Question 1

What title identifies a nurse who is responsible for following the patient from admission through discharge or resolution of illness while working with a broad range of health care providers?

Accepted Answer

A case manager is a nurse who is responsible for overseeing a patient's care from admission through discharge or resolution of illness, coordinating with various healthcare providers to ensure cohesive and comprehensive care.

Question 2

A nurse makes patient care assignments as follows: RN1 has rooms 200-210;RN2 has rooms 211-221;RN3 has rooms 222-232.The two unlicensed assistive personnel have half the rooms,with one assigned to 200-215 and the second to 216-232.What term is used to identify the care delivery model being used?

Accepted Answer

The care delivery model described is Modular Nursing, where the unit is divided into modules, and each module is assigned a team of staff members, including RNs and unlicensed assistive personnel, to provide care.

Question 3

A patient is admitted with pneumonia.The case manager refers to a plan of care that specifically identifies dates when supplemental oxygen should be discontinued,positive-pressure ventilation with bronchodilators should be changed to self-administered inhalers,and antibiotics should be changed from intravenous to oral treatment,on the basis of assessment findings.This plan of care is referred to by what term?

Accepted Answer

A clinical pathway is a multidisciplinary plan that sequences interventions by various service providers over an anticipated time frame for a particular diagnosis, procedure, or health condition. It outlines specific stages in patient care, including transitions from more intensive to less intensive treatments as the patient's condition improves, as described in the scenario.

Question 4

A nurse manager is mentoring a novice nurse manager in determining staffing needs.The mentor explains that the acuity level of the patient is determining by implementing what process?

Accepted Answer

The acuity level of a patient is determined by quantifying the amount and intensity of care required. This process helps in understanding how much care a patient needs, which is crucial for staffing decisions.

Question 5

Which factors would be considered in the first steps in developing an effective patient classification system? (Select all that apply. )

Accepted Answer

The answer of Which factors would be considered in the...

Question 6

The nurse manager is planning staffing levels and realizes that the first step is to focus on what activity?

Accepted Answer

The first step in planning staffing levels involves understanding the intensity of care required by patients, as this directly influences the number and type of staff needed to provide adequate care.

Question 7

A hospital converts to a system of care delivery in which RNs,LPNs,and unlicensed assistive personnel (UAP)are responsible for implementing a specific task,such as medication administration or personal hygiene,for the entire nursing unit.What term is used to describe this type of delivery system?

Accepted Answer

Functional nursing is a task-oriented approach where each member of the nursing team is assigned specific tasks for a large group of patients, rather than being responsible for the total care of a certain number of patients.

Question 8

A patient is admitted for a hysterectomy,and the RN develops and implements the plan of care but also delegates to the LPN/LVN the responsibility of administering oral medications.While off duty,this RN receives a call requesting a change in the plan of care because the patient has developed deep vein thrombosis.The nurse who originally planned the care is practicing which type of nursing care delivery?

Accepted Answer

Primary nursing involves one nurse being responsible for overseeing a patient's care from admission to discharge, including planning and evaluating the care, even when not on duty. This scenario reflects primary nursing as the RN developed the plan of care and is contacted for changes while off duty.

Question 9

Nurses on a unit provide personal hygiene,administer medications,educate the patient and family about treatments,and provide emotional support.These nurses provide patient care based on which nursing delivery system?

Accepted Answer

Total patient care involves nurses being responsible for all aspects of a patient's care during their shift, including personal hygiene, medication administration, education, and emotional support, similar to the description provided.

Question 10

When deciding which staffing option to use on a nursing unit that will open soon,the manager recognizes what basic fact related to this issue?

Accepted Answer

Staff satisfaction is often linked to patient satisfaction because satisfied staff are more likely to be engaged, motivated, and provide higher quality care.

Question 11

What is customer satisfaction primarily based upon?

Accepted Answer

Customer satisfaction is primarily based on personal interactions with employees, as these interactions often directly influence a customer's perception of service quality and overall experience. Positive, helpful, and friendly interactions can significantly enhance customer satisfaction.

