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Leadership test 2 Quiz sobre Chapter 18, criado por Esmeralda Espitia em 27-02-2020.

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Chapter 18

Questão 1 de 25

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1. When goals/outcomes are somewhat unclear in early preparation for a complex change, the manager and the change management team develop several acceptable goals/outcomes. This change in management approach is termed:

Selecione uma das seguintes:

  • a. unfreezing.

  • b. nonlinear.

  • c. cybernetic.

  • d. linear.

Explicação

Questão 2 de 25

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2. The home health agency hired an expert in financial management to evaluate and propose a plan for reversing growing expenses and decreasing revenues. The expert is well respected, both personally and professionally, by members living in this small community. To be effective, staff will need to perceive this change agent as:

Selecione uma das seguintes:

  • a. trusted, quiet.

  • b. flexible, informal.

  • c. credible, enthusiastic

  • d. communicative, personable.

Explicação

Questão 3 de 25

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3. The nurse manager frequently interacts with staff and other hospice facility employees. Communication is purposeful because the manager assesses current issues, such as specific satisfactions and dissatisfactions with the newly implemented computerized documentation system. Informally, the manager gathers available staff members to address similar learning needs. Many times, staff members are found coaching other staff about improving use of the new system. According to Senge (1990), the activities demonstrated in this example are:

Selecione uma das seguintes:

  • a. dialogue, team learning.

  • b. resilience, personal mastery.

  • c. shared vision, systems thinking.

  • d. mental models, teachable moments.

Explicação

Questão 4 de 25

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4. The clinical coordinator expects the position description of the new wound care specialist to change nurses’ responsibilities in caring for clients with skin integrity problems. The best approach to address this need for change, yet to have the best outcomes for clients, staff nurses, and the organization, is to:

Selecione uma das seguintes:

  • a. select one of the change models.

  • b. use Lewin’s model and principles of change.

  • c. apply both planned and complexity theory approaches.

  • d. form a task force of nursing staff and wound care specialists.

Explicação

Questão 5 de 25

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5. Complex change situations require that the change leader promote ongoing visioning among staff members. One strategy is to:

Selecione uma das seguintes:

  • a. consciously evaluate invisible mental models.

  • b. allow for individual outcomes.

  • c. encourage cooperative actiUvitieSs. N T O

  • d. operate between order and disorder.

Explicação

Questão 6 de 25

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6. To effectively achieve a change goal/outcome in a change situation, the wound care specialist will:

Selecione uma das seguintes:

  • a. preserve the status quo.

  • b. diminish facilitators and reinforce barriers.

  • c. weigh the strength of forces.

  • d. strengthen facilitating forces.

Explicação

Questão 7 de 25

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7. The wound care nurse decided to involve those to be affected by change early in the change management process. This can positively result in:

Selecione uma das seguintes:

  • a. coordination.

  • b. resistance.

  • c. anticipation.

  • d. participation.

Explicação

Questão 8 de 25

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8. The oncology clinical manager and the educational coordinator asked nursing staff to complete a brief written survey to assess their attitudes and knowledge related to having used the new infusion equipment for 6 weeks. The stage of change in this situation is:

Selecione uma das seguintes:

  • a. developing awareness.

  • b. experiencing the change.

  • c. integrating the change.

  • d. perceiving awareness.

Explicação

Questão 9 de 25

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9. An example of one strategy to improve participation in the change process by staff fitting the behavioral descriptions of laggards, early majority, late majority, and rejecters is to:

Selecione uma das seguintes:

  • a. encourage teamwork.

  • b. transfer to a different unit.

  • c. require attendance at staff meetings.

  • d. delegate the roles and tasks of change.

Explicação

Questão 10 de 25

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10. An example of one strategy used to improve participation in the change process by staff fitting the behavioral description of innovators and early adopters is to:

Selecione uma das seguintes:

  • a. repeat the benefits of the change.

  • b. share change experiences early in the process.

  • c. initiate frequent interactions among staff.

  • d. provide select information to the staff.

