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 A
Explanation
Choice A rationale:
Hypovolemic shock is a life-threatening condition that occurs when the body loses a significant amount of blood or fluids, leading to a decrease in circulating blood volume. This can result in inadequate perfusion of organs and tissues, which can cause damage and even death if not treated promptly.
In this case, the athlete's symptoms and vital signs are consistent with hypovolemic shock. The athlete has been practicing twice a day in the heat, which can lead to significant fluid loss through sweating. The athlete is also dizzy, which is a common symptom of hypovolemia due to decreased blood flow to the brain. The athlete's blood pressure is low (100/2 mm Hg), pulse rate is elevated (100 beats/minute), and respiratory rate is increased (26 breaths/minute), all of which are compensatory mechanisms to try to maintain blood pressure and perfusion in the setting of hypovolemia. The athlete's skin is cool to touch
and pale in color, which is due to decreased blood flow to the skin. The athlete also does not remember the last voiding time, which may indicate decreased urine output, another sign of hypovolemia.
Key points supporting hypovolemic shock:
Significant fluid loss due to exercise in the heat Dizziness
Low blood pressure Elevated pulse rate Increased respiratory rate Cool, pale skin
Decreased urine output Additional details:
Hypovolemic shock can be caused by various factors, including:
Hemorrhage (blood loss) Severe dehydration Burns
Severe vomiting or diarrhea
Treatment for hypovolemic shock typically involves:
Intravenous fluid replacement to restore circulating blood volume Blood transfusion if the shock is due to hemorrhage
Oxygen therapy to support breathing
Medications to support blood pressure and heart function
Correct Answer is B
Explanation
Choice A rationale:
The spinal cord plays a crucial role in pain transmission, but it does not initiate the afferent pathways. It receives pain signals from nociceptors and relays them to the brain for processing.
The spinal cord is also involved in pain modulation, as it can dampen or amplify pain signals depending on various factors. However, it is not the primary trigger for pain sensation. That role belongs to nociceptors.
Choice B rationale:
Nociceptors are specialized sensory receptors that detect potentially damaging stimuli, such as intense heat, pressure, or chemical irritants.
They are located throughout the body, including the skin, muscles, joints, and internal organs.
When nociceptors are activated, they generate electrical signals that travel along nerve fibers to the spinal cord and brain. This process initiates the afferent pathways, which ultimately lead to the conscious perception of pain.
Nociceptors are essential for protecting the body from harm. They alert us to potential dangers and trigger responses that help us avoid injury or further damage.
Choice C rationale:
Endorphins are natural pain-relieving substances produced by the body. They act on receptors in the brain and spinal cord to reduce pain perception.
However, endorphins do not trigger the afferent pathways. They work by modulating pain signals that have already been initiated by nociceptors.
Choice D rationale:
The cortex is the outer layer of the brain that is responsible for higher-level functions, such as thinking, feeling, and decision- making.
It plays a role in the conscious experience of pain, but it does not trigger the afferent pathways.
The cortex receives pain signals from the spinal cord and processes them, leading to the awareness of pain.
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