Sullivan, Effective Leadership and

Management, 8/e

Chapter 3

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.

1. Seniority

2. Educational level

3. Experience

4. Nurse preference

5. 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?

1. Critical pathways

2. Total patient care

3. Team nursing

4. 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.