Leadership Test 3

A nurse manager approaches the nursing supervisor with a request for approval to incorporate 12-hour shifts into scheduling. The supervisor denies the request, stating this staffing pattern was used previously with poor outcomes. Which responses by the nurse manager may positively influence the supervisor? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I agree it was not effective years ago, but other units have now had success with it." 2. "What were your specific concerns about the 12-hour shifts?" 3. "I think it is unfair to refuse my unit this opportunity based on the past." 4. "Why are you always so opposed to change on my unit?" 5. "If we don't offer alternative staffing patterns, we aren't going to be able to attract new hires."

1,2

A nurse manager is aware that there is a strong "grapevine" communication system on the unit. The manager elects to use this grapevine to distribute information about an upcoming change in unit policy. In making this decision, the manager should consider which possibilities? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. The information may be rapidly disseminated. 2. The information may be altered as it moves across the grapevine. 3. Most people try to spread information accurately. 4. Most people do not pay any attention to the grapevine. 5. Professional nurses do not participate in grapevine communication

1,2

Which directions given by the nurse to the assistant are most likely to be understood and completed correctly? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "Here are your directions for this morning. Please give the clients in rooms 2156, 2158, and 2159 total bed baths." 2. "Go to the diet kitchen and get a cup of apple juice for the client in room 2112." 3. "Ambulate the clients on the south wing." 4. "Do you think you'll have time to do shampoos today?" 5. "It might be a good idea to get the client in room 2110 up in the chair this morning. Or maybe it would be better to wait until this afternoon."

1,2

The Institute of Medicine (IOM), has made recommendations for the nursing profession in its report "The future of nursing: Leading change, advancing health." Which recommendations will help nurses lead change? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Engage in lifelong learning 2. Remove scope of Practice barriers 3. Implement nurse residency programs 4. Change the structure of the organization 5. Lead change to advance health

1,2,3,5

The nurse manager has asked that another staff nurse position be funded for the unit. The supervisor denies the request. Which statements by the manager are examples of negative assertion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I know I haven't been too careful in keeping personnel costs low, but we are really going to need another position." 2. "I don't see why another position cannot be funded. We have met our budget each year for the last 3 years." 3. "I realize that my staff is not always positive about organizational changes, but having this extra staff member might reduce some of their stress." 4. "I can understand what you said about budget being tight, but we still need the position." 5. "Do you not understand how hard my nurses are working?"

1,3

Which statement describes the primary difference between group and individual decision making, besides the number of individuals involved? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. A decision made by a group is often better than a decision made by one person. 2. A decision made by an individual results in greater commitment. 3. Groups can provide more input into the process. 4. A decision made by a group can create a greater obligation to achieve results. 5. Routine decisions are more often made by individuals

1,3,4,5

A nurse often has difficulty explaining and getting a clear message through to the receiver. Which communication skills will help the nurse to improve communication. Note: Credit will be given only if all correct choices and not incorrect choices are selected. Select all that apply. 1. Check timing 2. Expect respect 3. Consider relationship to receiver 4. Find an interpreter 5. Reply appropriately

1,3,5

The nurse manager works at a rural hospital and is in charge of a medical unit. Another nurse manager is in charge of the adjacent surgical unit. Equipment is shared between the two units. The surgical unit manager frequently confronts and intimidates the manager of the medical unit regarding the use of the equipment. Which strategies could the manager of the medical unit use to generate feelings of personal power? Note: Credit will be given only if all correct choices and not incorrect choices are selected. Select all that apply. 1. Body language 2. Power plays 3. Arguing 4. Word choices 5. Listening

1,4,5

A task force leader says, "At the beginning of our next meeting, we are going to do some team-building exercises." Which comment by a group member indicates a need for further education about team building? 1. "I don't see anything wrong with the way our team works. Why do we have to go through team building?" 2. "That should help us meet the goals we have written." 3. "I did some team-building work a long time ago. I probably need a refresher." 4. "I hope the men on our task force will cooperate."

1. "I don't see anything wrong with the way our team works. Why do we have to go through team building?"

An employee is sabotaging the work of a newly oriented charge nurse, and the charge nurse has not been successful in addressing the problem. When the nurse manager addresses the issue, which is the most appropriate statement? 1. "I know it must be frustrating working with a new charge nurse, but how can we make this situation better?" 2. "This is not professional behavior, and you need to stop it or you will lose your job the next time I hear about it." 3. "I know the charge nurse is new to the role, but you should get used to it or there will be more changes." 4. "I know the new charge nurse is difficult to work with, but please help make the job easier to do."

1. "I know it must be frustrating working with a new charge nurse, but how can we make this situation better?"

In the morning care conference, the nurse instructs the assistant to feed breakfast to the clients in beds 2234, 2230, and 2241. The assistant indicates understanding of the assignment and repeats the bed numbers back to the nurse. What is the nurse's next step? 1. Check with the assistant to see how the assignment is going during the time breakfast is served. 2. Check the client's breakfast trays before they are returned to dietary. 3. Check with the clients to see if they had breakfast. 4. At the end of the shift, ask the assistant how the clients ate.

1. Check with the assistant to see how the assignment is going during the time breakfast is served.

The nurse manager is challenged to find an innovative way to adequately staff the unit and provide quality nursing care. Which ability would be most useful to the nurse in this situation? 1. Creativity 2. Problem solving 3. Brainstorming 4. Decision making

1. Creativity

The staff nurse is unsure of the correct protocol for calling in sick to work. The nursing supervisor told the nurse to call the nursing office; however, the nurse manager told the nurse to call the unit. This issue is likely the result of which distorted communication? 1. Intersender conflict 2. Intrasender conflict 3. Metacommunication 4. Downward communication

1. Intersender conflict

During an evaluation conference, the nurse manager observes nonverbal messages, including nodding in agreement and smiling. These behaviors are examples of which aspect of communication? 1. Metacommunication 2. Intrasender conflict 3. Fogging 4. Intersender conflict

1. Metacommunication

The nurse manager has determined that two staff nurses need to be hired. Which factor is most critical as the nurse manager prepares to submit the request to administration? 1. Timing of the request 2. Negative inquiry 3. Compromise 4. Persistence

1. Timing of the request

A nurse manager is focused on team-building activities with a group chosen to write new unit policies. As a beginning step in this process, the manager should ask which questions to assess the group's context? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "How well has this group been able to relate to similar groups across the organization?" 2. "What are the group's current goals?" 3. "How have the members organized the group?" 4. "What is the general culture of the group?" 5. "How complex is the job the group has been assigned?"

