Effective Leadership and Management in Nursing 8th Edition By Sullivan-Test Bank

Question 1
Type: MCSA
The nurse manager tells a newly hired nurse that the unit practices functional nursing. What should
the new nurse expect?

1. One nurse has responsibility for all the medications on the unit.
2. One nurse has responsibility for all the needs of three clients.
3. One charge nurse and one respiratory therapist have responsibility for all clients.
4. One nurse and one nursing assistant have responsibility for ten clients.
   Correct Answer: 1
   Rationale 1: Functional nursing breaks down client care into tasks assigned to the appropriate
   professional or skilled caregivers. This may result in one nurse (the “med nurse”) administering all
   the medications on the unit.
   Rationale 2: Total patient care is given by one nurse assigned to a few clients.
   Rationale 3: Team or modular nursing uses a variety of skilled caregivers to provide care to an
   assigned group of clients.
   Rationale 4: Team or modular nursing uses a variety of skilled caregivers to provide care to an
   assigned group of clients.
   Global Rationale:
   Cognitive Level: Applying
   Client Need: Safe Effective Care Environment
   Client Need Sub: Management of Care
   Nursing/Integrated Concepts: Nursing Process: Implementation
   Learning Outcome: 3-2: Describe what types of nursing care delivery systems exist.
   Question 2
   Type: MCMA
   A large metropolitan hospital uses differentiated practice as part of the structure of nursing services.
   Following this plan, nursing responsibilities are assigned based on which criteria?
   Note: Credit will be given only if all correct choices and no incorrect choices are selected.
   Standard Text: Select all that apply.
5. Seniority
6. Educational level
7. Experience
8. Nurse preference
9. Affordability
   Correct Answer: 2,3,4
   Rationale 1: Seniority does not mean competence.
   Rationale 2: Differentiated practice takes education (primarily associate’s degree and bachelor’s
   degree) into consideration when determining nursing responsibilities.
   Rationale 3: Experience is considered in differentiated practice.
   Rationale 4: Nurse preference is taken into consideration in differentiated practice.
   Rationale 5: While cost containment is always an issue, in true differentiated practice it is not a
   primary determinant of responsibilities.
   Global Rationale:
   Cognitive Level: Applying
   Client Need: Safe Effective Care Environment
   Client Need Sub: Management of Care
   Nursing/Integrated Concepts: Nursing Process: Planning
   Learning Outcome: 3-5: Explain characteristics of effective delivery systems.
   Question 3
   Type: MCSA
   The RN receives reports on eight clients in the morning. Client assignments are then delegated to an
   LPN and two nursing assistants. The morning is busy, with physician visits and new client orders,
   and the RN communicates these new orders to the LPN and nursing assistants. The RN also meets
   with the case manager to discuss nursing home placement for a client. What type of nursing care
   delivery system is in place in this hospital?
10. Critical pathways
11. Total patient care
12. Team nursing
13. Functional nursing
    Correct Answer: 3
    Rationale 1: Critical pathways are a set of strategies used by health care providers to attain
    expected outcomes. Critical pathways are not a nursing care delivery system, and there are
    insufficient data to determine if they are used in this scenario.
    Rationale 2: Total patient care is given by one nurse.
    Rationale 3: The RN in this case is leading a team. A variety of skilled caregivers cares for a group
    of clients.
    Rationale 4: Functional nursing breaks down the assignments into tasks.
    Global Rationale:
    Cognitive Level: Applying
    Client Need: Safe Effective Care Environment
    Client Need Sub: Management of Care
    Nursing/Integrated Concepts: Nursing Process: Implementation
    Learning Outcome: 3-2: Describe what types of nursing care delivery systems exist.
    Question 4
    Type: MCMA
    As the RN team leader, identify potential disadvantages of using team nursing to deliver care to
    assigned clients.
    Note: Credit will be given only if all correct choices and no incorrect choices are selected.
    Standard Text: Select all that apply.
14. Continuity of care may suffer.
15. Client/staff communication may be an issue.
16. There is little cost savings to the institution.
17. Delegation is necessary.
18. Not as many professional staff are required.
    Correct Answer: 1,2,4
    Rationale 1: Continuity of care may suffer when care is given by more than one person.
    Rationale 2: Team nursing requires excellent communication skills in all team members, who must
    communicate with clients, families, and each other.
    Rationale 3: Team nursing does save on personnel costs.
    Rationale 4: The RN must be careful to delegate only tasks that are appropriate for the skill level
    and licensure of the designated personnel. The RN is ultimately responsible for all client care.
    Rationale 5: Team nursing does reduce the numbers of professional staff required.
    Global Rationale:
    Cognitive Level: Applying
    Client Need: Safe Effective Care Environment
    Client Need Sub: Management of Care
    Nursing/Integrated Concepts: Nursing Process: Planning
    Learning Outcome: 3-3: Discuss the positive and negative aspects of different systems.
    Question 5
    Type: MCSA
    The hospital is opening its first intensive care unit. The nurse executive should plan to staff this unit
    according to which model of care?
19. Functional nursing
20. Team nursing
21. Total patient care
22. Modular nursing
    Correct Answer: 3