A registered nurse is attempting to change the method for documenting client care in a medical/surgical floor setting. What questions should be considered before planning change? (Select all that apply.)

How can the change be averted?

How cohesive does the group function as a unit?

Is the group as a whole amenable to change?

Is the group ready for change?

Answer and Explanation

Correct Answer : B,C,D

Choice A rationale:
Focuses on avoiding change rather than managing it effectively. Change is often necessary for improvement and growth. Seeking ways to avert it can hinder progress and prevent potential benefits.
Undermines the nurse's role as a change agent. Nurses are expected to play a proactive role in initiating and implementing change to enhance patient care and organizational effectiveness.
May lead to missed opportunities to address issues or challenges. By focusing on averting change, underlying problems may remain unaddressed, potentially compromising patient care or organizational efficiency.
Choice B rationale:
Addresses group cohesion, which is crucial for successful change implementation. Cohesive groups demonstrate better communication, collaboration, and support, facilitating acceptance and adaptation to change.
Recognizes that change can disrupt group dynamics and relationships. Assessing group cohesion allows for identification of potential challenges and development of strategies to strengthen relationships and foster teamwork during the change process.
Highlights the importance of considering the social and relational aspects of change. Change is not only a technical process; it involves individuals with emotions, beliefs, and social connections that need to be considered for successful implementation.
Choice C rationale:
Assesses the group's overall openness and willingness to accept change. Some groups may be more resistant to change due to past experiences, fear of the unknown, or attachment to existing practices.
Determines if the change aligns with the group's values and beliefs. Change that conflicts with deeply held values is likely to encounter stronger resistance and may require additional strategies to address concerns and build consensus.
Recognizes that not all groups are equally adaptable to change. Understanding the group's amenability to change helps in tailoring implementation strategies and managing potential resistance.
Choice D rationale:
Evaluates the group's preparedness for change in terms of knowledge, skills, and resources. Insufficient preparation can lead to confusion, frustration, and decreased effectiveness during the change process.
Considers the group's emotional readiness to accept and adapt to change. Even if a change is technically feasible, emotional resistance can hinder its success. Assessing readiness allows for addressing concerns and providing support to facilitate the transition.
Ensures that the group has the necessary support and resources to implement the change successfully. Change often requires training, guidance, and time for adjustment. Providing adequate support systems is essential for successful implementation.

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Correct Answer is A

Explanation

Choice A rationale:
Thrombophlebitis is a condition characterized by inflammation and blood clot formation within a vein. It commonly occurs in the legs, particularly after surgery or periods of prolonged immobility.
Anticoagulant medications work by preventing the formation of blood clots or by slowing their growth. They do not dissolve existing clots, but they can help prevent the clot from enlarging or breaking off and traveling to other parts of the body, such as the lungs (causing a pulmonary embolism).
Common anticoagulant medications used to treat thrombophlebitis include:
Heparin: This is a fast-acting injectable medication often used in the initial treatment of thrombophlebitis. Warfarin: This is an oral medication that takes a few days to start working but can be used for long-term treatment.
Direct oral anticoagulants (DOACs): These are newer oral medications that have a more predictable effect and fewer interactions with food and other medications compared to warfarin.
The choice of anticoagulant medication depends on several factors, including the severity of the thrombophlebitis, the patient's overall health, and any other medications they are taking.
Choice B rationale:
Antihistamine medications are used to treat allergic reactions. They do not have any effect on blood clots and would not be effective in treating thrombophlebitis.
Choice C rationale:
Antibiotic medications are used to treat infections caused by bacteria. They do not have any effect on blood clots and would not be effective in treating thrombophlebitis unless there is a concurrent bacterial infection.
Choice D rationale:
Antigens are substances that trigger an immune response in the body. They are not used to treat thrombophlebitis.

A. The treatment might have been successful, but we need to conduct another urinalysis to confirm. B. The treatment has not been effective, but you must continue with the antibiotic. C. The treatment has been successful, and you may stop taking the antibiotic. D. The treatment has been successful, but you must complete the full course of the antibiotic.

Correct Answer is D

Explanation

Rationale for Choice A:
While it's true that a urinalysis can confirm the eradication of bacteria, it's not routinely recommended in uncomplicated UTIs when symptoms have resolved.
Conducting a urinalysis at this point could potentially lead to unnecessary healthcare visits and costs.
It's important to prioritize patient adherence to the full course of antibiotics, as this is the most effective way to prevent recurrence of infection.
Rationale for Choice B:
This response is inaccurate and could discourage the patient from completing the treatment.
It's essential for the nurse to convey that the treatment is likely working, even though the patient is feeling better. Reinforcing the importance of completing the full course of antibiotics is crucial for optimal outcomes. Rationale for Choice C:
Stopping the antibiotic prematurely, even if symptoms have improved, can lead to:
Increased risk of recurrent UTI
Development of antibiotic resistance
Prolonged or more severe infections in the future
Completing the full course of antibiotics ensures that all bacteria are eradicated, reducing the likelihood of these complications.
Rationale for Choice D:
This response correctly emphasizes the importance of completing the full course of antibiotics, even when symptoms have resolved.
It addresses the patient's concern while providing accurate and essential information.
Key points to highlight in this response include:
The need to eliminate all bacteria, including those that may not be causing active symptoms
The prevention of antibiotic resistance
The reduction of the risk of recurrent UTIs

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A registered nurse is attempting to change the method for documenting client care in a medical/surgical floor setting. What questions should be considered before planning change? (Select all that apply.)

Nursing Test Bank

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Correct Answer is A

Explanation

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Explanation

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