Question 1

To lead in the midst of change and chaos,it is necessary to have a clear vision and support from one's followers.Which of the following illustrates that the staff support the nurse manager's vision on a nursing unit?

Accepted Answer

A)  Staff members refuse to attend orientation to electronic documentation on their own time even though lunch or dinner is provided at a nearby restaurant.
B)  The division's suggestion box reveals eight complaint messages about the nurse manager from nurses on her unit.
C)  No one attends a mandatory orientation class on electronic documentation even though staffing would allow for half of the unit to participate.
D)  Staff members are attending the manager's summer party to kick-off a new initiative for the unit's electronic documentation change. D

Question 2

Nurses must acclimate themselves to feelings of uneasiness,ambiguity,and the unknown to be effective nurses in our chaotic health-care system.They would do well to use which of the following theories to assist them in achieving success?

Accepted Answer

A)  Quantum theory
B)  Adaptation theory
C)  Developmental theory
D)  Scientific theory A

Question 3

By realizing that "The universe is no longer seen as made up of a multitude of objects,but as one indivisible dynamic whole with interrelated parts that can be understood only as a pattern of a cosmic process," nurses can improve their ability to assist their patients and families.Nurses can best adapt this philosophy by:

Accepted Answer

A)  Collaborating with specialists in caring for patients but letting the cardiac physician coordinate everything else
B)  Using a holistic approach to patient care in and out of the hospital
C)  Implementing critical pathways designed for specific disease entities
D)  Working closely with pastoral care to enable best practices B

Question 4

Mr.Orzo 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 regarding the process of how this behavioral change should occur.It is imperative that this contract include:

Accepted Answer

A)  A clause that protects the provider from any legal ramifications of Mr.Orzo's smoking cessation
B)  Mutually developed (by the health-care provider and Mr.Orzo) objectives
C)  A clause describing Mr.Orzo's nicotine addiction
D)  A nonspecific time frame for objectives to be accomplished so no added pressure will be put on Mr.Orzo

Question 5

Cross-training to another unit is a routine occurrence for most acute-care nurses.Which of the following is a good example of this?

Accepted Answer

A)  Using one's intuition wisely
B)  Refusing to float to another unit
C)  Managing time efficiently
D)  Being proactive and cost effective

Question 6

Denhardt and Denhardt have written about the difference between leadership and management.They describe leadership as being "what energizes people" and management as:

Accepted Answer

A)  "What determines a good leader from a poor leader"
B)  "As the ability to keep the day afloat without too many conflicts"
C)  "A way of working in a world of order"
D)  "Keeping away from conflict"

Question 7

For the nursing profession to grow and become an even stronger force in health care,chaos theory advocates that nurse leaders:

Accepted Answer

A)  Rethink the past and model themselves after previous nurse leaders.
B)  Develop specific short- and long-term plans with evaluation outcomes.
C)  Use their intuition,take risks,and be comfortable with uncertainty.
D)  Work side by side with physician mentors.

Question 8

Using both the yin (patience,process,and empathy)and yang (courage and positive action),Taoism suggests the leader must balance opposites and be able to manage and grow from conflict.Which of the following is an example of effective leadership on a nursing unit undergoing change regarding the use of an assistant nurse manager position since this position is not currently effective? The nurse manager:

Accepted Answer

A)  Asks all interested nurses to apply for the assistant nurse manager position
B)  Determines that the nurse who has been on the unit the longest should be promoted
C)  Chooses two charge nurses to manage the unit instead of one assistant nurse manager
D)  Decides to promote her niece,who is very action oriented and self-directed,to obtain her own nurse manager position

Question 9

Health-care insurance is very complex with the multiple types and payment plans.A new type of health-care insurance that is being introduced is one that gives a reduction in premiums if the patient takes responsibility for his or her health and stops smoking,loses weight,or engages in some type of health promotion.When the individual first reads about a policy like this and is in the process of considering a change in his or her insurance,which of the following phases of Lewin's Change Model is in process?

