Leadership and Nursing Care Management 5th Edition Test Bank

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Chapter 01: Leadership and Management PrinciplesTest BankMULTIPLE CHOICE1.Leadership is best defined as:a.an interpersonal process of participating by encouraging fellowship.b.delegation of authority and responsibility and the coordination of activities.c.inspiring people to accomplish goals through support and confidence building.d.the integration of resources through planning, organizing, and directing.ANS:CLeadership is the process of influencing people to accomplish goals by inspiring confidenceand support among followers.DIF:Cognitive Level: Remember (Knowledge)REF:Page 4TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care2.A medical-surgical unit reports higher rates of patient satisfaction coupled with high rates ofstaff satisfaction and productivity. Which of the following is attributed to the data?a.Effective leadershipb.Management involvementc.Mentoringd.Rewards and recognitionANS:AEffective leadership is important in nursing because of the impact on nurses’ work lives, itbeing a stabilizing influence during change, and for nurses’ productivity and quality of care.DIF:Cognitive Level: Apply (Application)REF:Page 1TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care3.A staff registered nurse (RN) is leading a multidisciplinary clinical pathway team in thedevelopment of care for patients with total knee replacement. Which of the followingstatements would exemplify leadership behaviors in a clinical pathway team meeting?a.“Nursing is responsible for pain control of the total knee replacement patient.”b.“Our pharmacist has provided some excellent pain control literature.”c.“Physical therapy’s expertise is in rehabilitation, not pain control.”d.“Total knee replacement patients require optimal pain control.”ANS:BLeadership is the process of influencing people to accomplish goals by inspiring confidenceand support among followers. The correct answer is supportive of a team member’s work anddepicts some skill at interpersonal relationships.DIF:Cognitive Level: Apply (Application)REF:Pages 3-4TOP:Nursing Process: AssessmentMSC:Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies

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4.Which of the following is true of management activities?a.Inspiring a vision is a management function.b.Management is focused on task accomplishment.c.Management is more focused on human relationships.d.Management is more important than leadership.ANS:BManagement is focused on task accomplishment.DIF:Cognitive Level: Remember (Knowledge)REF:Pages 2-3TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care5.During a staff meeting, a group of RNs has complained that medications are not arriving tothe unit in a timely manner. The nurse manager suggests that the group resolve this issuethrough the development and work of a multidisciplinary team led by one of these RNs. Thisscenario demonstrates:a.adaptation.b.empowerment.c.flexibility.d.relationship management.ANS:BEmpowerment is the giving of authority, responsibility, and the freedom to act. In thissituation, the manager has given authority, responsibility, and the freedom to act in theinvestigation and resolution of this issue.DIF:Cognitive Level: Apply (Application)REF:Page 5TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care6.A nurse is caring for an elderly patient who was admitted after sustaining a fall at home.When creating a care plan for the patient, she requests that the doctor order a home health visitto assess for home safety and medication compliance. In addition, the nurse is concernedabout the nutrition of the patient and requests a dietitian evaluation. The nurse isdemonstrating which of the following leadership skills?a.Care providerb.Business principlesc.Care coordinationd.Change managementANS:CCare coordination is the delivery of nursing services that involves the organization andcoordination of complex activities. The nurse uses managerial and leadership skills tofacilitate delivery of quality care.DIF:Cognitive Level: Apply (Application)REF:Page 3TOP:Nursing Process: PlanningMSC:Client Needs: Physiological Integrity: Reduction of Risk Potential7.Interpersonal communication and the ability to apply _____ are two critical skills every nurseneeds to enhance professional practice.