Explicação

Questão 11 de 25

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11. As a new manager, you are shocked to learn that your unit is still using heparin in heparin locks. You are aware of evidence related to this practice and want to change this practice as quickly as possible on your unit. You are in which stage of Lewin’s stages of change?

Selecione uma das seguintes:

  • a. Unfreezing

  • b. Experiencing the change

  • c. Moving

  • d. Refreezing

Explicação

Questão 12 de 25

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12. To engage your staff in awareness of their current practice and how it is affirmed or not by evidence, you plan a short series of learning presentations on evidence and use of heparin and saline to maintain IV patency. You meet with the educator to plan out the goals for each session with the overall purpose of increasing knowledge and awareness of staff in readiness to consider questions related to the IV practice. This learning approach is an example of which change management approach?

Selecione uma das seguintes:

  • a. Linear

  • b. First-order

  • c. Facilitative

  • d. Integrative

Explicação

Questão 13 de 25

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13. To engage your staff in awareness of their current practice and how it is affirmed or not by evidence, you plan a short series of learning presentations on evidence and use of heparin and saline to maintain IV patency. You meet with the educator to plan out the goals for each session with the overall purpose of increasing knowledge and awareness of staff in readiness to consider questions related to the IV practice. Staff nurses who gain information on current IV therapy practices are engaging in which phase of Rogers’ decision-making process?

Selecione uma das seguintes:

  • a. Persuasion

  • b. Knowledge

  • c. Confirmation

  • d. Decision

Explicação

Questão 14 de 25

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14. Elizabeth, an RN with approximately 15 years of service on your unit, walks away from one of the learning sessions on IV care and you overhear her telling a colleague that she thought the session was a waste of time because “the unit has been using heparin for years and there has never been any adverse effects.” According to Havelock (1973), this comment may originate from failure in which phase of the six phases of planned change?

Selecione uma das seguintes:

  • a. Generating self-renewal

  • b. Choosing the solution

  • c. Diagnosing the problem

  • d. Building a relationship

Explicação

Questão 15 de 25

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15. Elizabeth, an RN with approximately 15 years of service on your unit, walks away from one
of the learning sessions on IV care and you overhear her telling a colleague that she thought
the session was a waste of time because “the unit has been using heparin for years and there
has never been any adverse effects.” You follow up with Elizabeth and discover that she is really quite angry about the information sessions because she feels that you are implying that
“what she has been doing all these years means that she is incompetent and doesn’t care about her patients.” Your response to her indicates that:

Selecione uma das seguintes:

  • a. Elizabeth will never adopt the change.

  • b. Elizabeth is insecure in her practice.

  • c. Elizabeth requires more information about the practice.

  • d. change involves emotions.

Explicação

Questão 16 de 25

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16. Elizabeth, an RN with approximately 15 years of service on your unit, walks away from one of the learning sessions on IV care and you overhear her telling a colleague that she thought the session was a waste of time because “the unit has been using heparin for years and there has never been any adverse effects.” You follow up with Elizabeth and discover that she is really quite angry about the information sessions because she feels that you are implying that “what she has been doing all these years means that she is incompetent and doesn’t care about her patients.” Which of the following would be the most effective response to Elizabeth?

Selecione uma das seguintes:

  • a. “I understand how you feel, but you are going to have to change.”

  • b. “It is unfortunate that you feel this way. Others seem quite excited about the new
    information.”

  • c. “It is difficult sometimes to change what we know very well. Sometimes it can be
    frightening.”

  • d. “Perhaps I can arrange some more information sessions for you, so you can see
    just how important this change is to patient safety.”

Explicação

Questão 17 de 25

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17. Elizabeth is an example of a(n):

Selecione uma das seguintes:

  • a. early adopter.

  • b. late majority.

  • c. laggard.

  • d. resister.

