©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
NU 452 Test 2 Questions With Correct
Answers
PPACA's Payment Reform Provisions - The Patient Protection and Affordable Care Act -
answer✔· Value-based purchasing -defined as a function of quality, efficiency, safety, and cost
· Accountable care organizations (ACOs)
· Bundled payments
· The medical home
· The health insurance marketplace
Fiscal Planning - answer✔- Not intuitive; a learned skill that improves with practice
- An important but often neglected dimension of planning
- Should reflect the philosophy, goals, and objectives of the organization
--What you think is important is where you should be putting your money
--i.e. if organization has a philosophy is giving into the community - something within budget
should be going to the community
--budgeting for the unit needs to be congruent with the philosophy of the organization
("important part of the budgeting process")
- A skill increasingly critical to nursing managers because of increased emphasis on finance and
"big business" of health care
1|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
Balancing Cost and Quality - answer✔· In order to have the revenue that we need to be doing
the greatest good for the greatest number of ppl - need to look at balance between cost &
quality
Balancing Cost and Quality: cost containment - answer✔· Controlling the expenses within
preplanning budget constraints (you have your budget - and controlling within it)
· Refers to effective and efficient delivery of services while generating needed revenues for
continued organizational productivity
· *The responsibility of every health-care provider*, and the viability of most health-care
organizations, today depends on its ability to use its fiscal resources wisely
· Sometimes nurses at the bed side don't think about this; but what nurses do every day makes
a big difference
Balancing Cost and Quality: Cost Effective - answer✔· Cost-effective means producing *good*
results for the amount of money spent
o Has the money spent produced good results; what it worth the cost
· Expensive items can be cost-effective and inexpensive items may not
o Just because something is low cost, does not equal cost effectiveness
o *Also, just bc spend a lot of money, won't always get better outcomes*
· Cost-effectiveness then must take into account factors such as anticipated length of service,
need for such a service, and availability of other alternatives
o i.e. how frequently will that item or service be used; takes into account overall how much will
be spending
o (in united states, we spend more per captia on health care but outcomes are not the best)
Responsibility Accounting - answer✔· Ultimately, who is responsible for budgeting in the
hospital
· Each of an organization's revenues, expenses, assets, and liabilities is someone's responsibility
· As a corollary, the person with the most direct control or influence on any of these financial
elements should be held accountable for them, usually the leader-manager
2|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
-When thinking about the unit - *the nurse manager would be responsible for budgeting within
the unit; they are the one that knows what employees/personnel needed*
· The unit manager also can best monitor and evaluate all aspects of a unit's budget control
· *Forecasting*
Forecasting - answer✔involves making an educated budget estimate using historical data
-It is the nurse mangers responsibility how best to forecast - making an estimate on your
budget
Budget - answer✔-A plan that uses numerical data to predict the activities of an organization
over a period of time
-The desired outcome of budgeting is maximal use of resources to meet organizational short-
and long-term needs
· goal of budget: to maximize our resources available (greatest good for the most amount of
people)
· also, to realize when resources are not adequate bc can jeopardize patient safety
-A budget provides a mechanism contributions for planning and control, as well as for
promoting each unit's needs and contributions
budgeting process - answer✔· can be related to nursing process
· Essential to get input from all levels of the organization is essential
How is budgeting process related to the nursing process? - answer✔1) *Assess* what needs to
be covered in the budget- input from all levels of the organization
2) *Diagnosis* of the goals for the budget - what needs to be accomplished.. cost-effectiveness
3) *Plan* for the budget cycle- usually annual; could be perpetual so always have 12 months of
budget ahead
4) *Implementation* or ongoing management and analysis of the budget- ongoing monitoring
and analysis to assure meeting budget
5) *Evaluate* and periodic review of the budget for the fiscal year- reviewed and modified as
needed through the fiscal year
3|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
the manger needs to account for: - answer✔-fixed expenses
-variable expenses
-controllable expenses
-uncontrollable expenses
Fixed expenses - answer✔do not vary with volume
· Rent/mortgage on the building
· Managers salary / top level administrative salary
Variable expenses - answer✔do vary with volume
· Supplies
Controllable expenses - answer✔controlled or varied by manager
· Number of personnel that are working
Uncontrollable expenses - answer✔can't control equipment depreciation
· Equipment breaks
*Types of Budgets: Personnel Workforce Budget* - answer✔1) Accounts for the majority of
health-care organization's expense
· largest component* of the budget for health care organization - basically, our nurses
2) Health care is labor intensive
· Type of question on test 2: coming up with acuity to come up with nursing hours; will not have
to determine whether have enough staff
· Nursing hrs: include people are on duty for every shift; includes all personnel there (unit
clerks, RNs, tech partners all considered part of the nursing care hours)
o Includes productive time & non-productive time
o Non-productive time: i.e. on orientation or time spent in meetings
*calculating nursing care hours* - answer✔nursing hours worked in 24 hrs / patient census
