Week 1- Chapters 9, 10, 15

Question 1

Which of the following is a key function associated with the Canadian health care system?
a. Financing.
b. Accessibility.
c. Implementation of insurance programs.
d. Universality.

Answer 1

ANS: A
Four key functions are associated with the Canadian health care system: (1) stewardship or governance, (2) financing, (3) human and physical resources, and (4) organization and management of service delivery.

Question 1

What was the main purpose of the establishment of the Health Council of Canada in 2011?
a. Assess health and human resource allocation.
b. Monitor the progress of health care reform.
c. Evaluate the duplication in current scopes of practice.
d. Integrate technology in acute care institutions.

Answer 1

ANS: B
As part of the renewal effort, the Health Council of Canada was established to monitor the progress and health outcomes (Health Council of Canada, 2011).

Question 2

The Canada Health Act (1985) establishes the criteria for:
a. Provincial health care funding priorities.
b. Nurse-to-patient ratios.
c. Hospital accreditation standards.
d. Federal financial support of a national health care insurance system.

Answer 2

The Canada Health Act (1985) establishes the criteria for federal government financial support of a national health care insurance plan that aims to ensure that Canadians have reasonable access to medically necessary hospital and physician services without direct personal cost. Federal funding is transferred to provinces and territories to provide these basic services if provinces and territories meet specified criteria and conditions. In this way, the Canada Health Act (1985) represents a central tenet of establishing availability of basic, universal medical care for all Canadians.

Question 3

Which criterion of the Canada Health Act prohibits user charges or extra billing?
a. Universality.
b. Accessibility.
c. Public administration.

Answer 3

ANS: B
Accessibility is fulfilled when insured persons must have reasonable and uniform access to insured health services, free of financial or other barriers. Contributions by patients through user charges or extra billing are prohibited.

Question 4

Who is responsible for providing health care funding for recent immigrants?
a. Local institutions.
b. Canada’s Immigrant Council.
c. Federal Government.
d. provincial government

Answer 4

ANS: C
The federal government directly funds services to such groups as First Nations and Inuit people, military personnel, prisoners in federal penitentiaries, and recent immigrants.

Question 5

A nurse manager at a home health care service has resigned to take a position at a local ambulatory care centre. To initiate current changes, the nurse manager has to be knowledgeable about the differences between a home health care institution and an ambulatory care centre, which is a primary care institution. Primary care institutions are facilities that provide:
a. Rehabilitative or long-term care.
b. Disease-restorative care.
c. First access to care.
d. Only outpatient services.

Answer 5

ANS: C
In an ambulatory care institution, emphasis is placed on providing health maintenance and chronic or long-term care in a team setting to individuals who have an identified need from the time of diagnosis or impairment. This definition is consistent with that of primary health care

Question 6

A social determinant of health:
a. Is predictable of acuity.
b. Is biologic and genetic endowment.
c. Is related mainly to the psychological environment. d. Has little impact on health status.

Answer 6

ANS: B
Biologic and genetic endowment is one of 12 social determinants of health, as identified by the Canadian Nurses Association.

Question 7

The Canadian Classification of Health Interventions database was created for:
a. Physicians.
b. Registered nurses.
c. Unregulated health care providers.
d. All health provider groups.

Answer 7

ANS: D
The Canadian Classification of Health Interventions (Canadian Institute for Health Information, 2009) database includes a standardized list of diagnostic, therapeutic, support, and surgical interventions for all health provider groups.

Question 8

An academic teaching hospital that provides care for patients who require inpatient and ambulatory care for addictions, through a spectrum of wellness and illness services and providers, would be considered:
a. A health care network.
b. A tertiary care institution.
c. Rehabilitative.
d. Long-term care.

Answer 8

ANS: B
Tertiary care institutions or tertiary hospitals provide highly specialized services (e.g., academic teaching hospital).

Question 9

Which of the following has placed considerable strain on the Canadian health care system?
a. Decreasing costs.
b. A stable economy.
c. Increase in elderly population.
d. Status quo health care services.

