At which stage of Lewin ' s planned change indicates the nurse identifying, planning, and implementing appropriate strategies ensuring that driving forces exceed restraining forces?

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Question 1 of 9

At which stage of Lewin ' s planned change indicates the nurse identifying, planning, and implementing appropriate strategies ensuring that driving forces exceed restraining forces?

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.

Question 2 of 9

Latex allergy can be a type I IgE-mediated immediate hypersensitivity to plant proteins from the latex of rubber. It can manifest in its MOST severe form as _____.

Correct Answer: C

Rationale: The correct answer is C: Anaphylaxis. Anaphylaxis is the MOST severe form of an allergic reaction, including latex allergy. It is a systemic, potentially life-threatening reaction that can involve multiple organ systems. Symptoms can include difficulty breathing, swelling of the throat, a rapid drop in blood pressure, and cardiovascular collapse. Pruritus, erythema, and swelling (choice A) are common symptoms of allergic reactions but not specific to anaphylaxis. Asthma (choice B) can be a manifestation of latex allergy but is not the most severe form. Blisters and other skin lesions (choice D) are not typical of anaphylaxis but can occur in some cases of contact dermatitis from latex exposure.

Question 3 of 9

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?

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.

Question 4 of 9

What is the primary goal of cardiopulmonary resuscitation (CPR) in a cardiac arrest situation?

Correct Answer: B

Rationale: The primary goal of CPR is to restore spontaneous circulation and oxygenation to the body to maintain vital organ function. By performing chest compressions and rescue breaths, CPR aims to circulate oxygenated blood to the brain and other vital organs. This is crucial to prevent brain damage and increase the chances of survival. The other choices are incorrect because CPR does not address the underlying cause of cardiac arrest (A), provide pain relief (C), or prevent further complications such as organ failure (D). The immediate focus in a cardiac arrest situation is to maintain blood flow and oxygen delivery to vital organs until advanced medical care can be provided.

Question 5 of 9

Nurse Victor reviews the medical history of patient Mila. Which of the following conditions is the MOST common cause of cardiogenic shock?

Correct Answer: B

Rationale: The correct answer is B: Acute myocardial infarction (MI) is the most common cause of cardiogenic shock. During an MI, there is significant damage to the heart muscle, leading to a decrease in cardiac output and subsequent shock. This results in inadequate tissue perfusion and oxygen delivery. Choices A, C, and D are incorrect because decreased hemoglobin level (A) may lead to anemia but is not the most common cause of cardiogenic shock. Hypotension (C) is a symptom of shock, not the cause. Coronary artery disease (D) is a risk factor for MI but not the direct cause of cardiogenic shock.

Question 6 of 9

Which diagnostic procedure is commonly used to establish the diagnosis of lung cancer which provides a detailed description of the tracheobronchial tree and allows for biopsies of suspicious areas?

Correct Answer: B

Rationale: The correct answer is B: Bronchoscopy. This procedure involves inserting a thin, flexible tube with a camera through the mouth or nose to examine the tracheobronchial tree. It allows direct visualization of the airways, collection of tissue samples for biopsy, and detection of abnormalities like tumors. A: CT scan provides detailed images of the lungs but does not allow for direct tissue sampling. C: Sputum cytology involves examining sputum for cancer cells but may not provide accurate results. D: PET scan is used to detect metabolic activity in tissues, including tumors, but does not provide detailed visualization of the airways or allow for biopsies.

Question 7 of 9

When a nurse supports the welfare of the patient in relation to health, safety and personal rights, the ethical principle followed is

Correct Answer: D

Rationale: The correct answer is D: advocacy. Advocacy involves actively supporting and promoting the welfare and rights of the patient. Nurses advocate for their patients by ensuring their health, safety, and personal rights are upheld. This ethical principle goes beyond just fulfilling responsibilities or being accountable for one's actions. Responsibility (A) focuses on duties and tasks, accountability (B) is about being answerable for one's actions, and confidentiality (C) pertains to maintaining patient privacy. In this context, advocacy is the most appropriate choice as it encompasses actively working to protect and promote the best interests of the patient.

Question 8 of 9

A patient is prescribed a statin medication for lipid-lowering therapy. Which adverse effect should the nurse monitor closely in the patient?

Correct Answer: A

Rationale: The correct answer is A: Muscle pain or weakness. Statins can cause muscle-related side effects, including rhabdomyolysis, a severe condition that can lead to muscle pain and weakness. Monitoring for these symptoms is crucial to prevent serious complications. B: Dry cough is not a common side effect of statins. C: Hypertension is not directly associated with statin use. D: Hyperkalemia is not a typical adverse effect of statins.

Question 9 of 9

A nurse is preparing to assist with a lumbar epidural steroid injection (LESI) procedure for a patient with chronic back pain. What action should the nurse prioritize to ensure procedural accuracy?

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Confirming the patient's identity ensures the right patient is receiving the intended procedure. 2. Verifying the procedure site using two identifiers prevents errors in site selection. 3. This step aligns with the World Health Organization's Surgical Safety Checklist, reducing the risk of wrong-site procedures. 4. Positioning, sedation, and local anesthesia are important but secondary to ensuring the correct patient and site. Summary: - Option B: Positioning is essential but not the top priority for procedural accuracy. - Option C: Sedation aims to minimize discomfort but does not guarantee procedural accuracy. - Option D: Administering local anesthesia is crucial but not as critical as confirming patient identity and procedure site.

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