Week 13

2Which statements indicate that the nursing student understands the influence of technological advances on the health care environment?

"The development of electronic health records changed the way nurses chart."The majority of health care organizations all have electronic health records. Nurses switched to computer charting from paper when these advances occurred. Correct "Technological advances create a way for nurses to share real-time patient information."When a nurse charts a set of vital signs, other health care providers can see that information in real time on the computer. Correct "Increased global information sharing because of technological advances created more access to research."

3Which ANA components will help the nurse manager develop a staffing plan?

All settings should have well-developed staffing guidelines.All settings should have well-developed staffing guidelines. Staffing guidelines need to include measurable nurse-sensitive outcomes specific to that setting and health care consumer populations that are used as evidence to guide daily staffing. Correct Staffing needs must be determined based on an analysis of health care consumers.Staffing needs must be determined based on an analysis of health care consumer status (e.g., degree of stability, intensity, and acuity), and the environment in which the care is provided. Correct Registered nurses, including direct care nurses, must have a substantive and active role in staffing

6How has the uninsured and underinsured population influenced health care finance?

By shifting the focus to greater accessibility to preventive care

1Which are advantages of the case method (total patient care) delivery models?

Continuity of patient care Prompt recognition of slight changes in the patientWhen a nurse gives total care to a patient in the case method model of care, the nurse will notice subtle changes in the patient quickly. Correct A high level of trust between the nurse and patient

Which actions should be taken when a nurse leader plans the capital expenditure budget for a department?

Comparing the costs of fixing old equipment with purchasing new equipment

The nurse manager is beginning the budget process. Which actions would the nurse manager include in the first step?

Developing a plan to allocate resources Collecting information from internal and external sources Compiling data to determine the department's upcoming needs

3The nurses in the obstetrics department request that the material management committee purchase a new type of basin for use during deliveries. Which strategies should the material management committee consider to balance cost with quality?

Evaluate current need for basins Ask other departments how this change will affect themEven though only the nurses in the obstetrics department are asking for this change in supplies, the material management committee needs to consider this change in light of use of the current basin by all other departments. Focusing on the team (organization) rather than the individual (department) is a key strategy for managing cost and quality. Correct Compare this request with recent requests from other unit

6A new nurse is applying to a nurse-managed health center. Which is true of this model of care?

Focuses on primary care, which is provided by nurse practitioners who are affiliated with academic health centers

2The nursing staff have questions about the effectiveness of the organization's staffing plan. What concerns should the nurse leader anticipate?

How will the staffing levels be met?Staff may become dissatisfied with the organization's staffing plan when it is clear that the plan does not meet the needed staffing levels and the organization is unable to provide an adequate level. Correct How will the accuracy of data be determined?

4Match the patient care delivery model with its description.

PCMH NMHC ACOs

3How have current trends in health care led to increased patient-centered care and patient safety initiatives?

Patients have become more assertive about their own health care.Patients used to just do what the health care practitioner told them to do and did not question it. Patients now ask more questions and are assertive about their care, which has led to patient-centered care such as bedside reporting. Correct Patients have become more knowledgeable about diseases that affect them.The Internet and the media have helped patients learn more about diseases, which helps them know which questions to ask. This inclusion in their care has increased the patient-centered care approach. Correct The Internet and the media teach patients about Health Insurance Portability and Accountability Act (HIPAA) laws and health care policies Concerns about quality health care have resulted in the development of programs, policies, and guidelines focused on safety.

6The nurse is caring for a patient who reports headaches and slight nausea after receiving medication. How can the nurse use information technology to improve patient care?

Record the information in the patient's electronic medical record (EMR).

5The oncology department has installed a new computer system. With the increased use of the system, the nurse manager should carefully monitor which aspects of patient care to ensure that technology has not had a negative influence?

Teamwork

1Which is true of the baby boomer generation's influence on the health care environment?

The aging baby boomer generation comprises 78 million people that Medicare may need to absorb.

A patient is admitted for a routine surgical procedure. Which aspects of patient care are cost effective?

The health care provider explains to the patient the preparation for the procedure and what to expect during the procedure and the recovery.

1A nurse on the cardiovascular operating team has been asked to develop a policy for the use of a new drug-eluting stent. Which aspects of the policy should the nurse consider to ensure quality?