Answer 9

ANS: C
Scarce resources, increasing costs, a variable economy, an anticipated increase in the
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number of elderly people who will require care, and a growing demand for improvement in health care have placed considerable strain on the Canadian health care system.

Question 10

Instituting similarities in services across health care regions among provinces and territories is considerably complex because of:
a. A lack of knowledge and skill in their associated use.
b. The vast geographic areas present in the Canadian landscape.
c. Minimal diversity in provincial health care needs.
d. An inability to accurately reflect exact cost per service provided.

Answer 10

ANS: B
Efforts to reduce services to regions may be divisive if they are perceived to distribute funds unfairly or inequitably between similar regions within a province. Instituting similarities across health care regions is also considerably complex because of the vast geographic areas and diversity present in Canadian contexts.

Question 11

Samuel, a 4-year-old boy, has just received a diagnosis in the clinic of an extremely rare medical condition. The family is counselled that Samuel will be referred to which type of care?
a. Primary.
b. Secondary. c. Tertiary.
d. Quaternary.

Answer 11

ANS: D
Quaternary centres provide treatment of extremely rare medical conditions (they are generally part of a large, tertiary care hospital).

Question 12

According to the World Health Organization’s (1978) definition, primary health care is considered:
a. The entry point into the health care system.
b. An institution-based health care service.
c. To empower people to be responsible for their own health.
d. To focus mainly on acute care treatment.

Answer 12

ANS: C

Question 13

An example of additional health care services is: a. Dental cleaning and checkup.
b. Annual Papanicolaou (Pap) smear.
c. Childhood immunizations.
d. Hospital room costs.

Answer 13

ANS: A

Question 14

In Canada, which of the following has the most authority over the management and delivery of health care?
a. Hospital board of directors.
b. Regional health boards.
c. Provincial government.
d. Federal government.

Answer 14

ANS: C
Provinces and territories have the most authority over the organization, management, and delivery of health care.

Question 15

The Office of Nursing Policy is an advisory body for:
a. The Canadian Nurses Association.
b. The Canada Health Act Implementation Committee.
c. Health Canada.
d. Provincial and territorial ministries of health.

Answer 15

ANS: C
The Office of Nursing Policy is an advisory body within Health Canada that advises Health Canada on nursing perspectives, health care-related policies, issues, and programs.

Question 16

The largest percentage of health care costs is spent on a. Hospitals.
b. Medications.
c. Physicians.
d. Unregulated health care workers.

Answer 16

ANS: A

Question 17

Which response is not a tenet of Strengths-Based Nursing Leadership?
a. Understands the significance of subjective reality and created meaning.
b. Values self-determination.
c. Resides within the organization.
d. Recognizes the uniqueness of staff, nurse leaders, and the organization.

Answer 17

ANS: C
Principles of Strengths-Based Nursing Leadership recognizes the uniqueness of staff, nurse leaders and the organization, values self-determination, understands the significance of subjective reality and created meaning, and focuses on the person not the organization.

Question 18

Expanding the scope of practice for nurses is expected to? (Select all that apply.)
a. Reduce the number of unregulated care workers.
b. Improve access to care.
c. Increase work efficiency.
d. Alleviate the costs of delivering care.

Answer 18

ANS: B, C, D

Question 19

Implementing electronic health records (EHRs) and other health information technology as widely as possible in Canada is to ensure: (Select all that apply.)
a. Delivery of better quality of care.
b. Delivery of more efficient health services.
c. Reducing errors.
d. Reducing health care costs.

Answer 19

ANS: A,B,C

Question 20

A hospital and a nursing education program form a partnership to recruit more nurses to the region. This organizational structure is:
a. Being responsive to changes in the environment.
b. Being bureaucratic.
c. Creating permanent professional boundaries.
d. Delineating structures for all decision making.

Answer 20

A

Question 21

The chief nursing officer and the dean of the school of nursing believe that by establishing rules and regulations and controlling the environment, this partnership will:
a. Promote professional medical authority, autonomy, and responsibility.
b. Diminish quickly with no central figure.
c. Be essential for self-governance.
d. Provide for the establishment of medical committees.

