Leadership and Nursing Care Management 5th Edition Test Bank

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Chapter 01: Leadership and Management Principles
Test Bank
MULTIPLE CHOICE
1. Leadership is best defined as:
a. an interpersonal process of participating by encouraging fellowship.
b. delegation of authority and responsibility and the coordination of activities.
c. inspiring people to accomplish goals through support and confidence building.
d. the integration of resources through planning, organizing, and directing.
ANS: C
Leadership is the process of influencing people to accomplish goals by inspiring confidence
and support among followers.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 4
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
2. A medical-surgical unit reports higher rates of patient satisfaction coupled with high rates of
staff satisfaction and productivity. Which of the following is attributed to the data?
a. Effective leadership
b. Management involvement
c. Mentoring
d. Rewards and recognition
ANS: A
Effective leadership is important in nursing because of the impact on nurses’ work lives, it
being a stabilizing influence during change, and for nurses’ productivity and quality of care.
DIF: Cognitive Level: Apply (Application) REF: Page 1
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
3. A staff registered nurse (RN) is leading a multidisciplinary clinical pathway team in the
development of care for patients with total knee replacement. Which of the following
statements would exemplify leadership behaviors in a clinical pathway team meeting?
a. “Nursing is responsible for pain control of the total knee replacement patient.”
b. “Our pharmacist has provided some excellent pain control literature.”
c. “Physical therapy’s expertise is in rehabilitation, not pain control.”
d. “Total knee replacement patients require optimal pain control.”
ANS: B
Leadership is the process of influencing people to accomplish goals by inspiring confidence
and support among followers. The correct answer is supportive of a team member’s work and
depicts some skill at interpersonal relationships.
DIF: Cognitive Level: Apply (Application) REF: Pages 3-4
TOP: Nursing Process: Assessment
MSC: Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies

4. Which of the following is true of management activities?
a. Inspiring a vision is a management function.
b. Management is focused on task accomplishment.
c. Management is more focused on human relationships.
d. Management is more important than leadership.
ANS: B
Management is focused on task accomplishment.
DIF: Cognitive Level: Remember (Knowledge) REF: Pages 2-3
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
5. During a staff meeting, a group of RNs has complained that medications are not arriving to
the unit in a timely manner. The nurse manager suggests that the group resolve this issue
through the development and work of a multidisciplinary team led by one of these RNs. This
scenario demonstrates:
a. adaptation.
b. empowerment.
c. flexibility.
d. relationship management.
ANS: B
Empowerment is the giving of authority, responsibility, and the freedom to act. In this
situation, the manager has given authority, responsibility, and the freedom to act in the
investigation and resolution of this issue.
DIF: Cognitive Level: Apply (Application) REF: Page 5
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
6. A nurse is caring for an elderly patient who was admitted after sustaining a fall at home.
When creating a care plan for the patient, she requests that the doctor order a home health visit
to assess for home safety and medication compliance. In addition, the nurse is concerned
about the nutrition of the patient and requests a dietitian evaluation. The nurse is
demonstrating which of the following leadership skills?
a. Care provider
b. Business principles
c. Care coordination
d. Change management
ANS: C
Care coordination is the delivery of nursing services that involves the organization and
coordination of complex activities. The nurse uses managerial and leadership skills to
facilitate delivery of quality care.
DIF: Cognitive Level: Apply (Application) REF: Page 3
TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity: Reduction of Risk Potential
7. Interpersonal communication and the ability to apply _____ are two critical skills every nurse
needs to enhance professional practice.

a. vision
b. supervision
c. delegation
d. problem solving
ANS: D
Every nurse needs two critical skills to enhance professional practice. One is a skill at
interpersonal relationships. This is fundamental to leadership and the work of nursing. The
second skill is applying the problem-solving process. This involves critical thinking, problem
identification, and the development of objectivity.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 4
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
8. Good leaders need to be able to demonstrate an intuitive skill of empathy and expressiveness
when dealing with others in the workplace. This requires sensitivity and awareness of the
emotions and moods of others and is known as:
a. social awareness.
b. self-awareness.
c. self-management.
d. relationship management.
ANS: A
Social awareness is an intuitive skill of empathy and expressiveness in being sensitive and
aware of the emotions and moods of others.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 4
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
9. The manager of the emergency department in a large hospital focuses on customer service,
exudes the nursing code of ethics, and sees his or her job as an occupation with a lifetime
commitment. This is a concept known as:
a. leadership.
b. management.
c. professionalism.
d. vision.
ANS: C
Professionalism is an approach to an occupation that distinguishes it from being merely a job,
focuses on service as the highest ideal, follows a code of ethics, and is seen as a lifetime
commitment.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 5
TOP: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
10. _____ are vital to good leaders because they are able to take the vision of the leader and
achieve the determined goals.
a. Managers
b. Motivators

