Question 1

An adequate number of nursing staff has a positive effect on:

Accepted Answer

When nursing levels are optimized,there is a positive effect on quality,outcomes,and costs,with fewer adverse events and shorter length of patient stay.

Question 2

Because of a called-in absence,a nurse manager has to find a replacement for the uncovered position on the shift.Which of the following is an option?

Accepted Answer

One way a nurse manager can handle a called-in absence or otherwise uncovered position on a shift is to substitute a person of one classification for another,such as an LPN for an RN.

Question 3

Centralized scheduling has many advantages,including which of the following?

Accepted Answer

Centralized scheduling relieves nurse managers of time-consuming duties,freeing them for other activities.

Question 4

Most differentiated nursing practice models take into account the competency,education,and skill level of nurses.Which model responded to the nursing shortage by recommending that ancillary staff,such as emergency medical technicians and former military corpsmen,be used as nurse extenders?

Accepted Answer

Manthey's Primary Practice Partners model responded to the nursing shortage by recommending that former military corpsmen,emergency medical technicians,and registered certified technicians with special technical training become nurse extenders.

Question 5

A nurse manager had a few negative experiences when the nurse manager hired travel nurses.Because these travel nurses were coming from different parts of the United States,the nurse manager decided to check which of the following databases to see whether adverse actions had been taken against the nurses?

Accepted Answer

The Healthcare Integrity and Protection Data Bank and the National Practitioner Data Bank are two databases available for researching adverse actions taken against nurses.

Question 6

Functions to support quality patient care should be considered by both the organization and the nurse manager of the unit when staffing levels are determined.Which of the following is a staffing principle that relates to nurses rather than to the organization?

Accepted Answer

One principle related to staff is that patient needs should determine the required clinical competencies.

Question 7

Which type of staffing has been found to save money by decreasing turnover,sick leave,unpaid absences,float hours,and overtime?

Accepted Answer

All-registered nurse staffing is economical.It has been found to save money by reducing turnover,sick leave,unpaid absences,float hours,and overtime.

Question 8

Leaders and managers play different roles in staffing;therefore,one of the functions of the nurse manager with regard to staffing is:

Accepted Answer

The nurse manager facilitates discussion of workload issues,keeps policies in compliance with the law,and matches staff to client needs.

Question 9

Some organizations have used a number of flexible staffing options to make it easier to recruit and retain nurses.Which of the following is an example of a flexible option?

Accepted Answer

Cross-training can prepare nurses to work in more than one area to facilitate flexible scheduling.

Question 10

With advances in technology,the creation of a computer-based and network-based community infrastructure has become increasingly important.Which classification system was developed for community health nursing?

Accepted Answer

The three components of the Omaha classification system-problem classification,intervention scheme,and problem rating scale for outcomes-were developed for community health nursing.

Question 11

Between 2010 and 2020,over 40% of the registered nurse workforce will be over 50 years of age and is expected to retire or withdraw from the workforce.The Institute of Medicine has recommended that organizations retain these nurses by:

Accepted Answer

Some of the corrective measures identified by the Institute of Medicine to retain older nurses are implementing flexible work schedules,using shorter shifts,decreasing the patient-nurse ratio,fostering a professional nurse practice environment,and implementing ergonomic principles in health care facility design.

Question 12

Because of rising health care costs,many hospitals are developing disease management programs.An interdisciplinary approach is used in staffing these programs.This represents what type of staffing system?

Accepted Answer

In case management,the case manager works with an interdisciplinary team (including the patient,family,physician,and other health care providers)to develop a multidisciplinary action plan or critical path based on the patient's diagnosis;implements the plan or path by coordinating parts of the service delivery system;and monitors the patient's progress.

Question 13

Organizations are creatively attempting to hire nurses,yet a nursing shortage has become an obstacle.All of the following factors contribute to the nursing shortage except:

Accepted Answer

Facility restructuring for economic reasons,budget and staffing cuts,heavy workloads,mandatory overtime,nurse-to-nurse hostility,poor doctor and nurse relations,poorly prepared managers,changing legislation,and negative media stereotyping are some of the factors contributing to the nursing shortage.

Question 14

When nurse managers are given authority and assume responsibility,they can staff their own units through decentralized scheduling.What is one effect of decentralized scheduling?

Accepted Answer

Decentralized scheduling may use resources less efficiently and consequently make cost containment more difficult.

Question 15

Some institutions have initiated variable staffing patterns as a response to the nursing shortage.Which of the following staffing patterns lowers the cost per patient-day?

Accepted Answer

With 12-hour shifts,there is better use of nursing personnel,which lowers staffing requirements and consequently reduces the cost per patient-day.

Question 16

Clinical outcomes can be used to assess the adequacy of staffing.Which of the following indicates a need for better staffing?

Accepted Answer

Clinical outcomes that indicate a need for better staffing include adverse drug reactions,family complaints,injuries to patients,long length of stay,patient complaints,patient falls,postoperative infections,shock/cardiac arrest,skin breakdown,upper gastrointestinal bleeding,and urinary tract infections.

Question 17

Various scheduling and staffing methods have advantages and disadvantages for personnel.When new graduates enter the workforce,they are more likely to be given undesirable work schedules if what type of scheduling system is used?

Accepted Answer

Most people want to work the day shift,and assignments are usually made on a seniority-priority basis.This usually results in a predominance of new graduates staffing the evening and night shifts in a permanent shift scheduling system.

Question 18

The nurse manager used variable staffing for a 25-bed postoperative unit at full capacity.On the unit,there were four patients who had undergone total knee replacement and four who had undergone total hip replacement who required blood transfusions.What kind of variable staffing mix would the nurse manager most likely use?

Accepted Answer

With variable staffing,the ratios between different categories of personnel can be changed when patients' conditions are very acute.

Question 19

When figuring time standards for nursing care,the nurse manager needs to consider both direct and indirect care.An example of indirect care is:

Accepted Answer

Indirect care includes all activities that do not directly involve the patient,such as preparation for and cleaning up after medication administration and treatments,coordination of clinical care,reporting,communications,documentation of care,and coffee and lunch breaks.

Question 20

The Joint Commission calls on hospitals to use which strategy to help address the nursing shortage?

Accepted Answer

To develop a culture of retention,the Joint Commission recommends providing management training,among other things.

Quiz 13: Staffing and Scheduling