Answer 21

NS: B
Centralized decision-making structures that emphasize high control, and rules and regulations that lay out expectations, can be slow to respond to emerging trends. Organizations that are controlled in a heavily centralized way can diminish quickly without the strong central figure.

Question 22

A nurse manager understands that a matrix organizational structure:
a. Is a simplified organizational structure.
b. Has both a functional manager and a service or product-line manager.
c. Arranges departments strictly according to function.
d. Promotes harmony in organizational decision making.

Answer 22

ANS: B
Matrix structures are complex, integrated organizational structures that involve both functional managers and service or product-line managers. In this structure, team members or teams from various functional departments may combine to complete a project or program, thereby becoming responsible to both their functional department manager and their product-line manager. Harmony or disharmony cannot be assumed.

Question 23

Collaborative partnerships between hospitals and schools of nursing are examples of hybrid organizational structures. A hybrid organizational structure:
a. Has many divisions of labour.
b. Best fits long-term care units.
c. Has a mixture of the characteristics of various organizational types.
d. Places the authority for decision making closest to the places where workers
perform.

Answer 23

ANS: C

Question 24

In opening a new dialysis unit, the nurse manager has to develop a philosophy for the unit. This philosophy needs to:
a. Reflect the culture of the unit and its values.
b. Be developed by the nursing manager on the unit.
c. Identify the patients who will be served on the unit.
d. Replicate the organization’s philosophy.

Answer 24

A

Question 25

The hospital administration gives approval to the chief nursing officer to hire clinical nurse specialists in staff positions rather than in administrative positions. A clinical specialist who has staff authority but no line authority typically is able to:
a. Function through influence.
b. Take complete responsibility for the care of patients.
c. Interview and hire staff nurses for designated nursing units.
d. Be granted functional authority to determine standards of nursing care and enforce
them.

Answer 25

ANS: A
Staff positions provide support to line positions but have no direct accountability for staff or patient outcomes and therefore function through influence.

Question 26

A new director of nursing in a small rural hospital wants to make changes from the traditional model of governance to a shared-governance model. Of the following characteristics, which best describes the traditional organizational structure in which a staff nurse is assigned to carry out nursing tasks for patients but is not given the chance to provide input into forming the policies and procedures by which care is delivered or the standards by which care is evaluated?
a. Bureaucratic.
b. Decentralized.
c. Delegated authority and responsibility.
d. Delegated responsibility but no authority.

Answer 26

D

Question 27

The chief nursing officer is given the task of reviewing and revising the organization’s mission, philosophy, and technology. In reviewing them, the chief nursing officer understands that they should be reflected in:
a. The organizational structure.
b. Line and staff responsibilities.
c. The policies and procedures.
d. Government regulations.

Answer 27

A

Question 28

The facilities department is experiencing some challenges and is undergoing reorganization. Because of your familiarity with systems theory, you:
a. Know that this challenge is their issue and that it has nothing to do with your unit.
b. Understand that such events are localized and do not have an effect on the
organizational culture.
c. Know that the nature of challenges and reorganization in facilities will have an
effect on other areas.
d. Anticipate that your prior experiences with facilities have no effect on the current
situation.

Answer 28

C

Question 29

“Bayshore Hospital will provide care that is a national example of consumer service” is a:
a. Vision statement.
b. Statement of philosophy.
c. Mission statement.
d. Rationale for care.

Answer 29

A

Question 30

“At Thoroughcare, we provide health care for women and children in transition” is an example of a:
a. Vision statement.
b. Mission statement.
c. Goal statement.
d. Statement of philosophy.

Answer 30

B

Question 31

Which of the following is the most appropriate mission statement for a nursing centre?
a. “At Wellness, we provide rehabilitative services for addicted adolescents.”
b. “Georgetown provides treatment and prevention services for county residents.”
c. “At Heart, our aim is to provide services that lead the nation in health education
and research.”
“At Coeur, we strive to achieve optimal pain management with patients who are experiencing chronic pain.”