c. Visionaries
d. Followers
ANS: D
Without followers there is not leadership. Followers are vital because they accept or reject the
leader and determine the leader’s personal power.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 6
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
11. The best leadership style for unfavorable conditions is:
a. leader–member relations.
b. task-oriented structure.
c. position power.
d. laissez faire.
ANS: B
The need for task-oriented leaders occurs when the situation is extreme. The best leadership
style for unfavorable conditions is task-oriented.
DIF: Cognitive Level: Remember (Knowledge) REF: Pages 10, 12
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
12. Nursing management is defined as:
a. delegation of authority and responsibility and the coordination of tasks.
b. the integration of resources through planning, organizing, and directing.
c. the process of influencing patients to accomplish goals.
d. the coordination and integration of nursing resources by applying the management
process to accomplish nursing care and service goals and objectives.
ANS: D
The coordination and integration of nursing resources by applying the management process to
accomplish nursing care and service goals and objectives is the definition of nursing
management.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 22
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
13. A nursing unit has demonstrated lower patient satisfaction scores during the last quarter. The
manager of the unit has formed a small team to set long- and short-term goals for the unit with
action plans to increase patient satisfaction. This is an example of which management
process?
a. Planning
b. Organizing
c. Coordinating
d. Controlling
ANS: A

Planning is the managerial function of selecting priorities, results, and methods to achieve
results.
DIF: Cognitive Level: Apply (Application) REF: Pages 23-24
TOP: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
14. A nursing unit has discovered a series of medication errors with regards to a particular
computerized physician order set and the calculation within the order. The unit manager has a
theory on changes that should be made within the order to decrease the confusion for nursing
staff. However, the nurse manager realizes that changes would need to be made with
pharmacy input as well as other nursing units within the facility and the multi-hospital system.
Which of the following management theories is exemplified when the nurse manager
considers the impact of change on the organization as a whole?
a. Contingency theory
b. Systems theory
c. Complexity theory
d. Chaos theory
ANS: B
Systems theory helps managers recognize their work as being embedded within a system.
Managers use this theory to learn that changing one part of a system inevitably affects the
whole system.
DIF: Cognitive Level: Apply (Application) REF: Pages 30-32
TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity: Reduction of Risk Potential
15. The role of the _____ is to provide leadership and direction for all aspects of nursing care.
a. nurse manager
b. care provider
c. nurse executive
d. senior leader
ANS: C
The nurse executive is accountable for the environment in which clinical nursing practice
occurs. The nurse executive provides leadership and direction for all aspects of nursing care.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 34
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
16. The postoperative patient with anterior cervical laminectomy is complaining of tightness in
his throat. His voice is raspy. The staff nurse asks the unit secretary to page Dr. Julio stat. This
is an example of _____ leadership.
a. authoritarian
b. democratic
c. laissez-faire
d. servant
ANS: A

