Chapter 16 My Nursing Test Banks

Sullivan, Effective Leadership and Management, 8/e
Chapter 16

Question 1

Type: MCSA

A unit requires a great deal of staffing flexibility. To fill this need, the manager should use which strategy?

1. Maximizing the availability of nursing staff

2. Good communication among staff

3. A high RN-skill mix

4. Overlap between shifts

Correct Answer: 3

Rationale 1: Maximizing the availability of nursing allows for more nurses but doesnt take into account the staffing mix. If the RN number is low, flexibility is lower.

Rationale 2: Good communication among staff is very important but does not create the greatest flexibility.

Rationale 3: A high RN-skill mix allows for more flexibility to meet client needs. An RN is educated and licensed to provide care that an assistant or LPN cannot provide.

Rationale 4: Overlap between shifts may provide more staff, but if the staff members are not RNs, flexibility is not appreciably increased.

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: 16-4: Determine the appropriate staffing mix and distribution of staff.

Question 2

Type: FIB

The nurse manager is determining the days nursing care hours (NCHs) by analyzing the client workload. The unit census is 30 and there is a total of 220 nursing care hours. The average nursing hours per client per day (NHPPD) figured to the nearest hundredth decimal point is ____.

Standard Text: 

Correct Answer: 7.33

Rationale : Nursing hours per patient per day (NHPPD) is calculated by dividing the total nursing care hours (220) by the total census (30).

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-2: Demonstrate how to use patient classification systems to calculate nursing care hours necessary.

Question 3

Type: MCMA

The administration of a health care organization has proposed a new client care area staffing system. Which components of this system do not meet the American Nurses Association (ANA) requirements?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Registered nurses from across the facility were included on the committee that developed the system.

2. RNs will be required to accept flexible schedules that might require the nurse to practice on any unit in the facility.

3. The nurses level of educational preparation will be considered in staffing decisions.

4. The number of clients and their acuity will be considered for staffing purposes.

5. When low census occurs the unlicensed assistant category will be first to be furloughed.

Correct Answer: 2,5

Rationale 1: The ANA requires that staffing systems be developed with input from direct-care registered nurses.

Rationale 2: The ANA requirements state that the RN cannot be forced to work on a unit without having established that he or she is able to provide professional care on such a unit.

Rationale 3: The ANA requirements state that staffing will reflect the level of preparation and experience of those providing care.

Rationale 4: The ANA requirements state that staffing will be based on the number of patients and patient-acuity level.

Rationale 5: There is no mention of low census furlough in the ANA requirements for staffing systems.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 16-1: Determine staffing needs.

Question 4

Type: MCMA

The nurse manager is explaining the organizational staffing policy to a newly hired nurse. The nurse will be scheduled on an as-needed basis. The manager explains this policy is a supplemental scheduling policy. Which staffing strategies would be included in this policy?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Contracting with outside agency nurses

2. A decentralized float pool

3. Using nonlicensed personnel as substitutes for nurses

4. Establishing an internal float pool of nurses who are cross trained

5. Developing a float pool of nurses shared with another hospital in the system

Correct Answer: 1,2,4,5

Rationale 1: Agency nurses can be used as supplements, but their cost can be significant.

Rationale 2: A decentralized float pool provides personnel who usually work only for one nurse manager or only on one unit.

Rationale 3: Nonlicensed personnel cannot be used as substitutes for nurses.

Rationale 4: This can be an effective way to provide supplementary staff.

Rationale 5: This is an innovative idea that creates a system-wide internal float pool.

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: 16-6: Explain how to supplement staff when needed.

Question 5

Type: MCSA

A nurse manager needs to supplement the staff for the next schedule. Which option would be the most significant drain on the units staffing budget?

1. PRN nurse

2. Internal float nurse

3. Part-time nurse

4. Agency nurse

Correct Answer: 4

Rationale 1: PRN nurses are part of an internal float that provides supplemental staffing at a substantially lower cost than using agency nurses.

Rationale 2: Internal float nurses are part of an internal pool that provides supplemental staffing at a substantially lower cost than using agency nurses.

Rationale 3: Part-time nurses may work independently of organized supplement pools but still be assigned throughout the facility. Their salary typically is the same as or only slightly higher than that of regular staff.