Accepted Answer

A)  Thinking
B)  Moving
C)  Unfreezing
D)  Refreezing

Question 10

The new nurse manager is determining how to schedule staff for the holidays of Thanksgiving,Christmas,and New Years.Finally she decides the most equitable process would be:

Accepted Answer

A)  Have anyone with children get Thanksgiving and Christmas days off no matter what his or her seniority is.
B)  Assign the holidays randomly so there is no favoritism involved.
C)  Ask for preferences (first,second,and third choices) and then make a schedule to accommodate everyone's first choice on the specified holiday.
D)  Assign those with seniority the holidays of their choice and shifts that they request,and fill in with the rest of the staff as to what is still needing coverage.

Question 11

The most significant characteristic that will assist nurses to grow in this chaotic health-care environment is:

Accepted Answer

A)  Rigidity
B)  Efficiency
C)  Steadfastness
D)  Flexibility

Question 12

The Center for Creative Leadership published skills one should practice to be a more effective leader.These skills include:

Accepted Answer

A)  Individualization,short- and long-term goal accomplishment,and frequent self-evaluation
B)  Aggression,intenseness,and use of the most comprehensive planning strategies
C)  Competitiveness,caution,and no risk-taking
D)  Flexibility,collaboration,and willingness to partner with others

Question 13

Ms.Ron is the Patient Care Manager of the mobile intensive care unit (MICU).She wants to make a change in the culture of the unit so that more experienced nurses take on the less experienced nurses as mentees and not just preceptees.An effective first step for Ms.Ron to carry out with the staff before making this change is to:

Accepted Answer

A)  Conduct a Readiness to Change Assessment to identify how the staff feels on this issue.
B)  Announce that being a mentor is now part of the job description of any MICU nurse that has more than 5 years' experience.
C)  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.
D)  Discuss with the Staffing Supervisor if there are any extra MICU nurses that can be scheduled so only experienced nurses who volunteer will have to be mentors.

Question 14

Malloch and Porter-O'Grady point out that organizations "work from the inside out" and not from top to bottom.It is significant for staff nurses to participate fully in the decision-making processes of their health-care organizations and they can best do this by:

Accepted Answer

A)  Shadowing their physician colleagues
B)  Compromising with other health-care workers so that nursing gets its share of resources
C)  Empowering themselves and other nurses to negotiate for their patients
D)  Ignoring the administrators of the organization

Question 15

Unfreezing is the first stage of Lewin's theory of change.An example of this stage in nurses is:

Accepted Answer

A)  Using a new acuity system
B)  Having frequent staff meetings to discuss a possible change
C)  Accepting the new documentation method
D)  Evaluating the newly implemented procedure

Question 16

Wheatley and Kellnor-Rogers say systems maintain themselves only when change is occurring.Which of the following statements best describes this?

Accepted Answer

A)  Change is the essence of growth and survival.
B)  It is imperative to keep organizations in flux to be successful.
C)  The only idea for success is to keep things changing.
D)  Change always produces positive growth.

Question 17

It appears that many nurses use avoidance to manage conflict.However,this does not generally resolve the problem because:

Accepted Answer

A)  Avoiding will generate a win-win situation.
B)  Avoiding a conflict ultimately causes tension among team members and negatively influences the care environment.
C)  Most staff are not capable of fully avoiding or ignoring a problem and so they begin to compromise with the other group,which yields a win-win situation.
D)  Most problems that are ignored generally improve with time.

Question 18

Neubauer's process of renewing oneself consists of which of the following?

Accepted Answer

A)  Engaging in strenuous exercise
B)  Strategizing leadership skills
C)  Engaging in frequent self-assessments
D)  Creating to-do lists

Question 19

When someone questions a procedure,a commonly heard statement by many nurses is,"We've always done it this way." Which of the following best describes this attitude?

Accepted Answer

A)  Fearing change
B)  A desire for group cohesiveness
C)  A desire to get ahead
D)  Commitment

Question 20

Change often is described as all of the following EXCEPT:

Accepted Answer

A)  New
B)  Unexpected
C)  Negative
D)  Stable

Exam 7: Chaos and Disequilibrium: Invigorating, Challenging, and Growth-Producing