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Authoritarian leadership uses directive and controlling behaviors in which the leader
determines policies and makes decisions in isolation. The leader orders subordinates to carry
out the tasks or work. This style is helpful in crisis situations.
DIF: Cognitive Level: Apply (Application) REF: Page 10
TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological Integrity: Physiological Adaptation
17. A quality improvement team is working to enhance teamwork among the staff in a newly
developed Alzheimer’s program. Which of the following statements would be an expected
behavior that illustrates quantum leadership?
a. “After the meeting today, each member on this team will be a role model of good
communication techniques to other staff members.”
b. “How would you describe an ideal collaborative practice environment?”
c. “What do you think about sharing our opinions today in a mutually respectful
manner as we move around the table?”
d. “You folks are highly motivated and smart enough to develop a plan on your own.
I’ll support you as needed.”
ANS: B
Quantum leadership fosters an environment of curiosity, questioning, and exploration. Answer
A depicts an authoritarian leadership style.
DIF: Cognitive Level: Apply (Application) REF: Page 16
TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
18. A nursing executive is leading a multidisciplinary team of professionals who have worked
well together on prior initiatives. Which of the following leadership styles might work best in
this situation?
a. Authoritarian
b. Democratic
c. Transformational
d. Transactional
ANS: B
Democratic leadership would work best in this situation.
DIF: Cognitive Level: Apply (Application) REF: Pages 10, 14
TOP: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
MULTIPLE RESPONSE
1. Which of the following behavioral aspects are present in the feminist perspective leadership
style (select all that apply)?
a. Builds relationships
b. Focuses on completing tasks and achieving goals
c. Empowers others
d. Fosters an environment of mothering
e. Supports bargaining of tasks and roles

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f. Promotes personal growth
ANS: A, C, F
Leaders using the feminist perspective build connections, empower others, and support
personal growth to promote teamwork and to accomplish goals.
DIF: Cognitive Level: Understand (Comprehension) REF: Page 11
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
2. A nurse manager at Great Lakes Hospital is meeting with the dean of a well-recognized
university who is the keynote speaker today at the nursing conference. He remembers that one
of the RNs is interested in attending a well-known university to obtain a doctorate. The nurse
manager arranges for the RN to meet with this dean. The nurse manager is exhibiting
leadership behaviors consistent with (select all that apply):
a. feminist perspective.
b. servant leadership.
c. transactional leadership.
d. transformational leadership.
ANS: A, B, D
This behavior nurtures personal growth (servant leadership) and assists the RN to attain his or
her fullest potential (transformational leadership). This behavior also helps the RN build a
connection with the dean, a representative of the university (feminist perspective).
DIF: Cognitive Level: Apply (Application) REF: Pages 11, 14, 16
TOP: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
3. A nurse manager at Morgan Hill Community Hospital is known to be an excellent nursing
manager by the personnel working on her nursing unit. The nurse manager exhibits which of
the following behaviors (select all that apply)?
a. Knows the personnel and addresses them by name
b. Intervenes when she receives complaints
c. Has a consistent style that never varies
d. Is visible on the nursing unit by all shifts on a frequent basis
e. Evaluates a number of aspects of problems prior to making decisions
f. Uses decision by consensus to resolve conflicts
g. Fosters collaboration
ANS: A, D, E, G
These behaviors foster teamwork and positive morale.
DIF: Cognitive Level: Apply (Application) REF: Pages 6-8
TOP: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
4. To reach Magnet status the nursing service in a hospital must attain competency in which of
the following areas (select all that apply)?
a. Professionalism
b. Use of critical thinking skills
c. Business skills and principles

Loading page 8...

d. Leadership
e. Communication and relationship management
f. Knowledge of the health care environment
g. Implementation of an acuity-based staffing system
ANS: A, C, D, E, F
Magnet hospitals are recognized for the nurse’s critical role in the business of health care.
Professionalism, leadership, communication, and the ability to work with others as well as
understanding the business and principles of running a hospital business and health care
environment are required.
DIF: Cognitive Level: Apply (Application) REF: Pages 2-3
TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
5. Which of the following behaviors build trust between leaders and employees in an
organization (select all that apply)?
a. Sharing relevant information
b. Encouraging competition via winners and losers
c. Reducing controls
d. Meeting expectations
e. Avoiding discussion of sensitive issues
ANS: A, C, D
Leadership is founded on trust. Behaviors that build trust include sharing relevant
information, reducing controls, and meeting expectations. Trust-destroying behaviors include
being insensitive to beliefs and values, avoiding discussion of sensitive issues, and
encouraging competition.
DIF: Cognitive Level: Apply (Application) REF: Pages 8-9
TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
6. Which of the following traits describe a transactional leader (select all that apply)?
a. Functions in a caregiver role
b. Surveys their followers’ needs and sets goals for them
c. Uses charisma to produce greater effort in followers
d. Focuses on the maintenance and management of ongoing and routine work
e. Motivates followers to perform to their full potential
ANS: A, B, D
A transactional leader is a leader or manager who functions in a caregiver role and is focused
on day-to-day operations. Such leaders survey their followers’ needs and set goals for them
based on expectations. They are also leaders who are focused on maintenance and
management of ongoing and routine work. Transformational leaders use charisma to produce
greater effort and are able to motivate followers to perform to their full potential over time.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 14
TOP: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment: Management of Care