2, 3, 4

The work of a task force is completed, and the leader has compiled a written report of findings and recommendations. What actions are necessary by this leader? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Plan on the leader presenting the report to administrators. 2. Share the report with the full task force prior to presenting it to administrators. 3. Send the report to administrators by email. 4. Brief key administrators regarding the report prior to the administrative presentation. 5. Print and bind the presentation in a professional manner prior to presenting it to the full task force.

2, 4

The nurse manager is leading the monthly staff meeting for the professional nursing staff. Which statements by this leader reflect effective leadership? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I will assume responsibility for developing the mission and goals of the group." 2. "I have created an agenda that identifies the amount of time allotted for each step of the problem-solving process." 3. "I realize there will be dissension; however, I prefer that we not take time from our agenda to address it." 4. "The meeting will be called to order at noon and be adjourned in 1 hour." 5. "It is important that each of you is fully engaged in the decision-making process."

2, 4, 5

A problem has arisen on a unit with primarily Generation X nursing staff. Which strategies should the nurse manager employ to get staff input into solving this problem? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Schedule a staff meeting for discussion of the problem and its possible solutions. 2. Post a notice on the bulletin board explaining the issue. 3. Ask nurses individually for input. 4. Develop a possible solution and share it with nurses in a formal meeting. 5. Ask for input in text message and promise to respond to texts immediately.

2,3

The nursing supervisor is planning an education session on collaborative communication between nurses and physicians. Which topics should be on this agenda? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Interdisciplinary respect 2. Understanding the role of the physician 3. Understanding the role of the nurse 4. Communication across disciplines 5. Active listening skills

2,3,4,5

A nurse on a mission trip needs a urinary catheter for an infant. The nurse only has a pediatric feeding tube and must think creatively. The nurse knows the creative process includes which stages? Note: Credit will be given only if all correct choices and not incorrect choices are selected. Select all that apply. 1. Communication 2. Incubation 3. Verification 4. Innovation 5. Insight

2,3,5

The nurse manager is counseling a male nurse about several recent incidents in which female nurses complained that he was abrupt and condescending. What advice should the manager give this nurse? 1. "Make sure that anything you say is clear and concise." 2. "Don't feel as if you are responsible for fixing every problem." 3. "Avoid using phrases such as 'sort of' when talking to females." 4. "Don't personalize everything."

2. "Don't feel as if you are responsible for fixing every problem."

The nurse manager should be most careful not to hold preconceived beliefs when listening to which person? 1. The hospital administrator discussing next year's budget 2. A staff nurse the manager has worked with for 25 years 3. A newly licensed nurse who is hesitant to address the manager 4. A physician discussing prognosis with the client and family

2. A staff nurse the manager has worked with for 25 years

What is the most important reason that excellent communication skills are essential for nurses? 1. Nurses must communicate with all disciplines. 2. All nursing activities occur in relationships. 3. Interpersonal skills get the work done. 4. Good communication ensures no problems occur.

2. All nursing activities occur in relationships.

A nurse believes that milk is part of the healthy adult's diet. The nurse frequently offers milk to adults as a between-meal beverage. This action is based on which concept? 1. Evidence 2. An underlying assumption 3. An alternative perspective 4. An inquiring attitude

2. An underlying assumption

A nurse working in a rehabilitation center notices that clients frequently asking for something to drink. Which response indicates the use of creativity in finding a solution to this problem? 1. Calling local beverage distributors to inquire about service pricing 2. Asking all employees to write down their ideas about a solution 3. Determining what type of drinks most clients might want 4. Encouraging clients to bring a drink from home

2. Asking all employees to write down their ideas about a solution

A serious disagreement has arisen between two staff nurses. The unit manager elects not to make a decision regarding the disagreement until more evidence is collected. Which part of the nursing process does this manager's critical thinking reflect? 1. Assessment 2. Diagnosis 3. Planning 4. Evaluation

2. Diagnosis

When the nurse manager orders supplies for the unit, which communication mode is best? 1. Telephone 2. Email 3. In person 4. Voice mail

2. Email

In a group meeting, one of the members always arrives early and places the chairs in a circle so all members can interact. This person is responsible for confirming that the room is available for the monthly meetings. Which person does this describe? 1. Gatekeeper 2. Procedural technician 3. Coordinator 4. Initiator-contributor

2. Procedural technician

The nurse manager is planning to initiate new policies in the department and is reviewing several change theories. Which step of Havelock's model will the nurse find most closely resembles Lewin's moving stage? 1. Self-renewal occurs among all participants. 2. Solutions are identified to create change. 3. Resources are acquired to facilitate change. 4. Relationships are formed among all participants.

2. Solutions are identified to create change.

The nurse manager asks staff members to work as a group in planning the activities for Nurses' Week. The nurse manager should report to the supervisor that which type of group has been formed? 1. Command group 2. Task group 3. Competing group 4. Informal group

2. Task group

The nurse has a concern regarding the quality of care being provided in the hospital. What should the nurse consider first before communicating this concern? 1. The medium of the message 2. The relationship between the nurse and the receiver of the message 3. The timing of the message 4. What to include in the message

2. The relationship between the nurse and the receiver of the message

The nursing supervisor identifies ineffective communication as a problem among the managers. According to Lippitt's phases of change, which action by the supervisor reflects the final stage of improving this issue? 1. The supervisor uses outcome data to evaluate the amount of change that has occurred. 2. The supervisor has gradually withdrawn from the role of change agent. 3. The supervisor has developed strategies to maintain the change. 4. The supervisor has determined if anyone in the group is sabotaging change efforts.

