Sullivan, Effective Leadership and Management, 8/e
Chapter 16
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
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:
Sullivan, Effective Leadership and Management, 8/e Test Bank
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
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.
Question 5
Type: MCSA
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?
1. PRN nurse
2. Internal float nurse
3. Part-time nurse
4. Agency nurse
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.
Question 6
Sullivan, Effective Leadership and Management, 8/e Test Bank
Type: MCSA
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?
1. Immediate client needs
2. Historical data of expected client outcomes
3. Using hospital-wide data to staff individual units
4. Reduction of nursing care hours
Rationale 1: The American Nurses Association (ANA) has developed principles for nurse staffing, and the nurse
managers follow these guidelines.
Rationale 2: The Joint Commission does not identify specific levels of nursing care hours for specific patient
populations.
Rationale 3: Staffing and scheduling is the responsibility of the nurse manager.
Rationale 4: Although the hospital administration must ensure that the right number of competent staff is
provided to meet patient needs, the responsibility of staffing has been delegated to the nurse manager or charge
nurse.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 16-1: Determine staffing needs.
Question 8
Type: MCSA
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?
1. Block staffing
2. Creative scheduling
3. Flexible scheduling
4. Self-staffing
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 9
Type: MCSA
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?
1. A nurse from an outside agency
2. A nurse from a hospital unit that has a low census today
3. A nurse from a decentralized internal float pool
4. A nurse from the centralized internal float pool
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 16-6: Explain how to supplement staff when needed.
Question 10
Type: MCSA
Sullivan, Effective Leadership and Management, 8/e Test Bank
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?
1. “First you must determine the nursing care hours needed.”
2. “First you must become familiar with the classification system we use.”
3. “First consider how to modify the schedule to meet client needs.”
4. “First consider the need to supplement the current nursing staff so that arrangements can be made.”
Rationale 1: The average daily census of the hospital probably will not have a direct bearing on the staffing mix
of this unit.
Rationale 2: The staffing mix should be based on the needs of the clients currently on the unit. A higher need for
assessment, education, or discharge planning requires more registered nurses.
Rationale 3: The number of staff on vacation is not an issue, as the clients still need care.
Rationale 4: The financial productivity of the unit should not be an issue as that is historical data, not current
client care need data.
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 12
Type: MCSA
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?
1. Staff members would prefer to make out their own schedules.
2. Nursing shortages and salary constraints have affected staffing patterns.
3. Lower client acuity has contributed to the need for more flexibility.
4. Flexible pattern staffing is the easiest method available.
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 16-5: Describe the various ways to schedule staff.
Question 13
Type: MCSA
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?
1. The hospital is experiencing a nursing shortage, so staff members are very busy.
2. The client mix on the unit is much more varied.
3. The unit has just adopted combined staffing patterns.
4. There is a 1-hour overlap of staff between shifts.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 16-4: Determine the appropriate staffing mix and distribution of staff.
Question 14
Type: MCSA
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?
Sullivan, Effective Leadership and Management, 8/e Test Bank