Leadership NUR 4120 Chapter 8

A leader-manager plans to implement normative-reeducative strategies to facilitate change in a community health clinic. What action will the leader-manager most likely choose? a. Addressing likely points of resistance before they can be stated by nurses who are reluctant to change b. Communicating the fact that the majority of nurses are enthusiastic supporters of the change c. Publicizing the benefits of the proposed change and the research that supports it d. Providing incentives to nurses who are willing to adopt the change early

B

A multidisciplinary team has been assigned responsibility for managing the change process in a large health-care organization. What goal should this team set for their activities? a. Resistors will face workplace discipline. b. Employees will not sabotage the change process. c. Change will happen as quickly as possible. d. Change will become a constant state in the organization.

B

A nurse intends to enroll in graduate school and has informed a colleague of this intention. What response suggests that the colleague is in the precontemplation stage of change? a. "I haven't decided, but I might start looking into doing that as well." b. "That's a good idea for you, but I'm just thankful that I'm done with school." c. "I suppose that will open up some new opportunities for you." d. "That's my plan as well. When will you start?"

B

A nurse is ostracizing a staff member who dresses "unprofessionally" and is encouraging other nurses to treat the staff member in the same way. This most closely represents which change strategy? a. Power-coercive b. Normative-reeducative c. Rational-empirical d. Resistance-withdrawal

B

A planned change has been imposed by upper management at a large hospital and will greatly affect the delivery of care on inpatient units. What is an appropriate role for the leader-manager in this time of change? a. Mobilizing resistance in a respectful but assertive way b. Demonstrating a positive attitude toward the prospect of change c. Implementing the change as rapidly as possible d. Dialoguing with staff about the benefits of maintaining the status quo

B

A team has been formed to consider a change in medication delivery. How can the team leaders best promote a successful change? a. Implement the change as rapidly as possible in order to diffuse resistance. b. When planning, involve as many people who will be affected by the change as possible. c. Bring in outside experts to implement the change. d. Enforce compliance with the change fairly and consistently.

B

A workplace health initiative has been launched in which subsidies are being offered for gym memberships and exercise equipment. This initiative is most likely to affect individuals who are in which phase of the stages of change model? a. Precontemplation b. Contemplation c. Action d. Maintenance

B

Which factor is the greatest contributor to the resistance encountered with organizational change? a. Poor organizational leadership b. Presence of employee mistrust c. Ineffective organizational management d. Insufficient staff involvement in the process

B

Frequent turnover in leadership at a health-care organization has meant that change has often occurred by drift. What are characteristics of this mode of change? Select all that apply. a. Changes are planned by teams. b. Changes occur accidentally. c. Changes take place even though they are unplanned. d. Changes take place only as the result of threats. e. Change takes place democratically.

B, C

What characteristic of a health-care organization most clearly suggests that is an aged organization? a. The organization was established more than 75 years ago. b. The organization used to be the largest in the region but is now smaller than several similar organizations. c. The organization has a history of stifling innovation. d. The organization is having difficulty attracting new graduates.

C

A nurse-manager is applying chaos theory to a proposed change in the structure of care at a clinic. What skills will best facilitate the manager's application of this theory? a. Creating "buy-in" from the stakeholders b. Finding solutions to resistance to change c. Changing attitudes more than increasing knowledge d. Finding underlying order in seemingly random data

D

Nurses on a hospital unit have been informed that a change to the documentation system is being proposed. What factor surrounding this change is most likely to cause unfreezing? a. The proposed documentation system has been introduced in many hospitals in the region. b. The leader-manager supports a change in the documentation system. c. An influential nurse has extensive experience with different documentation systems. d. The nurses find the current documentation system unwieldy and inefficient.

D

The nurse who provides oversight to a large health-care organization can best demonstrate leadership during a time of change by: a. clearly and assertively reminding nurses of their responsibilities to accept change. b. asking permission of nurses before proposing a change process. c. acknowledging that there is going to be resistance during the change process. d. communicating a vision that change is an opportunity to be embraced.

D

The nurse-manager has begun the movement stage of a proposed change. What is the manager's most appropriate activity? a. Gather data about the need for change. b. Accurately diagnose the problem. c. Decide whether change is needed. d. Collaborate with stakeholders to develop a plan.

D

When applying the principles of complex adaptive systems (CAS) theory, the nurse-manager should consider what principle? a. Change must occur by organized, linear steps. b. Change should be guided by intuition instead of being constrained by planning. c. Change is easier in small organizations than large organizations. d. Small variations in the change process can have major effects.