2. The supervisor has gradually withdrawn from the role of change agent.

A newly licensed nurse working on a unit committee challenges every detail of a proposal the committee is developing. How should other committee members interpret this behavior? 1. This nurse is too inexperienced to realize the behavior is inappropriate. 2. This nurse is learning to be creative. 3. This nurse believes that new nurses are more knowledgeable than those who have worked several years. 4. This nurse misunderstands the work of the committee.

2. This nurse is learning to be creative.

A nurse has made several "near errors" in client care in the last 2 months. The nurse manager says, "These are simple errors. You just aren't listening." How could the nurse improve listening skills in this situation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. The nurse should try to think ahead about what the person talking is going to say. 2. The nurse should hold eye contact with the speaker at all times. 3. When listening to instructions, the nurse should ask anyone who interrupts to wait a moment. 4. The nurse should get sufficient time away from work to rest. 5. The nurse should be careful not to prejudge what the speaker is going to say.

3,4,5

The nurse is always intimidated when asking a physician to clarify orders. Which statements should the nurse use to help counteract this feeling? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I'm sorry, doctor, but I need for you to repeat the dosage on that medication order." 2. "Doctor, what was the dosage on that medication you ordered, and do you want the client up in a chair today?" 3. "How often did you want the furosemide given?" 4. "Uh, can you tell me if you need for this client to be NPO today?" 5. "Doctor, what rate did you want for the IV?"

3,5

Which example represents a qualifier that may interfere with the message being communicated? 1. "Please notify me when this task is complete." 2. "Are you satisfied with the care you are receiving?" 3. "I hate to bother you with this, but we have a problem." 4. "How can I help you solve your issues with this physician?"

3. "I hate to bother you with this, but we have a problem."

After several near-incidents during procedures, the nurse manager is increasingly concerned about how nursing staff members communicate with physician staff. Which advice from the manager would be most beneficial to the nursing staff? 1. "Don't forget, you are just as good as they are." 2. "Physicians just don't listen as well as nurses." 3. "Let's review the steps of the procedures that we know are the biggest problems." 4. "I'm going to listen to the physicians, but I think most of the problem is with the physicians, not the nurses."

3. "Let's review the steps of the procedures that we know are the biggest problems."

The nurse manager has completed a series of team-building exercises with a command group. Which statement by a group member indicates that cohesiveness is occurring? 1. "I think I understand the work of the group now." 2. "I have gotten to know my group members better during these exercises." 3. "We have so much work to do in this group." 4. "I like the members of the group."

3. "We have so much work to do in this group."

The nursing faculty would like to incorporate problem-based learning into the curriculum. Which action is essential? 1. Obtain funding for a simulation mannequin. 2. Write standardized scripts for volunteers who will portray clients. 3. Add more information to existing care plans as the study unfolds. 4. Assign client care debate topics to teams of three or four students

3. Add more information to existing care plans as the study unfolds.

The nurse manager has instituted a policy of sending information to the staff in emails. Many misunderstandings have occurred since this policy was implemented. What technique should the manager use to reduce this miscommunication? 1. Use text messaging instead of email. 2. Require a return email from everyone reading the information. 3. Be certain that emails go only to the intended recipients. 4. Send all emails with a message line that says "Important."

3. Be certain that emails go only to the intended recipients.

The hospital chief operating officer holds monthly focus groups with the purpose of gaining ideas and insights from nursing administration and staff nurses. Which type of communication does this indicate? 1. Lateral communication 2. Downward communication 3. Diagonal communication 4. Grapevine communication

3. Diagonal communication

At the beginning of a brainstorming session, the manager lists the rules to be followed. Which rule should be included and enforced? 1. Do not suggest any solution that is prohibitively expensive. 2. Suggest only ideas that the group has not already tried. 3. Do not critique any ideas presented. 4. Limit the session to the first 15 ideas

3. Do not critique any ideas presented.

The nursing group has been charged with the task of solving a patient care problem on the unit. Which step should this group take first in this process? 1. Investigate what has already been tried to solve the issue. 2. Brainstorm about potential solutions. 3. Gather information to define the problem. 4. Categorize information in order of reliability

3. Gather information to define the problem.

The nurse asks the nurse manager if he can go home early because the census is low. When the request is denied, the nurse states, "I don't understand why I can't leave early. I will use vacation time, and this will help minimize personnel costs for the shift." This statement is an example of which technique of influencing the supervisor? 1. Fogging 2. Negative assertion 3. Negative inquiry 4. Compromise

3. Negative inquiry

The novice nurse manager is acting in the role of change agent for the unit. Which statement indicates that this manager needs further training in regard to change? 1. "I must not get so bogged down in details that I lose focus on the ultimate goal." 2. "As we go through this process, I think I need to be flexible but persistent." 3. "Those who are resistant will probably accept it sooner or later with my support." 4. "I think the implementation will go much better if I stay available the whole time."

4. "I think the implementation will go much better if I stay available the whole time."

An inexperienced speaker is practicing delivering a speech. Which statement indicates a lack of understanding about how easily communication is distorted? 1. "I know I can better connect with my audience with good eye contact." 2. "If I repeat a complicated section in another way, comprehension is improved." 3. "If I know the background of the audience, it can help with tailoring the content." 4. "The topic is not complicated, so I don't have to worry about misunderstanding."

4. "The topic is not complicated, so I don't have to worry about misunderstanding."

Which factor best represents a driving force in the process of change? 1. An ineffective nurse manager 2. An administration composed of long-term employees 3. A staff composed of long-term employees 4. A financial deficit of millions of dollars

4. A financial deficit of millions of dollars

The staff nurse would like to improve personal communication with peers, patients, and the medical staff. Which strategy would be most effective for this nurse? 1. Plan to be more assertive in all communication. 2. Work to manage fear of conflict. 3. First learn to delegate clearly to others. 4. Attend the hospital-based communication training.

