Chapters 9 and 10
The nurse-manager is frustrated by the quantity of paper clutter. How should the manager best deal with this time waster? a. Require face-to-face communication between staff members rather than written documentation. b. Set aside a block of time once per week to process documents. c. Deal with paper correspondence as soon as possible after it arrives. d. Place additional recycling and trash receptacles throughout the unit.
C
How can subordinates be discouraged from taking up a nursing manager's time unproductively? Select all that apply. a. Having the manager be accessible in the nursing station b. Instituting an open-door policy c. Having limited office seating available d. Refocusing conversations as needed e. Work in a public area
C, D
What changed the structure of Medicare payments from a retrospectively adjusted cost reimbursement system to a prospective, risk-based one? a. Zero-based budgets b. Diagnosis-related groupings c. Prospective payment system d. Incremental budgets
b
A client has a managed care program that is organized on the basis of capitation. What is a characteristic of this client's health care? a. Health-care providers earn a bonus if the client remains free of disease for a predetermined length of time. b. The client pays a fixed percentage of the cost of any health care, usually between 10% and 20%. c. The program uses a "gatekeeper" to ensure appropriate utilization of services. d. The client's providers are paid the same amount each month, regardless of the client's use of services.
d
A nurse-manager set a goal early in the year take better control of time management. Upon achieving this goal, the manager is likely to experience what benefits? Select all that apply. a. Increased learning b. Increased influence on coworkers c. Increased knowledge d. Enhanced productivity e. Decreased stress
D, E
Which statement about time management is true? a. Most people have an accurate perception of the time they spend on a particular task or the total amount of time they are productive during the day. b. Nurses with clearly identified personal goals and priorities have greater control over how they spend their time. c. Writing goals down is not usually necessary if the goals are limited to fewer than five in number. d. Keeping a time inventory for a day will allow the manager to identify a time management pattern.
B
A disease outbreak in the local community caused an unprecedented increase in staffing costs. In what category of expenses should the nurse-manager place these costs? a. Controllable b. Fixed c. Capital budget d. Noncontrollable
D
A nurse-manager is working in the context of an accountable care organization (ACO). What task will this manager most likely perform? a. Coordinating care for Medicare clients b. Providing community-based illness prevention c. Health promotion d. Determining whether clients' care plans are justified
a
An organization is considering the adoption of flexible budgeting. What advantage will this type of budgeting provide to the organization? a. Increased ability to adapt to changing circumstances throughout the year b. Increased reimbursement from state and federal agencies c. Longer budget cycles d. Increased opportunities for staff to participate in the budget process
a
A recent switch to a new laundry provider at a long-term care facility has been described as "cost-effective." What does this imply about the change in laundry service? a. It is the least expensive service available. b. It is worth the cost. c. It is reimbursable. d. The cost was anticipated.
B
The nurse-manager is creating a list in order to promote efficiency and productivity. What is the manager's best action? a. Use long-term goals as the framework for creating the list. b. Include slightly more activities than can be completed in a day, in order to motivate. c. Begin by ranking the priority of tasks that need to be accomplished. d. Keep each day's list as similar as possible to each other day's lists.
C
A manager has identified the need to spend more time planning in order to accomplished each day's tasks. When should the manager do this planning? a. Whenever a block of time is available b. At the beginning of each day c. In the middle of the day, after high-priority tasks have been completed d. At the end of the day, in preparation for the next day
B
A nurse-manager has set a goal of addressing external time wasters. What phenomenon should the manager address? a. Difficulty in setting clear, achievable objectives b. The manager's inability to say no to coworkers' and subordinates' requests c. The fact that the manager has a tendency to procrastinate d. The large quantity of paperwork that the manager must complete
D
Determine the nursing care hours per client day (NCH/PPD) if the following staffing existed for a 24-hour period (unit census = 10): 12 midnight to 12 noon, 1 registered nurse, 1 licensed vocational nurse 12 noon to 12 midnight, 1 registered nurse, 1 licensed vocational nurse, 1 unit clerk (8 hours only) a. 5.6 NCH/PPD b. 4.8 NCH/PPD c. 5.0 NCH/PPD d. 6.2 NCH/PPD
a
A nurse-manager is having difficulty finishing the necessary tasks for each day. When implementing the time management process, what should the manager do first? a. Complete the highest priority task. b. Allow enough time for sufficient daily planning. c. Reprioritize based on new information received. d. Delegate work that cannot be accomplished in a day.
