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Leadership and Management for Nurses, 3e (Finkelman)
Chapter 3 Operational and Strategic Planning: Change, Innovation, and Decision Making
1) The manager of a maternal-child health unit announces that the unit will be redesigned to help
meet the Institute of Medicine healthcare competencies. What scenario is one that the staff of this
unit might expect?
1. Nursery, labor and delivery, and postpartum nurses will be cross-trained to work in each of
these areas.
2. The nurses will be expected to participate in telehealth throughout a three state region.
3. There will be a reduction in staff numbers.
4. The unit will be closed for remodeling.
2) In which situation would it be necessary to re-regulate practice? Select all that apply.
1. Nurses are asked to cross-train to another specialty.
2. An insurance company opens a nationwide nurse call line.
3. The hospital hires unlicensed assistive personnel.
4. A nursing school revises its curriculum.
5. The healthcare organization goes national and hopes to encourage mobility among its
administrative nurses.
3) Management has called a meeting to discuss the increase in negative patient satisfaction
surveys. Which stage of Lewin's model of change does this represent?
1. Moving
2. Refreezing
3. Unfreezing
4. Working
4) The hospital would like to decrease the amount of medication errors made secondary to
transcription errors. In order to accomplish this, it is hoped that all physicians will be trained in
the use of computerized physician orders by the end of the fiscal year. This is an example of
which stage of Lewin's model of change?
1. Refreezing
2. Unfreezing
3. Moving
4. Working
5) Which activities represent the eight-step process for organizational change? Select all that
apply.
1. Management has created a sense of urgency for the change by publishing outcome data on the
organization's intranet.
2. Management has worked to develop and communicate a vision that can be shared by all
employees.
3. Management has empowered employees to make changes.
4. Management is engaged in "deep change."
5. Management has orchestrated and celebrated some short-term successes along the path to
6) The nurse manager is coping with a staff member who is very resistant to change. Which
strategy would be beneficial for this nurse manager?
1. Maintain open communication with this staff member to establish trust.
2. Help the staff member focus on parts of the change rather than on the whole change at one
time.
3. Take over all of the processes of the change.
4. Ignore any hidden agendas brought by this staff member.
7) The nurse manager is aware of a significant change that will occur sometime in the next six
months. How can this manager begin to prepare the staff for this change? Select all that apply.
1. Keep the staff apprised of as much information about the change as is possible.
2. Attempt to keep the unit staffing as stable as possible during the time of change.
3. Insist that all discussions about the change be conducted in a respectful manner.
4. Let the initial information about the change come "through the grapevine."
5. Avoid surprises by telling the staff about how the change will increase workload very early in
the process.
8) Which option best describes a change agent that demonstrates a transformational style of
leadership during the change process?
1. The change agent describes the vision for the change, sets high expectations, and is a role
model for the staff.
2. The change agent expresses personal views about the change and empathizes with the staff.
3. The change agent expects staff to follow the change agent's directions required to meet the
goal.
4. The change agent provides the staff members with the resources needed to do their job.
9) During the change process to implement an electronic medical record, a nurse manager says,
"We are experiencing a 'slow death'." What evidence would the manager have to support this
conclusion?
1. Work processes seem scattered
2. Staff burnout with complaints increasing
3. Use of a detailed project plan
10) A nurse manager is collecting staff views about a current unit problem to make a decision
about actions to take. Which style of decision-making is this manager employ?
1. Unilateral
2. Individual
3. Authoritarian
4. Consensus
11) A patient's finger stick blood sugar registers 70. The nurse must follow the policy and
procedure for caring for a patient with hypoglycemia. This is an example of what type of
decision-making process?
1. Programmed decision-making
2. Crisis decision making
3. Time-limited decision making
4. Non-routine decision-making
12) A problem has been identified in the healthcare facility. What should the nurse who has been
assigned the task of change agent do next?
1. Develop an alternative plan.
2. Gather data.
3. Collaborate with others.
4. Empower staff.
13) The nurse is working in a facility that is considering a major change by incorporating
interprofessional teams in all departments and units. Which type of planning is required?
1. Policy planning
2. Strategic planning
3. Project planning
4. Strategic planning and project planning
14) The nurse has been assigned to be a change agent for the facility's change to a computerized
charting system. What type of planning will this require?
1. Strategic
2. Policy
3. Project
4. Both strategic and project
15) What is the first step in coping with changes that occur in the healthcare environment?
1. Understanding personal response to change.
2. Identifying the change agent.
3. Investigate the facility's history of change.
16) The nurse manager is developing a staff education session on change in healthcare. Which
concepts should be included in this information? Select all that apply.
1. Oftentimes, before one change in healthcare is completed, another is taking place.
2. Most changes are focused on the organization's structure.
3. Change has been the normal state for healthcare providers for some time.
4. Change disturbs the organization's equilibrium.
5. Sometimes multiple changes occur together in healthcare.