4. Attend the hospital-based communication training.

The nurse manager has been asked to assemble several groups to work on tasks to improve the unit's performance and client satisfaction scores. This manager would put the fewest people in a group working on which type of task? 1. Additive 2. Disjunctive 3. Divisible 4. Conjunctive

4. Conjunctive

The nurse has been concentrating on improving personal communication skills. Which option represents the final step in this nurse's work to improve communication? 1. Think about the goals of the communication. 2. Develop an appropriate and thoughtful response. 3. Decide how to say what you want conveyed. 4. Ensure the communication is understood

4. Ensure the communication is understood

The nurse manager has scheduled a series of meetings with employees to solve a unit problem. The manager purposefully created a two-week gap in the meetings to allow which portion of the creative process to occur? 1. Farsight 2. Verification 3. Preparation 4. Incubation

4. Incubation

The nurse manager is calculating the cost of offering two bonus incentives to nursing staff for covering call-ins for sickness. After reviewing the statistics, the manager finds that option A is more cost-effective than option B but decides to implement option B because it seems safer. Which option best describes the basis of this decision? 1. Probability 2. Probability analysis 3. Objective probability 4. Subjective probability

4. Subjective probability

In which situation should the nurse be most concerned that communication was distorted? 1. The nurse obtains an admission history from the parents of an adopted child. 2. The nurse gives discharge instructions to a couple in their early 80s. 3. The nurse manager hires a new nurse originally from the Philippines. 4. The emergency nurse receives a confused client who was transferred in an ambulance

4. The emergency nurse receives a confused client who was transferred in an ambulance

In which situation would a "meeting before the meeting" be advisable? 1. The nurse is managing a standing committee on the unit. 2. The nurse is meeting with a social group to establish a plan for weight loss by walking. 3. The nurse has written information to distribute to members before the meeting. 4. The nurse expects the disagreement that started in the last meeting to carry over into this meeting.

4. The nurse expects the disagreement that started in the last meeting to carry over into this meeting.

Growth and maintenance of a group is facilitated by nurturing roles. Which roles characterize nurturing roles? 1. Follower 2. Encourager 3. Energizer 4. Harmonizer 5. Gatekeeper

1, 2, 4, 5

The manager is preparing to integrate TeamSTEPPS on the unit. TeamSTEPPs involves which phases? 1. Training on site 2. Assessing need 3. Designing implementation 4. Increasing efficiency 5. Implementing and sustaining training

1, 2, 5

The healthcare facility has elected to make a significant change in organization strategy. The change has been thoroughly researched and all levels of leadership have been included in the decision. Which roles are commonly undertaken by the nurse manager when such a change is necessary? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Disciplinarian 2. Resister 3. Fact manager 4. Liaison 5. Support person 6. Discussion leader

1,3,4,5,6

A proposed change in a healthcare organization is controversial and will require cooperation from all parties involved. Which change strategy should the change agent use? 1. Empirical-rational 2. Normative-reeducative 3. Power-coercive 4. Empirical-reeducative

2. Normative-reeducative

Which statement may reveal that the team member making the comment has a hidden agenda? 1. "I don't understand the second of the goals we are discussing." 2. "Are we voting on this outcome or has it already been decided?" 3. "I have to remember to add membership on the team to my resume." 4. "Are there other teams working on similar projects on other units in the hospital?"

3. "I have to remember to add membership on the team to my resume."

This is the first meeting of a task force. What should be the leader's primary objective of this meeting? 1. Determining when the task force has to complete the assignment 2. Identifying the expected outcomes in terms of measurable objectives 3. Asking members if they have time to serve on the task force 4. Establishing a standard of total participation

4. Establishing a standard of total participation

A group member has failed to complete assigned tasks for three of the last four meetings, despite reminders that incomplete work slows down the entire team. At each meeting, the noncompliant member promises to complete tasks for the next meeting. What group actions are likely to occur? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. The remaining group members may begin to use manipulation to get the tasks done. 2. The other group members may attack the noncompliant member. 3. Other group members will quietly complete the noncompliant member's work. 4. The remainder of the group will ignore the noncompliant member. 5. The group members will extend patience and understanding to the noncompliant member.

1, 2, 4

A nurse manager is using Homans's framework to evaluate the need for team building in a group appointed to work on accreditation issues. Which strategies should the manager use as part of this evaluation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Observe group member behaviors during a meeting. 2. Listen to how group members interact with one another. 3. Compare the group to a similar group from the last accreditation cycle. 4. Review the group's final report. 5. Ask a team member how the work of the group is proceeding.

1, 2, 5

Which activities are expected from the nurse manager as team leader? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Offering constructive criticism 2. Settling all employee conflicts 3. Encouraging group discussions 4. Facilitating group processes 5. Fostering team dependence

1, 3, 4

A nurse manager has just completed a difficult assignment managing a group that was not cohesive. Which group should the nurse identify as likely having good cohesiveness? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Nurses who each have 7 to 8 years of experience 2. Nurses who work on different units throughout the hospital 3. Staff nurses who are interested in learning about the task of the group 4. Staff nurses who work with one another on a daily basis 5. Staff nurses who are all between 35 and 40 years of age

1, 3, 4, 5

A staff nurse is the manager of a command group consisting of other staff nurses, a nurse manager, a physician, and physical therapist. What line authority does the group manager hold? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. The group manager has line authority in relation to the group members individually. 2. The group manager has line authority in relation to the other nurses in the group, but not in relation to the other disciplines in the group. 3. The group manager has no line authority in this group. 4. The group manager has line authority in relation to all members of the group except the physician. 5. The group manager has line authority in relation to all member of the group collectively.

1, 5

A nursing supervisor would like the nurse manager to serve as change agent for a needed revision to unit policy. Which statements would alert the supervisor that this manager is not the best choice for this assignment? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "Well, we don't want to rock the boat too much." 2. "Do you think we can get enough support from the nurses to make this change?" 3. "We tried making a change like this before and it didn't work out well." 4. "To make this big change, we need to start making smaller changes now." 5. "There is going to be resistance, but I think it can be overcome."

