1. There is no overlap of staff.
2. There are not enough nurses working during a 24 hour period of time.
3. This would create discord and confusion with other health care departments.
4. This staffing pattern would not be cost-efficient.
Correct Answer: 4
Rationale 1: With 10 hour shifts there is an overlap of staff.
Rationale 2: In order to cover 24 hours, three nurses are needed. In order to cover 24 hours with 12-hour shifts,
two nurses are needed.
Rationale 3: There is no evidence that 10-hour shifts for nurses would adversely affect other departments.
Rationale 4: Since there is substantial overlap when covering 24-hours with 10-hour shifts, this staffing pattern is
generally not cost-efficient.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 16-5: Describe the various ways to schedule staff.
Question 15
Type: MCMA
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?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Current licensure to practice within the state
2. Orientation to the facility and the unit
3. Certification as an agency nurse
Sullivan, Effective Leadership and Management, 8/e Test Bank
4. Documentation of malpractice insurance
5. Documentation of ability to work unsupervised in the environment
Rationale 2: Agency nurses are a considerable cost to an organization and their use may cause staff resentment
since agency nurses may be making two or three times the salary of the in-house nurse. Usually is it more cost-
effective to offer an incentive and overtime to the current nursing staff.
Rationale 3: Although it does take time and a significant amount of documentation to orient the agency this is not
as big a problem as the cost.
Rationale 4: The physicians may not know that the nurse is from an agency. Their primary interest is that their
client’s needs are met.
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: 16-6: Explain how to supplement staff when needed.
Question 17
Type: MCSA
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?
1. External pools
2. Internal pools
3. Open shift management
4. Float pools
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 18
Type: MCSA
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?
1. No current address on file for the nurse
2. Past employment history not documented in file
3. Evaluation of the nurse’s performance missing from file
4. No documentation of past certifications in file
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 16-6: Explain how to supplement staff when needed.
Question 19
Type: MCSA
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?
Sullivan, Effective Leadership and Management, 8/e Test Bank
1. Additional registered nurses
2. Additional unit clerks
3. Additional licensed practical nurses
4. Additional unlicensed assistive personnel
Rationale 2: Human resources policy on employment will refer to general employment guidelines for all
employees, not guidelines on staffing ratios.
Rationale 3: The policy and procedures of the organization will set staffing criteria. The Joint Commission only
determines if the organization is following its own policy.
Rationale 4: The current schedule will list vacancies but not the staffing guidelines for the unit.
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: 16-4: Determine the appropriate staffing mix and distribution of staff.
Question 21
Type: MCSA
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?
1. Increase the number of unlicensed assistive personnel.
2. Increase the number of licensed practical nurses.
3. Increase the number of non-nursing support personnel.
4. Increase the number of registered nurses.
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 16-1: Determine staffing needs.
Question 22
Type: MCSA
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?
1. Staffing 8-hour shifts uses slightly more full-time equivalents (FTEs).
2. Staffing 12-hour shifts uses more full-time equivalents (FTEs).
3. Staffing 12-hour shifts uses significantly fewer full-time equivalents (FTEs).
4. There is no difference in the full-time equivalents (FTEs) required.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 16-3: Calculate FTEs.
Question 23
Type: MCSA
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.