YODER WISE TB QUESTIONS AND
ANSWERS
1. Nursing professionals in the twenty-first century will accomplish most of their work:
a. Through teams of internationally prepared professionals.
b. In teams and through group work.
c. Through long-term, secure jobs.
d. In competitive environments and work groups. - Answer-ANS: B
The future is about teams and group work. Competition will be out and collaboration will
be in. Job security will be out and career options will be in. Our brightest and best may
leave more often than they do at present to pursue career options internationally.
TOP: AONE competency: Knowledge of the Health Care Environment
2. Based on studies of workplace environments for nurses and future projections, the
workplace of the future will be:
a. Less intense because of more technology.
b. About the same as it is now.
c. More intense because of more technology.
d. Fluctuating between intense periods and less intense periods. - Answer-ANS: C
Technology will continue to revolutionize health care and contribute to complexity
compression. In addition to access to knowledge, electronic records, and current
applications of technology, technology will include robotics, which will change how
chronic disease can be managed, and bioengineering will make possible interventions
that do not yet exist.
3. Which of the following actions is most representative of how health care of the future
might be delivered? As a nurse leader, you:
a. Refer families who require immediate help to a local food bank. You also work with
local agencies and families to establish a mothers collective in which mothers learn
about nutrition and prepare low-cost, nutritious meals that are shared with the mothers
in the collective.
b. Work together with a local agency to set up a free clinic in which addicts and the
homeless can receive free health care and prescriptions for immediate needs.
c. Ensure that individuals who are admitted to your unit are asked about their smoking
history and that preoperative and postoperative planning takes into account how
smoking will affect status during and after surgery.
d. Address the health of those who are overweight and obese on your unit by ensuring
that hospital meals offer nutritious, healthy food - Answer-ANS: A
Referral to a food bank addresses the needs of a specific population, while exemplifying
an important leadership strength: thinking long-term, acting short-term. The project that
involves mothers will teach mothers about nutrition and engage them in preparation of
low-cost, healthy meals while promoting longer-term changes in healthy eating.
,4. You notice that wait times in your Emergency Department are growing longer,
because of factors such as increases in the numbers of persons with chronic disorders,
discharge of patients into the community at a higher level of acuity, and limited
resources for transfer of inpatients. You begin to think about an application that would
use your knowledge of the Emergency Department but also software and business
applications and wonder if this would reduce wait times. You have not encountered
anything similar to this idea. According to the Wise Forecast Model©, you are in what
phase?
a. Wild thinking
b. Act widely
c. Think wildly
d. Learn widely - Answer-ANS: C
The second step in the Wise Forecast Model© is to think wildly. Step two is designed to
create connections among disparate thoughts. This thinking might be seen as the start
of innovations.
5. Your organization is in the middle of re-designing patient care units, with decisions
based on best practices and various other sources of evidence. In the middle of the
transition, there is a temporary halt called to the transition because of a re-design of the
health care system and greater emphasis on primary care. What would be a healthy
response to this situation?
a. Salvage as much of the original planning as possible so as to reduce expenditures.
b. Engage in consultation to create innovative solutions that bridge the existing plans
and the new directions.
c. Abandon the current planning in favor of addressing the new trends.
d. Continue with the current planning because trends come and go. - Answer-ANS: B
Stability and total chaos are the ends of a continuum. Moving in some way between
those two ends suggests that we live in a constant state of disequilibrium in which we
strive toward stability while recognizing we experience chaos. As we continue to move
from "traditional" practices to evidence-based ones and from a heavy focus on tertiary
care to one that values primary care, we can assume that we might experience more
chaos. Chaos can lead to new learning and new, innovative solutions. As nurses, it is
important to be able to function in an evolving environment.