1,2,3

Part of the facility's performance evaluation is based on the nurse's strength in the three types of decisions. During a nurse manager's performance evaluation, the supervisor says, "You are very good at adaptive decisions, but you need to be more precise in routine decisions. When the situation calls for really innovative decisions, you do not seem sure of yourself." How should the manager interpret this information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I am not following the policies and rules well." 2. "I should review the procedure manual." 3. "I'm good at using my previous experiences to guide my decisions." 4. "I am strongest in making decisions when the problems are very unusual or unclear." 5. "I make good decisions when the situation is novel."

1,2,3

Which statements by a hospital executive reflect power-coercive strategies to implement change? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "We must follow the federal guidelines in the way we bill for our services." 2. "If we don't reduce our nosocomial infection rate, Medicare won't reimburse us." 3. "Administration has to make this change or our accreditation status will be at risk." 4. "This change is the only logical action we can take." 5. "All our sister institutions in the association have already made this change."

1,2,3

Which statements by a nurse in the emergency department are examples of groupthink? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "We've already talked about this enough. We need to present a united front on this issue." 2. "The medical unit nurses won't like this decision because it is too much work." 3. "Let's all vote yes on this so we can get back to work." 4. "We need to consider the workload of the intensive care unit nurses." 5. "Does anyone else have any ideas to discuss?"

1,2,3

A disagreement has arisen between two staff nurses. Both have discussed the situation with the manager. The manager feels that that problem is likely self-solving. How should the manager approach this situation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Allow some time to pass to see if the situation resolves. 2. Support both nurses as they work through this issue. 3. Provide any resources the nurses may need to help solve the problem. 4. Intervene if the problem begins to impact client care. 5. Ignore the situation.

1,2,3,4

A nursing supervisor has introduced a needed change in policy to the nurse managers. The managers have met maximum resistance when attempting to gain support for the change. Which options reflect valid strategies for the nurse managers? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Meet with the supervisor and discuss modifications of the proposed change. 2. Slow down the change process. 3. Meet with the supervisor and suggest abandoning the change. 4. Work together to identify strategies to overcome resistance. 5. Proceed with the change.

1,2,4,5

Currently, clients on a unit are bathed in the morning between 8:00 a.m. and 11:00 a.m. The nursing staff is contemplating changing that routine to bathing clients in the evening between 7:00 p.m. and 9:00 p.m. Which statement reflects an underlying assumption that might affect the staff's ability to think critically about this change? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "The day shift just wants to shift work onto the evening shift." 2. "Everyone likes to bathe right before bed." 3. "I read a research article that reported that clients sleep better if they have been bathed right before bedtime." 4. "The physician staff will be upset if we change our morning routine." 5. "If we let them change this, they will want to make lots of other changes, too."

1,2,4,5

A nurse manager is committed to establishing an environment that supports critical thinking and creativity. What strategies would help in this effort? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Provide opportunities for staff to interact with nurses from outside the facility. 2. Give the nurses freedom to design their work environment. 3. Create a spreadsheet for nurses to complete describing their creative efforts. 4. Assign each nurse 15 minutes during a staff meeting to talk about his or her creative efforts. 5. Be receptive to ideas even if they seem strange at the beginning

1,2,5

A major change has occurred in the governance of the hospital. How can the nurse manager help staff cope with this change? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Disperse information about the change as quickly as possible. 2. Discourage any negative discussion about the change. 3. Remind staff that change is part of the healthcare environment. 4. Talk about the change in positive terms. 5. Withdraw slightly from those who oppose the change.

1,3,4

A nursing administrator overhears nurses conversing during a break in a seminar on change. The administrator would interpret which statement as meaning that the nurse who made it is ready to become a change agent? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I know that suggesting this change may backfire on me." 2. "I don't expect too much conflict or resistance to this change." 3. "I see an opportunity to make a difference in the way this facility provides nursing care." 4. "I think the status quo is just fine for now." 5. "This change is certainly going to be a challenge, but that's okay."

1,3,4

The nurse manager has determined that changes are necessary in the way holiday shifts are assigned. When assessing the political climate surrounding this potential change, the nurse manager would ask which questions? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Who is in control of the way holiday shifts are being assigned? 2. What communication technology is available to distribute information about the change in holiday shift assignments? 3. Who will lose when holiday shift assignments are changed? 4. Will changing holiday shift assignments affect the budget? 5. Who is benefiting the most from the way holiday shifts are currently assigned?

1,3,5

Which statements exemplify the attributes of critical thinking essential to nurses? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I am always curious about why we do things the way we do." 2. "I think we need to hurry up and make a decision." 3. "Can you help me understand your perspective a little better?" 4. "I don't think that your concern is necessarily pertinent to this issue." 5. "I don't think I can make that decision until I have more information."

1,3,5

A nurse manager is faced with the task of introducing an unpopular change to a staff that includes several nurses who have acted as rejecters to previous changes. The manager expects resistance but hopes to identify these rejecters early in the process. The manager should be particularly alert to which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I don't care what they say; I'm not giving care that way." 2. "I don't think this is going to work, but I'll probably come around to it sooner or later." 3. "I'm not crazy about this idea, but we do need to change how we are providing care." 4. "I bet I can make it very difficult for this change to occur." 5. "It won't be so bad. I like change."

1,4

A nurse manager's supervisor reports that many staff members have complained about the manager's rigidity. What situations reflect this rigidity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. The manager has historically used trial and error as a decision-making strategy. 2. The manager takes unnecessary risks when staffing the unit. 3. The manager is not concerned when staff members arrive late to work. 4. The manager uses old ways of thinking to solve the day-to-day issues of the unit. 5. The manager does not consider the advice of the assistant manager when making a decision.

1,4

The nurse manager needs to cover vacation shifts and must decide whether to use agency nurses or the PRN nursing pool. The manager must decide between the two choices. Decision making includes which steps? Note: Credit will be given only if all correct choices and not incorrect choices are selected. Select all that apply. 1. Seek alternatives. 2. Make a decision. 3. Define the problem. 4. Weigh the criteria. 5. Troubleshoot.