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a.visionb.supervisionc.delegationd.problem solvingANS:DEvery nurse needs two critical skills to enhance professional practice. One is a skill atinterpersonal relationships. This is fundamental to leadership and the work of nursing. Thesecond skill is applying the problem-solving process. This involves critical thinking, problemidentification, and the development of objectivity.DIF:Cognitive Level: Remember (Knowledge)REF:Page 4TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care8.Good leaders need to be able to demonstrate an intuitive skill of empathy and expressivenesswhen dealing with others in the workplace. This requires sensitivity and awareness of theemotions and moods of others and is known as:a.social awareness.b.self-awareness.c.self-management.d.relationship management.ANS:ASocial awareness is an intuitive skill of empathy and expressiveness in being sensitive andaware of the emotions and moods of others.DIF:Cognitive Level: Remember (Knowledge)REF:Page 4TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care9.The manager of the emergency department in a large hospital focuses on customerservice,exudes the nursing code of ethics, and sees his or her job as an occupation with a lifetimecommitment. This is a concept known as:a.leadership.b.management.c.professionalism.d.vision.ANS:CProfessionalism is an approach to an occupation that distinguishes it from being merely a job,focuses on service as the highest ideal, follows a code of ethics, and is seen as a lifetimecommitment.DIF:Cognitive Level: Remember (Knowledge)REF:Page 5TOP:Nursing Process: ImplementationMSC:Client Needs: Safe and Effective Care Environment: Management of Care10._____ are vital to good leaders because they are able to take the vision of the leader andachieve the determined goals.a.Managersb.Motivators

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c.Visionariesd.FollowersANS:DWithout followers there is not leadership. Followers are vital because they accept or reject theleader and determine the leader’s personal power.DIF:Cognitive Level: Remember (Knowledge)REF:Page 6TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care11.The best leadership style for unfavorable conditions is:a.leader–member relations.b.task-oriented structure.c.position power.d.laissez faire.ANS:BThe need for task-oriented leaders occurs when the situation is extreme. The best leadershipstyle for unfavorable conditions is task-oriented.DIF:Cognitive Level: Remember (Knowledge)REF:Pages 10, 12TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care12.Nursing management is defined as:a.delegation of authority and responsibility and the coordination of tasks.b.the integration of resources through planning, organizing, and directing.c.the process of influencing patients to accomplish goals.d.the coordination and integration of nursing resources by applying the managementprocess to accomplish nursing care and service goals and objectives.ANS:DThe coordination and integration of nursing resources by applying the management process toaccomplish nursing care and service goals and objectives is the definition of nursingmanagement.DIF:Cognitive Level: Remember (Knowledge)REF:Page 22TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care13.A nursing unit has demonstrated lower patient satisfaction scores during the last quarter. Themanager of the unit has formed a small team to set long-and short-term goals for the unit withaction plans to increase patient satisfaction. This is an example of which managementprocess?a.Planningb.Organizingc.Coordinatingd.ControllingANS:A

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Planning is the managerial function of selecting priorities, results, and methods to achieveresults.DIF:Cognitive Level: Apply (Application)REF:Pages 23-24TOP:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment: Management of Care14.A nursing unit has discovered a series of medication errors with regards to a particularcomputerized physician order set and the calculation within the order. The unit manager has atheory on changes that should be made within the order to decrease the confusion for nursingstaff. However, the nurse manager realizes that changes would need to be made withpharmacy input as well as other nursing units within the facility and the multi-hospital system.Which of the following management theories is exemplified when the nurse managerconsiders the impact of change on the organization as a whole?a.Contingency theoryb.Systems theoryc.Complexity theoryd.Chaos theoryANS:BSystems theory helps managers recognize their work as being embedded within a system.Managers use this theory to learn that changing one part of a system inevitably affects thewhole system.DIF:Cognitive Level: Apply (Application)REF:Pages 30-32TOP:Nursing Process: PlanningMSC:Client Needs: Physiological Integrity: Reduction of Risk Potential15.The role of the _____ is to provide leadership and direction for all aspects of nursing care.a.nurse managerb.care providerc.nurse executived.senior leaderANS:CThe nurse executive is accountable for the environment in which clinical nursing practiceoccurs. The nurse executive provides leadership and direction for all aspects of nursing care.DIF:Cognitive Level: Remember (Knowledge)REF:Page 34TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care16.The postoperative patient with anterior cervical laminectomy is complaining of tightness inhis throat. His voice is raspy. The staff nurse asks the unit secretary to page Dr. Julio stat. Thisis an example of _____ leadership.a.authoritarianb.democraticc.laissez-faired.servantANS:A