6. Your organization is in the middle of re-designing patient care units, with decisions
based on best practices and various other sources of evidence. In the middle of the
transition, there is a temporary halt called to the transition because of a re-design of the
health care system and greater emphasis on primary care. As a manager in this
situation, your staff experience a gap between what they expected (the original re-
design of the units) and what is actually happening (a need to integrate primary care in
some way). According to Selye, the nurses on your nursing team are likely experiencing
what?
,a. Eustress
b. Distress
c. Stress
d. Compression - Answer-ANS: C
Selye described stress as being on a continuum between stress that is positive
(eustress) and stress that is negative (distress). Because individuals perceive the same
event differently, from the information that is given, it is not possible to determine
whether the nurses experience the events as eustress or distress; what is most likely is
that the nurses are experiencing stress, which is what occurs when there is a gap
between expectations and what is actually occurring.
7. As a nurse manager, it is important to become a "future thinker." Which is an
example of a "future thinker"?
a. Keeping traditional practices
b. Moving toward evidence-based practices
c. Finding less need for more knowledge
d. Believing that macromarketing will be a necessity - Answer-ANS: B
Future forecasts include evolutions in power, structure, and knowledge; rapid change in
the healthcare system; the demise of macromarketing; and increased evidence-based
practice.
8. As a team, you and the staff have determined that there is a need to reduce
medication errors on your unit. Together, you developed the questions that you would
like addressed and searched the literature for relevant research studies. Based on the
evidence, you suggested a change to your practices and now are involved in
implementation of these changes. Today, there was a major study released that would
significantly change what you have decided to do. What are you and your staff
experiencing?
a. Compression complexity
b. Distress
c. Information lag
d. Technology advancement - Answer-ANS: A
This situation exemplifies complexity compression, a term that means many changes
are happening almost simultaneously and before one practice can be firmly implanted in
our minds, we are already addressing some other new change. This compression can
be distracting or useful.
9. Nursing research has indicated that the foundation for becoming a nursing leader is
the ability to:
a. Write effectively.
b. Speak two or three languages.
c. Focus on day-to-day priorities.
d. Think futuristically. - Answer-ANS: D
, Whether you are a leader, a follower, or a manager, being able to visualize in your mind
what the ideal future is becomes a critical strategy. A vision can range from that of an
individual to that of a group or to a whole organization.
10. The chief nursing officer has been developing her portfolio for years. What is the
chief nursing officer modeling?
a. Her clinical expertise
b. Affection for tradition
c. Her employability
d. Her busy professional life - Answer-ANS: C
Being employed is no longer sufficient; we must be employable. A portfolio outlines
achievements and experiences that communicate employability.
11. Your unit has a number of patients who have undergone limb amputation. In
working with the clients, you begin to think beyond therapies such as
pharmacotherapeutics and surgery and you explore biomechanics, robotics, mind-body
approaches, and cognitive behavioral therapies as possibilities in working with these
clients. You begin to amass information in a number of areas with which you previously
had little familiarity. According to the Wise Forecast Model©, you are
a. Acting wildly.
b. Learning wildly.
c. Engaging in interprofessional care.
d. Increasing your complexity compression. - Answer-ANS: B
The first step, learn widely, means that we must extend our sources of knowledge
beyond our role and clinical areas of interest. In fact we must extend our learning
beyond nursing and health care. Widely might encompass another discipline such as
architecture or engineering.
12. The starfish analogy is exemplified in which of the following?
a. A unit manager resigns after continued tension between the administration and her
regarding implementation of primary nursing. The primary nursing project dies.
b. Nurses try to establish a clinic that provides ambulatory care to parents and young
children in an impoverished neighborhood. Community members advocate for funding
from political leaders and insurers.
c. Alana, a new graduate, promotes continence care based on evidence. When she
presents her ideas, senior staff refuses to consider it.
d. The head of a community health service moves on to another position. Programs are
disbanded. - Answer-ANS: B
The starfish analogy points to the connectivity that we have with one another and how
we influence and are influenced by others all the time. This affords many opportunities
for leadership that are dependent not on formal titles but on opportunities to shape the
work at hand.