Deck 16: Staffing and Scheduling

Question 1

Which group determines the level of nursing care and hours of care necessary to meet the needs of the hospitalized client?

A) American Nurses Association (ANA)
B) The Joint Commission
C) Nurse managers
D) Hospital administrators

Answer 1

Nurse managers

Question 2

The administration of a health care organization has proposed a new client care area staffing system. Which components of this system do not meet the American Nurses Association (ANA) requirements?

A) Registered nurses from across the facility were included on the committee that developed the system.
B) RNs will be required to accept flexible schedules that might require the nurse to practice on any unit in the facility.
C) The nurse's level of educational preparation will be considered in staffing decisions.
D) The number of clients and their acuity will be considered for staffing purposes.
E) When low census occurs the unlicensed assistant category will be first to be furloughed.

Answer 2

RNs will be required to accept flexible schedules that might require the nurse to practice on any unit in the facility.
When low census occurs the unlicensed assistant category will be first to be furloughed.

Question 3

The nurse manager is determining the day's nursing care hours (NCHs) by analyzing the client workload. The unit census is 30 and there is a total of 220 nursing care hours. The average nursing hours per client per day (NHPPD) figured to the nearest hundredth decimal point is ____.

Answer 3

7.33

Question 4

A critical care nurse has reported off because of an illness. Which choice of replacement for this nurse would provide the best continuity of quality nursing care?

A) A nurse from an outside agency
B) A nurse from a hospital unit that has a low census today
C) A nurse from a decentralized internal float pool
D) A nurse from the centralized internal float pool

Question 5

The unit has open shifts even after staff members have signed up for overtime. The chief nurse officer (CNO) does not want to hire agency nurses to cover these shifts. The nurse manager does not understand why the CNO is offering staff an incentive versus hiring agency nurses. Which would be a reasonable conclusion?

A) It takes a significant amount of time to orient agency nurses.
B) The agency nurses are costly.
C) There is a significant amount of documentation required for agency nurses.
D) The physicians are not comfortable with agency nurses.

Question 6

A new nurse manager asks to see the Joint Commission manual in order to determine adequate staffing for the next shift. How should the supervisor respond to this request?

A) "The Joint Commission manual is kept with the other unit manuals."
B) "For that information you will need to refer to the human resources department's policy on employment manual."
C) "You need to look at the policy and procedure manual for the organization, not the Joint Commission manual."
D) "Before you look any further, refer to the unit's current schedule."

Question 7

The nurse manager of an intensive care unit has several open shifts that require an RN to fill. Several nurses have taken overtime shifts but there are still several uncovered shifts. The chief nurse officer (CNO) decides to fill these vacancies with agency nurses. The CNO realizes that agency personnel must have which requirements prior to working in the facility?

A) Current licensure to practice within the state
B) Orientation to the facility and the unit
C) Certification as an agency nurse
D) Documentation of malpractice insurance
E) Documentation of ability to work unsupervised in the environment

Question 8

The State Board of Health requests the employee file of all agency nurses employed within the past year. At the end of the review the organization receives a sanction associated with these nurses. What is the most likely cause of this sanction?

A) No current address on file for the nurse
B) Past employment history not documented in file
C) Evaluation of the nurse's performance missing from file
D) No documentation of past certifications in file

Question 9

A newly hired nurse manager is being mentored in this new role. How should the mentor advise this manager regarding staffing for the next shift?

A) "First you must determine the nursing care hours needed."
B) "First you must become familiar with the classification system we use."
C) "First consider how to modify the schedule to meet client needs."
D) "First consider the need to supplement the current nursing staff so that arrangements can be made."

Question 10

The nurse manager is explaining her staffing budget to the hospital administration. The manager has developed a flexible staffing pattern. The administration questions the manager as to why this pattern was developed. Which answer is most correct?

A) Staff members would prefer to make out their own schedules.
B) Nursing shortages and salary constraints have affected staffing patterns.
C) Lower client acuity has contributed to the need for more flexibility.
D) Flexible pattern staffing is the easiest method available.

Question 11

A nurse manager needs to supplement the staff for the next schedule. Which option would be the most significant drain on the unit's staffing budget?

A) PRN nurse
B) Internal float nurse
C) Part-time nurse
D) Agency nurse

Question 12

The nurse manager is explaining the organizational staffing policy to a newly hired nurse. The nurse will be scheduled on an as-needed basis. The manager explains this policy is a supplemental scheduling policy. Which staffing strategies would be included in this policy?

A) Contracting with outside agency nurses
B) A decentralized float pool
C) Using nonlicensed personnel as substitutes for nurses
D) Establishing an internal float pool of nurses who are cross trained
E) Developing a float pool of nurses shared with another hospital in the system

Question 13

The hospital has elected to use the demand management staffing system instead of the patient classification system. Because of this decision, the nurse manager who is staffing must focus on which of the following?

A) Immediate client needs
B) Historical data of expected client outcomes
C) Using hospital-wide data to staff individual units
D) Reduction of nursing care hours

Question 14

A hospital has open shifts on its medical-surgical unit. The manager has listed open shifts on the hospital's intranet. This is an example of which type of scheduling?

A) External pools
B) Internal pools
C) Open shift management
D) Float pools

Question 15

A unit requires a great deal of staffing flexibility. To fill this need, the manager should use which strategy?

