By what distributive justice principle is each acting? A. Elena adheres to the principle to each the same thing and Joe adheres to the principle to each according to his need B. Elena adheres to the principle to each according to his merits while Joe adheres to the principle of to each according to his need. C. Joe adheres to the principle of to each according to his ability to compete in the open marketplace and Elena adheres to the principle to each according to his merits D. Joe adheres to the principle of to each according to his ability to compete in the open marketplace and Elena adheres to the principle of to each according to his need.

C. Joe adheres to the principle of to each according to his ability to compete in the open marketplace and Elena adheres to the principle to each according to his merits

Joel is a nurse manager at Blue Skies Hospital. He is friendly, kind, and charismatic. He treats each of his team members well by recognizing and meeting their unique needs and encouraging them intellectually. Which of the following statements best reflect the effects of his leadership style? A. Joel is a transactional leader; his team members will assume a quid pro quo response manifested by meeting deadlines and doing the work before them to get paid B. Joel is a transformational leader; his team members will assume a quid pro quo response manifested by meeting deadlines and doing the work before them to get paid C. Joel is a transformational leader; his team will likely have a sense of increased worth, share his vision, and feel challenged; they will likely have higher job satisfaction and morale, perform better, and be committed to the organization D. Joel is a transactional leader; his team will likely have a sense of increased worth, share his vision, and feel challenged; they will likely have higher job satisfaction and morale, perform better, and be committed to the organization

C. Joel is a transformational leader; his team will likely have a sense of increased worth, share his vision, and feel challenged; they will likely have higher job satisfaction and morale, perform better, and be committed to the organization

John works in Washington, DC, at Social Ventures United, a non-profit organization created to help shape health policy in the U.S.. His supervisor realizes that she will have to review the policy process again after John makes which of the following statements? A.The policy stream model reflects the notion that a policy change can occur when the problem is sufficiently large, the proposed policy is sufficiently appealing, and the political climate is sufficiently amenable to change B.Longest's policy reflects the notion of incrementalism through a three stage process: policy formulation, policy implementation, and policy evaluation C. Longest's model indicates that policy occurs when the problem, policy, and politics are simultaneously prepared for a proposed change D. Policy formulation includes all of the activities of policy design, including informing legislators

C. Longest's model indicates that policy occurs when the problem, policy, and politics are simultaneously prepared for a proposed change

Which of the following is not a key message in the Future of Nursing by the IOM? A. Nurses should achieve higher levels of education and training. B. Nurses should practice to the full extent of their education and training. C. Nurses should assume positions of leadership in healthcare organizations. D. Nurses should be full partners in redesigning healthcare in the U.S.

C. Nurses should assume positions of leadership in healthcare organizations.

Georgia Miller just qualified for Medicare. In her CMS-provided brochure, how were the various parts of Medicare likely described? A. Part A covers hospitalization, Skilled Nursing Facilities, and outpatient services. Part B covers prescription medications but creates a 'donut hole' where patients will be fully responsible for medication costs for part of the year. Part C covers cardiac and chiropractic services. Part D covers home health, lab services, screenings, and "Silver Sneakers", a gym membership. B. Part A covers nursing homes, physicians, and cardiac screening. Part B covers outpatient services like visits to physicians' offices, dental cleanings, PT, OT, NP and some lab services. Part C allows Medicare members to enroll in HMOs to keep their Medicare co-pays low. Part D covers prescription medications for more conditions common among the elderly (heart disease, arthritis, pain, and Alzheimers). C. Part A covers Skilled Nursing Facilities, hospice, home health, and hospital stays. Part B covers outpatient services like visits to physicians, NPs, PTs, OTs, home health; some lab services, and some preventative services. Enrollees will be charged a premium for this coverage. Part C allows Medicare beneficiaries to enroll in a managed care plan to receive their Part A and Part B coverage. Part D covers outpatient prescription medication. D. Part A allows people like Georgia to enroll in managed care plans to receive their Medicare. Part B covers hospitalization, outpatient visits to healthcare providers, lab services, and some preventative services. Part C covers SNFs, hospice, and home health. Part D covers outpatient prescription medications, but there is a 'donut hole', a period in which enrollees are responsible for the full costs of the medications.