Answer 31

D
The mission statements of nursing centres are oriented toward achieving optimal health status for a defined group of patients or consumers.

Question 32

Which of the following most influences the organizational structure of the organization?
a. Mission statement.
b. Statement of philosophy.
c. Vision statement.
d. Goal statement.

Answer 32

A
Mission statements specify the reasons for the organization’s existence and include the population served and services offered, which, in turn, influence which technologies and human resources will be required.

Question 33

In which of the following situations would you expect low morale and frustration?
a. Statement of philosophy indicates “We value our staff.” When staff members
resign, careful evaluation is done to determine whether staff should be replaced by full- or part-time employees.
b. Practices include annual staff recognition celebrations. During times of change,
staff members are actively included in issue identification and solution finding.
c. Recruitment ads promise opportunities for advancement for everyone. Promotions
are given only to individuals with long-standing service and entrenched
relationships.
d. The vision indicates that there is strong commitment to lead in research. The
organization has tried to implement a strong campaign to attract leading nurse researchers but has experienced difficulty in doing so.

Answer 33

ANS: C
Although frustration may occur with external factors that affect ability to act on values and aspirations, lack of congruence between what is espoused as a value within the organization, such as promising advancement as an incentive to join the organization, and what is actually done, such as restricting advancement to internal candidates with much organizational history, can cause low morale and confusion.

Question 34

In Valley Hospital, there is a great deal of discussion about the balance between hospital-wide budget decision making and unit-based budget decision making. This discussion represents:
a. A search for the “sweet spot.”
b. Conflict between the values of nursing and those of the health care organization.
c. Traditional organizational values.
d. Differences between bureaucratic and nonlinear thinking.

Answer 34

ANS: A
The important point for an organization—the balance between centralization and decentralization of authority and decision making—is known as the “sweet spot.”

Question 35

With revenue reductions and cost saving measures, the number of managers has been reduced, which has increased the number of team leaders, supervised by managers, by as many as three. This change may result in:
a. Decreased patient satisfaction.
b. Increased efficiency in costs.
c. A more positive perception of managers.
d. Little change to manager–staff relationships.

Answer 35

A

Question 36

Lachine Hospital has well-defined organizational units that provide maintenance, financial services, care for cardiac patients, care for surgical patients, and so on. The organizational chart indicates that surgical units report to a surgical manager, all nursing units report to a vice president of nursing, financial services units report to an accountant and then to a business executive, and so on. The primary disadvantage of this organizational structure is:
a. Breakdown in function and communication across specialties.
b. Lack of congruence in culture and organizational values.
c. Highly centralized decision making anD Authority.
d. Wide span of control.

Answer 36

ANS: A
In a functional organizational structure, departments and services function according to specialty. This model supports professional expertise but can lead to silos in communication and decision making and to discontinuity in patient services.

Question 37

In the Unity Health Care organization, decisions, including those at the unit level, are made by a group of senior executives. Rules for employees are clear, and nursing care is delineated by procedures and protocols. This exemplifies:
a. Transformational leadership.
b. Transactional leadership.
c. Bureaucratic organization.
d. Chaos theory.

Answer 37

C

Question 38

In a health care agency that has a bureaucratic organization, communication flows:
a. Laterally.
b. Bottom to top.
c. Top to bottom.
d. Intermittently.

Answer 38

C

Question 39

Saskia is a clinical nurse educator in the dialysis unit at Pineview Health Centre and provides education, consultation, and training support. Saskia has:
a. Direct responsibility for patient care.
b. Direct accountability for patient outcomes.
c. A relationship of authority over staff
d. An influence over patient outcomes.

Answer 39

D

Question 40

A statement such as “We believe in the right of patients to make choices and to have care that is sensitive to their preferences and needs” is a _____ statement.
a. Mission.
b. Goal.
c. Vision.
d. Philosophy.

Answer 40

D

Question 41

What are key features of positive organizational culture? (Select all that apply.)
a. Supports professional development of members.
b. Promotes positive perceptions of unit leadership and workplace empowerment.
c. Respects values and norms.
d. Promotes new ways of improving practice.