A) Maximizing the availability of nursing staff
B) Good communication among staff
C) A high RN-skill mix
D) Overlap between shifts

Question 16

The medical-surgical unit is at capacity and the clients have a high acuity, requiring care such as turning, bathing, toileting, and feeding. Which level of supplementary staff would be cost-effective?

A) Additional registered nurses
B) Additional unit clerks
C) Additional licensed practical nurses
D) Additional unlicensed assistive personnel

Question 17

The medical-surgical unit's census has decreased since the previous shift. The manager is reviewing the staffing grid. Which factor is used to determine staffing mix?

A) Average daily census of the hospital
B) Client care needs
C) Number of staff on vacation
D) Financial productivity of the unit

Question 18

The nursing staff of a medical-surgical unit would like to work four 10-hour shifts each week. For which reason would the unit nurse manager probably deny this request?

A) There is no overlap of staff.
B) There are not enough nurses working during a 24 hour period of time.
C) This would create discord and confusion with other health care departments.
D) This staffing pattern would not be cost-efficient.

Question 19

On two recent occasions, the experienced nurse manager has found it nearly impossible to discuss upcoming events with all the staff on the unit. What is a common reason for this problem?

A) The hospital is experiencing a nursing shortage, so staff members are very busy.
B) The client mix on the unit is much more varied.
C) The unit has just adopted combined staffing patterns.
D) There is a 1-hour overlap of staff between shifts.

Question 20

The unpredictability of the labor and delivery area requires a set staff mix for every shift. Which type of staffing pattern should the manager use to ensure this mix?

A) Block staffing
B) Creative scheduling
C) Flexible scheduling
D) Self-staffing

Question 21

Two nurses have agreed to share a schedule in which each will work 4 hours each day for a total of 20 hours a week. In 2 weeks ____ FTEs will be generated by these nurses.

Question 22

An emergency department manager is looking over the next month's schedule and decides to supplement the schedule due to vacations. The manager decides to use decentralized pool staffing to lower costs and provide quality care. Which group of nurses is a part of this manager's decentralized staffing?

A) PRN staff from the external pool of nurses
B) Agency nurses
C) PRN staff from the emergency department nurses
D) PRN staff from the nurses who work on medical-surgical units

Question 23

A nurse has agreed to work on the Baylor plan. The nurse should arrange day care for which shifts?

A) A 12-hour shift on Saturday
B) An 8-hour shift on Monday
C) An 8-hour shift on Sunday
D) A Thursday shift once a month
E) Shifts every weekend

Question 24

A nursing supervisor is setting up a new unit and must make a blanket decision about whether the unit will be staffed on 12-hour shifts or 8-hour shifts. What should this supervisor keep in mind when making this decision?

A) Staffing 8-hour shifts uses slightly more full-time equivalents (FTEs).
B) Staffing 12-hour shifts uses more full-time equivalents (FTEs).
C) Staffing 12-hour shifts uses significantly fewer full-time equivalents (FTEs).
D) There is no difference in the full-time equivalents (FTEs) required.

Question 25

A nursing supervisor requests information technology support for posting all nursing scheduling online. What justification can the supervisor provide for this request?

A) If schedules are posted online they are open for all to see.
B) Posting schedules online will promote fairness in shift assignments.
C) It is easier to change the schedule if it is posted online.
D) If the schedule is posted online, all shifts must be 12-hours shifts.
E) Open shift scheduling is easier to maintain if all schedules are online.

Question 26

An acute care nursing unit has determined that an acuity level III client requires 6 hours of nursing care per shift while a level IV client requires 8 hours. Today the unit has seven level III clients and nine level IV clients. The manger should staff for ___ hours of nursing care for the next shift.

Question 27

The nurse manager of a postsurgical unit is preparing the next month's schedule. The manager has reviewed the surgery schedule for the corresponding month and notes there are several high-acuity surgeries. Which staffing adjustment would the manager make to best provide the care needed by these postoperative clients?

A) Increase the number of unlicensed assistive personnel.
B) Increase the number of licensed practical nurses.
C) Increase the number of non-nursing support personnel.
D) Increase the number of registered nurses.

Question 28

The OB manager is looking at staffing for the night shift. The postpartum unit is busy and the labor-delivery unit has four clients in labor. The manager collects data from the nursing staff regarding the acuity of their clients. These data assist the manager in determining the staff for the next shift. This is an example of which type of system?

A) Demand management
B) Block scheduling
C) Organizational related
D) Patient classification

Question 29

The hospital is caring for more high-acuity clients due to the recent flu endemic. The chief nurse officer (CNO) reviews the census from last year's flu season and instructs the manager to schedule more registered nurses for the weekend. Which system has the CNO used?

A) Patient classification systems management
B) Demand management system
C) The Baylor plan
D) Automated staffing

Question 30

A health care facility has adopted automated scheduling across all client care areas. When presenting this decision to nursing staff, the nurse executive should include which information?

A) "This system will allow nurses to spend more time with those clients who need us the most."
B) "We expect that using this system will help us improve client outcomes."
C) "There will be little financial gain to the institution, but we are committed to improving our scheduling."
D) "Using this Baylor plan will help us improve client outcomes."
E) "This system will allow nurses to choose shifts and clients."