Rationale 4: Agency nurses used for supplemental staffing often earn two to three times the salary of in-house nurses.

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: 16-6: Explain how to supplement staff when needed.

Question 6

Type: MCSA

The hospital has elected to use the demand management staffing system instead of the patient classification system. Because of this decision, the nurse manager who is staffing must focus on which of the following?

1. Immediate client needs

2. Historical data of expected client outcomes

3. Using hospital-wide data to staff individual units

4. Reduction of nursing care hours

Correct Answer: 2

Rationale 1: Patient classification systems focus on immediate client needs.

Rationale 2: Demand management uses unit specific historical data to determine client outcomes and nursing hours needed to meet these outcomes.

Rationale 3: The data used to staff are client outcome data.

Rationale 4: The goal is appropriate use of nursing care hours, not reduction.

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: 16-4: Determine the appropriate staffing mix and distribution of staff.

Question 7

Type: MCSA

Which group determines the level of nursing care and hours of care necessary to meet the needs of the hospitalized client?

1. American Nurses Association (ANA)

2. The Joint Commission

3. Nurse managers

4. Hospital administrators

Correct Answer: 3

Rationale 1: The American Nurses Association (ANA) has developed principles for nurse staffing, and the nurse managers follow these guidelines.

Rationale 2: The Joint Commission does not identify specific levels of nursing care hours for specific patient populations.

Rationale 3: Staffing and scheduling is the responsibility of the nurse manager.

Rationale 4: Although the hospital administration must ensure that the right number of competent staff is provided to meet patient needs, the responsibility of staffing has been delegated to the nurse manager or charge nurse.

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: 16-1: Determine staffing needs.

Question 8

Type: MCSA

The unpredictability of the labor and delivery area requires a set staff mix for every shift. Which type of staffing pattern should the manager use to ensure this mix?

1. Block staffing

2. Creative scheduling

3. Flexible scheduling

4. Self-staffing

Correct Answer: 1

Rationale 1: Block staffing is scheduling a set staff mix for every shift so that adequate staff is available at all times. This staffing is commonly used in areas such as labor and delivery and the emergency care unit.

Rationale 2: Staffing for this unit is likely to be rather repetitive and predictable rather than creative.

Rationale 3: Flexible scheduling combines shifts of differing lengths and presents a challenge to nurse managers. It is not as predictable and set as block scheduling.

Rationale 4: Self-staffing and scheduling is a staffing model whereby managers and their staff completely manage staffing and schedules. This could potentially be done following a block staffing outline but can follow other staffing schedules as well.

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: 16-4: Determine the appropriate staffing mix and distribution of staff.

Question 9

Type: MCSA

A critical care nurse has reported off because of an illness. Which choice of replacement for this nurse would provide the best continuity of quality nursing care?

1. A nurse from an outside agency

2. A nurse from a hospital unit that has a low census today

3. A nurse from a decentralized internal float pool

4. A nurse from the centralized internal float pool

Correct Answer: 3

Rationale 1: Nurses from outside agencies may be unfamiliar with the routine in the unit, and their services are substantially more expensive. They may be used as supplemental staff, but continuity of care may be compromised.

Rationale 2: Nurses from another unit may not have the expertise needed to care for patients on a highly specialized unit.

Rationale 3: In decentralized pools, a staff member works for one unit manager or on only one unit. Highly specialized units tend to rely on decentralized internal float pool nurses.

Rationale 4: A nurse from the centralized internal float pool would likely be familiar with facility policy, layout, and culture, but may not be skilled in caring for critically ill clients.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-6: Explain how to supplement staff when needed.

Question 10

Type: MCSA

A newly hired nurse manager is being mentored in this new role. How should the mentor advise this manager regarding staffing for the next shift?

1. First you must determine the nursing care hours needed.

2. First you must become familiar with the classification system we use.

3. First consider how to modify the schedule to meet client needs.

4. First consider the need to supplement the current nursing staff so that arrangements can be made.

Correct Answer: 2

Rationale 1: Nursing care hours can be determined after the nurse manager has become familiar with the current patient classification.

Rationale 2: The person responsible for staffing should first become familiar with the staffing method used.

Rationale 3: Modification of the schedule is part of the implementation process. Supplementing staff as needed is part of the implementation process.

Rationale 4: Supplementing staff as needed is part of the implementation process.

