Deck 3: Disequilibrium and Chaos: Challenging, Invigorating, and Growth Producing

Question 1

The new nurse manager is using a Newtonian perspective to lead. Which action will this new nurse manager take?
1)Increase uncertainty.
2)Empower the group.
3)Build relationships.
4)Establish goals.

Answer 1

4

Question 2

Which action will help a nurse provide strategic leadership?
1)Focus on predictability.
2)Avoid the edge of chaos.
3)Expect few nurses to be leaders.
4)Work smarter.

Answer 2

4

Question 3

How can new leaders best participate fully in the decision-making processes of their health-care organizations to accomplish goals?
1)Collaborate with just other nurses to obtain new perspectives.
2)Compromise with other health-care workers so that nursing gets its share of resources.
3)Engage in continuous quality improvement.
4)Work in a silo by oneself.

Answer 3

3

Question 4

Wheatley and Kellner-Rogers (1996) say that systems maintain themselves only when change is occurring. How should the nurse interpret this statement?
1)Disorder is a means to survival.
2)It is imperative to keep organizations in status quo.
3)An idea should have its own place and be labeled.
4)Change always produces positive growth.

Question 5

One home care agency is being bought by a competing company that has a different type of patient assignment system for nurses. The director of the agency being purchased decides to share the new assignment system with the staff. The director encourages the staff to consider trying it now and compiling some feedback about how it works before the acquisition occurs. What is the rationale for the director's actions?
1)It is better to choose to change and design one's own approach to change than to have a change imposed by some external force.
2)The new company will most likely force the staff nurses to adopt this care delivery system on the first day after the merger.
3)Change should be quick so there is not enough time to complain about potential ramifications.
4)Change theory indicates the most beneficial changes are made spontaneously by only a few of the people who will be a part of the change process.

Question 6

Which behavior in a nurse leader exemplifies yin?
1)Takes positive action to deal with resistance to change
2)Uses courage to deal with resistance to change
3)Uses empathy to deal with resistance to change
4)Uses opposites to deal with resistance to change

Question 7

When someone questions a procedure, a commonly heard statement by many nurses is, "We've always done it this way." Which description best illustrates this attitude?
1)Limiting change
2)Desiring group cohesiveness
3)Honoring the past
4)Providing commitment

Question 8

How do Denhardt and Denhardt (2006) describe management?
1)"What determines a good leader from a poor leader"
2)"What energizes people"
3)"A way of working in a world of order"
4)"The dance and art of leadership"

Question 9

Which example illustrates the nurse manager's strategies have decreased barriers to change?
1)Staff members refuse to attend orientation to electronic documentation on their own time even though lunch is provided at a nearby restaurant.
2)The division's suggestion box reveals eight complaint messages about the nurse manager from nurses on the unit.
3)No one attends a mandatory orientation class on electronic documentation even though staffing would allow for half of the unit to participate.
4)Staff members are attending the manager's summer party to kick-off a new initiative for the unit's electronic documentation change.

Question 10

A nurse manager has a vision of providing holistic quality care to patients and families. Which action should the nurse manager take to strategically and successfully fulfill this vision?
1)Deemphasize empowerment of staff members.
2)Use the position's leverage.
3)Partner with agencies outside the organization.
4)Create to-do lists for those involved in the change.

Question 11

Which action indicates a nurse leader is following the chaos theory?
1)Rethinks the past and models self after previous nurse leaders
2)Develops specific short- and long-term plans with evaluation outcomes
3)Uses intuition and is comfortable with uncertainty
4)Works side by side with physician mentors

Question 12

Which action can increase a nurse manager's power most dramatically?
1)Preserving the status quo
2)Maintaining sacred cows
3)Empowering staff members to make change
4)Unionizing with other administrators

Question 13

Unfreezing is a stage of Lewin's theory of change. Which example in nursing depicts this stage?
1)Using a new acuity system
2)Having frequent staff meetings to discuss a possible change
3)Accepting the new documentation method
4)Evaluating the newly implemented procedure

Question 14

A nurse wants to make a change on the unit. Which principle should the nurse remember?
1)One's past experience with change does not affect participation.
2)A change in one part of the system affects other parts of the system.
3)Conflict is a sign the change is not working.
4)People should be informed to change.