B
A nurse-manager is prioritizing tasks. Which tasks should the manager put into the "do now" category? a. Adding follow-up comments to an incident report from the previous day b. Covering sick calls for the upcoming shift to ensure there are enough nurses c. Conducting a new employee's initial performance review d. Meeting with the chairperson of the hospital's strategic planning committee
B
A leader-manager has recognized the need to be more consistent with time management? What skill should the nurse develop in order to facilitate time management? a. Enlisting the help of an administrative assistant b. Recognizing the need for goal setting c. Prioritizing tasks accurately d. Handling emergency situations quickly
C
When participating in fiscal planning, a leader should perform what role? a. Monitoring aspects of budget control b. Accurately assessing personnel needs using agreed-on standards or an established client classification system c. Documenting the need for resources on a unit d. Being visionary in identifying short- and long-term unit fiscal needs
D
The nurse-manager of a hospital unit has categorized some tasks in the "do now" category. The tasks most likely reflect: a. the unit's day-to-day operational needs. b. issues related to long-term goals. c. large, time-consuming tasks. d. problems that cannot be safely delegated.
a
What is an implication of responsibility accounting for a nurse who manages a hospital unit? a. The manager is accountable for the way that resources on used on the unit. b. The manager has a responsibility to submit the unit budget on time each year. c. The organization's financial officer works with manager regarding budget approval. d. The budgeting process must be transparent and data must be made publicly available.
a
An older adult client has been admitted to the hospital with pneumonia and has been placed on a critical pathway. This tool will allow the care team to: a. minimize the client's out-of-pocket expenses for care. b. decrease the amount of paperwork required for reimbursement. c. minimize administrative costs. d. standardize the client's care.
d
What was the primary reason for the development of the prospective payment system? a. Skyrocketing health-care costs following the advent of Medicare and Medicaid b. The passage of the Health Maintenance Act of 1973 c. The introduction of the Health Security Act to Congress d. A coalition held by the three largest private insurers in 1975
a
Which statements regarding fiscal planning are true? Select all that apply. a. Social influences affect fiscal planning. b. A successful fiscal planner must be creative. c. An understanding of economic forces is necessary to perform fiscal planning. d. Practical experience is a key to being a good fiscal planner. e. Subordinates should be excluded from fiscal planning.
a, b, c, d
A nurse-manager is participating in the budgeting process. What task should the manager perform first? a. Creating a spending plan b. Determining what needs to be covered in the budget c. Identifying the organization's strengths and weaknesses d. Determining how to maximize cost-effectiveness
b
The manager is using a decision package to set funding priorities for a hospital unit. What type of budgeting is the manager most likely using? a. Flexible b. Operating c. Capital d. Zero based
d
A manager is trying to get in the habit of creating a daily list of tasks. The manager should: a. avoid changing the list once initial planning is completed. b. include flexibility in the implementation of the list. c. include all relevant short-term, intermediate, and long-term goals. d. keep the list highly structured, thus decreasing the possibility of procrastination.
B
A nurse-manager admits to feeling frustrated and confused by the fact that each day "just slips away," leaving many important tasks undone. How should this manager begin develop better time management skills? a. Identify a mentor who can plan the manager's schedule. b. Complete a time inventory to identify how time is used. c. Experiment with adjustments to the daily schedule. d. Request a temporary reduction in workload.
B
A nurse-manager is beginning a day and is responsible for completing numerous tasks, including one high-priority task, three medium-priority tasks, and several lower priority tasks. How should the manager plan the day? a. Complete some low-priority tasks first to make room for focusing on the high-priority task. b. Complete the high-priority task as early in the day as possible. c. Arrange the tasks according to the amount of time that they will require. d. Complete the low-priority tasks first, then a medium-priority task, and then focus exclusively on the high-priority task.
B
A nurse-manager is reviewing a backlog of correspondence and reads an e-mail asking for feedback from a manufacturer about a piece of equipment that is used at the facility. The manager reads that the sender asked for all feedback to be submitted by the end of last week. In what category of prioritizing should this task be placed? a. Squeaky wheel b. Don't do c. Do later d. Do now
B
A nurse-manager has been required to justify each item of the following year's proposed budget. The manager has been instructed that referring to the previous year's expenditures is not a sufficient justification. What type of budgeting is being used in this facility? a. Incremental budgeting b. Perpetual budgeting c. Zero-based budgeting d. Managed care
C
A nurse-manager is having an exceptionally busy day and tells a colleague, "There's no way I can take a lunch break today. I've got too much to do." What is the colleague's best response? a. "It's important to take breaks, so there's never any valid reason for skipping lunch." b. "I know that happens sometimes. Let me know if you need help with organizing your day." c. "You probably just need to reorganize your day. Do you need help with that?" d. "Let's take a quick break and get something to eat, even if we have to come back a bit early."