C. Part A covers Skilled Nursing Facilities, hospice, home health, and hospital stays. Part B covers outpatient services like visits to physicians, NPs, PTs, OTs, home health; some lab services, and some preventative services. Enrollees will be charged a premium for this coverage. Part C allows Medicare beneficiaries to enroll in a managed care plan to receive their Part A and Part B coverage. Part D covers outpatient prescription medication.

Dr. Johnson is a psychiatrist treating Belinda Manygoats, a Native American woman, for depression and alcohol abuse. He prescribes her disulfiram and fluoxetine. Belinda told Dr. Johnson that she prefers a more traditional approach using herbs and praying, but Dr. Johnson assured her that the medications were more effective. Which of the following Institutes of Medicine aim for healthcare did Dr. Johnson fail? A. Effectiveness, as disulfiram and fluoxetine are not the most effective agents to treat alcohol abuse and depression. B. Safety, as disulfiram and fluoxetine cannot be safely administered together. C. Patient-centeredness, because the patient's preferences, needs, and values were not honored. D. Equitable, because he delivered different care to her because of her racial background than he would have if she were Caucasian.

C. Patient-centeredness, because the patient's preferences, needs, and values were not honored.

Payment controls, according to Bodenheimer & Grumbach, focus on which two areas? A. Price of and access to services. B. Location and utilization of services C. Price and utilization of services. D. Government and private insurance payment systems.

C. Price and utilization of services.

David is a nurse at Lutheran Medical Services, where he works in coordination with Dr. Elliott to provide inpatient care for the most rare and complex health concerns (i.e., oligodendroglioma, congenital heart defects, etc.). What level of care does this best describe? A. Primary B. Secondary C. Tertiary D. Quartenary

C. Tertiary

Which of the following best describes the typical uninsured person in the U.S.? A. An adult unemployed male over the age of 26. B. A recent immigrant being paid 'under the table' for manual labor. C.A minority adult from working family earning a low income with no access to employer-based insurance. D. A minority female working full time with an income equal to 100% of the FPL.

C.A minority adult from working family earning a low income with no access to employer-based insurance.

Abbey is a nursing director at Mountain High Rehab Center. During her performance review, she was noted to have exceptional skills in articulating a vision for the department, using her experience to judge risks, seeing opportunities in the midst of sometimes quite challenging situations, and adapting well to new situations. She was encouraged to work more on being consistent and vigilant in her behavior, communicating more effectively in the face of repetitive tasks, and identifying recurrent problems. Which of the following best summarizes her performance? A. Abbey demonstrates good leadership traits and good management traits. B. Abbey demonstrates good management traits. C. Abbey demonstrates good management traits and should improve her leadership traits. D. Abbey demonstrates effective leadership traits and should improve her management traits.

D. Abbey demonstrates effective leadership traits and should improve her management traits.

Which of the following is central to effectively accomplishing change in an organization? A. The change must be based on evidence B. The change proposed needs to be a good idea. C. The leader needs to be transformational in her approach. D. People impacted by the change must be engaged in the change process.

D. People impacted by the change must be engaged in the change process.

Why is public health infrastructure important, according to the Institutes of Medicine? A.It sets policy for the entire healthcare system in the U.S. B. It serves as the end result of planning, delivering, and evaluating public health C. It serves as a safety net for those who cannot access private healthcare D. Provides capacity to care for acute and chronic threats to the nation's health

D. Provides capacity to care for acute and chronic threats to the nation's health

As a nurse working in Washington, DC, on healthcare policy, Julia wants to make sure that any cost control measures she recommends are painless. Which of the following would she not recommend? A. Cutting the price of pharmaceuticals and other supplies B. Eliminating medical interventions that show no benefit C. Increasing the provision of those preventive services that cost less than the illnesses they prevent D. Restricting access to care

D. Restricting access to care

Richard is a nurse at Mesa View Hospital. He sees patients every day who lack sufficient resources for follow up care. He begins working in the community to raise awareness of the issue and garner support for securing funding for outpatient services for these socioeconomically challenged patients. Working within the community sphere of influence, Richard knows which of the following is true? A. The community sphere of influence interacts with the government sphere of influence, so his next step should be city hall. B. Spheres of influence work in silos, so he will need to focus all of his energies in the community. C. Community activism is the single most powerful sphere for influencing policy. D. The community sphere of influence interacts with the other spheres of influence (government, workplace / workforce, associations / interest groups).

