Healthcare Systems Management
Exam Answer Key
Course Introduction
Healthcare Systems Management explores the organization, structure, and operation of healthcare delivery systems, focusing on the challenges and strategies for effective management in various healthcare settings. The course examines topics such as healthcare policy, leadership, financial management, quality improvement, information technology, and regulatory compliance. Through case studies and real-world examples, students learn how to evaluate and improve healthcare processes, enhance patient care, and adapt to the evolving landscape of the healthcare industry. This course equips students with the essential knowledge and practical skills needed to lead teams, manage resources, and make informed decisions in healthcare organizations.
Recommended Textbook
Leadership and Nursing Care Management 6th Edition by Diane Huber
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689 Verified Questions
689 Flashcards
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Chapter 1: Leadership and Management Principles
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Sample Questions
Q1) A medical-surgical unit reports higher rates of patient satisfaction coupled with high rates of staff satisfaction and productivity. Which of the following is attributed to the data findings?
A) Effective leadership
B) Management involvement
C) Mentoring
D) Rewards and recognition
Answer: A
Q2) Nursing management is defined as:
A) delegation of authority and responsibility and the coordination of tasks.
B) the integration of resources through planning, organizing, and directing.
C) the process of influencing patients to accomplish goals.
D) the coordination and integration of nursing resources by applying the management process to accomplish nursing care and service goals and objectives.
Answer: D
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Chapter 2: Change and Innovation
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Sample Questions
Q1) A nurse manager recognizes that her staff's emotional responses to organizational change are similar to:
A) adaptation techniques.
B) integrative tactics.
C) symptoms of mental illness.
D) the grief model.
Answer: D
Q2) Which of the following factors is used to describe the degree to which successful planned change is thought to be better than the status quo?
A) Complexity
B) Compatibility
C) Trialability
D) Relative advantage
Answer: D
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Chapter 3: Organizational Climate and Culture
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Sample Questions
Q1) How is culture measured within an organization?
A) Through the use of time-motion studies
B) Through the use of quantitative instruments
C) Through the use of qualitative instruments
D) With a combination of qualitative and quantitative measures
Answer: D
Q2) Characteristics of a Magnet hospital include:
A) multidisciplinary collaboration.
B) nursing leader authority.
C) physician control.
D) social worker retention.
Answer: A
Q3) How is culture represented at the unit level, with an underlying belief in patient-centered care?
A) Open visiting hours in the critical care unit (CCU)
B) Strict visiting hours in the CCU
C) Tape-recorded report
D) Verbal handoff conducted at the nurses' station
Answer: A
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Page 5
Chapter 4: Managerial Decision Making
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Sample Questions
Q1) A multidisciplinary team makes a decision to develop a plan for the use of thrombolytics in the emergency medical service system. Questions are asked such as, "Is the client a candidate for thrombolytic therapy? Does the client have a history of gastrointestinal bleeding? Has the client ever had a stroke? Does the client have any bleeding disorders?" Which of the following decision-making strategies would work best in this situation?
A) Fishbone diagram
B) Decision tree
C) Flowchart
D) Data analytics
Q2) How is decision making at the staff nurse level exemplified?
A) The staff nurse adapts to a challenging patient assignment.
B) The staff nurse refers issues to the performance improvement committee.
C) The staff nurse accepts the status quo.
D) The staff nurse questions current practice and refers to unit leadership for change.
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Chapter 5: Managing Time and Stress
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Sample Questions
Q1) What are some potential reasons that nurses experience higher levels of stress? (Select all that apply.)
A) Nurses are skilled at setting boundaries.
B) Nurses often put others' needs ahead of their own.
C) Staff nurses are under pressure to do more with less.
D) There are support staff cuts.
E) There are fluctuations in staffing levels.
Q2) Nurses who must manage unplanned and regular responsibilities simultaneously may experience:
A) complexity compression.
B) resilience.
C) moral distress.
D) empowerment.
Q3) A nurse manager has several complaints from her staff that she is inaccessible during the day. What is the best strategy the nurse manager takes to improve her staff satisfaction?