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: 16-1: Determine staffing needs.

Question 11

Type: MCSA

The medicalsurgical units census has decreased since the previous shift. The manager is reviewing the staffing grid. Which factor is used to determine staffing mix?

1. Average daily census of the hospital

2. Client care needs

3. Number of staff on vacation

4. Financial productivity of the unit

Correct Answer: 2

Rationale 1: The average daily census of the hospital probably will not have a direct bearing on the staffing mix of this unit.

Rationale 2: The staffing mix should be based on the needs of the clients currently on the unit. A higher need for assessment, education, or discharge planning requires more registered nurses.

Rationale 3: The number of staff on vacation is not an issue, as the clients still need care.

Rationale 4: The financial productivity of the unit should not be an issue as that is historical data, not current client care need data.

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: 16-4: Determine the appropriate staffing mix and distribution of staff.

Question 12

Type: MCSA

The nurse manager is explaining her staffing budget to the hospital administration. The manager has developed a flexible staffing pattern. The administration questions the manager as to why this pattern was developed. Which answer is most correct?

1. Staff members would prefer to make out their own schedules.

2. Nursing shortages and salary constraints have affected staffing patterns.

3. Lower client acuity has contributed to the need for more flexibility.

4. Flexible pattern staffing is the easiest method available.

Correct Answer: 2

Rationale 1: The fact that staff members like to make out their own schedule is not pertinent to a flexible pattern.

Rationale 2: Nursing shortages and wage constraints have necessitated an innovative approach to using the staff available to cover client care needs. A flexible staffing pattern can help fill this need.

Rationale 3: Client acuity has risen, not lowered.

Rationale 4: Flexible staffing can be very complex from a management standpoint.

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: 16-5: Describe the various ways to schedule staff.

Question 13

Type: MCSA

On two recent occasions, the experienced nurse manager has found it nearly impossible to discuss upcoming events with all the staff on the unit. What is a common reason for this problem?

1. The hospital is experiencing a nursing shortage, so staff members are very busy.

2. The client mix on the unit is much more varied.

3. The unit has just adopted combined staffing patterns.

4. There is a 1-hour overlap of staff between shifts.

Correct Answer: 3

Rationale 1: A nursing shortage and a busy staff should not impact the managers ability to communicate information to staff.

Rationale 2: The amount of variation in client mix should not adversely affect the managers ability to provide information to the staff.

Rationale 3: A combined staffing pattern allows for such variation in shifts that the manager may not come into contact with all of the staff during the managers work hours.

Rationale 4: An overlap of staff should make communication easier for the manager.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 16-4: Determine the appropriate staffing mix and distribution of staff.

Question 14

Type: MCSA

The nursing staff of a medicalsurgical unit would like to work four 10-hour shifts each week. For which reason would the unit nurse manager probably deny this request?

1. There is no overlap of staff.

2. There are not enough nurses working during a 24 hour period of time.

3. This would create discord and confusion with other health care departments.

4. This staffing pattern would not be cost-efficient.

Correct Answer: 4

Rationale 1: With 10 hour shifts there is an overlap of staff.

Rationale 2: In order to cover 24 hours, three nurses are needed. In order to cover 24 hours with 12-hour shifts, two nurses are needed.

Rationale 3: There is no evidence that 10-hour shifts for nurses would adversely affect other departments.

Rationale 4: Since there is substantial overlap when covering 24-hours with 10-hour shifts, this staffing pattern is generally not cost-efficient.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 16-5: Describe the various ways to schedule staff.

Question 15

Type: MCMA

The nurse manager of an intensive care unit has several open shifts that require an RN to fill. Several nurses have taken overtime shifts but there are still several uncovered shifts. The chief nurse officer (CNO) decides to fill these vacancies with agency nurses. The CNO realizes that agency personnel must have which requirements prior to working in the facility?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Current licensure to practice within the state

2. Orientation to the facility and the unit

3. Certification as an agency nurse

4. Documentation of malpractice insurance

5. Documentation of ability to work unsupervised in the environment

Correct Answer: 1,2,4

Rationale 1: An agency nurse must have a current licensure to practice in the state in which the requesting organization resides.

Rationale 2: The agency nurse must be oriented to both the facility and the agency.