Unbiased approachWhen developing the policy for which patients will receive the new stent, the nurse needs to use a fair and unbiased process for making the decision. Being equitable is a characteristic of health care quality that relates to material management. Correct Availability of device Ability to meet the needs of all patients

Which reimbursement method incentivizes nurse practitioners to give the highest quality patient care?

Value-based purchasing

6Which statement explains why the nursing manager of the ICU would use National Database for Nursing Quality Indicators (NDNQIs) to construct an effective staffing plan?

"NDNQIs are useful for addressing patient safety and other quality care issues in situations in which they may be impacted by how nursing care is delivered."

5What statement explains the purpose of the Patient Protection and Affordable Care Act (PPACA)?

"The PPACA was designed to expand insurance programs, control health care costs, and improve quality of care."

5Which nurse characteristics are considered by the nurse leader when developing best staffing practices in line with the AHRQ framework?

Age EducationThe AHRQ considers how multiple factors, including nurse characteristics, are related to health outcomes. Educational level is a component of nurse characteristics the nurse manager would consider in developing best staffing practices. Correct Experience

4Which financial principles can be used by the nurse manager to help shape the health care environment?

Auditing helps the nurse manager provide accurate numbers in reported data to promote financial integrity.Financial function is compromised when nurse managers are functioning with inaccurate numbers or a culture of dishonesty. Auditing activities ensure nurse managers have accurate information and shape the health care environment by supporting a culture of honesty. Correct Evidence-based financial management helps the nurse manager provide accurate, comprehensive data and make informed decisions.Financial management includes identifying and reporting costs, understanding data, and reviewing financial forecasts to make decisions. Evidence-based financial management provides nurse managers with proven principles that actually work. Correct Controllership helps the nurse manager analyze cost and revenue, identify long-term financial needs, and create strategic partnerships

2What are disadvantages of the functional task-oriented model of nursing care delivery?

Critical patient changes may not be noticed quickly.A disadvantage of the functional model of nursing care is that critical patient changes may go unnoticed by the nurse. This is due to fragmentation of care and the nurse caring for a large group of patients. Correct Assessing a patient's response to treatment is challenging.In the functional model of care, the fragmentation of care among providers may make it more difficult to assess a patient's response to treatment. If the nurse is caring for a large group of patients, it may be difficult to reassess patients after interventions. This is a disadvantage of the functional model of nursing care. Correct The nurse has less communication with the patient and family.In the functional model of care, the nurse cares for a large group of patients. He or she may not have time to develop rapport and communicate effectively with patients and families. This is a disadvantage of the functional model of nursing care. Correct The patient may be confused regarding the roles of various health care providers.

The nurse leader is giving a presentation to the hospital board regarding the importance of adequate staffing levels. What points should the nurse leader include in the presentation?

Improve patient satisfactionAdequate staffing levels do increase patient satisfaction. Correct Decrease patient complaintsWhen there is adequate staff to provide care to patients, both patient and family complaints are reduced. Correct Reduce medical and medication errorsWhen nursing staff is able to take the appropriate time to prepare medications and confirm orders, both medical and medication errors are reduced. Correct Improve nurse retention and job satisfaction

5Which concepts are related to patient-centered medical homes (PCMHs)?

Multidisciplinary teamwork Focus on personalized plan of care Increased access to providers through technology

1A nurse manager is in charge of staffing her unit within the hospital. Which unit-specific factors need to be taken into consideration in choosing her staff?

Progression of patient illnessThe stage or progression of patient illness will be a unit-specific factor that the nurse takes into consideration in choosing her staff. Correct Type of nursing care required Number of different patient conditions

A patient has been diagnosed with type 2 diabetes and needs supplies for testing blood sugar levels. Which action shows that the charges for this patient's supplies have been captured in a timely fashion?

Supplies are ordered at the point of service and charged to the patient's account.

4The emergency department nurse manager has noted that staff spend excess time inputting vital signs during computerized charting. To develop improved procedures, the manager collaborates with the information technology (IT) team. Which is an appropriate measure to implement?

Synchronize computerized charting with the biomedical devices used to collect physiologic data.

2Two major hospitals have merged to form a single health care system. The chief nursing officer from each hospital has been selected to serve on the material management task force. Which strategies for balancing cost with quality should the chief nursing officers emphasize?

Use of specific and consistent practices Creation of integrated policies and procedures