1. Which statement best describes functional nursing care delivery?

1. A) Nursing care is holistic and patient centered

2. B) The nurse must be a licensed person
3. C) Emphasis is on getting work done through tasks
4. D) It is also known as total patient care

Ans: C

Feedback:

Functional nursing is task focused. None of the other options identify that
connection.

2. The nurse is assigned to administer medications to all patients throughout

the shift. What is this an example of?

1. A) Team nursing
2. B) Case method nursing
3. C) Primary care delivery
4. D) Functional nursing care

Ans: D

Feedback:

Being assigned a specific task to do is part of functional nursing. None of the

other options identify that connection.

3. A nurse has accepted a position as a staff nurse and will practice primary
care nursing. The nurse will be the only RN on the team. What is an appropriate
role expectation for role fulfillment?

1. A) Planning nursing care independently of others

2. B) Assigning work according to the expertise of group members
3. C) Being responsible for care planning 24 hours a day
4. D) Carrying out the majority of personal care for your patients

Ans: B

Feedback:

In primary nursing, the sole RN would not plan the care without others input or
be responsible for care planning for 24 hours. Neither would the RN carry out
the majority of personal care.

4. With modular nursing, who checks the completion of tasks assigned to a

team member?
 1. A) The charge nurse
2. B) The area manager
3. C) The team leader
4. D) Another team member

Ans: C

Feedback:

The team leader should check the work of team members. None of the other
options identify the role correctly.

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5. Which statement is correct concerning primary nursing care?

1. A) Requires minimal RN staffing

2. B) Is easy to implement
3. C) Provides challenging work
4. D) Has proved to be a failure

Ans: C

Feedback:

Primary care provides challenging work for nurses; however, it is not easy to
implement and requires an all-RN staff. None of the other options accurately
describes the concept of primary nursing care.

6. What

1. A) Containing health-care costs

2. B) Providing challenging work
3. C) Enhancing professionalism
4. D) Decreasing length of hospital stays

Ans: A

Feedback:

The ANA maintains that case management is designed to contain health-care

costs. None of the other options identify a goal of casement.

7. What is the most important component in being well organized and

increasing productivity on the unit?

1. A) Adequate resources
2. B) A well-trained staff
3. C) A well-thought-out plan
4. D) Time to carry out your duties
Ans: C

Feedback:

Unless the plan is well thought out, patient care has the potential to be
disorganized. None of the other options identify that connection.

is the goal of case management?

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8. Which statement best describes case management?

1. A) Clinical outcomes should occur within a prescribed time frame

2. B) Case managers do not provide direct patient care
3. C) Managed care practice is a unit-based model of care
4. D) The goal is outcome management for every patient

Ans: A

Feedback:

In case management, clinical outcomes need to occur within prescribed time

frames. Case managers do not provide care; neither is managed care unit
based. The goal is outcome management for specific patients, but not every
patient needs case management.

9. What

1. A) Caregivers alter the plan as they deem necessary

2. B) Variances be indicated for patient deviations
3. C) Time frames for implementation be left open
4. D) Critical paths not be considered in care planning

Ans: B

Feedback:

In care MAPs, it is necessary to provide variances when there are patient

deviations, because this is a major component to case management. None of
the other options identify that connection.

10. Which is a true statement about the patterns of patient care management?

1. A) Functional nursing is organized according to the desires of the

worker
2. B) Primary nursing and total patient care are synonymous
3. C) Team leading includes the concept of patient care conferences
4. D) Case load nursing provides little autonomy for nurses
Ans: C

Feedback:

Team leading includes the need for patient care conferences. None of the other
options identify that need.

11. Where did critical pathways originate from?

1. A) Case management
2. B) Functional nursing
3. C) Team nursing
4. D) Primary care nursing

Ans: A

Feedback:

Critical pathways were developed as a result of the case management system.

None of the other options identify that original connection.

is necessary when implementing care multidisciplinary action plans (MAPs)?

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12. What nursing model provides the foundation for matching patient needs
with nursing competencies?

1. A) Primary nursing practice

2. B) Differentiated nursing practice
3. C) Modular nursing
4. D) Case management

Ans: B

Feedback:

To facilitate the effective use of nursing resources, patient needs and nursing
competencies should be matched. None of the other options identify that
connection.

13. What is one of the most important differences between case management
and disease management?

1. A) Disease management referrals begin in the hospital inpatient

setting
2. B) Disease management is a collaborative process to meet patient
needs
3. C) High-cost population groups are targeted in disease management
4. D) Disease management treatment is episodic
Ans: C

Feedback:

Although there are many similarities between disease management and case
management, the primary goal of disease management is to target high-cost
disease populations.

14. What

1. A) Total patient care

2. B) Functional nursing
3. C) Team or modular nursing
4. D) Primary care nursing

Ans: A

Feedback:

Total patient care, utilizing the case method of assignment, is the oldest form of
patient care organization and is still widely used today.

is the oldest form of organizing patient care that is still widely used today?

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15. What type of nursing uses mini teams, typically an RN and unlicensed
health-care workers, to provide care to a small group of patients who are
centralized geographically?

1. A) Total patient care

2. B) Functional nursing
3. C) Modular nursing
4. D) Primary care nursing

Ans: C

Feedback:

Modular nursing and model RN line use mini teams, typically an RN and
unlicensed health-care worker(s), to provide care to a small group of patients,
centralized geographically. None of the other options provide that staffing
format.