Rationale 3: There is not a certification for agency nurses.

Rationale 4: Either the nurse or the supplying agency must have documentation of malpractice insurance that covers the nurse.

Rationale 5: The nurse must be supervised by an in-house nurse and cannot work unsupervised.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-6: Explain how to supplement staff when needed.

Question 16

Type: MCSA

The unit has open shifts even after staff members have signed up for overtime. The chief nurse officer (CNO) does not want to hire agency nurses to cover these shifts. The nurse manager does not understand why the CNO is offering staff an incentive versus hiring agency nurses. Which would be a reasonable conclusion?

1. It takes a significant amount of time to orient agency nurses.

2. The agency nurses are costly.

3. There is a significant amount of documentation required for agency nurses.

4. The physicians are not comfortable with agency nurses.

Correct Answer: 2

Rationale 1: Although it does take time and a significant amount of documentation to orient the agency this is not as big a problem as the cost.

Rationale 2: Agency nurses are a considerable cost to an organization and their use may cause staff resentment since agency nurses may be making two or three times the salary of the in-house nurse. Usually is it more cost-effective to offer an incentive and overtime to the current nursing staff.

Rationale 3: Although it does take time and a significant amount of documentation to orient the agency this is not as big a problem as the cost.

Rationale 4: The physicians may not know that the nurse is from an agency. Their primary interest is that their clients needs are met.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-6: Explain how to supplement staff when needed.

Question 17

Type: MCSA

A hospital has open shifts on its medicalsurgical unit. The manager has listed open shifts on the hospitals intranet. This is an example of which type of scheduling?

1. External pools

2. Internal pools

3. Open shift management

4. Float pools

Correct Answer: 3

Rationale 1: External pools are nurses employed from outside the organization, such as agency nurses.

Rationale 2: Internal pools are pools of nurses within the organization from which the unit manager may assign supplemental staff as needed.

Rationale 3: Open shift management is a technique in which a nurse may self-schedule by monitoring open shifts on the hospital intranet.

Rationale 4: Float pools are pools of nurses within an organization who work on units in which there is a need. They are typically assigned that day or within 24 hours of their shift.

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: 16-5: Describe the various ways to schedule staff.

Question 18

Type: MCSA

The State Board of Health requests the employee file of all agency nurses employed within the past year. At the end of the review the organization receives a sanction associated with these nurses. What is the most likely cause of this sanction?

1. No current address on file for the nurse

2. Past employment history not documented in file

3. Evaluation of the nurses performance missing from file

4. No documentation of past certifications in file

Correct Answer: 3

Rationale 1: The agency employing the nurse is required to maintain a file of the nurses current address, past employment history, and past certifications.

Rationale 2: The agency employing the nurse is required to maintain a file of the nurses current address, past employment history, and past certifications.

Rationale 3: The hiring organization must have a mechanism in place to evaluate agency nurses performance.

Rationale 4: The hiring organization is most interested in current certifications, not past certifications.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 16-6: Explain how to supplement staff when needed.

Question 19

Type: MCSA

The medical-surgical unit is at capacity and the clients have a high acuity, requiring care such as turning, bathing, toileting, and feeding. Which level of supplementary staff would be cost-effective?

1. Additional registered nurses

2. Additional unit clerks

3. Additional licensed practical nurses

4. Additional unlicensed assistive personnel

Correct Answer: 4

Rationale 1: Additional RN staff would not be cost-effective for these tasks.

Rationale 2: Additional unit clerks are not likely to alleviate this staffing issue.

Rationale 3: Additional LPN staff would be less expensive than additional RN staff but are not the least expensive choice.

Rationale 4: Additional unlicensed assistive personnel could provide the care needed if supervised.

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: 16-4: Determine the appropriate staffing mix and distribution of staff.

Question 20

Type: MCSA

A new nurse manager asks to see the Joint Commission manual in order to determine adequate staffing for the next shift. How should the supervisor respond to this request?

1. The Joint Commission manual is kept with the other unit manuals.

2. For that information you will need to refer to the human resources departments policy on employment manual.

3. You need to look at the policy and procedure manual for the organization, not the Joint Commission manual.

4. Before you look any further, refer to the units current schedule.

Correct Answer: 3

Rationale 1: While this is likely a true statement it does not get to the problem with the managers statement.