Answer 41

All of the above

Question 42

A nurse manager working in a hospital-based matrix structure understands that: (Select all that apply.)
a. This structure includes reporting to both a functional manager and a service- or product-line manager
b. This structure can be effective in the current health care environment
c. This structure leads to a decrease in bureaucracy
d. This structure permits better cross-communication among various organizational
units or departments

Answer 42

A, B, D

Question 43

Shared governance is a flat type of organizational structure that: (Select all that apply.)
a. Helps nursing staff have more autonomy to govern their practice.
b. Has a foundation of accountability.
c. Provides the functional areas needed to support professional practice.
d. Requires new behaviours of all staff.

Answer 43

All of the above

Question 44

Complex care of acutely ill patients is required on a surgical unit in which differentiated nursing practice is its model of care delivery. The concept of differentiated nursing practice is based on:
a. Licensure status.
b. Experience in the agency.
c. Leadership capabilities.
d. Education and expertise.

Answer 44

D

Question 45

The relief charge nurse has assigned a newly registered baccalaureate-prepared nurse to be one of the team leaders for the shift from 1500 to 2300 hours. In making this decision, the charge nurse has overlooked this nurse’s:
a. Clinical expertise.
b. Leadership ability.
c. Communication style.
d. Conflict-resolution skills.

Answer 45

A

Question 46

When interviewing an applicant for a position, the nurse manager describes the unit’s care delivery system as one in which each nursing assistant is cross-trained to perform specific tasks, and in which the RNs handle all intravenous medications, admissions, and discharge teaching. The nurse applicant knows this nursing care delivery strategy to be:
a. The case method.
b. Functional nursing.
c. Primary nursing.
d. Nurse case management.

Answer 46

B

Question 47

You are the nurse manager of a nursing service organization that provides around-the-clock care to patients in their homes. To achieve an optimal outcome for a patient who is recovering from a hip replacement, the nursing staff will probably follow the nursing care guidelines presented in which of the following?
a. Nursing care plan.
b. Physician’s orders.
c. Critical pathway.
d. Clinical practice guidelines.

Answer 47

C

Question 48

The nurse case manager is working with a patient admitted for end-stage renal disease. The case manager’s major goal during this hospitalization is to:
a. Implement the care map on admission.
b. Provide direct nursing care throughout hospitalization.
c. Supervise the nursing staff members who implement the care map.
d. Prevent the need for additional hospitalizations resulting from complications of the
patient’s disease.

Answer 48

D

Question 49

The nurse manager at a cardiac rehabilitation unit was asked to select a care delivery model. Which of the following methods would be the most cost effective?
a. Functional method.
b. Case management method.
c. Primary care method.
d. Team method.

Answer 49

B
Team nursing, functional nursing, and case management are all considered efficient, cost-effective methods of care delivery because they enable use of various types of health care providers (rather than baccalaureate nurses in direct care, which is the primary nursing method). Case management is considered particularly cost effective in patient care settings that have the potential for high resource consumption, such as settings with medically complex cases, through collaboration and close attention to outcomes.

Question 50

In an acute care unit, the nurse manager utilizes the functional nursing method as the care delivery model. The nurse manager’s main responsibility is the needs of which of the following?
a. The department.
b. The unit.
c. Staff members.
d. The patient.

Answer 50

ANS: D
In a functional nursing model, in which other team members are focused on performing specific tasks, the nurse manager assumes primary responsibility for patient outcomes.

Question 51

n a small rural nursing home a director of nursing decides to implement a partnership model, because of a shortage of nurses, to help with certain tasks. What combination of health care providers constitutes a partnership care delivery model?
a. RN and licensed practical nurse/licensed vocational nurse.
b. RN and RN.
c. RN and medication assistants.
d. RN and certified nurses’ aides.

Answer 51

C
The partnership care delivery model is a variation of primary nursing in which an RN works with a medication assistant, who performs basic nursing functions.