16. Primary care nursing is organized so that the patient is at the center of the
structure. How many nurses have 24-hour responsibility for care planning and
coordination?

1. A) One
2. B) Two
3. C) Three
 4. D) Four

Ans: A

Feedback:

Primary care nursing is organized so that the patient is at the center of the
structure. One nurse has 24-hour responsibility for care planning and
coordination.

17. What

1. A) Individual patient
2. B) Care for populations
3. C) Group of patients with same chronic illness
4. D) Group of patients with same acute need for surgery

Ans: A

Feedback:

While the focus historically for case management has been the individual
patient, the case manager employed in a disease management program plans
the care for populations or groups of patients with the same chronic illness.

was the focus historically for case management?

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18. What

is included in an MAP?

1. Critical path

2. Nursing care plan

3. Indication of times when nursing interventions occur

4. Nurses follow the care plan to facilitate expected outcomes

1. A) 1, 2, 3
2. B) 1, 2, 4
3. C) 1, 3, 4
4. D) 2, 3, 4

Ans: A

Feedback:
The care MAP is a combination of a critical path and a nursing care plan, except
that it shows times when nursing interventions should occur as well as
variances. All health- care providers follow the care MAP to facilitate expected
outcomes.

19. When work is redesigned, it frequently has consequences for employees

that must be considered. What consequences must be considered?

1. Professional interactions 2. Degree of autonomy

3. Employee evaluation

4. Communication patterns

1. A) 1, 2, 3
2. B) 1, 2, 4
3. C) 1, 3, 4
4. D) 2, 3, 4

Ans: D

Feedback:

When work is redesigned, it frequently has personal consequences for

employees that must be considered. Social interactions, the degree of
autonomy, the abilities and skills necessary, employee evaluation, and
communication patterns are often affected by work redesign.

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20. What is the positive patient outcome during a single shift of case method
nursing? Select all that apply.

1. A) Clear lines of responsibility

2. B) Nursing autonomy
3. C) Holistic patient care
4. D) Unfragmented care

Ans: A, B, C, D Feedback:

This method of assignment is still widely used in hospitals and home health
agencies. This organizational structure provides nurses with high autonomy and
responsibility. Assigning patients is simple and direct and does not require the
planning that other methods of patient care delivery require. The lines of
responsibility and accountability are clear. The patient theoretically receives
holistic and unfragmented care during the nurses time on duty. To maintain
quality care, this method requires highly skilled personnel and thus may cost
more than some other forms of patient care.

21. What is the primary outcome resulting from the implementation of the
functional nursing care delivery system?
 1. A) A cost-effective method of care delivery
2. B) Another permanent care delivery option
3. C) Ancillary staff with varying levels of training and education
4. D) A care delivery system addressing the needs of the baby boom
patient

Ans: C

Feedback:

The employment of personnel with various levels of skill and education

proliferated as new categories of health-care workers were created. Currently,
most health-care organizations continue to employ health-care workers of many
educational backgrounds and skill levels. None of the other options represent a
primary outcome of resulting from the implementation of functional nursing.

22. Which statement demonstrates an intervention focused on the primary

disadvantage of team nursing?

1. A) iWe are working with 1 fewer team members today.i

2. B) iThe team will be meeting for a care report update in 5 minutes.i
3. C) iOur patient assignment is comprised of both males and femalesi
4. D) iWe will be having a member of the float pool on our team today.i

Ans: B

Feedback:

Disadvantages to team nursing are associated primarily with improper

implementation rather than with the philosophy itself. Frequently, insufficient
time is allowed for team care planning and communication. This can lead to
blurred lines of responsibility, errors, and fragmented patient care. None of the
other options address a known disadvantage of team nursing.

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23. Which statement demonstrates an understanding of the factors that are

considered when a change in the care delivery system is being proposed? Select
all that apply.

1. A) iWe have determined that our level of care would improve if we

provided it
differently.i
2. B) iIts questionable whether our current nursing staff is large enough
to support the
proposed change.i
3. C) iWe will discuss our proposed change with the multidisciplinary
team members.i
 4. D) iAdministration has been supportive of the planned change in our
care delivery
system.i

Ans: A, B, C, D

Feedback:

If evaluation of the present system reveals deficiencies, the manager needs to

examine available resources and compare those with resources needed for the
change. There must be a commitment on the part of top-level administration
and a majority of the nursing staff for a change to be successful. Because health
care is multidisciplinary, the care delivery system used will have a heavy impact
on many others outside the nursing unit; therefore, those affected by a system
change must be involved in its planning. The philosophy of the nursing services
division must support the delivery model selected. Changing the philosophy is
not appropriate.

24. Which concept should a care delivery system support? Select all that apply.

1. A) Organization
2. B) Nursing process
3. C) Cost effectiveness
4. D) Patient satisfaction

Ans: A, B, C, D

Feedback:

Each units care delivery structure should facilitate meeting the goals of the
organization, be cost-effective, satisfy the patient, provide role satisfaction to
nurses, allow implementation of the nursing process, and provide for adequate
communication among health-care providers. While important, nursing research
is not a concept that is considered when selecting a care delivery system.

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