chptr 14 questions
Where did critical pathways originate from? A) Case management B) Functional nursing C) Team nursing D) Primary care nursing
Ans: A Feedback: Critical pathways were developed as a result of the case management system. None of the other options identify that original connection.
Which statement best describes case management? A) Clinical outcomes should occur within a prescribed time frame B) Case managers do not provide direct patient care C) Managed care practice is a unit-based model of care D) The goal is outcome management for every patient
Ans: A Feedback: In case management, clinical outcomes need to occur within prescribed time frames. Case managers do not provide care; neither is managed care unit based. The goal is outcome management for specific patients, but not every patient needs case management.
Primary care nursing is organized so that the patient is at the center of the structure. How many nurses have 24-hour responsibility for care planning and coordination? A) One B) Two C) Three D) Four
Ans: A Feedback: Primary care nursing is organized so that the patient is at the center of the structure. One nurse has 24-hour responsibility for care planning and coordination.
what is the goal of case management? A) Containing health-care costs B) Providing challenging work C) Enhancing professionalism D) Decreasing length of hospital stays
Ans: A Feedback: The ANA maintains that case management is designed to contain health-care costs. None of the other options identify a goal of casement.
what is included in a MAP? 1. Critical path 2. Nursing care plan 3. Indication of times when nursing interventions occur 4. Nurses follow the care plan to facilitate expected outcomes A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4
Ans: A Feedback: The care MAP is a combination of a critical path and a nursing care plan, except that it shows times when nursing interventions should occur as well as variances. All health- care providers follow the care MAP to facilitate expected outcomes.
what is the oldest form of organizing patient care that is still widely used today? A) Total patient care B) Functional nursing C) Team or modular nursing D) Primary care nursing
Ans: A Feedback: Total patient care, utilizing the case method of assignment, is the oldest form of patient care organization and is still widely used today.
what was the focus historically for case management? A) Individual patient B) Care for populations C) Group of patients with same chronic illness D) Group of patients with same acute need for surgery
Ans: A Feedback: While the focus historically for case management has been the individual patient, the case manager employed in a disease management program plans the care for populations or groups of patients with the same chronic illness.
Which concept should a care delivery system support? Select all that apply. A) Organization B) Nursing process C) Cost effectiveness D) Patient satisfaction
Ans: A, B, C, D Feedback: Each units care delivery structure should facilitate meeting the goals of the organization, be cost-effective, satisfy the patient, provide role satisfaction to nurses, allow implementation of the nursing process, and provide for adequate communication among health-care providers. While important, nursing research is not a concept that is considered when selecting a care delivery system.
Which statement demonstrates an understanding of the factors that are considered when a change in the care delivery system is being proposed? Select all that apply. A) We have determined that our level of care would improve if we provided it differently. B) Its questionable whether our current nursing staff is large enough to support the proposed change. C) We will discuss our proposed change with the multidisciplinary team members. D) Administration has been supportive of the planned change in our care delivery system.
Ans: A, B, C, D Feedback: If evaluation of the present system reveals deficiencies, the manager needs to examine available resources and compare those with resources needed for the change. There must be a commitment on the part of top-level administration and a majority of the nursing staff for a change to be successful. Because health care is multidisciplinary, the care delivery system used will have a heavy impact on many others outside the nursing unit; therefore, those affected by a system change must be involved in its planning. The philosophy of the nursing services division must support the delivery model selected. Changing the philosophy is not appropriate.
Which statement demonstrates an intervention focused on the primary disadvantage of team nursing? A) We are working with 1 fewer team members today. B) The team will be meeting for a care report update in 5 minutes. C) Our patient assignment is comprised of both males and females D) We will be having a member of the float pool on our team today.
