1. The number of adverse events such as falls and pressure ulcers on the unit is increasing. An ideal staffing plan to address this issue would include which of the following? Increasing the:
a. total number of staff on the unit.
b. staff and RN hours per patient.
c. total number of staff and implementing 12-hour shifts.
d. number of RNs and number of RNs with experience on the unit.
2. A small rural hospital has been designated as a critical access hospital. It has 40 beds and an average occupancy of 34 beds. To prepare the staffing, the chief nursing officer computes the occupancy as being:
a. 90%.
b. 85%.
c. 75%.
d. 60%.
3. To prepare staffing schedules, a nurse manager needs to calculate paid non-productive time. When calculating paid non-productive time, the nurse manager considers:
a. work time, educational time, and holiday time.
b. paid hours minus worked hours.
c. vacation time, holiday time, and sick time.
d. paid hours minus meeting time.
4. An important aspect of managing the costs on a unit is to plan accurately for staffing needs. Nurse managers use staffing plans to:
a. assign staff on the unit on a daily basis.
b. ensure that days off are planned for the staff.
c. outline the number of individuals by classification on a per-shift basis.
d. predict the numbers and classifications of float staff needed to augment regular staff.
5. A nurse manager must consider a number of external variables when preparing the personnel budget and projecting the unit’s staffing needs. An external variable to be considered is:
a. organizational staffing policies.
b. staffing models.
c. changes in services that will be offered.
d. department of Health licensing standards.
6. A nurse manager must also consider a number of internal variables that will affect staffing patterns. An internal variable to be considered is:
b. state licensing standards.
c. American Nurses Association.
d. consumer expectations.
7. A nurse manager uses many sources of data when planning the unit’s workload for the year. Which of the following data must be considered in the planning?
a. Hours of operation of the unit
b. Trends in acuity on the unit
c. Maximum work stretch for each employee
d. Weekend requirements
8. Scheduling is a function of implementing the staffing plan by assigning unit personnel to work specific hours and specific days of the week. To retain nursing staff, the nurse manager must incorporate into the schedule plan:
a. all weekends off.
b. all holidays off.
c. a variety of scheduling options.
d. rotating shifts.
9. The difference between staffing and scheduling is that staffing:
a. puts the right person in the right position.
b. puts the right person in the right time and place.
c. refers to the number of nursing hours per patient per day.
d. looks after interpretation of benefits and compensation.
10. A busy neurologic ICU and step-down unit most likely would use which patient-classification system?
a. Factor evaluation
b. Prototype evaluation
c. Hybrid system
d. AHRQ system
11. A factor evaluation system:
a. utilizes financial data to determine number of staff-to-patient ratios.
b. utilizes DRGs to determine acuity on a unit.
c. combines interventions and time required for interventions to determine levels of care required.
d. combines financial resources and nursing interventions to determine patient contact hours.
12. Staff members on your unit raise concern that there is rising acuity on the unit and lack of responsiveness in addressing these needs through appropriate staffing. They point to increased incidences of adverse and sentinel events on the unit. To address this concern, your hospital organization would do best to:
a. implement a patient-classification system immediately.
b. participate in databases that compare the outcomes and staffing levels versus those of similar institutions.
c. provide increased numbers of staff to the unit.
d. ignore such concerns because acuity is variable.
13. A particular classification system assigns revenue according to the functional capacity of patients and the progression of patients during their stay in rehabilitation units. More independent patient activities, such as prompted voiding, require higher staff utilization than dependent activities but do not result in increased staff resources. This is an example of:
a. bureaucracy.
b. concern related to the validity of classification systems.
c. inadequate reliability of classification systems.
d. inappropriate subjectivity in making judgments about staffing.
14. In the past year, you have noticed an increase in patient falls on your unit. In reading studies related to staffing and patient outcomes, you realize that you will need to plan for:
a. higher patient care hours.
b. safer facilities.
c. institution of a patient-classification system.
d. an increased number of RN positions.
15. A strategy to increase RN staff retention at Valley Hospital includes:
a. better compensation and benefits.
b. clearer position descriptions.
c. lay-offs of nursing assistants.
d. adequate staffing to meet acuity levels.
16. In evaluating weekend mortality rates, the head nurse on the cardiac unit is surprised to find that they are higher than on weekdays. In exploring the reasons for this apparent anomaly, the head nurse focuses on:
a. availability of diagnostic personnel.
b. availability of physicians.
c. communication with on-call providers.
d. acuity level of patients.
17. A nurse staffing plan takes into account:
a. specific nurse-to-patient ratios per shift.
b. participation of nurses in projecting staffing needs.
c. compensation and benefits for each level of staff.
d. the occupancy load of a unit.
18. As the unit manager, you post the staffing plan and compliance reports. This initiative is aimed at:
a. maintaining unit morale.
b. complying with national requirements.
c. demonstrating patient outcomes.
d. inviting staff participation in decision making.
19. To maintain patient safety, studies suggest that scheduling should avoid:
a. rotating shifts.
b. weekends.
c. 8-hour shifts.
d. mandatory overtime.
20. In a job interview for a staff position, which of the following indicates your knowledge of patient safety?
a. “Will I be able to get overtime hours on your unit?”
b. “If there is an opportunity to work extra shifts, I would really like that.”
c. “Is there a strategy in place to reduce the number of overtime hours on the unit?”
d. “I see no reason why I wouldn’t be able to work overtime.”
21. To reduce reliance on overtime hours, an organization develops a strategy for floating nurses during staff shortages. To maximize patient safety and reduce costs, the healthcare organization:
a. develops a centralized pool of float nurses.
b. assigns nurses from less busy units to ones with increased acuity levels.
c. floats nurses only between units on which the nurses have been cross-trained.
d. assigns float nurses to basic care only.
22. To project staffing needs and to avoid understaffing, it is important that nurse managers consider which of the following?
a. Maximum productive hours
b. Average non-productive hours
c. Minimum benefit hours
d. Maximum vacation time
23. Your healthcare organization has a decentralized system for scheduling. As part of this process, after you have developed a draft schedule, you may need to:
a. seek budgetary approval.
b. balance personal schedules against institutional needs.
c. negotiate the schedule with unit staff.
d. submit the schedule to a centralized staffing office for review.
24. The American Nurses Association has advocated for the Registered Nurse Safe Staffing Act. This legislation is based on ANA Safe Staffing Principles and takes what factors into consideration for planning staffing on a nursing unit?
a. Patient acuity and complexity
b. Education and training of the nurses
c. Technology available and use on the unit
d. All factors listed are to be considered
1. In reviewing the job description of a nurse manager, the staff becomes aware that a nurse manager’s role is complex. Which of the following duties are required of a nurse manager? (Select all that apply.)
a. Ensure unit productivity reports.
b. Develop policy and legislation to protect nurses’ well-being.
c. Plan staffing of UNPs only.
d. Prepare a unit budget that reflects unit staffing needs.
e. Monitor nurse-sensitive indicators such as falls and incidence of infections.