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Authoritarian leadership uses directive and controlling behaviors in which the leaderdetermines policies and makes decisions in isolation. The leader orders subordinates to carryout the tasks or work. This style is helpful in crisis situations.DIF:Cognitive Level: Apply (Application)REF:Page 10TOP:Nursing Process: ImplementationMSC:Client Needs: Physiological Integrity: Physiological Adaptation17.A quality improvement team is working to enhance teamwork among the staff in a newlydeveloped Alzheimer’s program. Which of the following statements would be an expectedbehavior that illustrates quantum leadership?a.“After the meeting today, each member on this team will be a role model of goodcommunication techniques to other staff members.”b.“How would you describe an ideal collaborative practice environment?”c.“What do you think about sharing our opinions today in a mutually respectfulmanner as we move around the table?”d.“You folks are highly motivated and smart enough to develop a plan on your own.I’ll support you as needed.”ANS:BQuantum leadership fosters an environment of curiosity, questioning, and exploration. AnswerA depicts an authoritarian leadership style.DIF:Cognitive Level: Apply (Application)REF:Page 16TOP:Nursing Process: EvaluationMSC:Client Needs: Safe and Effective Care Environment: Management of Care18.A nursing executive is leading a multidisciplinary team of professionals who have workedwell together on prior initiatives. Which of the following leadership styles might work best inthis situation?a.Authoritarianb.Democraticc.Transformationald.TransactionalANS:BDemocratic leadership would work best in this situation.DIF:Cognitive Level: Apply (Application)REF:Pages 10, 14TOP:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment: Management of CareMULTIPLE RESPONSE1.Which of the following behavioral aspects are present in the feminist perspective leadershipstyle(select all that apply)?a.Builds relationshipsb.Focuses on completing tasks and achieving goalsc.Empowers othersd.Fosters an environment of motheringe.Supports bargaining of tasks and roles

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f.Promotes personal growthANS:A, C, FLeaders using the feminist perspective build connections, empower others, and supportpersonal growth to promote teamwork and to accomplish goals.DIF:Cognitive Level: Understand (Comprehension)REF:Page 11TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care2.A nurse manager at Great Lakes Hospital is meeting with the dean of a well-recognizeduniversity who is the keynote speaker today at the nursing conference. He remembers that oneof the RNs is interested in attending a well-known university to obtain a doctorate. The nursemanager arranges for the RN to meet with this dean. The nurse manager is exhibitingleadership behaviors consistent with(select all that apply):a.feminist perspective.b.servant leadership.c.transactional leadership.d.transformational leadership.ANS:A, B, DThis behavior nurtures personal growth (servant leadership) and assists the RN to attain his orher fullest potential (transformational leadership). This behavior also helps the RN build aconnection with the dean, a representative of the university (feminist perspective).DIF:Cognitive Level: Apply (Application)REF:Pages 11, 14, 16TOP:Nursing Process: ImplementationMSC:Client Needs: Safe and Effective Care Environment: Management of Care3.A nurse manager at Morgan Hill Community Hospital is known to be an excellent nursingmanager by the personnel working on her nursing unit. The nurse manager exhibits which ofthe following behaviors(select all that apply)?a.Knows the personnel and addresses them by nameb.Intervenes when she receives complaintsc.Has a consistent style that never variesd.Is visible on the nursing unit by all shifts on a frequent basise.Evaluates a number of aspects of problems prior to making decisionsf.Uses decision by consensus to resolve conflictsg.Fosters collaborationANS:A, D, E, GThese behaviors foster teamwork and positive morale.DIF:Cognitive Level: Apply (Application)REF:Pages 6-8TOP:Nursing Process: ImplementationMSC:Client Needs: Safe and Effective Care Environment: Management of Care4.To reach Magnet status the nursing service in a hospital must attain competency in which ofthe following areas(select all that apply)?a.Professionalismb.Use of critical thinking skillsc.Business skills and principles