Question 52

The case method of care delivery could be best justified for which of the following scenarios?
a. Stable patient population with long-term care and family needs.
b. Acute care surgical unit with predictable postsurgical outcomes and many
technical procedures.
c. Pediatric intensive care unit that heavily involves families and also patients.
d. Home health care environment with patients who have varying degrees of acute
illness.

Answer 52

C

Question 53

During times of nursing shortage and increased nursing costs in health care, which of the following nursing care delivery models might come under greatest scrutiny?
a. Case method.
b. Team nursing.
c. Functional nursing.
d. Nurse case management.

Answer 53

A

Question 54

A patient complains to you that she has no idea who “her nurse” is on any given day. “I ask one nurse for my pills, and she says, ‘That is not my job.’ I ask the pill nurse about my lab tests, and she says that I should ask another nurse.” The nursing care delivery model most likely to be employed in this situation is
a. Differentiated practice.
b. Team nursing.
c. Functional nursing.
d. Case management.

Answer 54

C

Question 55

The functional nursing model might be particularly effective in which of the following?
a. Promoting communication among diverse team members.
b. Facilitating multiple perspectives on the total care of a patient.
c. Avoiding patient–provider conflict.
d. Developing competence and confidence in unlicensed workers.

Answer 55

D

Question 56

n
In particular, she finds that the team model:
a. Can be effective in recognizing individual strengths and backgrounds of staff
comparing team and functional models of care, a nurse manager favours the team model.
members.
b. Promotes autonomy and independence of the RN.
c. Avoids conflict because of role clarity.
d. Is efficient in delivering care to a large group of patients with the use of a staffing
mix.

Answer 56

A

Question 57

To effectively delegate in a team nursing environment, the RN team leader must be familiar with the legal and organizational roles of each group of personnel and must:
a. Be able to effectively communicate with patients.
b. Build relationships with physicians.
c. Be able to adapt to daily changes in staffing.
d. Adapt in communicating information to the supervisor.

Answer 57

C

Question 58

A nurse manager questions the true difference between primary nursing and total patient care. After careful consideration of both models, the nurse manager concludes that primary nursing differs significantly from total patient care in which way?
a. Breadth of nursing knowledge required
b. Intention to provide holistic nursing.
c. Time period of accountability.
d. Levels and types of assessment.

Answer 58

C
Significant overlap can be seen between primary nursing and total patient care in terms of breadth of assessment and knowledge required to provide holistic care. A primary difference is that nurses in the total care model assume accountability while on shift, whereas primary nurses assume responsibility from a patient’s time of admission to discharge and 24 hours a day during the hospital stay.

Question 59

A conflict develops between an associate nurse and a primary nurse over the assessment of a patient with pulmonary edema. On the basis of her assessment of the patient, the associate nurse insists that it is her role to change the care plan because she is the one who has made the assessment. As the nurse manager, you clarify that:
a. It is the role of the primary nurse to make alterations on the basis of assessment data and input.
b. The associate nurse is accountable and responsible while the primary nurse is off duty and therefore is able to alter the care plan.
c. Neither the primary nurse nor the associate nurse should make changes without first consulting you as the manager.
d. It really does not matter who alters the nursing care plan because it depends on
situation and time to do so.

Answer 59

A
The primary nursing model assumes that the primary nurse is accountable for patient care, even while off duty. The primary nurse is responsible for establishing the patient plan of care and therefore for altering it with the input of an associate. The associate is responsible for implementation of the care plan that has been established when the primary nurse is off duty.

Question 60

When comparing functional nursing and primary nursing, a nurse manager, after evaluating particular models of nursing care for potential adoption, determines that patient and nurse satisfaction in primary nursing are:
a. Similar to those in functional nursing.
b. Not of significance in either model.
c. Low in comparison with that in functional nursing.
d. High in comparison with that in functional nursing.

Answer 60

D
Primary nursing tends to be satisfying for RNs who enjoy a high level of accountability and autonomy in decision-making. Patient satisfaction is also high, inasmuch as patients form close therapeutic relationships with the nurse because of the continuousness of the
relationship.

