Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
vb vb vb vb vb vb vb vb vb
Chapter 19: Nursing Leading Change: A Relational Emancipatory Framework for H
ealth and Social Action
Waddell/Walton: Yoder-
Wise’s Leading and Managing in Canadian Nursing, Third Edition
MULTIPLE CHOICE
An asset-based approach to change includes which of the following?
It is a strength-based approach.
Focuses on fixing deficits.
Addresses short term fixes.
It is the dominant approach to change.
ANS: A
All but a strength-
based approach are based on the deficits based dominant directive to change.
DIF: Cognitive Level: Understand
REF: Page 335 TOP: Nursing Process: Implement
ation
The relational emancipatory framework consists of which of the following?
Critical thinking
Critical dialogue
Constructive criticism
All of the options
ANS: D NURSINGTB.COM
The relational emancipatory framework is based on interdisciplinary thinking, dialogue, and
constructive criticism. Asking questions that examine both benefits and limitations of a pro
posed change supports increased knowledge across all disciplines.
DIF: Cognitive Level: Understand REF: Page 338 TOP: Nursing Process: Planning
The nurse manager frequently interacts with staff and other hospice facility employees. Co m
munication was purposeful because the manager assessed current issues, such as specific sa
tisfactions and dissatisfactions with the newly implemented computerized documentation sy
stem. Informally, the manager gathered available staff members to address similar learni ng
needs. Many times staff members were found coaching other staff about improving use of
the new system. According to Senge (1990), the activities demonstrated in this example are
:
Dialogue and team learning.
Resilience and personal mastery.
Shared vision and systems thinking.
Mental models and teachable moments.
ANS: A
Building shared vision occurs when leaders involve all members in consolidating persona
l visions of the future into one vision common to members and leaders.
DIF: Cognitive Level: Apply
REF: Page 344 TOP: Nursing Process: Implement
ation
,Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
vb vb vb vb vb vb vb vb vb
To create collaborative relationships the most important aspect is?
Developing partnerships
Negotiating power
Compromising
Cooperating
ANS: B
All empowering relationships are characterized by ―power with‖ relationships that encour
ag e full participation by all participants. Nurses leading a change process need to be awar
e of power dynamics, understand how they operate, and know how to negotiate power effe
ct ively for inclusivity and positive social change to occur. This approach includes develop
in g partnerships, compromising, and cooperating.
DIF: Cognitive Level: Apply
REF: Page 337 TOP: Nursing Process: Implement
ation
Complex change situations require that the change leader promote ongoing envisionin
among staff members. One strategy is to:
Consciously evaluate invisible mental models.
Allow for individual outcomes.
Encourage cooperative activities.
Operate between order and disorder.
ANS: A
According to Senge‘s (1990) theory on change, each individual or organization bases acti v
ities on a set of assumptions, or a set of beliefs, or on mental pictures about the way that t
he world should work. WhenNtheRse iIn v i Gsi b l Be m.oCdelMs are uncovered and consciously evalu
UHSHN HHT vb
ated, it is possible to determine their influences on work accomplishment.
DIF: Cognitive Level: Apply
REF: Page 344 TOP: Nursing Process: Implement
ation
To effectively achieve a change goal/outcome in a change situation, the wound care speciali st
will:
Preserve the status quo.
Diminish facilitators of change and reinforce barriers to change.
Weigh the strength of forces.
Strengthen facilitating forces.
ANS: D
For change to be effective, the facilitators of change must exceed the force of the barriers;
thus strengthening the facilitating forces would achieve this aim.
DIF: Cognitive Level: Understand
REF: Page 334 TOP: Nursing Process: Implement
ation
The wound care nurse decided to inform members of the health care team to be affected b
y change early in the change management process. This can positively result in:
Coordination.
Resistance.
Anticipation.
, Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
vb vb vb vb vb vb vb vb vb
Participation.
ANS: D
Successful change means persistence and advancement of the change, which requires t
he undivided focus of all team members. Early involvement and participation are criti
cal to capturing the undivided focus of team members.
DIF: Cognitive Level: Understand REF: Page 338 TOP: Nursing Process: Planning
Which of the following is not a component of critical thinking?
Challenging assumptions
Exploring alternatives
Engaging in reflection
Accepting context
ANS: D
Essential components of critical thinking: identifying and challenging assumptions, challe
nging the influence of context, imagining and exploring alternatives, and engaging in refle
c tive skepticism.
DIF: Cognitive Level: Apply
REF: Page 339 TOP: Nursing Process: Assessme
nt
Which of the following is not an aspect of reflection?
Is social
Is action oriented
Is easily practiced
d. Is political
ANS: C
NURSINGTB.COM
There is a tendency to think of reflection as something that happens quietly within a perso
n. Nurses require critical consciousness to remove from their current cultural, social, and p
olitical environment and engage in a responsible critical moral dialogue toward a new cu lt
ural, social, and political understanding.
DIF: Cognitive Level: Understand
REF: Page 339 TOP: Nursing Process: Implement
ation
Phase two of the emancipatory relational framework is reflection and planning. Which of t h
e following is most important in this phase?
Using experiential and propositional knowledge
Sharing change experiences early in the process.
Taking a biomedical perspective to change
Building a conceptual map
ANS: A
Sharing change experiences, and building a conceptual map are aspects of reflection and pl
anning. Taking a biomedical perspective is not a part of any phase in the emancipatory rela
tional framework. Using experiential and propositional knowledge includes knowledge from
experiences and knowledge from the literature which is imperative to conscious change.