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d.Leadershipe.Communication and relationship managementf.Knowledge of the health care environmentg.Implementation of an acuity-based staffing systemANS:A, C, D, E, FMagnet hospitals are recognized for the nurse’s critical role in the business of health care.Professionalism, leadership, communication, and the ability to work with others as well asunderstanding the business and principles of running a hospital business and health careenvironment are required.DIF:Cognitive Level: Apply (Application)REF:Pages 2-3TOP:Nursing Process: EvaluationMSC:Client Needs: Safe and Effective Care Environment: Management of Care5.Which of the following behaviors build trust between leaders and employees in anorganization(select all that apply)?a.Sharing relevant informationb.Encouraging competition via winners and losersc.Reducing controlsd.Meeting expectationse.Avoiding discussion of sensitive issuesANS:A, C, DLeadership is founded on trust. Behaviors that build trust include sharing relevantinformation, reducing controls, and meeting expectations. Trust-destroying behaviors includebeing insensitive to beliefs and values, avoiding discussion of sensitive issues, andencouraging competition.DIF:Cognitive Level: Apply (Application)REF:Pages 8-9TOP:Nursing Process: EvaluationMSC:Client Needs: Safe and Effective Care Environment: Management of Care6.Which of the following traits describe a transactional leader(select all that apply)?a.Functions in a caregiver roleb.Surveys their followers’ needs and sets goals for themc.Uses charisma to produce greater effort in followersd.Focuses on the maintenance and management of ongoing and routine worke.Motivates followers to perform to their full potentialANS:A, B, DA transactional leader is a leader or manager who functions in a caregiver role and is focusedon day-to-day operations. Such leaders survey their followers’ needs and set goals for thembased on expectations. They are also leaders who are focused on maintenance andmanagement of ongoing and routine work. Transformational leaders use charisma to producegreater effort and are able to motivate followers to perform to their full potential over time.DIF:Cognitive Level: Remember (Knowledge)REF:Page 14TOP:Nursing Process: ImplementationMSC:Client Needs: Safe and Effective Care Environment: Management of Care

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7.Which of the following factors are central to successful nursing leadership(select all thatapply)?a.Access to information and resourcesb.Respectful and collaborative teamworkc.Supportive cultures in which nurses are valued for their expertised.Formal and informal powere.Vertical compensationANS:A, B, C, DFormal and informal power, access to information and resources, opportunity for growth,supportive organizational cultures in which nurses are valued for their expertise, respectfulteamwork, and adequate compensation are factors central to successful nursing leadership.DIF:Cognitive Level: Remember (Knowledge)REF:Page 17TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care8.Which of the following definitions apply to management(select all that apply)?a.It is a process of inspiring people to accomplish goals through support andconfidence building.b.It is the process of coordination and integration of resources to accomplish specificgoals.c.It includes the activities of planning, organizing, coordinating, directing, andcontrolling.d.It is a process of planning and directing human effort to achieve establishedobjectives.e.It is the directing of the organizations’ money, facilities, and supplies to achieveresults.ANS:B, C, D, EManagement is defined as the process of coordination and integration of resources throughplanning, organizing, coordinating, directing, and controlling to accomplish specific goals.Management is a process of planning and directing human effort to achieve establishedobjectives while ensuring that the organizations’ money, facilities and supplies are directed ina manner which achieves the best results.DIF:Cognitive Level: Apply (Application)REF:Page 21TOP:Nursing Process: EvaluationMSC:Client Needs: Safe and Effective Care Environment: Management of Care

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Chapter 02: Change and InnovationTest BankMULTIPLE CHOICE1.A hospital system is implementing an electronic health record. The facility conducts educationand training for nursing staff, medical staff, and ancillary staff over a period of 6 months. Thisis an example of:a.emergent change.b.planned change.c.transformation.d.innovation.ANS:BPlanned change is a decision to make a deliberate effort to improve a system.DIF:Cognitive Level: Apply (Application)REF:Page 38TOP:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment: Management of Care2.The use of a new idea or method is the definition of:a.change.b.innovation.c.resistance.d.stereotyping.ANS:BInnovation is the use of a new idea or method.DIF:Cognitive Level: Remember (Knowledge)REF:Page 38TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care3.The chief nursing officer (CNO) of a hospital system works with senior leadership forapproval to initiate an electronic health system. He recruits a nursing informaticist and a chiefmedical informatics officer to begin the process of planning the education and roll-out of thenew electronic system. The CNO could be viewed as the:a.resistor.b.innovator.c.change agent.d.strategist.ANS:CThe change agent is a person or thing that produces a particular effect or change. The changeagent can be a person who functions as a change facilitator.DIF:Cognitive Level: Apply (Application)REF:Page 38TOP:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment: Management of Care