Ans: B Feedback: Disadvantages to team nursing are associated primarily with improper implementation rather than with the philosophy itself. Frequently, insufficient time is allowed for team care planning and communication. This can lead to blurred lines of responsibility, errors, and fragmented patient care. None of the other options address a known disadvantage of team nursing.
what is necessary when implementing care multidisciplinary action plans (MAOPs) A) Caregivers alter the plan as they deem necessary B) Variances be indicated for patient deviations C) Time frames for implementation be left open D) Critical paths not be considered in care planning
Ans: B Feedback: In care MAPs, it is necessary to provide variances when there are patient deviations, because this is a major component to case management. None of the other options identify that connection.
A nurse has accepted a position as a staff nurse and will practice primary care nursing. The nurse will be the only RN on the team. What is an appropriate role expectation for role fulfillment? A) Planning nursing care independently of others B) Assigning work according to the expertise of group members C) Being responsible for care planning 24 hours a day D) Carrying out the majority of personal care for your patients
Ans: B Feedback: In primary nursing, the sole RN would not plan the care without others input or be responsible for care planning for 24 hours. Neither would the RN carry out the majority of personal care.
What is one of the most important differences between case management and disease management? A) Disease management referrals begin in the hospital inpatient setting B) Disease management is a collaborative process to meet patient needs C) High-cost population groups are targeted in disease management D) Disease management treatment is episodic
Ans: C Feedback: Although there are many similarities between disease management and case management, the primary goal of disease management is to target high-cost disease populations.
Which statement best describes functional nursing care delivery? A) Nursing care is holistic and patient centered B) The nurse must be a licensed person C) Emphasis is on getting work done through tasks D) It is also known as total patient care
Ans: C Feedback: Functional nursing is task focused. None of the other options identify that connection.
What type of nursing uses mini teams, typically an RN and unlicensed health-care workers, to provide care to a small group of patients who are centralized geographically? A) Total patient care B) Functional nursing C) Modular nursing D) Primary care nursing
Ans: C Feedback: Modular nursing and model RN line use mini teams, typically an RN and unlicensed health-care worker(s), to provide care to a small group of patients, centralized geographically. None of the other options provide that staffing format.
Which statement is correct concerning primary nursing care? A) Requires minimal RN staffing B) Is easy to implement C) Provides challenging work D) Has proved to be a failure
Ans: C Feedback: Primary care provides challenging work for nurses; however, it is not easy to implement and requires an all-RN staff. None of the other options accurately describes the concept of primary nursing care.
Which is a true statement about the patterns of patient care management? A) Functional nursing is organized according to the desires of the worker B) Primary nursing and total patient care are synonymous C) Team leading includes the concept of patient care conferences D) Case load nursing provides little autonomy for nurses
Ans: C Feedback: Team leading includes the need for patient care conferences. None of the other options identify that need.
What is the primary outcome resulting from the implementation of the functional nursing care delivery system? A) A cost-effective method of care delivery B) Another permanent care delivery option C) Ancillary staff with varying levels of training and education D) A care delivery system addressing the needs of the baby boom patient
Ans: C Feedback: The employment of personnel with various levels of skill and education proliferated as new categories of health-care workers were created. Currently, most health-care organizations continue to employ health-care workers of many educational backgrounds and skill levels. None of the other options represent a primary outcome of resulting from the implementation of functional nursing.
With modular nursing, who checks the completion of tasks assigned to a team member? A) The charge nurse B) The area manager C) The team leader D) Another team member
Ans: C Feedback: The team leader should check the work of team members. None of the other options identify the role correctly.
What is the most important component in being well organized and increasing productivity on the unit? A) Adequate resources B) A well-trained staff C) A well-thought-out plan D) Time to carry out your duties
Ans: C Feedback: Unless the plan is well thought out, patient care has the potential to be disorganized. None of the other options identify that connection.
The nurse is assigned to administer medications to all patients throughout the shift. What is this an example of? A) Team nursing B) Case method nursing C) Primary care delivery D) Functional nursing care
Ans: D Feedback: Being assigned a specific task to do is part of functional nursing. None of the other options identify that connection.