A) Notify staff when she will be out of the office.
B) Block time for daily rounds with staff.
C) Set realistic follow-up deadlines for staff issues, questions, and concerns.
D) Ask the staff to communicate with her through their supervisors.
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Chapter 6: Legal and Ethical Issues
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Sample Questions
Q1) On admission, the patient was found to have a blood glucose level of 218. The RN knows that except in emergency situations, it is hospital policy to obtain physician's orders before administering any medication. Because the on-call physician did not return the page, the nurse administered insulin according to the common sliding scale. Four hours later, the patient was found nonresponsive in her bed and later died. According to the autopsy, the patient died from heart failure. Her postmortem blood glucose level was 22. The nurse's actions are an example of:
A) breach of contract.
B) common negligence.
C) intentional malpractice.
D) medical oversight.
Q2) A staff nurse is facing a dilemma between meeting clinical ethical standards and meeting organizational goals. The nurse manager understands that the best way to assist staff members in resolving ethical dilemmas effectively is to focus on:
A) doing the right thing and taking the right action.
B) meeting clinical standards before organizational goals.
C) meeting organizational goals before clinical standards.
D) referring indecisive staff members for additional training.
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Page 8
Chapter 7: Communication Leadership
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Sample Questions
Q1) E-mail is a great tool for communication. When should e-mail not be used? (Select all that apply.)
A) When you are mad.
B) When scheduling a meeting
C) When you are canceling or apologizing
D) If there is any chance your words could be misunderstood
E) When rebuking or criticizing
Q2) Organizational tones are based mostly on:
A) unspoken cultural norms.
B) commitment to success.
C) communication behavior.
D) leadership styles.
Q3) Interpersonal communication is defined as:
A) the conscious intent by one individual to modify the thoughts or behaviors of others.
B) a combination of written and spoken communication.
C) a theory used to describe a manner of communicating.
D) communication between two or more individuals involving face-to-face interaction.
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Chapter 8: Team Building and Working With Effective Groups
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Sample Questions
Q1) When teams are assigned, but not designed, dysfunction can occur. What are some characteristics of a dysfunctional team? (Select all that apply.)
A) Confusion over the purpose of the team
B) Lacks real authority
C) Effective interpersonal communication patterns
D) Team needs placed above individual needs
E) Lack of evaluation criteria
Q2) Group as well as individual accountability exists within a:
A) work group.
B) true team.
C) pseudoteam.
D) committee.
Q3) Any collection of interconnected individuals working together for the same purpose is known as a(n):
A) club.
B) group.
C) meeting.
D) organization.
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Chapter 9: Delegation in Nursing
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Sample Questions
Q1) The nurse has asked a nurse's aide to greet a postoperative patient who has just arrived on the unit and to determine whether he is in stable condition. This act of delegation is an example of a nurse inappropriately delegating:
A) assessment of the patient.
B) evaluation of an intervention.
C) nursing judgment.
D) teaching to a delegate.
Q2) If a licensed practical/vocational nurse (LPN/LVN) provides discharge teaching, who is ultimately responsible?
A) Chief executive officer
B) Institution where the LPN/LVN works
C) Risk manager
D) UAP
Q3) The process for a nurse to direct another person to perform nursing tasks and activities is:
A) authorization.
B) delegation.
C) empowerment.
D) supervision.
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Page 11
Chapter 10: Power and Conflict
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Sample Questions
Q1) The main effects of conflict are individual effects, interpersonal relationships, and organizational effects. What are some of the positive effects of conflict within an organization? (Select all that apply.)
A) Absenteeism
B) Team cohesiveness
C) Disrupted communication
D) Stimulation of creativity and innovation
E) Improved quality of decisions
Q2) A common source of conflict in nursing occurs when the nurse wants to perform patient teaching or counseling, but there are competing priorities and the nurse has inadequate time to spend with the patient. This type of conflict is related to:
A) interpersonal conflict.
B) intergroup conflict.
C) intrapersonal conflict.
D) intragroup conflict.