1,4,5

The nurse is using critical thinking skills to decide which of several options is the best. Which question is most important for the nurse to take into consideration? 1. Are there different situational effects or contexts to be considered? 2. How has the problem usually been handled? 3. What is the easiest and least expensive alternative? 4. Can the problem be solved using the nursing process?

1. Are there different situational effects or contexts to be considered?

The person who has just been promoted to nurse manager is male. If this nurse communicates in a way that is considered typical for men, what can the staff expect? 1. He will focus more on the issue than on personal experience. 2. He will strive to reach consensus within the group. 3. He will strive to avoid conflict within the group. 4. He will prefer to ask questions rather than make statements

1. He will focus more on the issue than on personal experience.

The nurse administrator has been asked to work with other administrators to make a change in a long-standing hospital policy. What should be the nurse's first action? 1. Research the options that will work best for the nursing staff and the hospital. 2. Speak positively of the change to ensure the most "buy-in" from the nurses. 3. Encourage the other administrators to choose the option that is easiest for the nurses. 4. Ensure that each nurse is aware of the change and why it is necessary

1. Research the options that will work best for the nursing staff and the hospital.

A newly hired nurse is asked to join a group working on unit protocols. This nurse is verbal and dominates the conversation of the group. The group leader identifies the disruption this nurse causes as being from which phenomenon? 1. Status incongruence 2. Group isolates 3. Emergence 4. Deviation

1. Status incongruence

The nurse manager is facilitating change to a new documentation system in the unit. If the manager wants to use the most common method to overcome resistance to the change, which strategy would be chosen? 1. The manager distributes a handout explaining the new system and how to use it. 2. The manager creates a "quick tip" sheet about how to use the system and schedules practice sessions for each nurse. 3. The manager identifies a key supporter of the change and has that nurse act as mentor to the remaining staff. 4. The manager threatens to transfer anyone who resists the change

1. The manager distributes a handout explaining the new system and how to use it.

Which situation requires an adaptive decision? 1. The nurse manager discovers that two clients require the use of a new piece of equipment and that the one the hospital has is the only one in the state. 2. The nurse has made a medication error on an experimental medication. 3. The nursing student makes an error when changing a client dressing. 4. The nurse manager scheduled too many nurses for the client census on the night shift, and all of the nurses scheduled have already been asked to take a low-census unpaid day off this month.

1. The nurse manager discovers that two clients require the use of a new piece of equipment and that the one the hospital has is the only one in the state.

Which situation best exemplifies the nurse manager as a team leader? 1. The nurse manager posts the unit's positive accomplishments from the past month in the break room. 2. The nurse manager controls the staff meetings so the staff can get back to work quickly. 3. Every year the nurse manager does staff member evaluations to determine pay raises. 4. The nurse manager encourages conjunctive task performance on the unit.

1. The nurse manager posts the unit's positive accomplishments from the past month in the break room.

Which ground rule statements by the leader will help the group meeting stay on task and on time? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "We will wait until everyone who is going to attend is here before we call the meeting to order." 2. "We will always meet on the second Wednesday of the month at 1:00 p.m. because this is the time all members have indicated is most convenient." 3. "If you have information to distribute for discussion, please bring a copy for every member." 4. "We will limit verbal participation to designated key members each week." 5. "You can expect to receive an agenda for the meeting at least 1 week in advance of the meeting."

2, 5

A nurse manager who is retiring is helping the new manager learn about the position. As part of this education, the current manager has the new manager make all decisions that can be made under certainty. What conditions will these decisions have in common? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. There is risk associated with the decision. 2. The alternatives are known. 3. The conditions of each alternative are clear. 4. Possible consequences of alternatives are not known. 5. The decision is complex and dynamic.

2,3

The nurse is working on a committee tasked with making a major organizational change. Which comments by the nurse would help to advance the work of this committee? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I would like to focus on completing this process so we can move on." 2. "Have we looked at all available data in order to make an informed decision?" 3. "What are the obstacles to implementing this change within the organization?" 4. "Are we including the opinions of all stakeholders in this decision?" 5. "I think it does not really matter when we institute this change, as long as it is over quickly."

2,3,4

The staff is transitioning to a major change in the provision of nursing care in a large hospital. Which behaviors should the nurse manager watch for that would indicate possible problems? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Nurses are discussing the change at breaks and meals. 2. Nurses are doing both the old work and the new work. 3. A nurse says, "I guess everything we've done for years is wrong." 4. The provision of care with the new system takes longer than expected. 5. Nurses are doing parts of the old procedure and parts of the new procedure.

2,3,5

Although the postoperative assessment of a client reveals no abnormalities, the nurse believes the client's condition is deteriorating and orders frequent vital signs. This intervention was made on the basis of which type of problem solving? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Experimentation 2. Intuition 3. Satisficing 4. Past experience 5. Trial-and-error method

2,4

Which statement indicates understanding how a nurse could improve personal decision-making skills? 1. "We should gather a group together to make important unit decisions to ensure fairness." 2. "I should practice making decisions by developing potential solutions and then choosing one." 3. "We can make a decision and then ask for input from others to make sure it was the right choice." 4. "I know I will never be able to improve my decision-making skills because I am not a strong person."

2. "I should practice making decisions by developing potential solutions and then choosing one."

The nurse is acting as team leader for a client care conference. Which opening statement is best for this meeting? 1. "We are all here to discuss the issues with this client's discharge. What issues are we facing?" 2. "The issue with this client is the time limit for Medicare to pay has almost expired, and we aren't ready for discharge." 3. "I don't really have time for this meeting today; is there anything I can do to expedite this meeting?" 4. "I will let you all decide what might be best, as I am not really as familiar with this client as I should be."

2. "The issue with this client is the time limit for Medicare to pay has almost expired, and we aren't ready for discharge."