Rationale 2: Human resources policy on employment will refer to general employment guidelines for all employees, not guidelines on staffing ratios.

Rationale 3: The policy and procedures of the organization will set staffing criteria. The Joint Commission only determines if the organization is following its own policy.

Rationale 4: The current schedule will list vacancies but not the staffing guidelines for the unit.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 16-4: Determine the appropriate staffing mix and distribution of staff.

Question 21

Type: MCSA

The nurse manager of a postsurgical unit is preparing the next months schedule. The manager has reviewed the surgery schedule for the corresponding month and notes there are several high-acuity surgeries. Which staffing adjustment would the manager make to best provide the care needed by these postoperative clients?

1. Increase the number of unlicensed assistive personnel.

2. Increase the number of licensed practical nurses.

3. Increase the number of non-nursing support personnel.

4. Increase the number of registered nurses.

Correct Answer: 4

Rationale 1: While unlicensed assistive personnel would be needed for some nursing care, these surgeries are high acuity. UAPs are not the most critical employee for their care.

Rationale 2: LPNs could be helpful in caring for these clients, but since these are high acuity surgeries, this employee classification is not the most helpful.

Rationale 3: Non-nursing support personnel are important to client care, but adding this classification of employee is not the most helpful choice.

Rationale 4: Since these are high-acuity clients, critical thinking and clinical judgment will be important. The employees best prepared to care for these clients are RNs.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-1: Determine staffing needs.

Question 22

Type: MCSA

A nursing supervisor is setting up a new unit and must make a blanket decision about whether the unit will be staffed on 12-hour shifts or 8-hour shifts. What should this supervisor keep in mind when making this decision?

1. Staffing 8-hour shifts uses slightly more full-time equivalents (FTEs).

2. Staffing 12-hour shifts uses more full-time equivalents (FTEs).

3. Staffing 12-hour shifts uses significantly fewer full-time equivalents (FTEs).

4. There is no difference in the full-time equivalents (FTEs) required.

Correct Answer: 4

Rationale 1: Staffing 8-hour shifts does not use more FTEs.

Rationale 2: Staffing 12-hours shifts does not use more FTEs.

Rationale 3: Staffing 12-hour shifts does not use fewer FTEs.

Rationale 4: There is no difference in FTEs required.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 16-3: Calculate FTEs.

Question 23

Type: MCSA

The OB manager is looking at staffing for the night shift. The postpartum unit is busy and the labor-delivery unit has four clients in labor. The manager collects data from the nursing staff regarding the acuity of their clients. These data assist the manager in determining the staff for the next shift. This is an example of which type of system?

1. Demand management

2. Block scheduling

3. Organizational related

4. Patient classification

Correct Answer: 4

Rationale 1: Demand management predicts needs over the next few days, not the next shift.

Rationale 2: In block scheduling, a set amount of nurses would work during the shift and client acuity would not be as big a factor.

Rationale 3: Organizational related refers to the principles for nurse staffing, not a staffing system.

Rationale 4: Patient classification systems focus on the clients acuity as it is currently occurring.

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: 16-2: Demonstrate how to use patient classification systems to calculate nursing care hours necessary.

Question 24

Type: MCSA

The hospital is caring for more high-acuity clients due to the recent flu endemic. The chief nurse officer (CNO) reviews the census from last years flu season and instructs the manager to schedule more registered nurses for the weekend. Which system has the CNO used?

1. Patient classification systems management

2. Demand management system

3. The Baylor plan

4. Automated staffing

Correct Answer: 2

Rationale 1: Patient classification systems focus on patient acuity in which data is collected on the current census.

Rationale 2: Demand management system focuses on predicting and controlling the demand for nurses and uses historical data.

Rationale 3: The Baylor plan is a method for weekend staffing.

Rationale 4: Automated staffing matches client demand to nurse staffing on a more individual level. It does not use historical data.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 16-2: Demonstrate how to use patient classification systems to calculate nursing care hours necessary.

Question 25

Type: MCSA

An emergency department manager is looking over the next months schedule and decides to supplement the schedule due to vacations. The manager decides to use decentralized pool staffing to lower costs and provide quality care. Which group of nurses is a part of this managers decentralized staffing?