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7. Which of the following factors are central to successful nursing leadership (select all that
apply)?
a. Access to information and resources
b. Respectful and collaborative teamwork
c. Supportive cultures in which nurses are valued for their expertise
d. Formal and informal power
e. Vertical compensation
ANS: A, B, C, D
Formal and informal power, access to information and resources, opportunity for growth,
supportive organizational cultures in which nurses are valued for their expertise, respectful
teamwork, and adequate compensation are factors central to successful nursing leadership.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 17
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
8. Which of the following definitions apply to management (select all that apply)?
a. It is a process of inspiring people to accomplish goals through support and
confidence building.
b. It is the process of coordination and integration of resources to accomplish specific
goals.
c. It includes the activities of planning, organizing, coordinating, directing, and
controlling.
d. It is a process of planning and directing human effort to achieve established
objectives.
e. It is the directing of the organizations’ money, facilities, and supplies to achieve
results.
ANS: B, C, D, E
Management is defined as the process of coordination and integration of resources through
planning, organizing, coordinating, directing, and controlling to accomplish specific goals.
Management is a process of planning and directing human effort to achieve established
objectives while ensuring that the organizations’ money, facilities and supplies are directed in
a manner which achieves the best results.
DIF: Cognitive Level: Apply (Application) REF: Page 21
TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment: Management of Care

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Chapter 02: Change and Innovation
Test Bank
MULTIPLE CHOICE
1. A hospital system is implementing an electronic health record. The facility conducts education
and training for nursing staff, medical staff, and ancillary staff over a period of 6 months. This
is an example of:
a. emergent change.
b. planned change.
c. transformation.
d. innovation.
ANS: B
Planned change is a decision to make a deliberate effort to improve a system.
DIF: Cognitive Level: Apply (Application) REF: Page 38
TOP: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
2. The use of a new idea or method is the definition of:
a. change.
b. innovation.
c. resistance.
d. stereotyping.
ANS: B
Innovation is the use of a new idea or method.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 38
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
3. The chief nursing officer (CNO) of a hospital system works with senior leadership for
approval to initiate an electronic health system. He recruits a nursing informaticist and a chief
medical informatics officer to begin the process of planning the education and roll-out of the
new electronic system. The CNO could be viewed as the:
a. resistor.
b. innovator.
c. change agent.
d. strategist.
ANS: C
The change agent is a person or thing that produces a particular effect or change. The change
agent can be a person who functions as a change facilitator.
DIF: Cognitive Level: Apply (Application) REF: Page 38
TOP: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment: Management of Care

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4. A small critical care unit forms a team of nurses to implement bedside rounds at shift change.
The nurses have researched the efficacy of bedside rounds and have determined that this
evidence-based practice will lead to improved communication of patient status. Which type of
change does this demonstrate?
a. First-order change
b. Second-order change
c. Emergent change
d. Organizational change
ANS: A
First-order change occurs in a stable system and is characterized by rational stepwise
processes. It is useful for smaller scale changes at a unit-based level. Adaptation and
adjustment occurs when nursing uses a new evidence-based protocol and puts it into practice.
DIF: Cognitive Level: Apply (Application) REF: Page 39
TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological Integrity: Physiological Adaptation
5. How is the refreezing stage of change similar to the nursing process?
a. Refreezing is similar to the assessment phase of the nursing process.
b. Refreezing is similar to the problem identification phase of the nursing process.
c. Refreezing is like the planning and implementation phase of the nursing process.
d. Refreezing is like evaluation in the nursing process.
ANS: D
Refreezing is like evaluation in the nursing process.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 41
TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
6. Which of the following factors is used to describe the degree to which successful planned
change is thought to be better than the status quo?