D. The community sphere of influence interacts with the other spheres of influence (government, workplace / workforce, associations / interest groups).

Which of the eight primary dimensions of patient centeredness is Jenifer meeting when she addresses her patient's concern about aftercare, where to obtain her medications, what follow- up appointments are in place to prevent a readmission, and what are danger signs to look for after leaving the hospital A. Involvement of family and friends B. Coordination and integration of services C. Access to care D. Transition and continuity

D. Transition and continuity

Ryan is a new nurse at Desert View Clinic. Desert View is under a capitated payment contract with Red Heart Insurance. He's eager to help Desert View remain financially solvent, so he makes sure to accomplish as much as possible during each patient visit. Which of the following cost-conscious nursing actions is Ryan following? A. Capturing all charges in a timely fashion. B. Discussing costs of care with patients. C. Predicting and using nursing resources efficiently. D. Understanding what is required to remain financially sound.

D. Understanding what is required to remain financially sound.

Which of the following best describes CHIP, the Children's Health Insurance Program? A.CHIP is designed to cover children from families whose income is equal to 133% FPL. It provides a broader array of services than Medicaid, but also charges a premium equal to 1% of the family's income. States have limited discretion in what services are covered, but receive federal block grants to cover the majority of the healthcare costs incurred under the plan. B.CHIP was a program designed by President Johnson during his "War on Poverty". It was designed to cover children of the "near poor", or those with household incomes greater than 133% FPL but less than 200% of FPL. It lost its financing in 2007 under President Bush, regained it in 2009 under President Obama, but was ultimately shuttered with the development of the ACA. C.CHIP is designed to cover children's healthcare expenses not covered by Medicaid, such as outpatient medications, pre-school, dental visits, and preventative care such as well baby checks. CHIP requires premiums of its enrollees, equal to 1% of the child's familial income. D.Designed to cover the "near poor", CHIP covers children up to the age of 19 in families with incomes too high to qualify for Medicaid. States have broad discretion in setting their income eligibility standards, and eligibility varies across states. States have the option of covering pregnant women who meet certain criteria and the option to provide coverage to the children of state employees under certain circumstances. What healthcare services CHIP covers varies from state to state.

D.Designed to cover the "near poor", CHIP covers children up to the age of 19 in families with incomes too high to qualify for Medicaid. States have broad discretion in setting their income eligibility standards, and eligibility varies across states. States have the option of covering pregnant women who meet certain criteria and the option to provide coverage to the children of state employees under certain circumstances. What healthcare services CHIP covers varies from state to state.

After years of working hard. Abdul Salam has been promoted to a vice president position at Baytown Medical Center. He oversees nursing throughout the entire organization, whether the nurse works in outpatient, inpatient, home health, skilled nursing, surgery, or emergency services. Sometimes he is accused of having a 'silo' mentality because he is only concerned with nursing. What type of organizational structure does Baytown Medical Center have?

Functional Structure

Maria Elena is a director over behavioral health at Desert View Healthcare Systems. She oversees the inpatient behavioral health unit, the outpatient behavioral health clinic, the psychiatric consult liaison team in the emergency room, and the electro-convulsive-therapy (ECT) services in the operating room. All the staffs working in these areas (nursing, pharmacy, housekeeping, social work, dietary) report to him. What type of organizational structure best describes Desert View Healthcare System? ______________________

Service Line

Randy's nurse manager attends to his needs and motivates him and his team by having a "can do" attitude, encouraging the team to creatively solve problems, and provides weekly quizzes to pique their intellectual curiosity to help improve processes. What type of leadership theory is Randy's nurse manager manifesting?

Transformational