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- 1.P { margin-bottom: 0.08in; } The nurse manager tells the staff that this year’s budget numbers will not change, even if census drops over the rest of the year. How should the staff interpret this information?
- A.
The budget is a fixed one.
- B.
The hospital uses incremental budgets.
- C.
The hospital uses a variable budget.
- D.
The hospital starts the budgeting process with a zero-based budget.
- 2.P { margin-bottom: 0.08in; } The nurse manager identified that the census was higher than anticipated and the client acuity level was also high; however, there were fewer nursing hours paid. This variance is an example of which budgetary variance?
- A.
Efficiency
- B.
Nonsalary expenditure
- C.
Rate
- D.
Volume
- 3.P { margin-bottom: 0.08in; } As a member of the budgeting committee, the nurse manager reviews the salaries for file clerks in the accounting department. These salaries should be included in which budget item?
- A.
The fixed cost
- B.
The variable cost
- C.
The indirect cost
- D.
The direct cost
- 4.P { margin-bottom: 0.08in; } The nurse manager's goal is to adequately staff the unit and use minimal supplementary staff. The manager has added the cost of this supplementary staff to the unit’s operating budget. A colleague informs the manager it should have been added to which budget?
- A.
The personnel budget
- B.
The operating budget
- C.
The revenue budget
- D.
The fixed budget
- 5.P { margin-bottom: 0.08in; } A client’s spouse is concerned about the cost of hospitalization. The nurse says, “Since your spouse is on Medicare, the hospital will be paid according to the DRG.” What does the nurse mean by this statement?
- A.
Medicare will pay the total cost for the care provided.
- B.
Medicare will pay an average of the total costs.
- C.
Medicare will pay based on the usual cost of the treatments provided.
- D.
Medicare will pay based on a set amount for the specific condition for which the client was hospitalized.
- 6.P { margin-bottom: 0.08in; } During an interview with a potential employee, the nurse manager tells the individual that an additional 10 percent of the hourly rate will be paid for working the 7:00 pm–7:00 am shift. What is another way the manager could have described this difference in pay?
- A.
“You will receive an additional 10 percent for overtime.”
- B.
“The night shift differential is 10 percent.”
- C.
“Your evening premium is 10 percent.”
- D.
“You will get a 10 percent cost-of-living raise for working the night shift.”
- 7.P { margin-bottom: 0.08in; } The nurse manager of a critical care unit creates the operating budget with the knowledge that a minimum of two professional nurses must be paid per shift regardless of the patient census. Which group determines this standard?
- A.
Hospital administration
- B.
Nursing administration of the hospital
- C.
The Joint Commission
- D.
Nursing personnel of the special care units
- 8.P { margin-bottom: 0.08in; } A hospital’s budget is incremental. Which statement by the nurse manager reflects use of this type of budget?
- A.
“The finance department sent me the budget worksheet with last year’s expenses.”
- B.
“We have $1,000 left in our education account that we need to spend before the year is over. Who has an idea for a class to attend?”
- C.
“I have to justify all our activities as if we have never done them before.”
- D.
“I like this type of budget preparation because it is fairly simple and straightforward.”
- E.
“In order to create next year’s budget, I am to start at 80 percent of what we budgeted last year.”
- 9.P { margin-bottom: 0.08in; } A nurse educator is asked by the chairperson of the department to submit a list of equipment that could be used to meet the department's goals. The list includes projectors, computers, office supplies, and computer-assisted programs. How would the educator categorize the materials?
- A.
As an expense
- B.
As part of revenue
- C.
As part of the capital budget
- D.
As part of the operating budget
- 10.P { margin-bottom: 0.08in; } The nurse manager is reviewing the previous month’s budget and notes a favorable efficiency variance of the full-time equivalents (FTEs). Which options may be reasons for this favorable variance?
- A.
Greater client acuity
- B.
Extravagant use of resources
- C.
Understaffing the unit
- D.
Low client acuity
- E.
Use of agency nurses to supplement staff
- 11.P { margin-bottom: 0.08in; } The nurse manager is creating the budget for the next fiscal year. Because the client census has been higher in the past year, more supplies were used. Which type of cost does this reflect?
- A.
Fixed costs
- B.
Variable costs
- C.
Direct costs
- D.
Zero-based costs
- 12.P { margin-bottom: 0.08in; } With the current health care industry focus on managed care, nurses must be more cost-conscious. Which option is an example of a nurse being cost-conscious?
- A.
The nurse reviewing the client’s itemized bill each day
- B.
The nurse’s decision to use fewer supplies when changing a dressing
- C.
The nurse manager reviewing client costs on a daily basis
- D.
The nurse manager requesting that the materials management director obtain quotes for less expensive items
- 13.P { margin-bottom: 0.08in; } A nursing executive is comparing the entire hospital financials for the month and notes that the medical laboratory’s revenue is higher than environmental services. What is a possible explanation?
- A.
The laboratory has increased charges for its services.
- B.
Environmental services is a non-revenue-producing cost center.
- C.
The laboratory is a non-revenue-producing cost center.
- D.
The nursing units affect the laboratory charges.
- 14.P { margin-bottom: 0.08in; } A nurse manager of a medical unit and a nurse manager of a critical care unit are discussing their personnel budgets. The medical unit budget is higher than the critical care unit budget. What are plausible reasons for this difference?
