Question 1

The primary reason for calculating productive hours paid instead of simply calculating work paid per year is that productive hours enable the manager to:

Accepted Answer

Calculating productive hours paid allows the manager to determine the number of hours available for patient care, which is essential for staffing and scheduling purposes. This information can also help in determining workload and managing resources efficiently. Anticipating total costs of patient care, knowing staff availability due to illness, and determining when orientation is needed are all important factors, but they are not the primary reasons for calculating productive hours paid.

Question 2

The chief nursing officer works with her nurse managers by helping them understand how to develop and implement a budget.How would a nurse manager best describe a budget?

Accepted Answer

A budget is a financial plan that outlines the expected income and expenses for a specific period of time. It helps managers make decisions about resource allocation and sets a framework for monitoring and controlling expenditures.

Question 3

The chief nursing office continues to seek ways to improve health care services to patients and to save the hospital money.However,with most physicians paid on a fee-for-service contract,the chief nursing office faces a challenge.Fee-for-service can provide incentive for:

Accepted Answer

B

Question 4

Which of the following factors is not implicated in rising health care costs?

Accepted Answer

The answer of Which of the following factors is not...

Question 5

Which of the following is an example of an initiative that may reduce total health care costs?

Accepted Answer

By offering nurse practitioner-led clinics that educate parents about nonpharmacologic strategies for managing ear infections, it can reduce unnecessary antibiotic prescriptions and costly doctor visits, thus reducing the overall healthcare cost.

Question 6

In preparing a budget,the nurse manager needs to anticipate the cost of benefits (e.g.,health,life insurance,pension,and retirement plans).On the basis of the usual cost of benefits,how much should a nurse manager include for a total full-time salary cost of $312,000?

Accepted Answer

Benefits typically cost an employer about 23% to 27% of the total salary cost. For a total full-time salary cost of $312,000, 23% of $312,000 is $71,760, and 27% of $312,000 is $84,240.

Question 7

After reviewing her monthly budget report,the nurse manager sees that she has a negative variance,which prompts her to change the staffing schedule.A negative or unfavourable variance in a monthly expense report may result from:

Accepted Answer

A negative variance occurs when actual expenses exceed budgeted expenses. Higher than expected numbers of acutely ill patients can lead to increased staffing needs and other costs, resulting in higher actual expenses than planned.

Question 8

A nurse manager gives approval for two staff nurses to attend a national conference.When reviewing the budget,the nurse manager looks at which line item?

Accepted Answer

The operating budget is where expenses related to day-to-day operations are listed, including items such as salaries, supplies, and travel expenses. Therefore, when reviewing the budget for approval of nurses attending a conference, the nurse manager would be looking at the operating budget to ensure there is enough funding available for the travel expenses.

Question 9

Physicians in a small rural hospital are reluctant to discharge older adult patients because many of the patients live more than an hour's drive from the hospital.Also,many of the patients lack the resources to travel these long distances for follow-up care.The hospital administration pressures the physicians to discharge patients sooner and to be more consistent with the number of hospitalization days specified within the diagnosis-related groups.Which of the following would most likely prompt the action of administrators?

Accepted Answer

The hospital administration is likely to be prompted to action by a financial concern, and option A suggests a deficit related to the hospital's handling of patient discharges. Option B does not suggest a financial concern, option C is specific to physicians' pay scales and not relevant to the hospital administration's concerns, and option D does not give specific information about any financial issues.

Question 10

Of the following,which is the most effective strategy that a nurse manager could employ to reduce unnecessary costs in specific health care settings?

Accepted Answer

Training nurses on accurate documentation of supplies used for patient care can help reduce unnecessary costs by minimizing wastage of supplies and preventing overuse of items. This can also help in ordering supplies only when needed, reducing inventory and storage costs. Reducing overtime hours and staff numbers may affect patient care and compromise quality, so those options are not preferred. Making decisions for patients about their care is not ethical and can lead to legal repercussions.

Question 11

Choosing and purchasing new eyeglasses,Mr.Jones sends the receipt in to his private health insurance provider for which of the following?

Accepted Answer

Cost-based reimbursement involves the insurance company reimbursing expenses based on the actual costs incurred, which applies to Mr. Jones' situation with his eyeglasses.

Question 12

In a nurse managers' meeting,the chief nursing officer encourages the managers to brainstorm ways to reduce costs.Nurse managers have the greatest effect on reducing costs by managing:

Accepted Answer

Nurse managers have the greatest effect on reducing costs through staffing management. This includes optimizing staff schedules, reducing overtime, and ensuring an appropriate staff-to-patient ratio, which can significantly impact the overall operational costs of healthcare facilities. Supplies, fixed costs, and medication costs also contribute to expenses, but staffing typically represents the largest portion of a healthcare facility's budget, giving nurse managers more leverage in this area for cost reduction.

Question 13

Because of the complexity of reimbursement systems and its implications for the services available to patients,the nurse has a key role in which of the following?

Accepted Answer

The complexity of reimbursement systems and its implications for patients require nurses to be advocates for patients with regard to services required and services used. Nurses need to ensure that patients receive the necessary services, and they should be knowledgeable about reimbursement limitations to help patients obtain adequate care. Increasing the volume of services and decreasing the number of patients served, accomplishing more with each visit and decreasing the volume of services used, and decreasing the volume of services used and the number of return visits are not appropriate roles for nurses in this context.