Question 61

In transitioning to a primary nursing model, it is important for a nurse manager who enjoys a high level of control over patient care to understand that his or her decision-making at the patient care level:
a. Is increased.
b. Is decreased.
c. Is relinquished.
d. Remains the same.

Answer 61

B

Question 62

You are considering putting forward a proposal to move the model of care from team nursing to a primary nursing hybrid—a patient-focused care model. In considering this proposal, you recognize that significant costs specific to operationalizing this model are related to which of the following?
a. Implementation of an all-RN staff complement.
b. Significant changes in the physical structure of units.
c. Orientation of staff to new roles and responsibilities.
d. Testing and piloting technology at the patient’s bedside.

Answer 62

B

Question 63

When hiring a case manager for a rehabilitation setting, you are most likely to consider which of the following?
a. A registered nurse with a master’s degree.
b. A physiotherapist with a background in stroke rehabilitation.
c. A social worker with a background in counselling.
d. A health care provider with advanced background who is focused on patient and
outcome.

Answer 63

D

Question 64

Case-managed care may enhance profit in a for-profit health organization by:
a. Minimizing costs in areas of high resource consumption.
b. Combining licensed and nonlicenced care providers in delivering patient care.
c. Increasing reimbursement from third-party payers.
d. Reducing the amount of technology used to support clinical decision-making.

Answer 64

A

Question 65

In considering whether to accept a job offer in a hospital in which the synergy model of care is used, you expect that which of the following is the driver of the necessary nurse competencies for practising within this model?
a. Educational background of the nurse.
b. Patient population characteristics.
c. Interdisciplinary health care teams.
d. National nurse-to-patient ratios.

Answer 65

ANS: B
The synergy model identifies patient characteristics as “drivers” of the necessary competencies for nurses.

Question 66

Nursing case management is geared to providing comprehensive care for those with complex health problems. Which of the following supports the use of a case management model? (Select all that apply.)
a. Decreases length of stay.
b. Increases efficient use of services.
c. Increases nurse sense of satisfaction.
d. Decreases human resource inequities.

Answer 66

A, B, C

Question 67

The total patient care method, or patient allocation method, of nursing care delivery is the oldest model of providing care to patients. One nurse provides total care to one or two critically ill patients, or to a group of patients. Which of the following contributes to the success of this model? (Select all that apply.)
a. Current global nursing shortage.
b. High costs.
c. Provides high quality care.
d. Engenders trust between family and nurse.

Answer 67

C, D

Question 68

The chief nursing officer implements the team nursing model on the acute care units. Expectations of the team leader include which of the following? (Select all that apply.)
a. Being attentive to the needs of the organization.
b. Being newly graduated with a baccalaureate degree.
c. Having several years of clinical nursing practice.
d. Being attentive to the needs of the patient.
e. Being attentive to the needs of the staff.

Answer 68

C, D, E

Question 69

A community-based pain management program is being planned for your region. As a coordinator of a home care agency, you have been requested to develop a conceptual framework, mission statement, philosophy, and objectives for the program. In what order will you pursue this endeavour?
a. Objectives, philosophy, and mission statement.
b. Philosophy, objectives, and mission statement.
c. Philosophy, mission statement, and objectives.
d. Mission statement, philosophy, and objectives.

Answer 69

D

Question 70

The clinic nurse understands that the advantages of planning include:
a. Assisting staff in critical thinking and improving decisions.
b. Orienting people to react instead of act.
c. Forcing managers to be financially efficient and effective.
d. Focusing on activities, not results.

Answer 70

A

Question 71

s a nursing leadership student, you have had the opportunity to develop a palliative care manual that will be used by the palliative care network (PCN) in your region for teaching health care providers. The PCN has requested that you provide a prioritized strategic plan of action for the manual on a province-/territory-wide basis. What is the first priority?
a. Motivate the target market.
b. Research the target market.
c. Communicate benefits to the target group.
d. Package the product.