Explicação

Questão 18 de 25

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18. Elizabeth, an RN with approximately 15 years of service on your unit, walks away from one of the learning sessions on IV care and you overhear her telling a colleague that she thought the session was a waste of time because “the unit has been using heparin for years and there has never been any adverse effects.” You follow up with Elizabeth and discover that she is really quite angry about the information sessions because she feels that you are implying that “what she has been doing all these years means that she is incompetent and doesn’t care about her patients.” After speaking with Elizabeth, a few days later you discover that she is now fine with the change but is concerned that other areas of the organization might resist the change because of perceptions related to patient safety and cost. She suggests that it is important to bring pharmacy on board as they have had previous concerns about the use of heparin. In relation to change theory, this is indicative of:

Selecione uma das seguintes:

  • a. systems level thinking.

  • b. linear thinking.

  • c. interprofessional collaboration.

  • d. first-order change.

Explicação

Questão 19 de 25

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19. Based on Elizabeth’s insights and suggestions, you involve pharmacy, only to discover that the change in practice involves practice committees, a medical practice committee, and concerns from administration about potential costs and safety of the proposed change to the IV protocols. The change process at this point is:

Selecione uma das seguintes:

  • a. linear.

  • b. nonlinear.

  • c. sabotaged.

  • d. neutralized.

Explicação

Questão 20 de 25

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20. Resistance is most likely when change:

Selecione uma das seguintes:

  • a. is not well understood.

  • b. involves many layers in an organization.

  • c. involves nonprofessional workers.

  • d. threatens personal security.

Explicação

Questão 21 de 25

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21. As the unit manager on the unit that is leading changes to heparin locks, you find that Elizabeth is very valuable in terms of her observations about other units and her knowledge of organizational processes, and now in discussing the new procedure with others. Elizabeth might be considered an:

Selecione uma das seguintes:

  • a. engager.

  • b. innovator.

  • c. informal change agent.

  • d. informant.

Explicação

Questão 22 de 25

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22. As the unit manager, you spend a day performing direct patient care and work with a new system that is designed to capture patient documentation at the bedside. During discussions with staff while giving care, you discover that the number of screens that need to be opened during documentation makes charting more complex and time consuming than traditional manual charting approaches. On the basis of this feedback, you:

Selecione uma das seguintes:

  • a. assume that the system is doing what it needs to do.

  • b. provide reassurance to staff that the unit has achieved its goals in implementation
    of the system.

  • c. ask some of the staff if they have had similar experiences with the system.

  • d. consult chart audit data and end user consultation reports to determine if errors and
    problems are occurring.

Explicação

Questão 23 de 25

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23. You anticipate that your region will soon move toward an e-health record system. You begin to discuss this with your staff and are disappointed that you receive little positive response from the staff about this possibility. One staff member, in particular, seems to sum it up by saying “e-health? Won’t happen in my working life! There are too many problems with it, like privacy issues.” This response is most likely motivated by

Selecione uma das seguintes:

  • a. lack of urgency regarding the need to change.

  • b. lack of evidence to support importance of technology.

  • c. deficits in education and experience.

  • d. lack of organizational support for change.

Explicação

Questão 24 de 25

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24. Sarah, RN, is one of your most enthusiastic staff members and has been to a workshop on preparing educational materials for patients. On the basis of this workshop, she would like to develop an information website for patients who are being admitted to the ward. An appropriate response to Sarah’s suggestion would be:

Selecione uma das seguintes:

  • a. “That is a great suggestion, but we have no resources for such an expensive undertaking right now.”

  • b. “Perhaps you can keep that in mind as we redesign our charting system.”

  • c. “We have too many seniors as patients, and you know that they don’t use
    technology.”

  • d. “There is a great group here that meets to look at technology pilots. Let’s see if
    you can join them and discuss your idea further.”

Explicação

Questão 25 de 25

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1. Which of the following are examples of application of the Leadership Rounding Tool? (Select all that apply.)

Selecione uma ou mais das seguintes:

  • a. “What is working well for you during bedside reporting?”

  • b. “What has not worked for you today?”

  • c. “Is there someone on your team who deserves special recognition for her efforts in the implementation?”

  • d. “Did you have a good vacation?”

Explicação