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ANS: A
The OCRS is a 76-item inventory that is used to analyze the ability of an organization to
manage change effectively. There are five dimensions that are a part of this assessment tool.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 46
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
8. A medical-surgical unit utilizes a group of nurses and patient care assistants to determine
ways to reduce the number of falls in the unit. They conduct Internet research to locate best
practice interventions. They create fall risk alerts in the unit, and they implement hourly
rounding to assess the need for toileting. After putting these small changes into place, they
will evaluate the data to determine effectiveness. This project is an example of:
a. rapid response teams.
b. Failure Modes and Effects Analysis.
c. root cause analysis.
d. Rapid Cycle Change.
ANS: D
Rapid Cycle Change is used in health care to improve patient safety and quality. It is based on
the idea that changes are tried on a small scale to see how they work.
DIF: Cognitive Level: Apply (Application) REF: Page 46
TOP: Nursing Process: Evaluation
MSC: Client Needs: Physiological Integrity: Reduction of Risk Potential
9. An organization has encountered a serious patient safety event that was reported to the state,
The Joint Commission, and the Centers for Medicare & Medicaid Services (CMS). An
extensive plan of correction was received, and the organization had to make some immediate
changes in practice. Additionally the organization anticipates a costly lawsuit. What is the best
method of educating staff about the practice changes that were issued?
a. “These changes need to be made because the state and CMS require it.”
b. “We understand this is a knee-jerk reaction, but please change the practice while
the surveyors are in the building.”
c. “We need to make this change because it will help our lawsuit.”
d. “This change is being made so that there is no further harm to another patient.”

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d. Denial
ANS: B
Resistance to change should be expected as integral to the process of change. It may be rooted
in anxiety or fear.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 46
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
11. Individual members of a group will adapt to change at different rates. Which of the following
groups would take the longest to accept change?
a. Early adopters
b. Late majority
c. Innovators
d. Laggards
ANS: D
Nurse leaders need to recognize that change will be accepted at varying rates and target
interventions accordingly. The five categories in order are innovators, early adopters, early
majority, late majority, and laggards.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 43
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
12. A process of intentional intervention to create something new is called:
a. altered direction.
b. organizational flux.
c. planned change.
d. status revision.
ANS: C

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MSC: Client Needs: Safe and Effective Care Environment: Management of Care
14. The charge nurse of a small nursing unit would like to gain staff acceptance of a
time-intensive, budget-imposed change required by the hospital administration. She plans to
emphasize several evidence-based research projects that have shown improved patient health
outcomes as a result of implementing this change. This is an example of which of the
following organizational change concepts?
a. Budget-oriented change
b. Transformation
c. Resistance
d. Emergent change
ANS: B
Transformation is the use of new ideas, innovation, and creativity to change fundamental
properties of the state of a system.
DIF: Cognitive Level: Apply (Application) REF: Page 38
TOP: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
15. The first stage of planned change involves:
a. accepting the need for change.
b. cognitive redefinition.
c. integration and stabilization.
d. problem solving.
ANS: A
Change must begin with an awareness of the need for change, and end with a general
acceptance of the necessity of change.
DIF: Cognitive Level: Remember (Knowledge) REF: Page 41
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care

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a. change agent.
b. implementation expert.
c. restructuring motivator.
d. supervisory threat.
ANS: A
The change agent needs to anticipate resistance, determine why it is occurring, and try to
determine what the person who is resisting is trying to protect.
DIF: Cognitive Level: Understand (Comprehension) REF: Page 43
TOP: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
18. A nurse manager recognizes that her staff’s emotional responses to organizational change are
similar to:
a. adaptation techniques.
b. integrative tactics.
c. symptoms of mental illness.
d. the grief model.
ANS: D
The grief model is the most accurate, because change produces a longing for what is familiar,
even if it is not what is best or realistic.
DIF: Cognitive Level: Apply (Application) REF: Page 47
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
19. A memo sent to the unit nurse manager reads that beginning next week, all nursing staff will
be expected to conform to a new dress code selected by the hospital board of directors. The
nurse manager understands that she needs to use her positional power to trigger a(n) _____
change cycle.
a. automatic
b.

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