Question 14

Within a health care environment,where the gap between revenues and costs can mean the difference between sustainability and nonsustainability of an organization or services,it is critical for nurse managers to:

Accepted Answer

It is important for nurse managers to balance value-added services, which are services that add worth for patients, against costs and revenues. Simply cutting high-cost programs may not be the most effective solution, as it could ultimately reduce the quality of care and patient satisfaction. Implementing programs that bring in additional revenues may also be helpful, but balancing these efforts against the cost and value of services is crucial for long-term sustainability. Maintaining a clear vision of how to trim health care costs is important, but it should not be the sole focus of nurse managers.

Question 15

In preparing her budget,a nurse manager determines that she needs to budget for six FTE registered nurse (RN)positions in the upcoming year.On the basis of a 40-hour week,this means that the nurse manager has determined that the budget will provide for what number of hours?

Accepted Answer

The answer of In preparing her budget,a nurse manager determines...

Question 16

A nurse manager determines that RN 1 has 5 weeks of vacation time and 3 days of education and has averaged 3 sick days a year.RN 2 has 6 weeks of vacation time,has asked to attend a 3-day conference and a 2-day workshop,and has no history of sick time.RN 3 is new,and you anticipate 3 weeks of orientation,as well as 4 weeks of vacation time.RN 4 has 6 weeks of vacation and has an ongoing health condition,so you anticipate 2 weeks of sick time,as well as 3 days for education.RN 5 has 5 weeks of vacation,has no education plans,and averages 5 sick days per year.RN 6 has 6 weeks of vacation,has no education plans,and has been off ill for 4 weeks.How many hours of productive paid time can be anticipated for the budget?

Accepted Answer

RN 1: 
- Vacation time = 5 weeks = 200 hours (assuming 40-hour work week)
- Education time = 3 days = 24 hours (assuming 8-hour work day)
- Sick time = 3 days x 8 hours = 24 hours

Total non-productive time = 248 hours

RN 2: 
- Vacation time = 6 weeks = 240 hours
- Conference and workshop = 5 days = 40 hours
- No sick time
- Total non-productive time = 240 + 40 = 280 hours

RN 3:
- Orientation time = 3 weeks = 120 hours
- Vacation time = 4 weeks = 160 hours
- Total non-productive time = 120 + 160 = 280 hours

RN 4:
- Vacation time = 6 weeks = 240 hours
- Sick time = 2 weeks x 40 hours = 80 hours
- Education time = 3 days x 8 hours = 24 hours
- Total non-productive time = 240 + 80 + 24 = 344 hours

RN 5:
- Vacation time = 5 weeks = 200 hours
- Sick time = 5 days x 8 hours = 40 hours
- Total non-productive time = 240 hours

RN 6:
- Vacation time = 6 weeks = 240 hours
- Sick time = 4 weeks x 40 hours = 160 hours
- Total non-productive time = 240 + 160 = 400 hours

Total non-productive time for all RNs = 248 + 280 + 280 + 344 + 240 + 400 = 1792 hours
Total productive time = 52 weeks x 40 hours/week x 6 RNs = 12,480 hours

Therefore, the answer is choice C: 10,848.

Question 17

Mr.and Mrs.Amin,an older adult couple with limited means and are considering options after the hospitalization of Mrs.Amin with a fractured hip.Mrs.Amin is stable but requires assistance with bathing,transfer,and mobility,and this will present stress for Mr.Amin,who was hospitalized with a mild myocardial infarction last year.Considering their means and health concerns,which of the following might be the best option?

Accepted Answer

Home care would be the best option for Mr. and Mrs. Amin as it would allow them to receive assistance with daily activities in the comfort of their own home, reducing stress and potential health risks associated with moving to a nursing home or hospital. Additionally, with limited means, home care may be more cost-effective than other options. Hospice care is intended for those with terminal illnesses, which does not appear to be the case for Mrs. Amin. Custodial nursing home care may also be costly, and may not be necessary if home care can meet their needs. Hospital care is not an appropriate option as Mrs. Amin is stable and does not require ongoing medical treatment.

Question 18

The standard of care in a certain labour and delivery unit is 14 hours per patient day (HPPD),and on an average day,three patients are in labour.Analysis of the past month indicates the unit was averaging 38 hours of care.What is the productivity rating for this situation?

Accepted Answer

The productivity rating is calculated by dividing the actual hours of care (38) by the expected hours of care (3 patients * 14 HPPD = 42) and then multiplying by 100 to get a percentage: (38/42) * 100 = 90.48%, which rounds to 111%.

Question 19

A staff nurse regularly works two 12-hour shifts each week and one 8-hour shift every other week.How many full-time equivalents (FTEs)is this position?

Accepted Answer

A full-time equivalent (FTE) is typically based on a 40-hour workweek. The nurse works 24 hours (2 x 12-hour shifts) every week and an additional 8 hours every other week, averaging 4 hours per week (8 hours over 2 weeks). This totals 28 hours per week (24 + 4), which is 70% of a 40-hour workweek, making the position 0.7 FTEs.

Question 20

The chief nursing office of a Magnet hospital has conducted a study of ways to improve health care services.Health care services that add value for patients:

Accepted Answer

The answer of The chief nursing office of a Magnet...

Quiz 14: Managing Costs and Budgets