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At which stage of Lewin ' s planned change indicates the nurse identifying, planning, and implementing appropriate strategies ensuring that driving forces exceed restraining forces?
- A. refreezing
- B. movement
- C. unfreezing
- D. in activism
Correct Answer: C
Rationale: The correct answer is C: unfreezing. Unfreezing is the initial stage in Lewin's planned change model where individuals become open to change by recognizing the need for it. During this stage, the nurse identifies the need for change, plans strategies to implement it, and works on overcoming resistance by ensuring that the driving forces (reasons for change) outweigh the restraining forces (barriers to change). Refreezing (A) is the final stage where the changes are reinforced and integrated into the organization. Movement (B) is the stage where actual change occurs, and in activism (D) is not a recognized stage in Lewin's model.
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You should check the patient for suspect disturbed thought processes related to depressed metabolism and altered cardiovascular and respiratory status. What is the rationale for orienting the patient to time, place, date, and events?
- A. Shows improved cognitive functioning
- B. Provides reality orientation to patient
- C. Permits evaluation of effectiveness of treatment
- D. Let the patient identify the time, place, date, and events correctly
Correct Answer: B
Rationale: The correct answer is B: Provides reality orientation to patient. Orienting the patient to time, place, date, and events helps them stay connected to reality and improves their awareness of their surroundings. This is crucial in assessing their cognitive functioning and ensuring they are grounded in the present moment. By providing reality orientation, healthcare providers can better understand the patient's current mental state and address any potential confusion or disorientation. This approach aids in establishing a therapeutic environment and enhances the patient's overall well-being. Choices A, C, and D do not capture the essence of reality orientation and its significance in maintaining the patient's mental clarity and connection to the present moment.
A patient with suspected community-acquired pneumonia (CAP) is empirically started on antibiotic therapy pending culture results. Which of the following antibiotic regimens provides appropriate coverage for typical bacterial pathogens commonly implicated in CAP?
- A. Ceftriaxone and azithromycin
- B. Vancomycin and piperacillin/tazobactam
- C. Ampicillin-sulbactam and levofloxacin
- D. Clindamycin and cefepime
Correct Answer: A
Rationale: The correct answer is A: Ceftriaxone and azithromycin. Ceftriaxone covers Streptococcus pneumoniae, the most common pathogen in CAP, while azithromycin covers atypical pathogens like Mycoplasma pneumoniae. Vancomycin and piperacillin/tazobactam (choice B) are not first-line treatments for CAP. Ampicillin-sulbactam and levofloxacin (choice C) cover some pathogens but not as comprehensively as ceftriaxone and azithromycin. Clindamycin and cefepime (choice D) do not provide adequate coverage for typical CAP pathogens.
A woman in active labor demonstrates signs of uterine inertia, with weak and irregular contractions contributing to slow cervical dilation. What nursing intervention should be implemented to address this abnormal labor pattern?
- A. Administering intravenous oxytocin to augment contractions
- B. Preparing for immediate cesarean section
- C. Facilitating maternal rest and hydration
- D. Performing an emergency manual rotation of the fetus
Correct Answer: A
Rationale: In cases of uterine inertia, where weak and irregular contractions are causing slow cervical dilation during labor, administering intravenous oxytocin can help augment contractions and stimulate more effective progress. Oxytocin is a hormone that naturally stimulates uterine contractions and is commonly used in clinical settings to induce or enhance labor. By increasing the strength and frequency of contractions, oxytocin can help address uterine inertia and promote efficient cervical dilation to facilitate the progress of labor. It is important to monitor the response to oxytocin carefully to avoid complications such as hyperstimulation of the uterus, which can lead to fetal distress.
The physician ordered to start Ms. Mely on Total Parenteral Nutrition (TPN). What Is your INITIAL step to be undertaken PRIOR to this intervention?
- A. Determine if the family can afford the whole treatment,
- B. Evaluate the tolerance of the patient to glucose.
- C. Identify allergies of patient to the supplemental nutrition.
- D. Assess the basic understanding of the patient regarding TPN
Correct Answer: B
Rationale: The correct initial step before starting TPN is to evaluate the patient's tolerance to glucose. This is crucial to ensure the patient can metabolize the glucose effectively and avoid complications such as hyperglycemia. Assessing affordability (A) is important but not the immediate concern. Identifying allergies (C) should be done but is not the first step. Assessing the patient's understanding (D) is important but not as critical as evaluating glucose tolerance before starting TPN.
In nursing, Nurse Trining explained that the MAIN goal of conducting research is to______.
- A. Justify the role of nurses as health care provider
- B. establish a credit body of evidence to support and improve the delivery of care .
- C. identify research priorities that will justify the Oversupply of nurses
- D. develop a body of knowledge to address non-nursing problems
Correct Answer: B
Rationale: The correct answer is B: establish a credit body of evidence to support and improve the delivery of care. Conducting research in nursing aims to generate a robust evidence base to inform and enhance the quality of care provided to patients. This evidence helps in identifying best practices, improving patient outcomes, and advancing the nursing profession as a whole. Choice A is incorrect because the main goal of research is not to solely justify the role of nurses, but rather to improve care delivery. Choice C is incorrect as the goal is not to justify an oversupply of nurses, but to address healthcare needs effectively. Choice D is incorrect because the focus of nursing research is on nursing-related issues, not non-nursing problems.