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Leadership and Nursing Care Management 5th Edition Huber Test Bank

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Leadership and Nursing Care Management 5th Edition Huber Test Bank

ISBN-13: 978-1455740710

ISBN-10: 1455740713

Description

Leadership and Nursing Care Management 5th Edition Huber Test Bank

ISBN-13: 978-1455740710

ISBN-10: 1455740713

 

 

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Free Nursing Test Questions:

 

Chapter 21: Staffing and Scheduling

Test Bank

 

MULTIPLE CHOICE

 

  1. The provision of efficient nursing services to clients, wherever delivered, depends on the:
a. appropriate nursing diagnoses.
b. current wage scale.
c. number of nurse leaders.
d. right skill mix.

 

 

ANS:  D

Whether in hospitals, community nursing organizations, long-term care, or other settings, the delivery of nursing services to clients is founded on having the right skill mix of providers in the right numbers at the right place and properly prepared to render care.

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 381

TOP:   Nursing Process: Planning

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. Staffing management is one of the most critical activities for nurse leaders at every level of the health care organization today because it affects:
a. delegation and supervision.
b. unit leadership productivity.
c. organizational outcomes.
d. professional development and quality control.

 

 

ANS:  C

Staffing management is one of the most critical yet highly complex and time-consuming activities for nurse leaders at every level of the health care organization today (Abdoo, 2000; Sullivan et al., 2003). How well or poorly nursing leaders execute staff management impacts the safety and quality of patient care, financial results, and organizational outcomes, such as job satisfaction and retention of registered nurses (RNs) (Beyers, 2000).

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 361

TOP:   Nursing Process: Planning

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. Evaluation of the effect of nurse staffing on quality patient, financial, and organizational outcomes is known as:
a. patient acuity.
b. staffing effectiveness.
c. nurse-to-patient ratio.
d. nursing workload.

 

 

ANS:  B

Staffing effectiveness is the evaluation of the effect of nurse staffing on quality patient, financial, and organizational outcomes.

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 361

TOP:   Nursing Process: Evaluation

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. The nursing manager of a general medical-surgical unit in a large hospital has gathered data reflecting the average length of time that it takes to provide nursing care to broad categories of client groups with typical characteristics. The system that the nursing manager has used to classify patients has been criticized for its reliability, validity, and:
a. comparability across settings.
b. medical elements.
c. stereotyping of patients.
d. subjective basis.

 

 

ANS:  A

Overall, patient classification systems have been criticized for reliability, validity, and comparability across settings.

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 371

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. The nursing manager of a general medical-surgical unit in a large hospital has gathered data reflecting the average length of time that it takes to provide nursing care to broad categories of client groups with typical characteristics. The nursing manager will most likely use the patient classification data he collected to:
a. avoid management layoffs.
b. change professional nursing roles.
c. obtain staffing reimbursement.
d. staff his nursing unit appropriately.

 

 

ANS:  D

Overall, patient classification systems attempt to identify condition severity that can approximate workload and become the basis for staffing and budgeting.

 

DIF:    Cognitive Level: Apply (Application)                               REF:   Page 371

TOP:   Nursing Process: Evaluation

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. 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

 

 

ANS:  C

A conceptual framework provides logic and order to complex processes for administrators and scientists to consider (Edwardson, 2007).

 

DIF:    Cognitive Level: Remember (Knowledge)                         REF:   Page 369

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. 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.

 

 

ANS:  C

One common element among care models is the value of the nurse and patient/family relationship. Patient assignment technology offers charge nurses access to real-time data in order to match the right nurse (i.e., competency, expertise) with the right patient and provide continuity of care during an episode of care. A second common trend is the evolving role of the charge nurse as the frontline leader with responsibility to coordinate patient flow with expert communication among health care team members.

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 372

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. Relationship-based care (RBC) is a common model used in care delivery. Person (2004) articulated that _____ is/are central to the RBC model.
a. continuity of care
b. case management
c. coordination of care
d. the needs or characteristics of the patients

 

 

ANS:  A

RBC is a common model used in care delivery (Koloroutis, 2004). Person (2004) articulated continuity of care as central to the RBC model, and this value model also integrates Jean Watson’s theory of caring (Watson, 2002).

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 372

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. 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.