D
A nurse-manager makes lists of tasks for each day. What should the manager do in order to ensure that lists accurately reflect changes in priorities? a. Reevaluate the lists on a regular basis and adjust them as needed. b. Ensure that each day's list is significantly different from the previous day's list. c. Make lists as detailed as possible in terms of the time allocated and the specifics of each task. d. Have the lists reviewed by a trusted colleague on a regular basis.
A
The nurse-manager at a long-term care facility is participating in fiscal planning for the first time. What is fiscal planning? a. A learned skill that improves with practice b. A job role of the facility business manager c. Part of the organizing phase of the management process d. Reactive, based on political, social, and economic forces
A
The nurse-manager of a community health clinic is participating in budget planning for the next year. The manager will most likely assign the most money to what expenditure category. a. The personnel budget b. Short-term capital acquisitions c. The operating budget d. Supplies and equipment
A
What is the reason that first- and middle-level managers experience more interruptions than higher level managers? a. They generally interact directly with a greater number of individuals in daily planning. b. They seldom have the clerical and secretarial help assigned to higher level managers. c. They often lack the time management skills that more experienced managers possess. d. They generally have heavier workloads than higher level managers.
A
Which activity is associated with a leadership role in time management? a. Assisting followers in working cooperatively to maximize time use b. Prioritizing day-to-day planning to meet short-term and long-term unit goals c. Building time for time management planning into the work schedule d. Utilizing technology to facilitate timely communication and documentation
A
Time management can be reduced to cyclic steps that include which of the following? Select all that apply. a. Allow time for planning and establish priorities. b. Complete tasks according to their difficulty, from easiest to most difficult. c. Complete the highest priority task, and whenever possible, finish one task before beginning another. d. Reprioritize based on remaining tasks and new information that may have been received. e. Divide each day into 1-hour blocks.
A,C, D
Which task should the team leader perform first when planning care for a group of clients? a. Plan so that each client on the team receives equal amounts of nursing care. b. Prioritize the amount and type of nursing care each client requires. c. Identify the staff who will comprise the individual care teams. d. Assign clients to the specific nursing teams.
B
A nurse-manager has recognized that unproductive socialization is making it difficult to complete each day's tasks. What action should the manager take to prevent this cause of inefficiency? a. Maintain an open-door policy so employees can have more rapid interactions with the manager. b. Schedule appointments so that interactions can be predicted and controlled. c. Request a transfer to a site where the manager knows fewer coworkers and employees. d. Ban socialization on the unit during working hours.
B
What is the best response for a nurse-manager to handle someone who has a pattern of lengthy chatter? a. "We'll need to make it brief since my schedule is tight today." b. "I can't speak with you now, but I'm going to have free time at 11 AM." c. "Stop by and we can talk during your lunch break." d. "I am sorry but I do not have anytime today to talk with you."
B
A novice nurse-manager is frequently late for appointments. This manager's colleagues are likely to have what perception of the manager? a. The manager is overworked with too many responsibilities. b. The manager needs additional management training. c. The manager does not value other people's time. d. The manager lacks the skill necessary for the job.
C
A nurse-manager is responsible for implementing a large and complex plan that will require much time and effort. How should the manager address this large task? a. Work on the task with few breaks in order to finish as quickly as possible. b. Delegate as much of the task as possible to employees and focus on evaluation. c. Break the task into smaller, less intimidating units. d. Delay beginning the task until it has the manager's undivided attention.
C
A unit manager has been instructed to complete a comprehensive audit of the unit's use of resources. The manager is daunted by the size of the task, which will likely take several weeks to complete. The manager should: a. set aside low- and medium-priority tasks until the project is complete. b. delegate the project to subordinates and ask for weekly updates. c. divide the project into smaller components that can be more easily completed. d. request clerical or secretarial assistance.
