Chapter 17: Nursing in an Evolving Health Care Delivery System

Chapter 17: Nursing in an Evolving Health Care Delivery System

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

What has shaped many of the changes in health care affecting nurses?

1. The American Medical Association
2. The U.S. Congress
3. Nursing Agenda for Health Care Reform
4. Third-party payers

Correct Answer: 4

Rationale: Third-party payers have attempted to control rapidly increasing healthcare costs that many believe to be out of control. The American Medical Association, U.S. Congress, and the Nursing Agenda for Health Care Reform have not at this time reshaped health care and healthcare costs.

Cognitive Level: Remembering

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: IV.A.1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice.

AACN Essential Competencies: V.2. Describe how health care is organized and financed, including the implications of business principles, such as patient and system cost factors.

NLN Competencies: Context and Environment; Practice; Apply financial theories in practice

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 2. Examine the issues of cost containment and access to health care as they affect nursing.

Page Number: p. 318

 

Question 2

To what does resource management for nurses refer?

1. Licensure of RNs
2. Hiring of personnel
3. Evidence-based practice
4. Cost-effective approaches to quality care

Correct Answer: 4

Rationale: Resource management uses cost-effective approaches to high-quality care. Basic resources include financial, physical, and human resources; but others are organizational systems, information systems, and technical capabilities. Licensure of RNs is the responsible of the state board of nursing and does not pertain to resource management for nurses. Hiring of personnel is a human resources and administrative concern. Evidenced based practice pertains to the use of the best scientific evidence, integrated with clinical experience, and incorporating patient values and preferences in the practice of professional nursing care.

Cognitive Level: Understanding

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: IV.A.1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice.

AACN Essential Competencies: V.2. Describe how health care is organized and financed, including the implications of business principles, such as patient and system cost factors.

NLN Competencies: Context and Environment; Practice; Apply financial theories in practice

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 2. Examine the issues of cost containment and access to health care as they affect nursing.

Page Number: p. 318

 

Question 3

Which resource management strategies have hospitals utilized?

1. The use of clinical nursing assistants (CNAs)
2. The hiring of medical librarians
3. Certification in a specialty area
4. Clinical ladders

Correct Answer: 1

Rationale: The intent of using certified nursing assistants was to relieve the professional nurse of tasks that can safely and effectively be delegated to someone with less educational preparation who can provide that level of care more cost-effectively. Hiring medical librarians would improve research within a hospital environment but would not affect the resource management of nurses. Certification in a specialty area and clinical ladders both promote professionalism within nursing practice but are not strategies utilized for resource management.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: IV.A.1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice.

AACN Essential Competencies: V.2. Describe how health care is organized and financed, including the implications of business principles, such as patient and system cost factors

NLN Competencies: Context and Environment; Practice; Apply financial theories in practice

Nursing/Integrated Concepts: Implementation; Nursing Process

Learning Outcome: 2. Examine the issues of cost containment and access to health care as they affect nursing.

Page Number: p. 318

 

Question 4

Which are considered barriers to the access of health care by Americans?

1. Cost of care
2. Community health centers
3. Lack of research for evidence-based practice
4. The use of nurse practitioners

Correct Answer: 1

Rationale: The Centers for Medicare and Medicaid Services reports that the U.S. expenditure for health care was $2.9 trillion in year 2013. Medicare and Medicaid totaled just over $1 trillion and costs are projected to increase as more people become eligible for Medicare. This will cause an increase to the tax subsidies for the new healthcare exchanges. Having community health centers and the use of nurse practitioners promotes access to health care. Research for evidence-based practice does not present a barrier for access to health care.

Cognitive Level: Understanding

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: IV.A.1. Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice.

AACN Essential Competencies: V.2. Describe how health care is organized and financed, including the implications of business principles, such as patient and system cost factors.

NLN Competencies: Context and Environment; Practice; Apply financial theories in practice

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 2. Examine the issues of cost containment and access to health care as they affect nursing.

Page Number: pp. 318–319