DIF: Cognitive Level: Apply REF: Pages 341–342
vb vb vb vb vb vb vb vb vb
Chapter 19: Nursing Leading Change: A Relational Emancipatory Framework for H
ealth and Social Action
Waddell/Walton: Yoder-
Wise’s Leading and Managing in Canadian Nursing, Third Edition
MULTIPLE CHOICE
An asset-based approach to change includes which of the following?
It is a strength-based approach.
Focuses on fixing deficits.
Addresses short term fixes.
It is the dominant approach to change.
ANS: A
All but a strength-
based approach are based on the deficits based dominant directive to change.
DIF: Cognitive Level: Understand
REF: Page 335 TOP: Nursing Process: Implement
ation
The relational emancipatory framework consists of which of the following?
Critical thinking
Critical dialogue
Constructive criticism
All of the options
ANS: D NURSINGTB.COM
The relational emancipatory framework is based on interdisciplinary thinking, dialogue, and
constructive criticism. Asking questions that examine both benefits and limitations of a pro
posed change supports increased knowledge across all disciplines.
DIF: Cognitive Level: Understand REF: Page 338 TOP: Nursing Process: Planning
The nurse manager frequently interacts with staff and other hospice facility employees. Co m
munication was purposeful because the manager assessed current issues, such as specific sa
tisfactions and dissatisfactions with the newly implemented computerized documentation sy
stem. Informally, the manager gathered available staff members to address similar learni ng
needs. Many times staff members were found coaching other staff about improving use of
the new system. According to Senge (1990), the activities demonstrated in this example are
:
Dialogue and team learning.
Resilience and personal mastery.
Shared vision and systems thinking.
Mental models and teachable moments.
ANS: A
Building shared vision occurs when leaders involve all members in consolidating persona
l visions of the future into one vision common to members and leaders.
DIF: Cognitive Level: Apply
REF: Page 344 TOP: Nursing Process: Implement
ation
,Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
vb vb vb vb vb vb vb vb vb
To create collaborative relationships the most important aspect is?
Developing partnerships
Negotiating power
Compromising
Cooperating
ANS: B
All empowering relationships are characterized by ―power with‖ relationships that encour
ag e full participation by all participants. Nurses leading a change process need to be awar
e of power dynamics, understand how they operate, and know how to negotiate power effe
ct ively for inclusivity and positive social change to occur. This approach includes develop
in g partnerships, compromising, and cooperating.
DIF: Cognitive Level: Apply
REF: Page 337 TOP: Nursing Process: Implement
ation
Complex change situations require that the change leader promote ongoing envisionin
among staff members. One strategy is to:
Consciously evaluate invisible mental models.
Allow for individual outcomes.
Encourage cooperative activities.
Operate between order and disorder.
ANS: A
According to Senge‘s (1990) theory on change, each individual or organization bases acti v
ities on a set of assumptions, or a set of beliefs, or on mental pictures about the way that t
he world should work. WhenNtheRse iIn v i Gsi b l Be m.oCdelMs are uncovered and consciously evalu
UHSHN HHT vb
ated, it is possible to determine their influences on work accomplishment.
DIF: Cognitive Level: Apply
REF: Page 344 TOP: Nursing Process: Implement
ation
To effectively achieve a change goal/outcome in a change situation, the wound care speciali st
will:
Preserve the status quo.
Diminish facilitators of change and reinforce barriers to change.
Weigh the strength of forces.
Strengthen facilitating forces.
ANS: D
For change to be effective, the facilitators of change must exceed the force of the barriers;
thus strengthening the facilitating forces would achieve this aim.
DIF: Cognitive Level: Understand
REF: Page 334 TOP: Nursing Process: Implement
ation
The wound care nurse decided to inform members of the health care team to be affected b
y change early in the change management process. This can positively result in:
Coordination.
Resistance.
Anticipation.
, Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
vb vb vb vb vb vb vb vb vb
Participation.
ANS: D
Successful change means persistence and advancement of the change, which requires t
he undivided focus of all team members. Early involvement and participation are criti
cal to capturing the undivided focus of team members.
DIF: Cognitive Level: Understand REF: Page 338 TOP: Nursing Process: Planning
Which of the following is not a component of critical thinking?
Challenging assumptions
Exploring alternatives
Engaging in reflection
Accepting context
ANS: D
Essential components of critical thinking: identifying and challenging assumptions, challe
nging the influence of context, imagining and exploring alternatives, and engaging in refle
c tive skepticism.
DIF: Cognitive Level: Apply
REF: Page 339 TOP: Nursing Process: Assessme
nt
Which of the following is not an aspect of reflection?
Is social
Is action oriented
Is easily practiced
d. Is political
ANS: C
NURSINGTB.COM
There is a tendency to think of reflection as something that happens quietly within a perso
n. Nurses require critical consciousness to remove from their current cultural, social, and p
olitical environment and engage in a responsible critical moral dialogue toward a new cu lt
ural, social, and political understanding.
DIF: Cognitive Level: Understand
REF: Page 339 TOP: Nursing Process: Implement
ation
Phase two of the emancipatory relational framework is reflection and planning. Which of t h
e following is most important in this phase?
Using experiential and propositional knowledge
Sharing change experiences early in the process.
Taking a biomedical perspective to change
Building a conceptual map
ANS: A
Sharing change experiences, and building a conceptual map are aspects of reflection and pl
anning. Taking a biomedical perspective is not a part of any phase in the emancipatory rela
tional framework. Using experiential and propositional knowledge includes knowledge from
experiences and knowledge from the literature which is imperative to conscious change.
DIF: Cognitive Level: Apply REF: Pages 341–342