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4.A small critical care unit forms a team of nurses to implement bedside rounds at shift change.The nurses have researched the efficacy of bedside rounds and have determined that thisevidence-based practice will lead to improved communication of patient status. Which type ofchange does this demonstrate?a.First-order changeb.Second-order changec.Emergent changed.Organizational changeANS:AFirst-order change occurs in a stable system and is characterized by rational stepwiseprocesses. It is useful for smaller scale changes at a unit-based level. Adaptation andadjustment occurs when nursing uses a new evidence-based protocol and puts it into practice.DIF:Cognitive Level: Apply (Application)REF:Page 39TOP:Nursing Process: ImplementationMSC:Client Needs: Physiological Integrity: Physiological Adaptation5.How is the refreezing stage of change similar to the nursing process?a.Refreezing is similar to the assessment phase of the nursing process.b.Refreezing is similar to the problem identification phase of the nursing process.c.Refreezing is like the planning and implementation phase of the nursing process.d.Refreezing is like evaluation in the nursing process.ANS:DRefreezing is like evaluation in the nursing process.DIF:Cognitive Level: Remember (Knowledge)REF:Page 41TOP:Nursing Process: EvaluationMSC:Client Needs: Safe and Effective Care Environment: Management of Care6.Which of the following factors is used to describe the degree to which successful plannedchange is thought to be better than the status quo?a.Complexityb.Compatibilityc.Trialabilityd.Relative advantageANS:DRelative advantage is one of the factors that helps determine successful plannedchange. It isthe degree to which the change is thought to be better than the status quo.DIF:Cognitive Level: Remember (Knowledge)REF:Page 43TOP:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment: Management of Care7.The _____ is a tool which is useful in assessing the readiness for organizational change.a.Organizational Change-Readiness Scale (OCRS)b.five-dimensional scalec.Rapid Cycle Changed.plan-do-study-act model

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ANS:AThe OCRS is a 76-item inventory that is used to analyze the ability of an organization tomanage change effectively. There are five dimensions that are a part of this assessment tool.DIF:Cognitive Level: Remember (Knowledge)REF:Page 46TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care8.A medical-surgical unit utilizes a group of nurses and patient care assistants to determineways to reduce the number of falls in the unit. They conduct Internet research to locate bestpractice interventions. They create fall risk alerts in the unit, and they implement hourlyrounding to assess the need for toileting. After putting these small changes into place, theywill evaluate the data to determine effectiveness. This project is an example of:a.rapid response teams.b.Failure Modes and Effects Analysis.c.root cause analysis.d.Rapid Cycle Change.ANS:DRapid Cycle Change is used in health care to improve patient safety and quality.It is based onthe idea that changes are tried on a small scale to see how they work.DIF:Cognitive Level: Apply (Application)REF:Page 46TOP:Nursing Process: EvaluationMSC:Client Needs: Physiological Integrity: Reduction of Risk Potential9.An organization has encountered a serious patient safety event that was reported to the state,The Joint Commission, and the Centers for Medicare & Medicaid Services (CMS). Anextensive plan of correction was received, and the organization had to make some immediatechanges in practice. Additionally the organization anticipates a costly lawsuit. What is the bestmethod of educating staff about the practice changes that were issued?a.“These changes need to be made because the state and CMS require it.”b.“We understand this is a knee-jerk reaction, but please change the practice whilethe surveyors are in the building.”c.“We need to make this change because it will help our lawsuit.”d.“This change is being made so that there is no further harm to another patient.”ANS:DRapid Cycle Changes or those that are emergent are put into place to improve patient care,with the emphasis on patient safety and quality goals. Staff should not be educated that thechanges are made based upon regulatory requirements or the avoidance of litigation.Misconceptions or inaccurate information can create resistance to change.DIF:Cognitive Level: Apply (Application)REF:Page 46TOP:Nursing Process: ImplementationMSC:Client Needs: Physiological Integrity: Reduction of Risk Potential10._____ is an expected part of change and is often related to fear and anxiety.a.Depressionb.Resistancec.Acceptance