C
How should the nurse-manager most effectively deal with the ever-changing nature of the nursing work environment? a. Evaluating the management skills of the nursing team leaders b. Providing time management classes for staff members c. Frequently reassessing personally established priorities d. Encouraging staff to engage in daily planning
C
What aspect of a client's care is most likely to be influenced by the Patient Protection and Affordable Care Act (PPACA)? a. The number of health insurance plans that the client can choose between b. The likelihood that the client will have to seek out-of-state treatment c. The client's ability to act as the "gatekeeper" of his or her own care d. The client's ability to qualify for Medicaid
a
What is the primary reason for documenting nursing interventions as soon as possible after an activity is completed? a. Decreasing the risk of inaccurate documentation b. Implementing effective time management skills c. Demonstrating professional nursing behavior d. Observing an established nursing principle
a
Which client would be most likely to qualify for Medicaid? a. An adult client who earns $750.00 per month b. A veteran who sustained injuries in combat c. A Native American client who lives on a reservation d. A child who requires physical therapy to recover from traumatic injuries
a
Which statement concerning a budget is true? a. A budget's reliability decreases if it is prepared significantly in advance of the funding period. b. Budgets should be created as far in advance is possible. c. A budget is revised every 3 months during a fiscal year. d. Budgets are reliable only when expenses are fixed.
a
During the budgetary process, a nurse-manager and the other members of the fiscal planning team are considering factors that may affect the accuracy of the budget. What factor should the team prioritize? a. Legislation regarding client safety b. Possible changes in reimbursement policies c. Depreciation of capital equipment d. Establishment of new HMOs in the region
b
The leader-manager of several inpatient units is participating in fiscal planning. During this process, the leader-manager should: a. assume primary responsibility for the organization's budgetary planning goals. b. monitor and evaluate all aspects of the unit's budget control. c. encourage broad participation of subordinates in the budgetary process. d. control unpredictable census variations that may undermine the personnel budget.
b
The managers of an HMO have argued against a proposed decrease in deductibles, citing a risk of moral hazard. What phenomenon would show that the managers' concerns were justified? a. Members of the HMO adopt high-risk behaviors because they know that treatment is available. b. Members of the HMO use more health-care services because of the reduced cost. c. Members are reluctant to comply with the HMO regulations. d. Members leave the HMO for other HMOs that have more favorable terms.
b
Which statement identifies a common mistake made related to daily planning? a. "Crises always come up so my plan is always changing." b. "I always handle each client's needs as they arise." c. "Sometimes it's difficult to reserve time for daily planning." d. "Client care requires a lot of reassessment by nursing."
b
The nurse is caring for a client who has health insurance that is a form of managed care. What are likely characteristics of this client's health-care plan? Select all that apply. a. Clients as gatekeepers of their health-care services b. A focus on prevention of illness c. Decreased emphasis on inpatient hospital care d. Capitation e. Unlimited choice of health-care providers
b, c, d
Which statements regarding a budget are true? Select all that apply. a. Personnel costs are normally considered to be an uncontrollable expense. b. A budget contains an estimate of both expenses and income for a fixed period. c. It allows for an institution to plan for the effective use of its resources. d. The cost of supplies is an example of a variable expense. e. A mortgage is an example of a fixed expense.
b, c, d, e
The unit manager is calculating the NCH/PPD for a 24-hour period. The manager will need what data to calculate this? Select all that apply. a. The acuity level of the clients on the unit b. The total number of hours worked by nursing personnel c. The average hourly wage of the nurses on the unit d. The complexity of nursing care that was provided on a particular unit in a 24-hour time span e. The unit census
b, e
Which statements demonstrate adherence to habits that supports good personal time management skills? Select all that apply. a. "It's important to me to be professional." b. "I'm learning to trust the members of my team." c. "I've learned that I'm most energetic in the morning." d. "I'll adjust my sleep schedule now that I'm on night shift." e. "I never quit a task that I've decided to do."
b,c,d
A client is a member of an HMO and has chronic shoulder pain from an old injury. The client has decided to pursue shoulder surgery and the HMO has required a utilization review. What will this review focus on? a. The circumstances surrounding the client's original injury b. The client's baseline level of functioning c. The costs and benefits of the proposed surgery d. The profit to be made from the surgery
c
What is the name for a provision of health care in an organized system to subscribing members in a geographical area with an agreed-on set of basic and preventive supplemental health maintenance and treatment services for a fixed, prepaid charge? a. Preferred provider organizations (PPOs) b. A traditional third-party payer indemnity plan c. A health maintenance organization (HMO) d. Diagnosis-related groupings (DRGs)
c
Which statement about American health-care budget spending is correct? a. A large health-care budget equals quality health-care outcomes. b. America spends less than any other industrialized country on health care. c. Outcomes related to low-birth-weight infants are worse than many other industrialized countries. d. The scarcity of resources is the biggest factor in the failure to reach outcomes.
c
A client belongs to an HMO that is a preferred provider organization (PPO). When requiring health care, this client will most likely: a. prove that he or she has received preventive care from a provider at some point. b. pay out of pocket for care and then submit for reimbursement. c. be assessed by a nurse before being referred to a physician. d. choose between the health-care providers that are in the PPO.
d