4|Page
11/16/2024 10:16 AM
NU 452 Test 2 Questions With Correct
Answers
PPACA's Payment Reform Provisions - The Patient Protection and Affordable Care Act -
answer✔· Value-based purchasing -defined as a function of quality, efficiency, safety, and cost
· Accountable care organizations (ACOs)
· Bundled payments
· The medical home
· The health insurance marketplace
Fiscal Planning - answer✔- Not intuitive; a learned skill that improves with practice
- An important but often neglected dimension of planning
- Should reflect the philosophy, goals, and objectives of the organization
--What you think is important is where you should be putting your money
--i.e. if organization has a philosophy is giving into the community - something within budget
should be going to the community
--budgeting for the unit needs to be congruent with the philosophy of the organization
("important part of the budgeting process")
- A skill increasingly critical to nursing managers because of increased emphasis on finance and
"big business" of health care
1|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
Balancing Cost and Quality - answer✔· In order to have the revenue that we need to be doing
the greatest good for the greatest number of ppl - need to look at balance between cost &
quality
Balancing Cost and Quality: cost containment - answer✔· Controlling the expenses within
preplanning budget constraints (you have your budget - and controlling within it)
· Refers to effective and efficient delivery of services while generating needed revenues for
continued organizational productivity
· *The responsibility of every health-care provider*, and the viability of most health-care
organizations, today depends on its ability to use its fiscal resources wisely
· Sometimes nurses at the bed side don't think about this; but what nurses do every day makes
a big difference
Balancing Cost and Quality: Cost Effective - answer✔· Cost-effective means producing *good*
results for the amount of money spent
o Has the money spent produced good results; what it worth the cost
· Expensive items can be cost-effective and inexpensive items may not
o Just because something is low cost, does not equal cost effectiveness
o *Also, just bc spend a lot of money, won't always get better outcomes*
· Cost-effectiveness then must take into account factors such as anticipated length of service,
need for such a service, and availability of other alternatives
o i.e. how frequently will that item or service be used; takes into account overall how much will
be spending
o (in united states, we spend more per captia on health care but outcomes are not the best)
Responsibility Accounting - answer✔· Ultimately, who is responsible for budgeting in the
hospital
· Each of an organization's revenues, expenses, assets, and liabilities is someone's responsibility
· As a corollary, the person with the most direct control or influence on any of these financial
elements should be held accountable for them, usually the leader-manager
2|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
-When thinking about the unit - *the nurse manager would be responsible for budgeting within
the unit; they are the one that knows what employees/personnel needed*
· The unit manager also can best monitor and evaluate all aspects of a unit's budget control
· *Forecasting*
Forecasting - answer✔involves making an educated budget estimate using historical data
-It is the nurse mangers responsibility how best to forecast - making an estimate on your
budget
Budget - answer✔-A plan that uses numerical data to predict the activities of an organization
over a period of time
-The desired outcome of budgeting is maximal use of resources to meet organizational short-
and long-term needs
· goal of budget: to maximize our resources available (greatest good for the most amount of
people)
· also, to realize when resources are not adequate bc can jeopardize patient safety
-A budget provides a mechanism contributions for planning and control, as well as for
promoting each unit's needs and contributions
budgeting process - answer✔· can be related to nursing process
· Essential to get input from all levels of the organization is essential
How is budgeting process related to the nursing process? - answer✔1) *Assess* what needs to
be covered in the budget- input from all levels of the organization
2) *Diagnosis* of the goals for the budget - what needs to be accomplished.. cost-effectiveness
3) *Plan* for the budget cycle- usually annual; could be perpetual so always have 12 months of
budget ahead
4) *Implementation* or ongoing management and analysis of the budget- ongoing monitoring
and analysis to assure meeting budget
5) *Evaluate* and periodic review of the budget for the fiscal year- reviewed and modified as
needed through the fiscal year
3|Page
, ©BRIGHTSTARS EXAM SOLUTIONS
11/16/2024 10:16 AM
the manger needs to account for: - answer✔-fixed expenses
-variable expenses
-controllable expenses
-uncontrollable expenses
Fixed expenses - answer✔do not vary with volume
· Rent/mortgage on the building
· Managers salary / top level administrative salary
Variable expenses - answer✔do vary with volume
· Supplies
Controllable expenses - answer✔controlled or varied by manager
· Number of personnel that are working
Uncontrollable expenses - answer✔can't control equipment depreciation
· Equipment breaks
*Types of Budgets: Personnel Workforce Budget* - answer✔1) Accounts for the majority of
health-care organization's expense
· largest component* of the budget for health care organization - basically, our nurses
2) Health care is labor intensive
· Type of question on test 2: coming up with acuity to come up with nursing hours; will not have
to determine whether have enough staff
· Nursing hrs: include people are on duty for every shift; includes all personnel there (unit
clerks, RNs, tech partners all considered part of the nursing care hours)
o Includes productive time & non-productive time
o Non-productive time: i.e. on orientation or time spent in meetings
*calculating nursing care hours* - answer✔nursing hours worked in 24 hrs / patient census
4|Page