Question 12

A patient is admitted with coronary artery disease and is scheduled for coronary artery bypass grafting (CABG).According to the clinical pathway the patient should be extubated and discharged from critical care the day after surgery.During surgery the patient's oxygen saturation decreased drastically because of chronic tobacco abuse.Subsequently,the patient remained on the ventilator an additional 2 days postoperatively.According to the clinical practice guideline for CABG,this situation results in what type of event?

Accepted Answer

A variance in clinical practice occurs when actual events deviate from the expected outcomes or processes outlined in clinical pathways or guidelines. In this case, the patient's extended time on the ventilator due to complications from chronic tobacco use represents a deviation from the expected clinical pathway of being extubated and discharged from critical care the day after surgery.

Question 13

A hospital is concerned with nurse retention and realizes that job satisfaction is a major influence.To best enhance employee satisfaction related to staffing,what intervention should the management team implement?

Accepted Answer

Adopting the concept of participatory staff involvement is the best intervention to enhance employee satisfaction related to staffing. This approach allows nurses to have a say in decisions that affect their work environment and schedules, leading to increased job satisfaction and potentially better retention rates. Negotiating for additional agency nurses, hiring more part-time employees, and regularly using "float" nurses are more about filling staffing gaps rather than directly improving job satisfaction and employee retention.

Question 14

The nurse manager determines that four RNs,five LPN/LVNs,and two unlicensed assistive personnel (UAP)are required per shift to meet the needs of the patient population on the unit,according to acuity and census.The nurse manager is concerned with what related process?

Accepted Answer

The nurse manager is concerned with staffing, which involves determining the number and mix of healthcare personnel needed to meet the patients' needs on the unit.

Question 15

When a nurse uses a criteria such as "high risk for falls," "infection protocols," and "special communication needs" to determine the mix and number of staff needed on a telemetry unit,what is the nurse is using?

Accepted Answer

A patient classification system is used to determine the mix and number of staff needed based on specific criteria such as "high risk for falls," "infection protocols," and "special communication needs." This system helps in assessing patient needs and allocating nursing resources accordingly.

Question 16

A task force is considering factors that contribute to high-quality safe staffing.Which statement reflects an understanding of the American Nurses Association's (ANA)recommendations?

Accepted Answer

The ANA emphasizes the importance of adequate staffing that allows registered nurses (RNs) to effectively apply the nursing process, ensuring high-quality, safe patient outcomes. This reflects an understanding that staffing should be flexible and responsive to the dynamic needs of patients, rather than fixed or solely cost-driven.

Question 17

A nurse plans care knowing when specific recovery milestones are expected.The nurse is providing care via what delivery model?

Accepted Answer

The answer of A nurse plans care knowing when specific...

Question 18

A patient has decided to stop hemodialysis because his renal failure progresses and he wishes to spend more time with family.Palliative care will continue,and the approach will be discussed with the patient and family as needed and at change of shift.The care delivery model in this situation is referred to by what term?

Accepted Answer

Patient-centered care focuses on respecting and responding to individual patient preferences, needs, and values, ensuring that patient values guide all clinical decisions. In this scenario, the decision to stop hemodialysis and focus on palliative care according to the patient's wishes exemplifies a patient-centered approach.

Question 19

A nursing unit comparing team nursing to the partnership model would find what statement to be true?

Accepted Answer

Leadership abilities of the RN are crucial in both the team nursing and partnership models, as they significantly influence the effectiveness of care delivery. In both models, the RN's ability to lead, delegate, and oversee care is central to achieving positive patient outcomes.

Question 20

How do accrediting agencies such as The Joint Commission address staffing?

Accepted Answer

Accrediting agencies like The Joint Commission focus on ensuring that healthcare organizations provide satisfactory care to patients. They do not typically impose specific staffing levels, staff mixes, or nurse-patient ratios. Instead, they assess whether the overall care delivery meets certain quality and safety standards.

Quiz 21: Staffing and Nursing Care Delivery Models