1. PRN staff from the external pool of nurses

2. Agency nurses

3. PRN staff from the emergency department nurses

4. PRN staff from the nurses who work on medical-surgical units

Correct Answer: 3

Rationale 1: External pool nurses are generally more expensive to employ.

Rationale 2: Agency nurses are from the external pool.

Rationale 3: PRN emergency department nurses are decentralized or from the same department and/or manager.

Rationale 4: PRN staff composed of nurses who work on medical-surgical units make up centralized internal float pools.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-4: Determine the appropriate staffing mix and distribution of staff.

Question 26

Type: MCMA

A nurse has agreed to work on the Baylor plan. The nurse should arrange day care for which shifts?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. A 12-hour shift on Saturday

2. An 8-hour shift on Monday

3. An 8-hour shift on Sunday

4. A Thursday shift once a month

5. Shifts every weekend

Correct Answer: 1,5

Rationale 1: 12-hour weekend shifts are part of the Baylor plan.

Rationale 2: Weekday shifts are not included in the Baylor plan.

Rationale 3: In the Baylor plan weekend shifts are 12 hours.

Rationale 4: Weekday shifts are not included in the Baylor plan.

Rationale 5: Under the Baylor plan the nurse works 12-hour shifts every weekend and is paid for a standard work week.

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: 16-5: Describe the various ways to schedule staff.

Question 27

Type: FIB

Two nurses have agreed to share a schedule in which each will work 4 hours each day for a total of 20 hours a week. In 2 weeks ____ FTEs will be generated by these nurses.

Standard Text: 

Correct Answer: true

Rationale : In a 2-week pay period, one FTE equals 80 hours. These two nurses are working 4 hours each per day for 10 days: 4 2 10 = 80 hours.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-3: Calculate FTEs.

Question 28

Type: MCMA

A health care facility has adopted automated scheduling across all client care areas. When presenting this decision to nursing staff, the nurse executive should include which information?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. This system will allow nurses to spend more time with those clients who need us the most.

2. We expect that using this system will help us improve client outcomes.

3. There will be little financial gain to the institution, but we are committed to improving our scheduling.

4. Using this Baylor plan will help us improve client outcomes.

5. This system will allow nurses to choose shifts and clients.

Correct Answer: 1,2

Rationale 1: Automated systems match nursing time to client need more effectively. This allows the nursing care to match the amount of care needed.

Rationale 2: Automated scheduling systems do improve client outcomes.

Rationale 3: Automated scheduling often results in improved financial outcomes.

Rationale 4: The Baylor plan is not an automated scheduling system.

Rationale 5: The automated system does not allow nurses to choose shifts or clients.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-5: Describe the various ways to schedule staff.

Question 29

Type: MCMA

A nursing supervisor requests information technology support for posting all nursing scheduling online. What justification can the supervisor provide for this request?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. If schedules are posted online they are open for all to see.

2. Posting schedules online will promote fairness in shift assignments.

3. It is easier to change the schedule if it is posted online.

4. If the schedule is posted online, all shifts must be 12-hours shifts.

5. Open shift scheduling is easier to maintain if all schedules are online.

Correct Answer: 1,2,5

Rationale 1: Posting schedules improves transparency.

Rationale 2: If everyone can see the schedule it is more likely that shift assignments will be fair. Favoritism would be difficult to hide.

Rationale 3: There is little difference between a written schedule and an online schedule in ease of change.

Rationale 4: There is no requirement that all shifts must be 12-hour shifts.

Rationale 5: If schedules are online it is easier for nurses to see open shifts that they might wish to work.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-5: Describe the various ways to schedule staff.

Question 30

Type: FIB

An acute care nursing unit has determined that an acuity level III client requires 6 hours of nursing care per shift while a level IV client requires 8 hours. Today the unit has seven level III clients and nine level IV clients. The manger should staff for ___ hours of nursing care for the next shift.

Standard Text: 

Correct Answer: 114

Rationale : To determine nursing care hours, multiply the number of hours per client by the number of clients in that category and add up the results. Category III = 7 clients 6 hours of care = 42. Category IV = 9 clients 8 hours of care = 72.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-2: Demonstrate how to use patient classification systems to calculate nursing care hours necessary.

Sullivan, Effective Leadership and Management, 8/e Test Bank

Copyright 2013 by Pearson Education, Inc.

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