Nokea
After discussing alternatives to dressing change procedures to minimize discomfort, the nursing staff accepted a new procedure. This is an example of which stage of Havelock's model of change?
- A. Moving
- B. Self-renewal
- C. Refreezing
- D. Unfreezing
Correct Answer: A
Rationale: The correct answer is A: Moving. In Havelock's model of change, the Moving stage involves implementing the chosen change after considering alternatives. In this scenario, the nursing staff accepted a new procedure, indicating they are moving forward with the change. This stage focuses on putting the change into action.
Summary of other choices:
B: Self-renewal - This choice is not applicable as self-renewal refers to personal growth and development, not organizational change stages.
C: Refreezing - This choice is incorrect as refreezing involves stabilizing the change and ensuring it becomes the new norm, which comes after the Moving stage.
D: Unfreezing - This choice is incorrect as unfreezing refers to preparing for change by overcoming resistance and creating readiness, which precedes the Moving stage.
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As an RN stands in line for the cafeteria cashier, he overhears the staff in front of him talking about a client the RN took care of earlier in the week. The client’s room number is mentioned along with the diagnosis and prognosis. Which of the following actions should the RN take?
- A. Join in the conversation in case the RN is assigned to care for the client in the future.
- B. Remind the staff members that they are in a public location and sharing this information is a breach of the Health Insurance Portability and Accountability Act (HIPAA).
- C. Correct a statement made by one of the staff members.
- D. Ignore the conversation.
Correct Answer: B
Rationale: The correct answer is B: Remind the staff members that they are in a public location and sharing this information is a breach of the Health Insurance Portability and Accountability Act (HIPAA).
Rationale:
1. HIPAA protects patients' confidentiality and prohibits the disclosure of personal health information without consent.
2. By reminding the staff members of this breach, the RN upholds ethical standards and protects the client's privacy.
3. Joining the conversation (choice A) would further violate the client's confidentiality.
4. Correcting a statement (choice C) may draw more attention to the conversation, potentially worsening the breach.
5. Ignoring the conversation (choice D) would be neglectful of the RN's duty to protect patient information.
For a 55-year-old female patient with type 2 diabetes and a nursing diagnosis of imbalanced nutrition: more than body requirements, which goal is most important?
- A. The patient will reach a glycosylated hemoglobin level of less than 7%.
- B. The patient will follow a diet and exercise plan that results in weight loss.
- C. The patient will choose a diet that distributes calories throughout the day.
- D. The patient will state the reasons for eliminating simple sugars in the diet.
Correct Answer: A
Rationale: The correct answer is A: The patient will reach a glycosylated hemoglobin level of less than 7%. This goal is most important because it directly addresses the patient's diabetes management by aiming to achieve good glycemic control. Lowering the HbA1c level to less than 7% is a key indicator of reduced risk for diabetes-related complications. Options B, C, and D are not as critical in addressing the specific nursing diagnosis of imbalanced nutrition. Option B focuses on weight loss, which may not necessarily address the underlying issue of imbalanced nutrition. Option C addresses meal distribution but does not directly target improved glycemic control. Option D emphasizes eliminating simple sugars but does not encompass the comprehensive management of diabetes.
Under which category does a violation of the nurse practice act fall?
- A. Juvenile
- B. Felony
- C. Misdemeanor
- D. Tort
Correct Answer: B
Rationale: The correct answer is B: Felony. Violating the nurse practice act involves serious breaches of professional standards, such as negligence or misconduct, which are considered criminal offenses. Committing a felony indicates a severe violation of the law, carrying significant legal consequences. Choices A, C, and D do not accurately represent the gravity of the offense, as they pertain to different legal categories with varying levels of severity. A juvenile offense is a violation committed by a minor, a misdemeanor is a lesser criminal offense, and a tort is a civil wrongdoing resulting in harm.
When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the healthcare provider prescribes prednisone (Deltasone). The nurse will anticipate that the patient may
- A. require administration of insulin while taking prednisone
- B. develop acute hypoglycemia while taking prednisone
- C. require administration of insulin while taking prednisone
- D. have rashes caused by metformin-prednisone interactions
Correct Answer: C
Rationale: Rationale for Correct Answer C (require administration of insulin while taking prednisone):
1. Prednisone can increase blood glucose levels by reducing insulin sensitivity.
2. Metformin alone may not control blood glucose levels adequately in the presence of prednisone.
3. Therefore, the patient may require insulin to manage blood glucose levels while on prednisone.
Summary of Incorrect Choices:
A: This is incorrect because insulin administration is not necessary due to the rash or the interaction between metformin and prednisone.
B: This is incorrect because prednisone can actually increase blood glucose levels, leading to hyperglycemia rather than hypoglycemia.
D: This is incorrect because the rash is not likely caused by an interaction between metformin and prednisone, but rather an allergic reaction to an unknown cause.
Which of the following clients would most likely be selected for case management?
- A. An adolescent with a gunshot wound who is in the ER.
- B. A young adult with a fractured pelvis.
- C. An elderly client awaiting a hip replacement.
- D. A 41-year-old client admitted for outpatient tonsillectomy.
Correct Answer: C
Rationale: The correct answer is C because an elderly client awaiting a hip replacement typically requires ongoing support and coordination of services, making them a good candidate for case management. This client would benefit from assistance with navigating the healthcare system, coordinating appointments, and ensuring continuity of care post-surgery.
Choice A is incorrect as the adolescent with a gunshot wound in the ER is likely to be in need of immediate medical intervention rather than case management. Choice B is incorrect as a young adult with a fractured pelvis may require medical treatment but may not necessarily need the level of ongoing support that case management provides. Choice D is incorrect as a 41-year-old client admitted for an outpatient tonsillectomy is a relatively straightforward procedure that may not require extensive case management services.