A medical-surgical unit has implemented a policy change.
The nurse manager notices that one of the nurses, who has a history of being resistant to change, is not delivering care according to the new policy.
What action should the nurse manager take?
Explain the importance and rationale of implementing the new policy to the nurse.
Encourage the nurse to verbalize the reasons for resistance to the change.
Indicate that there will be disciplinary consequences if the nurse does not implement the new policy.
Ignore the resistance and allow peer pressure to facilitate a change in the nurse’s behavior.
The Correct Answer is B
Choice A rationale:
While explaining the importance and rationale of the new policy may be helpful in some cases, it may not be sufficient for nurses who are resistant to change. This approach assumes that the nurse's resistance is due to a lack of understanding, which may not be the case. It's possible that the nurse understands the rationale but has other concerns or objections.
Focusing solely on explaining the rationale can make the nurse feel they are not being listened to or that their concerns are not being valued. This can further contribute to resistance.
Choice B rationale:
Encouraging the nurse to verbalize their reasons for resistance allows the nurse manager to understand the root cause of the resistance. This could include:
Concerns about the effectiveness of the new policy
Belief that the new policy will create more work or make their job more difficult
Feeling that they were not adequately consulted or involved in the decision-making process Personal factors such as fear of change or a preference for established routines
Once the nurse manager understands the nurse's concerns, they can work together to address them and find ways to facilitate acceptance of the new policy. This approach fosters open communication, collaboration, and shared decision-making, which are essential for successful change management.
Choice C rationale:
Indicating disciplinary consequences may be necessary in some cases, but it should be a last resort. It can create a negative and hostile work environment, further alienate the nurse, and potentially lead to resentment and decreased morale among other staff members.
It's important to prioritize understanding and addressing the underlying reasons for resistance before resorting to disciplinary measures.
Choice D rationale:
Ignoring the resistance and relying on peer pressure is a passive and ineffective approach. It does not address the nurse's concerns and may even exacerbate the situation. This can lead to conflict among staff members, create a divide between those who support the change and those who resist it, and potentially compromise patient care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Incorrect. Patients have a legal right to access their medical records under the Health Information Portability and Accountability Act (HIPAA). Denying access is a violation of patient rights and could lead to legal consequences.
Undermines patient autonomy and trust. Patients have a right to know what information is in their medical records and to participate in their own healthcare decisions. Denying access can erode trust in the healthcare system.
Potential for errors and misunderstandings. If patients cannot review their records, they may not be able to identify errors or misunderstandings that could impact their care.
Choice B rationale:
Correct. This response upholds patient rights while ensuring that the request for access is documented and handled appropriately.
Protects patient privacy and confidentiality. The written request process helps to ensure that only the patient or their authorized representative has access to the records.
Provides a mechanism for tracking and auditing access requests. This can help to prevent unauthorized access and ensure compliance with HIPAA regulations.
Choice C rationale:
Incorrect. Patients have a right to access their records at any time, not just when they are being discharged.
Delays access to information. Patients may need to review their records to make informed decisions about their care, even if they are not being discharged.
Potential for records to be lost or misplaced. There is a risk that records could be lost or misplaced if they are not provided to the patient until discharge.
Choice D rationale:
Incorrect. Patients do not need to provide a reason for wanting to access their medical records.
Intrusive and unnecessary. Patients may feel uncomfortable or embarrassed about having to explain their reasons for wanting to access their records.
Potential for discrimination. Patients may be less likely to request access to their records if they feel that they will be judged or questioned about their reasons for doing so.
Correct Answer is C
Explanation
Choice A rationale:
A colostomy is a surgical procedure that creates an opening in the colon (large intestine) to divert stool through the abdomen. While a colostomy can affect bowel function, it does not directly increase the risk of aspiration. This is because the colon is located further down the digestive tract and does not directly involve the airway.
Choice B rationale:
An ileostomy is a surgical procedure that creates an opening in the ileum (small intestine) to divert stool through the abdomen. Similar to a colostomy, an ileostomy does not directly increase the risk of aspiration because the ileum is also located further down the digestive tract and does not involve the airway.
Choice C rationale:
Enteral feedings, also known as tube feedings, involve delivering nutrients directly into the stomach or small intestine through a tube. Patients receiving enteral feedings through a nasogastric (NG) tube are at a significantly higher risk of aspiration for several reasons:
Impaired swallowing mechanisms: Many patients who require enteral feedings have impaired swallowing mechanisms, which can increase the risk of food or liquid entering the airway instead of the esophagus.
Tube placement: The NG tube itself can potentially irritate the esophagus or interfere with the normal closure of the upper esophageal sphincter, which can increase the risk of reflux and aspiration.
Feeding formula: Enteral feeding formulas are often thin and liquid-like, which can make them easier to aspirate than thicker liquids or solid foods.
Positioning: Patients receiving enteral feedings are often in a reclined position, which can make it easier for fluids to travel back up the esophagus and into the airway.
Choice D rationale:
A chest tube is a drainage tube inserted into the chest cavity to remove air or fluid. While a chest tube can affect respiratory function, it does not directly increase the risk of aspiration. This is because the chest tube drains fluid from the pleural space, which surrounds the lungs, and does not directly involve the airway or digestive tract.
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