 

 

ANS:  C

The synergy model for patient care is presented by the American Association of Critical-Care Nurses (Hardin & Kaplow, 2005). The core concept of the model is based on the nurse-patient relationship and acknowledges that the needs or characteristics of the patients and families drive the competencies of the nurse. Synergy, or optimum outcomes, results when the needs and characteristics of the patient clinical unit, or system, are matched with a nurse’s competencies (Kaplow & Reed, 2008).

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 372

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. The Joint Commission’s (TJC’s) staffing regulation states:
a. staffing ratios are recommended in perinatal and critical care areas.
b. nurse managers may determine the nurse-to-patient ratio as long as the patient’s needs are being met.
c. hospitals must also provide the right number of competent staff members to meet the patients’ needs.
d. hospitals may limit the number of admissions to ensure there are an adequate number of staff members to meet patient needs.

 

 

ANS:  C

TJC noted the following (2006): The goal of the human resources function is to ensure that the hospital determines the qualifications and competencies for staff positions based on its mission; populations; and care, treatment, and services. Hospitals must also provide the right number of competent staff members to meet the patients’ needs. (p. HR-1)

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 373

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. An approach for decreasing nursing RN skill mix was implemented in a “one size fits all” approach across organizations in the 1990s. These changes in skill mix led to:
a. decreases in RN workload.
b. increased nursing satisfaction.
c. decreased patient satisfaction.
d. decreased patient safety concerns.

 

 

ANS:  C

The approach for decreasing nursing RN skill mix was implemented in a “one size fits all” approach across organizations and often lacked evaluation of the skill mix change and other changes on the quality of care and nurse job satisfaction and retention (Eck, 1999; Norrish & Rundall, 2001). This was most apparent in California where a leaner RN skill mix was tried by Kaiser Permanente Northern California in the early 1990s. Skill mix was reduced from 55% RNs to 30% RNs in 1995 (Robertson & Samuelson, 1996). The changes in skill mix led to widespread real and perceived increases in RN workload, patient safety concerns, and nurse and consumer complaints.

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 374

TOP:   Nursing Process: Evaluation

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. A forecasted workload and a recommended care standard determine the:
a. staffing pattern.
b. skill mix of the unit.
c. nurse-to-patient ratios.
d. staffing management plan.

 

 

ANS:  A

The staffing management plan provides the structured processes to identify patient needs and then to deliver the staff resources as efficiently and effectively as possible. An effective plan first focuses on stabilizing the unit core staffing. A staffing pattern, or core coverage, is determined through a forecasted workload and a recommended care standard (e.g., hours per patient day).

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 375

TOP:   Nursing Process: Planning

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. The workload standard commonly used in nursing when calculating staffing patterns is:
a. patient days.
b. patient acuity system.
c. average length of stay.
d. nursing care hours per patient day.

 

 

ANS:  D

The amount of work performed by a unit is referred to as its workload, and workload volume is measured in terms of units of service. The workload standard commonly used is nursing care hours per patient day, although the validity of this measure is disputed.

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 375

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. The staffing method used when units are staffed below maximum workload conditions and staff is then supplemented when needed is called:
a. fixed staffing.
b. variable staffing.
c. strategic staffing.
d. staffing by acuity.

 

 

ANS:  B

With variable staffing, units are staffed below maximum workload conditions and staff is then supplemented when needed.

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 375

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. The process of providing and measuring the correct full-time equivalent (FTE), or complement, to adequately staff a given area is known as:
a. scheduling.
b. position control.
c. forecasted workload.
d. demand management.

 

 

ANS:  B

Position control is the process of providing and measuring the correct FTE, or complement, to adequately staff a given area.

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Pages 376-377

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. Key to effective staffing are protocols and processes for daily staffing decision support that are aligned with a budget-sensitive variable staffing plan. In a decentralized model, the responsibility of daily staffing allocation belongs to the:
a. float pool.
b. staffing office.
c. department manager.
d. chief nursing officer.

 

 

ANS:  C

In a decentralized model, individual department managers and directors are responsible for daily staffing allocation.

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 379

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. Assigning individual personnel to work specific hours, days, or shifts and in a specific unit or area over a specified period of time is known as:
a. scheduling.
b. staffing effectiveness.
c. nursing direct care hours.
d. human resources staffing strategy.

 

 

ANS:  A

Scheduling is the process of assigning individual personnel to work specific hours, days, or shifts and in a specific unit or area over a specified period of time (Barnum & Mallard, 1989).