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12
Chapter 11: Workplace Diversity
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Sample Questions
Q1) Which of the following supports successful workplace diversity?
A) Being a "devil's advocate"
B) Holding tight to one's cultural values
C) Respect for differences
D) Withholding judgment of others
Q2) The nurse manager of a nursing unit is a White, female working with a high percentage of Middle Eastern nursing staff. Which of these statements are true about the communication and leadership style of a low-context culture? (Select all that apply.)
A) Rules are clear and tend to be followed.
B) Low-context cultures require extensive, detailed explanations.
C) Verbal communication is less explicit.
D) Decisions are made in face-to-face conversations.
E) Decisions are focused around tasks.
Q3) Members of a generation who are linked through shared life experiences in their formative years are known as:
A) baby boomers.
B) generational markers.
C) generation gaps.
D) cohorts.
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Page 13
Chapter 12: Organizational Structure
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Sample Questions
Q1) Standardization of _____ provides a uniform structure for information delivery and flow in order to facilitate exchange among those involved in common work processes.
A) physician orders
B) communication
C) work processes
D) work outputs
Q2) Dividing work by occupation leads to a functional organization where services are arranged by the type of work performed. What are some benefits of the functional form within the health care organization? (Select all that apply.)
A) Professional silo
B) Fragmented care delivery
C) Cost reduction
D) Enhanced performance and quality
E) Promotion of professional development
Q3) The phrase "the buck stops here" best describes which of the following terms?
A) Accountability
B) Authority
C) Responsibility
D) Trustworthiness
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Page 14
Chapter 13: Decentralization and Shared Governance
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Sample Questions
Q1) One obstacle in the implementation of a shared governance model is that nurses have:
A) empowered participation in committee meetings.
B) limited time to work on projects.
C) the same basic educational foundation.
D) traditionally worked in decentralized structures.
Q2) The nurse manager should use which of the following behaviors when implementing a shared governance structure?
A) Autocratic decision making of the manager
B) Coaching the staff to be successful
C) Harboring the vision within the team
D) Reimbursing the staff for overtime
Q3) Research about shared governance suggests that it is:
A) enhancing the role of the nurse's aide within the organization.
B) improving organizational and patient outcomes.
C) not a cost-effective program when examining all areas of care.
D) too much additional work for the already overwhelmed RN.
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15
Chapter 14: Strategic Management
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Sample Questions
Q1) Addressing the strategic planning process questions involves considering environmental factors. An example of an external environmental factor to be considered is:
A) financial factors.
B) human resources.
C) political climate.
D) organizational culture.
Q2) The purpose of strategic management is to: (Select all that apply.)
A) ensure customer satisfaction.
B) establish a competitive position.
C) reach strategic objectives or goals.
D) develop the organizational mission.
E) provide a blueprint for operating a business.
Q3) The guiding framework that describes the organization's purpose and future direction is the:
A) futuristic guidelines.
B) mission and vision.
C) strategic plan.
D) core purpose.
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Page 16
Chapter 15: Professional Practice Models
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Sample Questions
Q1) Which of the following nursing care models are hospital based? (Select all that apply.)
A) Case management
B) Functional
C) Private duty
D) Team
Q2) A professional practice model is a:
A) conceptual framework and philosophy of nursing within an organization.
B) staffing grid that outlines nursing unit work schedules.
C) mechanism by which care is actually provided to patients and families.
D) blueprint for developing specific measurable objectives and actions.
Q3) Janice is assigned to pass medications this shift. Mary is assigned to do wound care, Jennifer will give all the baths, and Jim will take all the vital signs. This model of nursing care is called _____ nursing.
A) team
B) primary
C) modular
D) functional
Q4) A(n) _____ is the operational mechanism by which care is actually provided to patients and families.
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Chapter 16: Case and Population Health Management
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Sample Questions
Q1) According to the Centers for Disease Control (CDC), chronic diseases account for _____% of deaths in the United States.
A) 20
B) 40
C) 50
D) 70
Q2) The brokerage model and the comprehensive service center model are examples of which type of care model?
