Nursing Fundamentals for NCLEX: The Only Study Guide You Need To PASS NCLEX Exam | 2026

1.   How does managed care affect the economics of health care delivery? Decreases duplicate processes and redundant facilities

rationale:

The corporatization of health care amalgamates the smaller health care operations into the larger organizations to decrease duplicate and redundant health care provisions. For example, one hospital would provide a high level of cardiac care, while another hospital would focus on oncology.

2.   What is meant by the term integrated health care delivery system (IHS)?

A large health care system that can provide all needed services under one corporate umbrella

rationale:

As part of the corporatization of health care, the individual health care organizations are merging into systems to provide all needed services under one corporate umbrella. These are known as integrated health care delivery systems.

Characteristics of clinical pathways include all of the following except: Being a nurse-centered orientation

rationale:

Clinical pathways help reduce expensive variations in care. Clinical pathways are interdisciplinary plans of care that outline the optimal sequencing and timing of interventions for clients with a particular diagnosis, procedure, or symptom.

Patient-focused care is a recently developed term to describe: A nursing care delivery system

rationale:

Patient-focused care is another type of delivery system. The level of productivity is increased through centralization of functions (phlebotomy, diet instruction, respiratory therapy) on the unit under the direction of the RN and cross-training ancillary workers to do more than one function. The patient comes into contact with fewer people under this organizational framework.

3.   What are two tools that support case management? Clinical pathways and disease management

rationale:

Both of these tools support case management by coordination and delivery of high-quality care. Clinical pathways are interdisciplinary plans of care that outline the optimal sequencing and timing of interventions for clients with a particular diagnosis, procedure, or symptom.

A delivery of nursing care organized around tasks is known as: Functional nursing

rationale:

Aides and vocational nurses/licensed practical nurses are allowed to perform functions such as administration of medication and treatments. This functional kind of nursing results in a fragmented, impersonal kind of care.

A system in which a nurse plans and directs the care of clients over a 24-hour period is known as: Primary nursing

rationale:

In primary nursing the fragmentation between shifts and nurses is eliminated because one nurse is accountable for planning the care of the client around the clock.

4.   Which statement is true about the case management model of nursing care? It is based on previously defined client outcomes.

rationale:

Clinical pathways are a tool used to support case management and to define client outcomes.. These are interdisciplinary plans of care that outline the optimal sequencing and timing of interventions for clients with a particular diagnosis, procedure, or symptom to achieve a defined client outcome.

5.   What is the primary work environment of nurses who are case managers?

All types of health care organizations, as well as organizations with health-related functions, hire case managers.

rationale:

The case managers work in all types of health care institutions. They may also work for insurance or utilization review companies or in health-related areas of various types of large businesses.

6.   Which statement is true about client classification systems?

They provide historical data of the usage of nursing time, which is helpful when developing the department budget.

rationale:

A client classification or acuity system is used in many acute care hospitals to estimate the intensity of nursing care required to meet client needs.

7.   Which of the following best describes the concept of evidence-based practice? It provides for the use of recent research in current nursing practice.

rationale:

The IOM reported that it took 17 years for research to be reflected into daily practice. Evidence based practice is the use of the current best evidence to provide care and make decisions regarding client care.

A client is admitted to the labor and delivery unit where she is assigned a registered nurse who will manage her care for the duration of her hospitalization. What type of nursing care delivery model is represented in this nursing unit?

Primary care

rationale:

This is an example of primary care nursing, in which the RN is the principal or primary person to manage and coordinate the client's care around the clock. Patient-focused care is an interdisciplinary approach to client care. Functional care is the provision of care by nursing and nursing ancillary staff rather than

by an all-nursing staff as seen in primary care nursing. Case management is a model of care delivery in which an RN case manager coordinates and collaborates with other health services when a client has complicated health care needs, but the case manager may not be involved in the daily care activities of the client.

Which type of nursing delivery models would be appropriate in a rural area that would require fewer numbers of registered nurses? Select all that apply.

• Functional nursing
• Team nursing
• Patient-focused care

rationale:

When you have a limited number of RN's, then functional nursing, team nursing, and patient-focused care are useful, because you can deliver quality care by using more ancillary staff. Primary care is usually

24-hour RN coverage, and transition care is where APRNs conduct assessments and—with physicians—

design and coordinate patient care and discharge plans. The primary role of The Joint Commission (TJC) is: Ensuring medical facilities meet client safety guidelines

rationale:

The Joint Commission is the primary accrediting body for health care institutions. Its standards directly address client safety issues. Magnet status is approved by the American Nurses Association. TJC does not lobby Medicare/Medicaid issues. The CDC would be the agency that maintains standards regarding infection control for hospital compliance.

The Joint Commission publishes a Sentinel event alert every month. Which of the following is the best example of a sentinel event?

Code Pink is called after a newborn is discovered missing from the nursery.

rationale:

A sentinel event is an unexpected occurrence involving death or loss of limb or function. Examples of

sentinel events include serious medication errors, significant drug reactions, surgery performed on the wrong body site, blood transfusion reactions, and infant abductions.

The technique used to identify the factors involved in an error is called: A root cause analysis

rationale:

When an error is analyzed, the primary causes need to be determined so that a workable and effective solution can be developed. A root cause analysis is such a process designed to investigate and categorize the root cause of the event.

The person known for emphasizing the Pareto principle (80/20 rule) leading to the idea of total quality management is:

Joseph Juran

rationale:

Joseph Juran is one of the forefathers of quality initiatives. He stressed the meaning of the Pareto principle and how it applies to improving quality in all organizations.

The Joint Commission mandates the use of continuous quality improvement and measurement of specific quality outcomes, including clients admitted with:

Community-acquired pneumonia and congestive heart failure

rationale:

TJC mandates outcome measures for clients admitted with a diagnosis of acute MI, congestive heart failure, community-acquired pneumonia, surgical infection prophylaxis, pregnancy-related conditions, and deep vein thrombosis.

The primary barrier to the implementation of quality improvement processes is: Expense

rationale:

A primary barrier to implementing effective quality improvement programs is the cost. The cost of providing health care has greatly increased over the past few decades. However, through quality improvement measures, overall health care costs can be reduced.

The primary goal of the continuous quality improvement process of Six Sigma is to: Diminish misuse of processes

rationale:

The primary goal of Six Sigma is to increase profits by improving standard operating procedures, reducing errors, and decreasing misuse of the system.