- A.
There is a higher turnover rate of nursing staff on the medical unit.
- B.
Costs were incurred during a recent remodeling of the medical unit.
- C.
The client acuity on the critical care unit is higher.
- D.
The critical care manager is a better manager than the medical unit manager.
- E.
More staff on the medical unit received premium pay this year.
- 15.P { margin-bottom: 0.08in; } The chief nurse officer (CNO) is planning the budget for the coming year. A new position has been added to the nursing administration cost center. The CNO is determining how many benefit hours should be allocated for this new position. Which days should the CNO include in this calculation?
- A.
Sick days
- B.
Weekend days
- C.
Vacation days
- D.
Holidays
- E.
Bereavement days
- 16.P { margin-bottom: 0.08in; } The medical–surgical nursing manager notices the education expenditure for the month is over budget. How should the manager deal with this difference?
- A.
Complete an expenditure report for the month.
- B.
Complete a variance report for the month’s budget.
- C.
Forward a non-revenue-producing report to the administration.
- D.
Forward the expense line budget to the administration.
- 17.P { margin-bottom: 0.08in; } Every month the chief financial officer (CFO) reviews the budget with the hospital’s board of directors. The CFO requests a million dollars to purchase a new MRI (magnetic response imaging) unit for the radiology department. Which category best describes this request?
- A.
Non-revenue expense
- B.
Capital expense
- C.
Variable cost
- D.
Allocation of funds
- 18.P { margin-bottom: 0.08in; } A nurse manager is trying to educate the staff regarding efficiency and how it affects the unit’s costs. Strategies to increase efficiency could include which of the following?
- A.
Increasing the number of unlicensed assistants providing direct nursing care
- B.
Limiting dressing supplies on the nursing unit
- C.
Labeling the cost of each item in the clean supply closet
- D.
Eliminating staff education sessions
- 19.P { margin-bottom: 0.08in; } The budget committee of a hospital is holding the first meeting of the budgetary cycle in two weeks. The finance department is preparing an information packet to be distributed to members. What statistical information should be included?
- A.
The average daily census for the facility over the last year
- B.
Current community wage ranges for employee classifications
- C.
Changes in accrediting body or legislative regulations
- D.
Number of nurses terminated for cause over the last year
- E.
Current staff mix across the hospital
- 20.P { margin-bottom: 0.08in; } A hospital has used capital funds to purchase a new piece of diagnostic equipment. The hospital’s chief financial officer (CFO) says, “The cost of this equipment will be expensed out across all units that use it.” How should the nurse manager interpret this statement?
- A.
The equipment is jointly owned by all units that use it.
- B.
If clients on the manager’s unit require the use of this equipment, a portion of the cost will be charged to the unit.
- C.
The equipment will be rented to the units for use.
- D.
The nurse manager will ask physicians to refrain from using the equipment.
- 21.P { margin-bottom: 0.08in; } The newly hired nurse manager is involved in the first budgetary cycle since being hired. The manager lists some capital equipment needs and is surprised when they are not available for staff use two months after the request. What is the reason for this?
- A.
The equipment was not approved by the manger’s supervisor.
- B.
The budgetary cycle takes up to 1 year to occur.
- C.
The hospital has experienced a downturn in revenue and it not fulfilling promises.
- D.
The nurse manager failed to complete the correct request.
- 22.P { margin-bottom: 0.08in; } A nurse manager writes the following note: “Over personnel budget by $1,250 in April due to late snowstorm. Nurses unable to get to work. Overtime wages paid.” Why is this note important?
- A.
It will help the manager create the budget for the next year.
- B.
It is required by The Joint Commission.
- C.
All variances must be documented and forwarded to the hospital attorney.
- D.
It ensures that there is no question of diversion of hospital funds.
- 23.P { margin-bottom: 0.08in; } An unfavorable rate variance has occurred in the salary budget of a unit. When investigating this variance, the nurse manager should look for which situations?
- A.
Were any unexpected bonuses awarded?
- B.
Did agency personnel hours exceed the number predicted in the budget?
- C.
Were new employees hired at lower wages?
- D.
Did the number of client days exceed the predicted budgeted amount?
- E.
Were fewer nursing hours worked than were predicted?
- 24.P { margin-bottom: 0.08in; } The nurse manager is updating the position control sheet for the fiscal year prior to beginning a new budgetary cycle. What would the manager include in this sheet?
- A.
The FTE factor for an LPN hired this month
- B.
The current wage range for RNs working on the units
- C.
The names of all unit clerks working in the unit
- D.
The level of licensure of a nurse working on the unit
- E.
The fact that two RNs have retired this year
- 25.P { margin-bottom: 0.08in; } A nursing assistant tells a nurse, “I am going to have to call in sick tomorrow because I don’t have a babysitter.” How should the nurse respond to this information?
- A.
The assistant’s sick time is earned and should be used in any way the assistant wishes.
- B.
The assistant should use personal time, not sick time for this situation.
- C.
The assistant’s absence will not be a major problem for the unit as long as only one day is missed.
- D.
It will be okay for the assistant to miss a day because it will help another assistant get overtime wages.
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