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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.
Correct Answer: 3
Rationale 1: It is hard to prove that nurses thrive on transition.
Rationale 2: Nurses have not always reacted positively to change.
Rationale 3: Nurses are client advocates who routinely interact with multiple disciplines in the provision of
quality care.
Rationale 4: Nurses do act in the client’s best interest, but this option is not as strong as another.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-1: Explain why nurses have the opportunity to be change agents.
Question 15
Type: MCMA
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.
Standard Text: 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?”
Sullivan, Effective Leadership and Management, 8/e Test Bank
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.”
Rationale 4: A supportive work environment for those experiencing the change is the strategy most likely to
result in an easier transition.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5-5: Discuss how to handle resistance to change.
Question 17
Type: MCSA
A proposed change in a health care 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
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 5-4: Differentiate among change strategies.
Question 18
Type: MCMA
Sullivan, Effective Leadership and Management, 8/e Test Bank
The health care 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.
Standard Text: Select all that apply.
1. Disciplinarian
2. Resister
3. Fact manager
4. Liaison
5. Support person
6. Discussion leader
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.
Rationale 1: The ability to retain a big-picture focus while dealing with each part of the change is a desirable trait
for a change agent.
Rationale 2: The change agent must have sufficient flexibility to modify ideas when this will improve the change,
but enough persistence to resist nonproductive tampering with the planned change.
Rationale 3: It is likely that those who are resistant will adapt to the change if given enough time and support.
Rationale 4: Staying available the whole time is not realistic and will make it difficult for the change agent to
maintain the energy it will take to make the change more successful.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 5-6: Describe the nurse’s role in change.
Question 21
Type: MCMA
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.
Standard Text: 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.
Rationale 3: This attitude is a sign that the transition is not healthy.
Rationale 4: It is natural for the transition to a new process to take time. The nurse manager should be on the alert
if this continues.
Rationale 5: Making individual decisions about what parts of the old method to retain and what parts of the new
method to adopt is a sign that the transition is not healthy.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 5-6: Describe the nurse’s role in change.
Question 22
Type: MCSA
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.
Client Need: Safe Effective Care Environment
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-5: Discuss how to handle resistance to change.
Question 23
Type: MCMA
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.
Standard Text: 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?
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5-3: Discuss how the change process is similar to the nursing process.
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