Hospital administrators are considering changing from the traditional method of creating work schedules to a system in which the nurses will choose their own workdays. Choices will be made according to seniority. Which change strategy would likely be best for this endeavor? 1. A power-coercive strategy 2. A normative-reeducative strategy 3. An empirical-rational model 4. A driving force

2. A normative-reeducative strategy

The nurse manager feels that changing the unit's method of assigning break times would benefit the flow of client care. What should be the manager's first action associated with this idea? 1. Tell the staff that a change is coming, but that it is positive and they should not be worried. 2. Collect and analyze information about how the current system is working. 3. Mention in a staff meeting that the current system is causing a lot of trouble. 4. Identify how the manager would know if the change is benefiting the unit

2. Collect and analyze information about how the current system is working.

The chairperson of the nursing faculty leads the monthly meetings of the curriculum committee. This permanent group, which is designed to meet organizational goals, is which type of group? 1. Competing group 2. Command group 3. Task force 4. Informal group

2. Command group

A nursing task force has been created to determine whether a new model of differentiated practice would be more effective than the current model. The task force analyzes data as a basis to examine alternatives. Which activity does this represent? 1. Group problem solving 2. Critical thinking 3. Groupthink 4. Satisficing

2. Critical thinking

The new chairperson of the nursing department has determined that the faculty's teaching is stagnant and outmoded. The chairperson would like to encourage the faculty to adopt more innovative teaching strategies. According to Lewin, what is the first step in initiating this plan? 1. Bring an expert on innovative teaching strategies to campus for a meeting with faculty. 2. Include the staff in identifying problems related to teaching strategies. 3. Ask staff to assist in the development of a plan for implementing new teaching strategies. 4. Implement interventions to improve the teaching strategies currently used.

2. Include the staff in identifying problems related to teaching strategies.

A nurse plans to seek employment in an acute-care setting after graduation. Which form of communication would be most effective in applying for a position? 1. Send an email to the nurse manager, requesting a job interview. 2. Send a written letter and résumé in the mail. 3. Call the nurse manager to ask if any jobs are open. 4. Drop into the nurse manager's office to discuss employment options

2. Send a written letter and résumé in the mail.

A nursing group cannot complete a task assignment because information from another group has not been provided. Because the nursing group cannot complete its task, a group from physical therapy will not be able to complete its task. This is an example of breakdown in which task format? 1. Pooled interdependence 2. Sequential interdependence 3. Reciprocal interdependence 4. Reverse interdependence

2. Sequential interdependence

While providing continuing education about group dynamics and team building, the nurse manager attempts to explain the difference between a group and a team. Which statement by the manager is most effective? 1. A team is bigger than a group. 2. Teams have authority; groups may be informal. 3. A group has similar goals, whereas a team's goals are dissimilar. 4. Groups are formally designated by the organization, while teams are generally informally organized.

2. Teams have authority; groups may be informal.

A nurse leader is contemplating change on the unit. Which is the first step in the change process? 1. Defining costs/benefits 2. The problem has been clearly defined 3. Identify driving and restraining forces 4. Select and analyze data 5. Develop a plan for change

2. The problem has been clearly defined

Which statement by the formal leader of a nursing unit reflects the personality required to energize the staff and promote creativity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I would like to change the format we use for shift report, but I'm afraid it would upset staff members who have been here a long time." 2. "This is the decision I have made, and there is no room for discussion." 3. "I would like to thank everyone for your hard work and dedication while we have been short staffed." 4. "I am certain that our new assignment system is going to make the workload more equitable." 5. "I know this week has been rough. I feel a little like sandpaper myself."

3,4,5

A nurse manager has just posted the membership list for a newly formed quality management task force. Which statement, overheard by the manager, indicates the most potential for problems on the team? 1. "I'm glad I didn't get chosen for this task force. I'm so busy with my kids right now." 2. "I was on one of these teams at my last hospital." 3. "This is certainly an interesting choice of people to put together." 4. "She is such a good nurse; I hope she doesn't work herself too hard."

3. "This is certainly an interesting choice of people to put together."

Hospital administration has elected to use TeamSTEPPS as a method of team building. What should the nurse manager tell staff about this training? 1. "This program was developed by a nurse to use specifically in small hospitals." 2. "Teams of nurses will be sent to national training seminars." 3. "You can expect additional efforts to help us keep on track." 4. "This is a simulation-based training similar to the old disaster drills we used to do."

3. "You can expect additional efforts to help us keep on track."

A newly promoted nurse manager would like staff to solve problems without relying on preconceived ideas. How should the manager role-model this ability? 1. When disagreements occur on the unit, the manager privately asks the dissenters to be silent about the issue at meetings. 2. Tell staff members that they must present one opinion regarding the solutions they desire. 3. Demonstrate a genuine desire to find our why there is dissention. 4. Develop "tunnel vision" when it comes to problems on the unit.

3. Demonstrate a genuine desire to find our why there is dissention.

A nurse manager has been appointed leader of a large task force charged with a complex assignment. What strategies should the manager use? 1. Limit full task force meetings to an initial meeting, a middle meeting, and a final meeting. 2. Lead one of the subgroups established at the first full task force meeting. 3. Develop a work plan with interim deadlines. 4. Set deadlines that are at least 1 week earlier than necessary to give subgroups time to be late.

3. Develop a work plan with interim deadlines.

When faced with the prospect of change, the nurse states, "We have always done it this way and never had any problems." A few weeks later, the same nurse remarks, "This new way seems to work better than the old way did." This statement is characteristic of which type of change response? 1. Laggards 2. Early adopters 3. Early majority 4. Innovators

3. Early majority

Computerized charting will be initiated on select units of the hospital. Orientation to this new system will be provided to each nurse by a team of nurses educated in nursing informatics. This is an example of which type of change strategy? 1. Normative-reeducative strategies 2. Lippitt's phases 3. Empirical-rational model 4. Power-coercive strategies

3. Empirical-rational model

The CEO of the hospital approaches the chief nurse with a request that the nurse act as the primary change agent in the implementation of a new hospital-wide policy. Why would the nurse be a good choice for this assignment? 1. Nurses thrive on transition and work best in such circumstances. 2. Nurses are role models for reacting positively to change. 3. Nurses routinely interact with multiple disciplines. 4. Nurses are always acting in the client's best interest.