Question 15

Which most significant characteristic will assist nurses to grow in this chaotic health-care environment?
1)Rigidity
2)Efficiency
3)Steadfastness
4)Flexibility

Question 16

The uncertainty of health care flows from the chaotic nature of the world over time. This perspective is most similar to which idea?
1)There are far more questions than there are answers.
2)Uncertainty breeds discontent.
3)Nurses should try to plan every step.
4)Life is an endless, thankless journey.

Question 17

Which theory helps nurses realize all health-care systems work from the inside out?
1)Quantum theory
2)Adaptation theory
3)Developmental theory
4)Scientific theory

Question 18

A nurse has a conflict with a coworker and uses avoidance. Which outcome will most likely occur?
1)Generate a win-win situation.
2)Cause tension while negatively influencing care.
3)Result in compromise with both parties.
4)Will improve with time.

Question 19

A nurse leader/manager wants to change a process in the emergency department. Which strategies are most important for successful change?
1)Effective communication, recognition of staff welfare, and staff empowerment
2)Tangible awards for participating staff, arguments against the change by key people, and target dates for implementation of the change process
3)Staff unawareness, outcomes for the change, and time off work to discuss the change with participating staff
4)Consequences for staff who will not participate, favoritism toward all participating staff, and an evaluation plan for the change

Question 20

When should nurses start leading?
1)Whenever their preceptor says it is time
2)After working 3 years
3)When they are in management positions
4)As soon as they graduate

Question 21

A new type of health-care insurance is being introduced that gives a reduction in premiums if an individual stops smoking, loses weight, or engages in some type of health promotion. When the individual first reads the policy and is in the process of considering a change in behavior, which stage of Lewin's change model is in process?
1)Thinking
2)Moving
3)Unfreezing
4)Refreezing

Question 22

A nurse is comparing Kotter's model of change to Lewin's framework for assistance in initiating a goal for nursing. Which steps of Kotter's model correlate to Lewin's stage 2? Select all that apply.
1)Identify a need.
2)Encourage risk taking.
3)Gather the stakeholders.
4)Offer incentives for success of the goal.
5)Evaluate implications of the change as it takes hold.

Question 23

Which action by a nurse leader is paramount for making innovative changes in nursing?
1)Interconnecting solely with members of the nursing discipline
2)Seeing the health-care team as the focus of care
3)Incorporating a single perspective for improving care
4)Using diverse skill sets

Question 24

A patient care manager of the mobile intensive care unit (MICU) wants to make a change in the culture of the unit so that the more experienced nurses take on the less experienced nurses as mentees and not just as preceptees. What is an effective first step for the patient care manager to carry out with the staff according to Lewin's theory for change?
1)Have all staff bring an article about the benefits and drawbacks of experienced staff nurses being mentors.
2)Announce that being a mentor is now required of any MICU nurse that has more than 5 years' experience.
3)Meet with all of the experienced nurses and tell them the unit cannot survive without each one of them being responsible for a less experienced nurse.
4)Refine the job description of the mentor's role to make it more acceptable to the experienced nurse.

Question 25

A patient has a 22 pack-year of cigarette smoking history and presents today at the medical clinic wanting to stop smoking. Part of the smoking cessation program should include a contract. It is imperative that which aspect be included in this contract?
1)A clause that protects the provider from any legal ramifications of the patient's smoking cessation
2)Mutually developed (by the health-care provider and the patient) objectives
3)A clause describing the patient's nicotine addiction
4)A nonspecific time frame for objectives to be accomplished so no added pressure will be put on the patient