C HAPTER 08: P LANNED C HANGE
1. A change in the skills mix has been proposed at a care facilit y. What
action by the nurse-manager would best support a rational –empirical
change strategy?
a. Presenting the research evidence that supports the change
b. Publicizing the change to generate enthusiasm
c. Appointing “champions” to ensure communication throughout the
change process
d. Ensuring that employees know the consequences of resisti ng
ANS: A
Feedback:
Rational–empirical change strategies assume that resistance to change
comes from a lack of knowledge and that humans are rational beings
who will change when given factual information documenting the need
for change. Actions to cre ate awareness and enthusiasm are more
consistent with normative –reeducative strategies. A punitive approach
would be more consistent with a power –coercive strategy.
PTS: 1 DIF: Moderate REF: Page: 196–197
OBJ: 5 NAT: Client Needs: Safe and Effective Ca re
Environment: Management of Care TOP: Chapter Number: 08:
Title: Classic Change Strategies KEY: Integrated Process:
Nursing Process BLM: Cognitive Level: Appl y NOT: Multiple
Choice
,2. A nurse-manager has introduced a proposed change to the operations of an
ambulatory clinic and has been met with resistance. How should the
manager best interpret this resistance?
a. Resistance is an expected component of a proposed change.
b. Resistance confirms that the proposed change is necessary.
c. The presence of resistance s uggests that the change may be
unsuccessful.
d. The presence of resistance indicates a need to implement power –
coercive strategies.
ANS: A
Feedback:
Resistance is an expected component of a change process and it does
not suggest that change will be unsuc cessful. However, the presence of
resistance does not necessaril y validate that the change was necessary.
A manager should interpret the presence of resistance as indicated a
need to implement power –coercive change strategies.
PTS: 1 DIF: Moderate REF: Page: 199 OBJ: 6
NAT: Client Needs: Safe and Effective Care Environment:
Management of Care TOP: Chapter Number: 08: Title:
Resistance: The Expected Response to Change KEY:
Integrated Process: Nursing Process BLM: Cognitive Level:
Anal yze NOT: Multiple C hoice
3. A team has been formed to consider a change in medication delivery. How
can the team leaders best promote a successful change?
a. Implement the change as rapidl y as possible in order to diffuse
, resistance.
b. When planning, involve as many people who will be affected by the
change as possible.
c. Bring in outside experts to implement the change.
d. Enforce compliance with the change fairly and consistentl y.
ANS: B
Feedback:
Whenever possible, all those who may be affected by a change should
be involved in planning for that change. Making a change too quickl y
can result in poor outcomes because rigor is compromised. Outsiders
are often resisted more than internal change agents. A collaborative
approach is preferred to “enforcement,” even though fairness and
consistency are appropriate goals during a change process.
PTS: 1 DIF: Moderate REF: Page: 201 OBJ: 8
NAT: Client Needs: Safe and Effective Care Environment:
Management of Care TOP: Chapter Number: 08: Title:
Planned Change as a Collaborative Process KEY:
Integrated Process: Nursing Process BLM: Cognitive Level:
Appl y NOT: Multiple Choice
4. Frequent turnover in leadership at a health -care organization has meant
that change has often occurred by drift. What are characteristics of this
mode of change? Select all that apply.
a. Changes are planned by teams.
b. Changes occur accidentall y.
c. Changes take place even though they are unplanned.
1. A change in the skills mix has been proposed at a care facilit y. What
action by the nurse-manager would best support a rational –empirical
change strategy?
a. Presenting the research evidence that supports the change
b. Publicizing the change to generate enthusiasm
c. Appointing “champions” to ensure communication throughout the
change process
d. Ensuring that employees know the consequences of resisti ng
ANS: A
Feedback:
Rational–empirical change strategies assume that resistance to change
comes from a lack of knowledge and that humans are rational beings
who will change when given factual information documenting the need
for change. Actions to cre ate awareness and enthusiasm are more
consistent with normative –reeducative strategies. A punitive approach
would be more consistent with a power –coercive strategy.
PTS: 1 DIF: Moderate REF: Page: 196–197
OBJ: 5 NAT: Client Needs: Safe and Effective Ca re
Environment: Management of Care TOP: Chapter Number: 08:
Title: Classic Change Strategies KEY: Integrated Process:
Nursing Process BLM: Cognitive Level: Appl y NOT: Multiple
Choice
,2. A nurse-manager has introduced a proposed change to the operations of an
ambulatory clinic and has been met with resistance. How should the
manager best interpret this resistance?
a. Resistance is an expected component of a proposed change.
b. Resistance confirms that the proposed change is necessary.
c. The presence of resistance s uggests that the change may be
unsuccessful.
d. The presence of resistance indicates a need to implement power –
coercive strategies.
ANS: A
Feedback:
Resistance is an expected component of a change process and it does
not suggest that change will be unsuc cessful. However, the presence of
resistance does not necessaril y validate that the change was necessary.
A manager should interpret the presence of resistance as indicated a
need to implement power –coercive change strategies.
PTS: 1 DIF: Moderate REF: Page: 199 OBJ: 6
NAT: Client Needs: Safe and Effective Care Environment:
Management of Care TOP: Chapter Number: 08: Title:
Resistance: The Expected Response to Change KEY:
Integrated Process: Nursing Process BLM: Cognitive Level:
Anal yze NOT: Multiple C hoice
3. A team has been formed to consider a change in medication delivery. How
can the team leaders best promote a successful change?
a. Implement the change as rapidl y as possible in order to diffuse
, resistance.
b. When planning, involve as many people who will be affected by the
change as possible.
c. Bring in outside experts to implement the change.
d. Enforce compliance with the change fairly and consistentl y.
ANS: B
Feedback:
Whenever possible, all those who may be affected by a change should
be involved in planning for that change. Making a change too quickl y
can result in poor outcomes because rigor is compromised. Outsiders
are often resisted more than internal change agents. A collaborative
approach is preferred to “enforcement,” even though fairness and
consistency are appropriate goals during a change process.
PTS: 1 DIF: Moderate REF: Page: 201 OBJ: 8
NAT: Client Needs: Safe and Effective Care Environment:
Management of Care TOP: Chapter Number: 08: Title:
Planned Change as a Collaborative Process KEY:
Integrated Process: Nursing Process BLM: Cognitive Level:
Appl y NOT: Multiple Choice
4. Frequent turnover in leadership at a health -care organization has meant
that change has often occurred by drift. What are characteristics of this
mode of change? Select all that apply.
a. Changes are planned by teams.
b. Changes occur accidentall y.
c. Changes take place even though they are unplanned.
