Chapter 16 Effective Leadership and Management in Nursing 8th Edition

Chapter 16  Effective Leadership and Management in Nursing 8th Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
A unit requires a great deal of staffing flexibility. To fill this need, the manager should use which strategy?
1. Maximizing the availability of nursing staff
2. Good communication among staff
3. A high RN-skill mix
4. Overlap between shifts
Correct Answer: 3
Rationale 1: Maximizing the availability of nursing allows for more nurses but doesn’t take into account the staffing mix. If the RN number is low, flexibility is lower.
Rationale 2: Good communication among staff is very important but does not create the greatest flexibility.
Rationale 3: A high RN-skill mix allows for more flexibility to meet client needs. An RN is educated and licensed to provide care that an assistant or LPN cannot provide.
Rationale 4: Overlap between shifts may provide more staff, but if the staff members are not RNs, flexibility is not appreciably increased.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 16-4: Determine the appropriate staffing mix and distribution of staff.

Question 2
Type: FIB
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 ____.
Standard Text:
Correct Answer: 7.33
Rationale : Nursing hours per patient per day (NHPPD) is calculated by dividing the total nursing care hours (220) by the total census (30).
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 16-2: Demonstrate how to use patient classification systems to calculate nursing care hours necessary.

Question 3
Type: MCMA
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?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Registered nurses from across the facility were included on the committee that developed the system.
2. RNs will be required to accept flexible schedules that might require the nurse to practice on any unit in the facility.
3. The nurse’s level of educational preparation will be considered in staffing decisions.
4. The number of clients and their acuity will be considered for staffing purposes.
5. When low census occurs the unlicensed assistant category will be first to be furloughed.
Correct Answer: 2,5
Rationale 1: The ANA requires that staffing systems be developed with input from direct-care registered nurses.
Rationale 2: The ANA requirements state that the RN cannot be forced to work on a unit without “having established that he or she is able to provide professional care on such a unit.”
Rationale 3: The ANA requirements state that staffing will “reflect the level of preparation and experience of those providing care.”
Rationale 4: The ANA requirements state that staffing will be “based on the number of patients and patient-acuity level.”
Rationale 5: There is no mention of low census furlough in the ANA requirements for staffing systems.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 16-1: Determine staffing needs.

Question 4
Type: MCMA
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?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Contracting with outside agency nurses
2. A decentralized float pool
3. Using nonlicensed personnel as substitutes for nurses
4. Establishing an internal float pool of nurses who are cross trained
5. Developing a float pool of nurses shared with another hospital in the system
Correct Answer: 1,2,4,5
Rationale 1: Agency nurses can be used as supplements, but their cost can be significant.
Rationale 2: A decentralized float pool provides personnel who usually work only for one nurse manager or only on one unit.
Rationale 3: Nonlicensed personnel cannot be used as substitutes for nurses.
Rationale 4: This can be an effective way to provide supplementary staff.
Rationale 5: This is an innovative idea that creates a system-wide internal float pool.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 16-6: Explain how to supplement staff when needed.