Correct Answer: D

Rationale: The correct answer is D because having fewer nurses working than originally planned leads to a negative variance in staffing levels, which can impact patient care and operational efficiency. This results in increased workload for available staff, potential burnout, and compromised quality of care.
Choice A does not relate directly to staffing levels, so it is not a negative variance.
Choice B, having excess nurses, is actually a positive variance as it provides flexibility and potentially improved patient care.
Choice C, a rise in patient satisfaction ratings, is also positive and does not indicate a negative variance in the budget.

Correct Answer: A

Rationale: The correct answer is A because promoting the idea of clients getting an annual flu vaccination is a cost-saving method in client care. Flu vaccinations can prevent flu-related complications, reducing hospitalizations and associated costs. This proactive approach promotes preventive care, thereby saving money in the long run.


Choice B is incorrect because delaying emptying a colostomy bag can lead to skin irritation, infections, and odor issues, resulting in increased costs for treating these complications.


Choice C is incorrect because suggesting sterile technique for tracheostomy clients during ostomy care is not cost-saving; it may increase the use of resources without providing significant benefits.


Choice D is incorrect because assigning a complex task like administering closed irrigation to assistive personnel without proper training and supervision can lead to errors and complications, potentially increasing costs.

Correct Answer: C

Rationale: The correct answer is C: Work together with floor nurses to identify the causes of errors and develop solutions. This approach promotes collaboration and empowers the staff to actively participate in problem-solving. By involving the nurses in the process, the manager can gain valuable insights into the root causes of the medication errors, leading to more effective solutions. This approach also fosters a culture of shared responsibility and continuous improvement.


Choice A is incorrect because solely motivating nurses to report errors does not address the underlying causes and may not lead to effective solutions.
Choice B is incorrect as delegating the task to another department may result in a disconnect from the frontline staff who are directly involved in the errors.
Choice D is incorrect as highlighting punishments can create a culture of fear rather than focusing on prevention and improvement.

Correct Answer: B

Rationale: The correct answer is B because assessing the unit's workload and considering the services it provides is essential for developing an effective staffing budget. By understanding the workload, the nurse manager can determine the appropriate staffing levels needed to maintain quality care and meet patient needs. This approach ensures that staffing resources are allocated efficiently and effectively. Setting aside organizational changes (
A) could lead to overlooking current staffing needs. Identifying services offered by competing organizations (
C) is not directly relevant to determining the unit's staffing requirements. Ensuring work schedules are prepared in advance (
D) is important but not as crucial as understanding the workload when creating a budget.

Correct Answer: B

Rationale: The correct answer is B: Selecting only studies with meta-analyses since they are the weakest form of evidence. Meta-analyses are considered the highest level of evidence as they combine results from multiple studies, providing a more comprehensive and reliable assessment of the research topic. By including only studies with meta-analyses, one can ensure a thorough evaluation of the quality and strength of the research study. Other choices are incorrect because: A: Discarding systematic reviews is not advisable as they provide a structured and comprehensive analysis of existing research. C: Setting a specific sample size limit may exclude valuable studies with smaller sample sizes that are still methodologically sound. D: Relying solely on randomized controlled trials may limit the scope of research considered. E: Evaluating studies against appropriate standards is important but doesn't guarantee the highest quality and strength of research.