Potter: Fundamentals of Nursing, 8th Edition

Chapter 02: The Health Care Delivery System

Answer Key - Review Questions and Rationales
1. Answer: 2.
Nursing interventions focused on transition and continuity provide patients with
information about medications to take, dietary or treatment plans to follow, and danger
signals for which to look after hospitalization or treatment. These interventions also
provide patients and families with health care resources after discharge.
2. Answer: 4.
Maintaining ongoing competency is a nurses responsibility. Earning certification in a
specialty area is one mechanism that demonstrates competency. Specialty certification
has been shown to be positively related to patient safety.
3. Answer: 3.
Preferred provider organization (PPO) plans limit the enrollees choice to a list of
preferred providers such as hospitals and physicians. A participant pays more to use a
provider not on the preferred list. PPO plans focus on health maintenance.
4. Answer: 1.
Primary care activities are focused on health promotion. Health-promotion programs
contribute to quality health care by helping patients acquire healthier lifestyles. Healthpromotion activities keep people healthy through exercise, good nutrition, rest, and
adopting positive health attitudes.
5. Answer: 1.
Near-miss events are events that could have caused a problem with patient safety had
they not been stopped before patient harm occurred. Nurses who investigate ways to
prevent near-miss events work on issues surrounding patient safety.
6. Answer: 4.
Magnet status is a process and review in which hospitals participate that shows
achievement of excellence in nursing practice. The designation is given by the American
Nurses Credentialing Center and focuses on demonstration of quality patient care,
nursing excellence, and innovations in professional practice.
7. Answer: 1.
Interventions that focus on alleviation of fear and anxiety are related to allowing the
patient and family time to express fears and concerns, understand the impact that illness
will have on the patients ability to care for himself or herself, and often express worries
about ability to pay for medical care. Identifying staff that can help with payment plans
alleviates fear and anxiety.
8. Answer: 1, 4, 5.
Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.

Answer Key - Review Questions and Rationales

2-2

Managed care programs have administrative control over primary health care services for
a defined patient population. The provider or health care system receives a predetermined
capitated payment for each patient enrolled in the program. In this case the managed care
organization assumes financial risk in addition to providing patient care. The focus of
care of the organization shifts from individual illness care to prevention, early
intervention, and outpatient care. If people stay healthy, the cost of medical care declines.
Systems of managed care focus on containing or reducing costs, increasing patient
satisfaction, and improving the health or functional status of the individual.
9. Answer: 3.
Tertiary health care is focused on treatment of disease and illness. Tertiary health care
takes place in intensive care and subacute care units. Emergency departments are part of
secondary acute care. Preventive and health-promotion activities are part of primary care.
10. Answer: 1, 2, 3, 6.
Interventions for the patient-centered care principle of physical comfort are focused on
care that increases the comfort of the patient. Responding to patients need for pain
medications and using nursing interventions that increase comfort are important.
Teaching is focused on the principle of continuity and transition; scheduling
appointments is an intervention for access to care.
11. Answer: 2, 3, 4.
Nursing-sensitive outcomes are patient outcomes that are directly related to nursing care
such as changes in patients symptom experiences, functional status, safety, psychological
distress, and costs. They are also related to the environment in which nurses practice,
which impact patient outcomes. For example, the nursing staff that implements strategies
to decrease turnover on the nursing unit impacts overall hospital turnover rates. Nurses
assume accountability and responsibility for the consequences of these outcomes.
12. Answer: 1.
Restorative interventions focus on returning a patient to his or her previous level of
function or a new level of function limited by his or her illness or disability. The goal of
restorative care is to help individuals regain maximal functional status and enhance
quality of life by promoting independence.
13. Answer: 4.
Diagnosis-related groups (DRGs) are grouped inpatient hospital services for Medicare
patients. Each group has a fixed reimbursement amount, with adjustments based on case
severity, rural/urban/regional costs, and teaching costs. Hospitals receive a set amount for
each patient based on the assigned DRG, regardless of patients length of stay or use of
services. DRGs are part of the prospective payment system.

14. Answer: 3.

Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.

Answer Key - Review Questions and Rationales

2-3

Nursing informatics is the use of information, data, and technology to communicate,

manage knowledge, mitigate errors, and support decision making. It requires knowledge,
skills, and attitudes from the nurse to be able to effectively use information and
technology. Nursing informatics is focused on the organization, analysis, and
dissemination of information.
15. Answer: 2, 3, 5.
Patient-centered care that is focused on respect, values, preferences, and expressed needs
focuses on treating the patient with dignity and respect. A component is to keep the
patient informed and involved in decision making. Consider patient preferences and
perspectives when planning care. An environment where the patient is respected focuses
on quality of life.

Copyright 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.