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AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000432961.33881.be
Feature Articles

CE Test 2.5 Hours: Exploring the Concept and Use of Positive Deviance in Nursing

Contrada, Emily

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Continued Education
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TEST INSTRUCTIONS

* To take the test online, go to our secure Web site at http://www.nursingcenter.com/ce/ajn .

* To use the form provided in this issue, record your answers in the test answer section of the CE enrollment form below. Each question has only one correct answer. You may make copies of the form.

* Complete the registration information and course evaluation. Mail the completed enrollment form and registration fee to: Lippincott Williams and Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, Brick, NJ 08723. You will receive your certificate in four to six weeks. For faster service, include a fax number and we will fax your certificate within two business days of receiving your enrollment form. You will receive your CE certificate of earned contact hours and an answer key to review your results. There is no minimum passing grade.

* Registration deadline is August 31, 2015.

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DISCOUNTS AND CUSTOMER SERVICE

* Send in together two or more tests from any nursing journal published by Lippincott, Williams and Wilkins (LWW), and deduct $0.95 from the price of each test.

* We also offer CE accounts for hospitals and other health care facilities online at www.nursingcenter.com. Call 1-800-787-8985 for details.

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PROVIDER ACCREDITATION

LWW, publisher of AJN, will award the number of contact hours indicated for each continuing nursing education activity. LWW is accredited as a provider of continuing nursing education by the Commission on Accreditation of the American Nurses Credentialing Center (ANCC).

These activities are also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for the number of contact hours indicated. LWW is also an approved provider of continuing nursing education by the District of Columbia and Florida #50-1223. Your certificate is valid in all states.

The ANCC's accreditation status of the LWW Department of Continuing Education refers to its continuing nursing educational activities only and does not imply Commission on Accreditation approval or endorsement of any commercial product.

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CE TEST QUESTIONS

GENERAL PURPOSE:

To provide information about the Walker and Avant method of concept analysis and to explore and identify the essence of the term positive deviance in the nursing practice environment.

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LEARNING OBJECTIVES:

After reading this article and taking this test, you will be able to

* recognize the key features of the concept of positive deviance.

* identify the various terms and uses associated with this concept.

* apply the concept of positive deviance to nursing practice.

1. According to Huber, decision making involves multiple conditions of certainty, uncertainty, and

a. risk.

b. choice.

c. emotion.

d. experience.

2. The process of concept analysis involves examining the attributes or characteristics of a concept, resulting in an operational definition that is

a. creative.

b. workable.

c. precise.

d. conditional.

3. Pascale and colleagues describe positive deviance as a term that is

a. legitimate.

b. oxymoronic.

c. misleading.

d. innovative.

4. Spreitzer and Sonenshein described a normative approach that defines positive deviance as intentional behaviors that depart from the norms of a referent group in

a. uncommon ways.

b. beneficial ways.

c. radical ways.

d. honorable ways.

5. Bloch used which of the following terms to describe positive deviants?

a. trailblazers

b. groundbreakers

c. high achievers

d. diamonds in the rough

6. Some researchers view positive deviance as a process, one based on the belief that every organization has people who have access to the same resources as their colleagues but whose different work practices

a. are unique.

b. are questionable.

c. upset the status quo.

d. produce better outcomes.

7. Clancy advised managers of complex health care environments to find the positive deviants in their organizations and do which of the following?

a. Reward them in tangible ways.

b. Tap into their creative minds.

c. Make them administrative liaisons.

d. Ask them to share strategies with peers.

8. In a study of hospitalbased nurses, Hutchinson used which of the following terms to describe the behavior of nurses who bend the rules for the sake of their patients?

a. creative individualism

b. strategic risk taking

c. responsible subversion

d. productive nonconformism

9. Bloch stated that positive deviants

a. are anarchists.

b. want organizational success.

c. challenge authority figures.

d. serve intrinsic goals.

10. Which term describes how some nurses use imagination and creativity in examining a given practice and considering ways to accomplish or improve it?

a. active intelligence

b. inspired innovation

c. resourceful acumen

d. enlightened exploration

11. Most nurses realize that when they step outside the boundaries of hospital rules and protocols, they

a. have a higher goal in mind.

b. put their careers at risk.

c. lack peer support.

d. attract followers.

12. A common antecedent of positive deviance is

a. implementation of work-arounds.

b. respect for organizational norms.

c. individual prosocial behavior.

d. a certain level of clinical expertise.

13. The most practical consequence of positive deviance in nursing seems to be

a. attunement to the patient.

b. the sense of conflict.

c. experiential learning.

d. the deviance itself.

14. According to Dehler and Welsh, the “polar opposite” of positive deviance is

a. chaos.

b. defiance.

c. conformity.

d. accountability.

15. Walker and Avant used which of the following terms to describe categories of actual phenomena that by their existence demonstrate the occurrence of a concept?

a. empirical referents

b. corroborative indicators

c. constructive deviations

d. demonstrative phenomena

16. Berner and colleagues found that 92% of surveyed critical care nurses were aware of legal limits when they made patient care decisions. They also found that what percentage of the surveyed nurses reported having made decisions that went beyond those limits?

a. 50%

b. 60%

c. 70%

d. 80%

17. Complexity science suggests that complex systems require an approach that is

a. holistic.

b. individual.

c. simple.

d. flexible.

18. Dowding and Thompson stated that because of the impact of nurses’ decisions on patient outcomes and experiences, knowing which of the following is “of prime importance”?

a. how to adapt innovation for a particular system

b. how to measure the accuracy of nurses’ decisions

c. when to diverge from organizational norms

d. when to report nontraditional nursing practices

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