1. The nurses on a medical unit recently acknowledged that their efforts to introduce an evidence-based pain management regimen have failed. Which of the following factors is most likely to have contributed to the failur
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1. The nurses on a medical unit recently acknowledged that their efforts to introduce an evidence-based pain management regimen have failed. Which of the following factors is most likely to have contributed to the failure of the EBP initiative?
A) Differences between the educational levels of staff nurses and those promoting the change
B) Contradictions in the body of literature around the assessment and management of pain
C) Failure to integrate principles of the psychology of change
D) The sufficiency of the existing protocols and policies of pain management on the unit
2. A nurse has recognized the need to change the practice on an obstetrical unit so that more women choose to breastfeed their babies after discharge. Which of the following factors is most important in determining the success or failure of the subsequent evidence-based practice change?
A) The positive effects of breastfeeding in neonatal health and development
B) The strength and specificity of the nurse's vision for change
C) The depth and breadth of the nurse's experience base
D) The credibility that the nurse holds on the unit
3. How should a group of nurses best address the need for goals at the outset of an evidence-based practice change at their workplace?
A) The team should identify a set of common goals and write them down.
B) The team should allow individual nurses the autonomy to choose their own goals.
C) The team should identify goals from within the literature and disseminate them.
D) The team should allow the project goals to evolve as the initiative progresses.
4. An initiative to improve the quality of care that stroke patients receive is being considered in a county hospital. Which of the following questions should the implementation team ask as part of a SCOT analysis?
A) “Who are the stakeholders that would be affected by a change in our practice?”
B) “How will we define success during this initiative?”
C) “What are the costs that might be incurred if we attempt to change practice?”
D) “What are the challenges in our workplace that we need to address?”
5. A change in practice is being considered on a hospital unit that is producing an unacceptably high number of incident reports. Which of the following characteristics of the unit best exemplifies the first stage of Duck's Change Curve model?
A) A directive to change has been received but ignored.
B) The nurses on the unit lack knowledge and experience.
C) Relationships between staff and disciplines on the unit are antagonistic.
D) The leadership and culture of the unit are stagnant.
6. Nursing leaders are utilizing Kotter and Cohen's Model of Change to guide a change in pressure ulcer assessment and prevention. What task should the leaders first perform?
A) Assess nurses' willingness to change
B) Cultivate a sense of urgency
C) Mobilize evidence-based practice mentors
D) Communicate the proposed vision for change
7. Kotter and Cohen's Model of Change has been implemented successfully, resulting in an evidence-based change in pressure ulcer assessment and prevention on a unit. What is the final step in this change process?
A) Disseminating the results of the change in practice
B) Sending out mentors to stimulate similar change on other units and in other hospitals
C) Nourishing the change to ensure the new practice is sustained
D) Monitoring nurses' compliance with the new practice
8. According to Rogers' theory of diffusion of innovations, which of the following groups of nurses is primarily responsible for initiating evidence-based change?
A) Innovators
B) Mentors
C) Catalysts
D) Leaders
9. The clinical nurse educator on a palliative care unit perceives that many of the staff nurses are in the precontemplative and contemplative stages of readiness to adopt a new, evidence-based approach to pain assessment and management. Which of the following strategies should the educator adopt?
A) Presenting the findings from the literature that support the change in practice
B) Making connections with staff and fostering their readiness to change
C) Implementing the initial changes in practice that are necessary
D) Identifying and addressing those staff members who are resistant to change
10. Nursing leaders in a large, urban emergency department are aware that many nurses are skeptical of a proposed evidence-based change in the management of patients with mental health problems. How should the nursing leaders best address this skepticism?
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