A) Collaborate
B) Inter-professional
C) Interdisciplinary
D) Social work
Q3) Nursing outreach programs are the core element of:
A) population health management.
B) disease management.
C) case management.
D) care management.
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Page 18
Chapter 17: Evidence-Based Practice: Strategies for Nursing Leaders
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Sample Questions
Q1) The responsibility to articulate the business case for evidence-based practice to senior leadership lies with:
A) the staff nurse.
B) nursing leadership.
C) the governing board.
D) the quality improvement committee.
Q2) Nurse managers are responsible for developing the unit culture supporting innovation and evidence-based care. The nurse manager can facilitate and support EBP work by: (Select all that apply.)
A) set the staffing schedule.
B) allocate resources as needed.
C) set the expectations for the unit.
D) promote staff questioning practice.
E) encourage and respond to new ideas.
Q3) Evidence-based practice includes:
A) collaborative practice dynamics between health care professionals.
B) documentation of patient care as evidence of nursing practice.
C) integration of research with clinical expertise and patient values.
D) mutual goal setting and application in the clinical setting.
Page 19
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Chapter 18: Quality and Safety
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Sample Questions
Q1) TJC requires accredited organizations to participate in their core measure initiative. The current core measure sets include: (Select all that apply.)
A) stroke.
B) tobacco treatment.
C) pneumonia measures.
D) iatrogenic pneumothorax.
E) venous thromboembolism.
F) acute myocardial infarction.
Q2) The improvement process in which an organization measures its strategies, operations, or internal process performance against that of best-in-class organizations within or outside its industry determines how those organizations achieved their performance levels, and uses that information to improve its own performance is known as _____.
Q3) The purpose of a root cause analysis (RCA) is to:
A) discipline the staff involved in the patient safety event.
B) disclose the medical error to the patient/patient s family.
C) identify the person(s) responsible for committing the error.
D) identify the systems issues that led to a sentinel event.
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Chapter 19: Measuring and Managing Outcomes
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Q1) The specific tools used to make quality visible to stakeholders in health care are called:
A) indicators.
B) outcomes.
C) variable selections.
D) quality measures.
Q2) Areas of data evaluation on a balanced scorecard include: (Select all that apply.)
A) metrics.
B) key performance indicators.
C) environmental.
D) turnover rates
E) benchmarks
Q3) Outcome indicators such as nurse burnout, turnover, and job satisfaction are examples of which type of indicator?
A) Patient-focused
B) Provider-focused
C) Organizational-focused
D) Nursing-focused
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21
Chapter 20: Prevention of Workplace Violence
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Sample Questions
Q1) What percentage of assaults in the workplace are committed against health care workers?
A) 50%
B) 20%
C) 15%
D) 40%
Q2) The main components in a violence prevention program are: (Select all that apply.)
A) a written plan.
B) worksite analysis.
C) criminal control.
D) security staff training.
E) record keeping and evaluation of the program.
Q3) Jenna, a registered nurse (RN), has been accused of gossiping and bullying a new graduate RN on her unit. This type of workplace violence is called _____ violence.
A) horizontal
B) co-worker
C) threatening
D) nurse-to-nurse
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Chapter 21: Confronting the Nursing Shortage
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Sample Questions
Q1) The United States recruits more internationally educated nurses (IENs) than any other country. The largest group of IENs in the United States is from:
A) India.
B) Canada.
C) Great Britain.
D) the Philippines.
Q2) Staff development has been identified in the literature as an important factor in job satisfaction. The areas of professional staff development defined in the Magnet studies include: (Select all that apply.)
A) orientation.
B) formal education.
C) in-service education.
D) career development.
E) continuing education.
Q3) The average age of the registered nurse (RN) population is _____ years.
A) 26
B) 36
C) 45
D) 56
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Page 23
Chapter 22: Staffing and Scheduling
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Sample Questions
Q1) A(n) ______ provides logic and order to complex processes for administrators and scientists to consider.
A) staffing plan
B) organizational chart
C) conceptual framework
D) nursing care delivery model
Q2) The core concept of the synergy model for patient care is based on the nurse-patient relationship and acknowledges:
A) frontline charge nurses make informed patient care assignment decisions.