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d.DenialANS:BResistance to change should be expected as integral to the process of change. It may be rootedin anxiety or fear.DIF:Cognitive Level: Remember (Knowledge)REF:Page 46TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care11.Individual members of a group will adapt to change at different rates. Which of the followinggroups would take the longest to accept change?a.Early adoptersb.Late majorityc.Innovatorsd.LaggardsANS:DNurse leaders need to recognize that change will be accepted at varying rates and targetinterventions accordingly. The five categories in order are innovators, early adopters, earlymajority, late majority, and laggards.DIF:Cognitive Level: Remember (Knowledge)REF:Page 43TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care12.A process of intentional intervention to create something new is called:a.altered direction.b.organizational flux.c.planned change.d.status revision.ANS:CPlanned change is defined as a process of intentional intervention to create something new.From an organizational perspective, planned change is a decision to make a deliberate effortto improve the system.DIF:Cognitive Level: Remember (Knowledge)REF:Page 45TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care13.The most difficult to change is:a.attitudes.b.group behavior.c.knowledge.d.individual behavior.ANS:BGroup behavior and performance changes are the most difficult to change and take the longesttime.DIF:Cognitive Level: Apply (Application)REF:Page 48TOP:Nursing Process: Assessment

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MSC:Client Needs: Safe and Effective Care Environment: Management of Care14.The charge nurse of a small nursing unit would like to gain staff acceptance of atime-intensive, budget-imposed change required by the hospital administration. She plans toemphasize several evidence-based research projects that have shown improved patient healthoutcomes as a result of implementing this change. This is an example of which of thefollowing organizational change concepts?a.Budget-oriented changeb.Transformationc.Resistanced.Emergent changeANS:BTransformation is the use of new ideas, innovation, and creativity to change fundamentalproperties of the state of a system.DIF:Cognitive Level: Apply (Application)REF:Page 38TOP:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment: Management of Care15.The first stage of planned change involves:a.accepting the need for change.b.cognitive redefinition.c.integration and stabilization.d.problem solving.ANS:AChange must begin with an awareness of the need for change, and end with a generalacceptance of the necessity of change.DIF:Cognitive Level: Remember (Knowledge)REF:Page 41TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care16.The identification of forces that drive and restrain change is called a(n):a.equilibrium evaluation.b.force field analysis.c.status quo analysis.d.refreezing system.ANS:BDriving and restraining forces influence any situation. A force field analysis facilitates theidentification and analysis of driving and restraining forces in any situation.DIF:Cognitive Level: Remember (Knowledge)REF:Page 42TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care17.A nursing manager recognizes that the changes that she is expected by administration toimplement will be met with staff resistance. She is committed to determining the root of theresistance and communicating positively with her staff. The nurse manager’s actionscharacterize her as a(n):

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a.change agent.b.implementation expert.c.restructuring motivator.d.supervisory threat.ANS:AThe change agent needs to anticipate resistance, determine why it is occurring, and try todetermine what the person who is resisting is trying to protect.DIF:Cognitive Level: Understand (Comprehension)REF:Page 43TOP:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment: Management of Care18.A nurse manager recognizes that her staff’s emotional responses to organizational change aresimilar to:a.adaptation techniques.b.integrative tactics.c.symptoms of mental illness.d.the grief model.ANS:DThe grief model is the most accurate, because change produces a longing for whatis familiar,even if it is not what is best or realistic.DIF:Cognitive Level: Apply (Application)REF:Page 47TOP:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment: Management of Care19.A memo sent to the unit nurse manager reads that beginning next week, all nursing staff willbe expected to conform to a new dress code selected by the hospital board of directors. Thenurse manager understands that she needs to use her positional power to trigger a(n) _____change cycle.a.automaticb.directivec.participatived.positionalANS:BA directive change cycle occurs when a change is imposed by some external force.DIF:Cognitive Level: Understand (Comprehension)REF:Page 48TOP:Nursing Process: ImplementationMSC:Client Needs: Safe and Effective Care Environment: Management of Care20.An experienced nurse has recently taken a position on a telemetry unit in the local hospital.After 2 weeks on the job, he finds that the staffing is not what was discussed during hisemployment interview with the nurse manager. Which approach would be most appropriatefor the nurse to take?a.Give 2 weeks’ notice and begin seeking employment at another hospital.b.Discuss the situation with the nursing manager who interviewed him.c.Talk to other employees about the staffing situation.d.Notify the charge nurse that this was not what was explained to him prior to

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