 

DIF:    Cognitive Level: Understand (Comprehension)                  REF:   Page 368

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

MULTIPLE RESPONSE

 

  1. An RN is relocating and is seeking employment at a hospital that focuses on patient safety. Which staffing issues have a negative impact on patient safety (select all that apply)?
a. Eight-hour shifts
b. Twelve-hour shifts
c. Mandatory overtime
d. Student nurses on the unit
e. Unplanned overtime

 

 

ANS:  B, C, E

Mandatory and unplanned overtime and long shifts have been shown to have a negative impact on patient safety. Staff people who work long shifts are at higher risk for making errors.

 

DIF:    Cognitive Level: Apply (Application)                               REF:   Page 382

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. Examples of nursing care delivery models include (select all that apply):
a. team nursing.
b. quality nursing.
c. primary nursing.
d. private duty nursing.
e. patient-focused care.

 

 

ANS:  A, C, D, E

A nursing care delivery model “is defined as a method of organizing and delivering nursing care in order to achieve desired patient outcomes” (Deutschendorf, 2010, p. 444). Examples of nursing care delivery models include patient-focused care, team nursing, private duty nursing, total patient care, functional nursing, primary nursing, and various combinations.

 

DIF:    Cognitive Level: Apply (Application)                               REF:   Page 372

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. The hospital units most likely to employ a decentralized staffing model include (select all that apply):
a. the telemetry unit.
b. labor and delivery.
c. the medical-surgical unit.
d. the emergency department.
e. the neonatal critical care unit.

 

 

ANS:  B, D, E

In a decentralized model, individual department managers and directors are responsible for daily staffing allocation. Units with decentralized staffing are typically units whereby volume and/or acuity may be most unpredictable, and the nursing competencies are unique to that area (e.g., emergency department, labor and delivery, critical care).

 

DIF:    Cognitive Level: Apply (Application)                               REF:   Page 379

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. Community Hospital is having a transient nursing shortage due to a high number of sick calls. The staffing office utilizes the staffing pool to obtain the required number of nurses. The staffing pool may include what types of nurses (select all that apply)?
a. Travel nurses
b. Foreign nurses
c. Registry nurses
d. Per diem nurses
e. Full-time nurses

 

 

ANS:  A, C, D

Access to nurses outside the unit to cover transient shortages is critical to meet last-minute, unplanned nurse shortages, such as sick calls and high patient demand. Supplemental staffing resources, frequently referred to as the staffing pool, are defined as a group of nurses who supplement the core unit staffing. This includes per diem nurses, float pool nurses, part-time nurses desiring additional hours, seasonal nurses, agency nurses, and traveling nurses.

 

DIF:    Cognitive Level: Apply (Application)                               REF:   Page 380

TOP:   Nursing Process: Planning

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

COMPLETION

 

  1. When the needs and characteristics of the patient clinical unit, or system, are matched with a nurse’s competencies, _____ results.

 

ANS:

synergy

Synergy, or optimum outcomes, results when the needs and characteristics of the patient clinical unit, or system, are matched with a nurse’s competencies (Kaplow & Reed, 2008).

 

DIF:    Cognitive Level: Apply (Application)                               REF:   Page 372

TOP:   Nursing Process: Evaluation

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. The amount of work performed by a unit is referred to as its _____.

 

ANS:

workload

The amount of work performed by a unit is referred to as its workload, and workload volume is measured in terms of units of service. The unit of service is specific to the type of unit, such as the number of patients, patient days, deliveries, visits, treatments, encounters, or procedures.

 

DIF:    Cognitive Level: Remember (Knowledge)                         REF:   Page 375

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. Betty is calculating the total patient days on her unit. Her average daily census is 35 and her average length of stay is 2.4 days. The total patient days on Betty’s unit is _____ days.

 

ANS:

84

eighty-four

Total patient days are commonly used in inpatient hospital areas. This is calculated by multiplying the average length of stay and the average daily census.

 

DIF:    Cognitive Level: Apply (Application)                               REF:   Page 375

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

  1. The proportion of direct care RNs to total direct care nursing staff, expressed as a percentage of RNs to total nursing staff, is called _____.

 

ANS:

skill mix

Skill mix is the proportion of direct care RNs to total direct care nursing staff, expressed as a percentage of RNs to total nursing staff.

 

DIF:    Cognitive Level: Remember (Knowledge)                         REF:   Page 368

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

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