Answer 71

B

Question 72

The chief nursing officer has to write a strategic plan. The most difficult stage in the strategic planning process is:
a. Assessment of the external and internal environment.
b. Review of mission statement, goals, and objectives.
c. Identification of strategies.
d. Implementation of strategies.

Answer 72

A

Question 73

From your observation of planning activities in the organization, you have noticed that planning and decision making occur at various levels of the organization. The nurse manager has overall responsibility for which of the following?
a. Sending out postcards.
b. Organizing a telephone follow-up.
c. Monitoring ongoing activities and projects.
d. Listing the patient population.

Answer 73

C

Question 74

Which of the following represents a well-written objective?
a. “To reduce hospital-acquired infections and to implement procedures to reduce
infections.”
b. “To increase staff satisfaction and to decrease burnout.”
c. “To increase the health of the community.”
d. “To implement evidence-informed practice on nursing units, according to adoption
of evidence-informed processes, by June 1, 2016.”

Answer 74

D

Question 75

In assessing the internal environment, the strategic planning team at Pacific Hospital discovers that 90% of staff members have no idea what the current mission statement means. This is probably related to:
a. The level of abstraction inherent in mission statements.
b. Development of the statement by the administration team with no other staff involvement.
c. Outdated goals and objectives contained in the mission statement.
d. Failure to provide action statements within the mission statement.

Answer 75

B

Question 76

Through its strategic planning processes, the strategic planning team at Pacific Hospital learns that nursing staff members are uncomfortable with using evidence-informed practice, and that they perceive that only limited resources are available to support translation of evidence into their usual practice. Because this issue has been identified, the team determines that a plan of action is required to address the issue. Who should be involved in determining this plan?
a. Nursing unit managers
b. Staff nurses
c. All staff
d. Administration

Answer 76

A

Question 77

The process of developing, negotiating, and formalizing the targets of an organization is:
a. Objective development.
b. Goal setting.
c. Philosophy creation.
d. Strategic planning.

Answer 77

B

Question 78

Which of the following reflects a characteristic of an organizational environmental assessment?
a. It relates only to administration.
b. It is an informal evaluation of relationships.
c. It does not include the organizational climate.
d. It involves comparison of data against benchmarks.

Answer 78

B

Question 79

The strategic planning process shares many similarities with which of the following?
a. The mission statement.
b. The nursing process.
c. The goal-setting process.
d. The writing of objectives.

Answer 79

B

Question 80

Which of the following represents an effective goal statement?
a. “Involve patients and families in planning health care.”
b. “To revise clinical guidelines for incontinence care from evidence within 6
months.”
c. “Patients and families are partners first in care planning.”
d. “To acquire $4 million in additional funding within 12 months to support clinical
education programs for dementia.”

Answer 80

A

Question 81

After a year staff members at Pacific Hospital are frustrated, and the implementation of evidence-informed practice has gone poorly. In responding to this situation, the strategic planning team at Pacific Hospital:
a. Recommends that the mission, objectives, and goals of the hospital be reassessed.
b. Revises the goal statements in the strategic plan.
c. Consults an external team on preparation of materials on evidence-informed
practice.
d. Holds focus groups with staff to determine what kinds of issues, challenges, and
obstacles have occurred in implementation.

Answer 81

D

Question 82

The purpose of strategic planning includes which of the following? (Select all that apply.)
a. Leads to the achievement of goals and objectives.
b. Is not necessary for small organizations.
c. Gives meaning to work life.
d. Takes staff away from real work.

Answer 82

A, C

Question 83

Objectives developed in the strategic plan must be reviewed regularly for what reason(s). (Select all that apply.)
a. Because of legislative changes.
b. Because of restructuring changes.
c. Because of complaints about service.
d. Because of environmental processes.

Answer 83

A, B, D

Question 84

A clinic nurse developed objectives for a diabetic education program. Well-written objectives should be which of the following? (Select all that apply.)
a. Reasonable.
b. Understandable and specific.
c. People oriented.
d. Manager oriented.
e. Means oriented.
f. Measurable.

Answer 84

A, B, F