B) organizing and delivering nursing care achieves desired patient outcomes.
C) the needs or characteristics of the patients and families drive the competencies of the nurse.
D) the clinical nurse leader champions innovations that improve patient outcomes, ensures quality care, and reduces health care costs.
Q3) A common element among nursing care delivery models is the:
A) ratio of nurses to patients.
B) manager is the frontline leader.
C) value of the nurse and patient/family relationship.
D) needs of the patients drive the competency of the nurse.
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Page 24
Chapter 23: Budgeting, Productivity, and Costing Out Nursing
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Sample Questions
Q1) The incorporation of economic evaluation into clinical practice is important to productivity because:
A) rationing must occur.
B) health care resources are limited.
C) providers may not turn away clients.
D) uninsured clients get the same health care as insured clients.
Q2) The manager of a rural, thriving, nurse-managed clinic is considering purchasing equipment to furnish two additional examination rooms. The resource he must consider is the _____ budget.
A) capital
B) expense
C) operating
D) product line
Q3) The operating budget covers a specific period, called a _____ year.
A) fiscal
B) budget
C) calendar
D) federal government
Q4) A(n) _____ is the difference between the budgeted and the actual amounts.
Page 25
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Chapter 24: Performance Appraisal
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Q1) The effectiveness of the performance review process can be improved when the manager and the employee can collaboratively: (Select all that apply.)
A) set goals.
B) discuss merit raises.
C) make developmental plans.
D) determine performance corrections.
E) talk about future prospects.
Q2) A successful performance review system must be: (Select all that apply.)
A) in line with the organization's strategic objectives.
B) fair and transparent.
C) free from bias.
D) administratively practical.
E) effectively administered.
Q3) A performance appraisal bias that occurs when all members of the team receive the same satisfactory rating is:
A) halo.
B) recency.
C) similar-to-me.
D) leniency.
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Chapter 25: Emergency Management and Preparedness
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Q1) What are the major roles of nursing leadership in disaster planning? (Select all that apply.)
A) Providing clearly defined roles for staff nurses in a disaster situation
B) Ensuring the synchronization of department plans
C) Encouraging staff to stay at home in the event of a disaster to decrease confusion
D) Ensuring that the community is synchronizing internal department plans in the event of a disaster
E) Developing or refining the hospital's emergency operations plan.
Q2) The nursing leadership role once the all-hazards preparedness plan is completed is to:
A) confirm that resources are allocated appropriately.
B) ensure that every facility department understands their role is a disaster situation.
C) establish goals for all-hazards preparedness.
D) provide rewards for the committee's accomplishments.
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Chapter 26: Data Management and Clinical Informatics
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Q1) What are the roles of nursing informatics specialists? (Select all that apply.)
A) Data analysis and reporting to governmental agencies
B) Participation in education of nursing staff
C) Providing direct patient care
D) Providing information and evidence-based knowledge
E) Supporting clinical decision making
Q2) The goals of meaningful use include: (Select all that apply.)
A) improve quality of care and safety.
B) engage patients and their families in care.
C) improve population health.
D) reduce costs associated with health care.
E) improve care coordination.
Q3) Nurses utilize _____ through critical thinking and clinical reasoning skills to determine when and how to apply evidence-based knowledge.
A) orders
B) data
C) information
D) wisdom
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Chapter 27: Marketing
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Q1) What terms are considered to be the four As that influence a buyer's decision to purchase a product or service? (Select all that apply.)
A) Acceptability
B) Accreditation
C) Affordability
D) Accessibility
E) Awareness
Q2) Marketing mix from a seller's point of view includes:
A) client service, charges, comfort, and connecting.
B) customer solution, cost, convenience, and communication.
C) patient, physicians, perfection, and publicity.
D) product, price, place, and promotion.
Q3) A center of excellence for geriatric care is put in place in a large retirement community. This is an example of which of the following marketing concepts?
A) Segmentation
B) Targeting
C) Product differentiation
D) Positioning
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