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Exam 383 Exam 2 (1).
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Exam 383 Exam 2 (1).
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Exam 383 Exam 21. The nurse manager of a unit has lost many staff members, and the unit is now staffed
with a large number of agency and traveling nurses. She knows that the agency and
traveling nurses are all contracted to stay on the unit for the next 3 months. One way to
improve morale and decrease stress in the unit would be to:
a. Implement team nursing.
b. Request hospital-based "floating" nurses to substitute for the temporary staff.
c. Plan a social event and include the agency and traveling nurse staff members.
d. Plan unit-based social events for your remaining permanent staff members. - ANS-c.
Plan a social event and include the agency and traveling nurse staff members.
In a small rural nursing home, a director of nursing decides, because of a shortage of
nurses, to implement a partnership model to help with basic tasks that comply with state
rules regarding delegation. What type of design constitutes a partnership care delivery
model?
a. RN and LPN/LVN
b. RN and RN
c. RN and medication assistants
d. RN and certified nurses' aides - ANS-ANS: C
The partnership care delivery model is a variation of primary nursing in which an RN
works with a consistent assistant, who performs basic nursing functions consistent with
state delegation rules.
1. The number of adverse events such as falls and pressure ulcers on your unit is
increasing. An ideal staffing plan to address this issue would include which of the
following? Increasing the: - ANS-d.
Number of RNs and number of RNs with experience on the unit.
ANS: D
A number of studies have identified that adverse events such as falls and pressure
ulcers can be reduced by increasing the number of RNs on a unit (relative to other
personnel) and utilizing experienced RNs. Overtime and 12-hour shifts are linked to
greater incidence of errors.
,The number of adverse events such as falls and pressure ulcers on your 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. - ANS-ANS: D
A number of studies have identified that adverse events such as falls and pressure
ulcers can be reduced by increasing the number of RNs on a unit (relative to other
personnel) and utilizing experienced RNs. Overtime and 12-hour shifts are linked to
greater incidence of errors.
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: - ANS-b.
85%.
ANS: B
A way to assess a unit's activity level is to calculate the percentage of occupancy.
Formula: daily patient census (rounded) divided by the number of beds in the unit
The occupancy level is calculated as 34/40, or 85%.
The nurse manager is setting up the room assignments for the unit. She has one critical
patient on the unit, who is going to require more care than the others. Before delegating
a task, a nurse manager should:
a. Delegate the admission assessment to the LPN.
b. Review the employee's performance assessment for the most recent period.
c. Assess the amount of guidance and support needed in a particular situation.
d. Create a task analysis of critical behaviors for the individual. - ANS-ANS: C
To delegate effectively, the nurse manager must assess the abilities required in the
situation and the abilities that staff have to anticipate the amount of direction,
monitoring, explanation, and independence that can be assumed.
2. As a nurse manager, the one activity you should not overlook is:
a. Anticipating staff sick days.
b. Posting the yearly rotation schedule.
c. Scheduling staffing for holidays 6 months in advance.
d. Reviewing vacation requests. - ANS-d. Reviewing vacation requests.
,2. The nurse manager of a unit has lost many staff members, and the unit is now staffed
with a large number of agency and traveling nurses. She knows that the agency and
traveling nurses are all contracted to stay on the unit for the next 3 months. One way to
improve morale and decrease stress in the unit would be to:
a. Plan a social event and include the agency and traveling nurse staff members.
b. Plan unit-based social events for your remaining permanent staff members.
c. Request hospital-based "floating" nurses to substitute for the temporary staff.
d. Implement team nursing. - ANS-ANS: A
Social support, in the form of positive work relationships, can be an important way to
buffer the effects of a stressful work environment. Including all staff in the social event
enables those who are not normally part of the team to experience this support and
provides an opportunity for the staff as a whole to develop supportive relationships.
A key advantage that a nurse manager has in terms of delegating is that:
a. Clients receive less attention because too many staff make it difficult to coordinate
care.
b. Nurses report less pressure to perform necessary tasks themselves.
c. Administration can predict overtime more accurately.
d. Team skills can be used more effectively. - ANS-ANS: D
The use of multilevel healthcare providers enables healthcare organizations and nursing
to provide patient-centered care, with a focus on abilities and skills that can be
employed to perform "what is needed now." As tasks become more complicated,
delegating skills to others enables the nurse to effectively deliver a complex level of
care.
An older adult couple with limited means and on Medicare is considering options after
the hospitalization of Mrs. A. with a fractured hip. Mrs. A. is stable but requires
assistance with bathing, transfer, and mobility, and this will present stress for Mr. A.,
who was hospitalized with a mild myocardial infarction last year. Considering their
means and health concerns, which of the following might be the best option?
a. Hospice care
b. Custodial nursing home care
c. Home care
d. Hospital care - ANS-ANS: C
Of the options presented, C is the best alternative . Custodial nursing care is not
covered under Medicare and therefore, the financial burden of this option may cause
further stress for the couple. Medicare Part A is an insurance plan for hospital, hospice,
home health, and skilled nursing care that is paid for through Social Security. Because
Mrs. A. is stable and not terminal, she does not require hospice care. The assistance
, provided through home care is covered under Medicare and provides assistance for
needs such as those of Mrs. A.
3. As a nurse manager, the one activity you should not overlook is:
a. Posting the yearly rotation schedule.
b. Reviewing vacation requests.
c. Scheduling staffing for holidays 6 months in advance.
d. Anticipating staff sick days. - ANS-ANS: B
Free time and vacation time are needed for individuals to recharge. If time for work is
more than 60% of wake time, or when self-time is less than 10% of wake time, stress
levels increase.
A department manager's budget concerned with the income and expenses associated
with day-to-day activities of the unit is a(n):
a. operational budget.
b. capital budget.
c. construction budget
d. balanced budget. - ANS-a. operational budget.
3. To prepare staffing schedules, a nurse manager needs to calculate paid
nonproductive time. When calculating paid nonproductive time, the nurse manager
considers: - ANS-c.
Vacation time, holiday time, and sick time.
ANS: C
Nonproductive hours are hours of benefit time and include vacation, holiday, and
personal or sick time.
To prepare staffing schedules, a nurse manager needs to calculate paid nonproductive
time. When calculating paid nonproductive 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. - ANS-ANS: C
Nonproductive hours are hours of benefit time and include vacation, holiday, and
personal or sick time.
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