Deck 21: Staffing and Nursing Care Delivery Models

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?

A) Nurse manager
B) Case manager
C) Coordinator of patient-centered care delivery
D) Team leader in team nursing care delivery

Answer 1

Case manager

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?

A) Team
B) Primary
C) Partnership
D) Modular

Answer 2

Modular

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?

A) Patient classification system
B) Clinical pathway
C) Patient-centered plan of care
D) Diagnosis-related group (DRG)

Answer 3

Clinical pathway

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?

A) "Assessing patient satisfaction with nursing care."
B) "Quantifying the amount and intensity of care required."
C) "Examining the skill mix and educational preparation of the staff."
D) "Determining the number of hospital days required by the patients."

Question 5

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

A) Planned procedures
B) Ethnic diversity of patients
C) Clinical competency of staff
D) Educational level of nurses
E) Age of patients

Question 6

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

A) Knowing the intensity of care needed by patients according to physical and psychosocial factors
B) Examining the educational level of the staff
C) Assessing the skill level of caregivers
D) Reviewing the budget to determine the financial consequences of past staffing patterns

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?

A) Total patient care
B) Functional nursing
C) Team nursing
D) Primary nursing

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?

A) Modular
B) Primary
C) Team
D) Functional

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?

A) Total patient care
B) Partnership nursing
C) Team nursing
D) Functional nursing

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?

A) Continuity of care is enhanced and errors are reduced when nurses provide care over longer shifts and consecutive workdays,such as 12-hour shifts on three consecutive days per week.
B) The use of part-time nurses provides the variability needed to meet diverse patient needs.
C) Satisfaction of the staff equates to satisfaction of patients.
D) Nurses provide the same level of care,regardless of the work environment.

Question 11

What is customer satisfaction primarily based upon?

A) Access to modern,up-to-date facilities
B) Availability of an extensive menu selection
C) Personal interactions with employees
D) Having to undergo fewer invasive procedures

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?

A) Patient outcome
B) Variance
C) Care goal
D) Nursing standard

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?

A) Begin negotiating for additional agency nurses.
B) Propose hiring more part-time employees.
C) Adopt the concept of participatory staff involvement.
D) Regularly use "float" nurses to cover vacancies.

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?

A) Assignments
B) Staffing
C) Output
D) Productivity

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?

A) A patient classification system
B) Diagnostic-related groups
C) Case management
D) Clinical pathways

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?

A) Because patient needs remain constant on a daily shift,staffing needs at the beginning of the shift should be sufficient to provide safe,high-quality care.
B) Staffing should allow time for the RN to apply the nursing process so decisions result in high-quality,safe patient outcomes.
C) Patient acuity levels affect staffing by increasing the need for unlicensed personnel to provide routine basic care rather than increasing RNs in staff mix.
D) RN staffing is not cost-effective;thus,is it important for staffing models to limit the number of RNs assigned per shift.

Question 17

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

A) Patient classification systems
B) Clinical pathways
C) Functional nursing
D) Case management

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?

A) Partnership
B) Patient-centered
C) Case management
D) Total patient care

Question 19

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

A) With the partnership model,an RN does not have to be part of the mix.
B) Leadership abilities of the RN are a major determinant of effectiveness of care for both models.
C) The RN teaches the LPN/LVN or unlicensed assistive personnel (UAP)how to apply the nursing process in team nursing.
D) With team nursing the RN cares for the patient while the team members work with the family or significant others.

Question 20

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

A) Imposing maximum staffing levels
B) Requiring a specific staff mix
C) Stipulating nurse-patient ratios
D) Confirming delivery of satisfactory care

Question 21

A nurse responsible for staffing a medical-surgical unit must consider what factors (Select all that apply. )

A) The patient census
B) Physical layout of the unit
C) Complexity of care required
D) Educational level of all staff
E) Task preferences of the nurses