3. Nurses routinely interact with multiple disciplines.

The group leader often arrives several minutes late to meetings with excuses about workload, telephone calls, or traffic. Today's meeting was scheduled to begin 5 minutes ago, and the leader has not arrived. What should the group members do? 1. Call the leader's cell phone to see when arrival is expected. 2. Wait until the leader is 10 minutes late and then cancel the meeting. 3. One of the members should start the meeting. 4. Wait for the leader to arrive.

3. One of the members should start the meeting.

The nurse manager knows that maximum power will be needed to achieve a desired change and has identified a key person on the organizational chart who will be affected by the change. What is important for the nurse manager to do? 1. Try to minimize the impact of the change when talking to this person. 2. Bypass this person and talk to the administrator who supervises him or her. 3. Pay attention to the people above and below this person on the organizational chart. 4. Try to find some information against this person to use as leverage.

3. Pay attention to the people above and below this person on the organizational chart.

The nurse manager generally uses a stepwise method to arrive at decisions that are logical and that serve to maximize the achievement of the desired objective. Which decision-making model does this manager use? 1. Political decision-making model 2. Experimentation process 3. Rational decision-making model 4. Trial-and-error method

3. Rational decision-making model

The nurse manager is facing resistance to change from many staff nurses. Why should the manager work hard to address this resistance? 1. Resistance will keep the change from occurring at all. 2. Resistance from the late majority can keep others from accepting the change. 3. Resistance can negatively impact future client care. 4. Resistance allows others to take power from managers

3. Resistance can negatively impact future client care.

Hospital administration is working with a university school of nursing to establish a nursing residency program. Why is this a desired action? 1. A residency program eliminates the hospital's liability if a novice nurse makes an error. 2. A residency program is established to make nursing education more like physician education. 3. The Institute of Medicine (IOM) has proposed residency programs for nurses. 4. A residency program ensures that nurses participate in lifelong learning.

3. The Institute of Medicine (IOM) has proposed residency programs for nurses.

A staff nurse has been appointed to a task force. What can the nurse expect regarding this group? 1. There will be no official leader for the group. 2. The nurse will be working with people from several different departments within the hospital. 3. The assignment will be time limited. 4. The group members will compete for resources for their own units.

3. The assignment will be time limited.

Which action by the nurse manager is a demonstration of satisficing? 1. The nurse manager works with the staffing schedule until all requested days off are honored. 2. The nurse manager reposts a job opening because no applicants were a good fit for the current unit staff. 3. The nurse manager agrees with a proposed budget that does not provide badly needed new client beds. 4. The nurse manager insists on firing a nurse who is chronically late to work.

3. The nurse manager agrees with a proposed budget that does not provide badly needed new client beds.

Which statements by the nurse manager would demonstrate effective change management? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "If this approach doesn't work, at least we can say we've tried." 2. "Let's wait until the administration has completed their reorganization before we implement change." 3. "In order for this plan to work, everyone must agree to participate." 4. "We cannot lose sight of the mission and values of our institution as we begin to integrate these changes." 5. "Although this task is going to be difficult, we have the full support of our hospital administration."

4,5

A new IV pump has just been purchased by the facility. Which statement by the nurse manager reflects Rogers' first step in making the change to this new equipment? 1. "The nursing staff will have the final decision on whether to change to this IV pump." 2. "Before we make the final decision, we will do a three-month 'test run' of the equipment to make sure we like it." 3. "I have looked at the pump and I like it." 4. "I have information to share with you about the new IV pump we are considering for the unit."

4. "I have information to share with you about the new IV pump we are considering for the unit."

Which action will have the greatest impact on the successful implementation of a planned change? 1. Disciplining individuals who continue to be resisters to the change 2. Ensuring there are no remaining pockets of disagreement when the change occurs 3. Continually rewarding those working toward the change and ignoring those who are not 4. Creating a supportive environment for those undergoing the change

4. Creating a supportive environment for those undergoing the change

The nurse manager is concerned about a family member's complaint regarding the professional behavior of a nurse on the unit. Which is the most effective method to address this issue? 1. Post a memo to the nursing staff about expected professional behavior. 2. Send an email to the nursing staff about expected professional behavior. 3. Address the complaint with the individual nurse in a telephone conversation. 4. Discuss the complaint with the individual nurse face-to-face.

4. Discuss the complaint with the individual nurse face-to-face.

During the first meeting of a newly created task force, the nurse manager notices that individuals tend to cluster with members of their specific nursing units. The nurse manager begins the meeting with an explanation of the focus of the group. These behaviors are characteristic of which stage of Homans's group process? 1. Norming 2. Storming 3. Performing 4. Forming

4. Forming

The nurse has determined that in order to provide the highest quality care it is important to become more creative. What is the most effective way for the nurse to increase creativity? 1. Watch others implement creative solutions. 2. Work with a group to implement a creative solution. 3. Evaluate the effectiveness of creative solutions. 4. Practice the steps of the process as often as possible

4. Practice the steps of the process as often as possible

The leader of the task force group announces that tentative plans for Nurses' Week activities have been approved by the hospital administration. The task force has also been given a new task of developing criteria for the nursing awards. What must the group accomplish now? 1. Forming 2. Adjourning 3. Rebuilding 4. Re-forming

4. Re-forming

The nursing committee is planning a change in the unit's organization. Which statement reflects the priority expected outcome of these change agents' work? 1. The nurses involved will demonstrate management skills. 2. The nurses will agree with the change and present a united front for its adoption. 3. The change will guide nursing practice on the unit. 4. The change will lead to improved client care on the unit.

4. The change will lead to improved client care on the unit.

A group of nurses has been convened to solve a problem. As the first step in this process, the group leader asks for a definition of the problem to be solved. Which statement reflects the best problem statement? 1. Emergency department nurses do not make professional client handoff reports. 2. Long-term care facility nurses lack the education to make complete assessments prior to client transfers. 3. Housekeepers are getting sloppy about cleaning rooms. 4. Unit clerks have made 10 transcription errors in the last 6 months

4. Unit clerks have made 10 transcription errors in the last 6 months