D

Which action represents a management function in planned change? a. Inspiring group members to be involved in planned change b. Visionary forecasting c. Role modeling high-level interpersonal communication skills in providing support for individuals undergoing rapid or difficult change d. Identifying the options and resources available to implement change

D

Which activity associated with the unfreezing state of change will have the greatest impact on the success of the movement stage of the change process? a. Accurate identification of the problem requiring change b. Effective information gathering concerning the problem c. Key personnel voicing their opinions regarding the need for change d. The need for change is perceived by those affected by the problem

D

Which activity should a change agent perform in order to best assure a successful implementation of a change? a. Helping followers arrive at total consensus regarding the change b. Encouraging subgroup opposition to change so many viewpoints can be heard c. Using change by drift if the resistance to change is too strong d. Being available to support those affected by a change until the change is complete

D

Which statement best describes the philosophy of nonlinear change theories? a. Change occurs in sequential steps of varying speed. b. Change is predictable with proper analysis. c. Change success relies on clear policies and hierarchies. d. Change is necessary because organizational stability is brief.

D

A change in the skills mix has been proposed at a care facility. What action by the nurse-manager would best support a rational-empirical change strategy? a. Presenting the research evidence that supports the change b. Publicizing the change to generate enthusiasm c. Appointing "champions" to ensure communication throughout the change process d. Ensuring that employees know the consequences of resisting

A

A nurse-manager has introduced a proposed change to the operations of an ambulatory clinic and has been met with resistance. How should the manager best interpret this resistance? a. Resistance is an expected component of a proposed change. b. Resistance confirms that the proposed change is necessary. c. The presence of resistance suggests that the change may be unsuccessful. d. The presence of resistance indicates a need to implement power-coercive strategies.

A

In planning strategies to prevent stagnation and promote renewal, which action would most likely result in the desired outcome? a. Developing a program for recruitment of young talent b. Rewarding employees by promoting from within c. Having set pay increases mandated annually d. Using length-of-service to determine committee selection

A

Many nurses at an ambulatory clinic have expressed frustration about the low quality of care that clients have been receiving. How should a manager best interpret this situation? a. The nurses may be in the unfreezing phase of change. b. The clinic is likely an aged organization. c. The movement phase of change will be difficult to initiate. d. There is a need for the manager to demonstrate power-coercive strategies.

A

The leader-manager has successfully implemented a change and is now entering the refreezing stage of the change process. During this stage, the leader-manager should prioritize: a. restoring stability to the workplace. b. rewarding the employees who embraced the change early. c. communicating the specific benefits of the change. d. addressing the concerns of resistors.

A

The manager on a hospital unit has highlighted some of the large gaps between desired client outcomes and actual client outcomes. What component of Lewin's change theory is the manager demonstrating? a. Unfreezing b. Movement c. Refreezing d. Resistance

A

Which characteristic of a planned change is most likely to threaten its success? a. The suggested change is introduced to staff after the plan has been formalized. b. Individuals affected by the change are involved in planning for the change. c. The change agent is aware of the organization's internal and external environment. d. An assessment of resources to carry out the plan is completed before unfreezing.

A

The nurse-manager is describing the forces that are driving change in today's health-care environment. What phenomena should the nurse describe? Select all that apply. a. Increased cost of health-care services b. Shortages of health-care professionals and providers c. Decreased third-party reimbursement for health-care services d. Decreased use of technology due to high cost of implementation e. Increased need to update health-care-related technologies

A, B, C, E

Which statements are true regarding planned change? Select all that apply. a. Resistance to change should be expected as a natural part of the change process. b. Change should be viewed as a chance to do something innovative. c. Technical changes are more resisted by staff than social changes are. d. Change affects the homeostasis of a group. e. Careful planning can guarantee the success of a change initiative.

A, B, D

Which statement is true concerning the refreezing phase of the change process? Select all that apply. a. The focus of this phase is to integrate the change into the status quo. b. Stabilization of change requires a 6- to 9-month period of time. c. If refreezing is incomplete, prechange behavior will be resumed. d. The change agent must remain involved until the refreeze stage is complete. e. The priority in this phase is to identify resistance.

A, C, D

The nurse-manager would be justified in making a change for which reasons? Select all that apply. a. To solve an existing problem b. To test workers' abilities to adapt c. To increase staff efficiency d. To reduce unnecessary workload e. To improve staff productivity

A, C, D, E