Exam 2

Core critical thinking skills

1. Interpretation 2. Analysis 3. Inference 4. Evaluation 5. Explanation 6. Self-regulation

Health

A state of being people define in relation to their own values, personality, and lifestyle.

Types of theories

Grand Middle-range Practice Descriptive Prescriptive

Conceptual framework

Paradigm

Which statement reflects a proper understanding of Peplau's theory? (select all that apply) a. A collaborative relationship creates a maturing force. b. Involves the nurse acting as a resource and surrogate. c. Includes three phases that characterize the interpersonal relationship. d. Focuses on the interpersonal relationship between the client and the client's family. e. Focuses on the interpersonal relationship influenced by only the nurse's perceptions.

a. A collaborative relationship creates a maturing force. b. Involves the nurse acting as a resource and surrogate. c. Includes three phases that characterize the interpersonal relationship.

Which statement reflects a characteristic of prescriptive theories? a. They are action-oriented b. They explain client assessment c. They focus on a specific field of nursing. d. They are first level of theory development.

a. They are action-oriented

Which nursing theory focuses on the client's self-care needs? a. Roy's theory b. Orem's theory c. Watson's theory d. Leininger's theory

b. Orem's theory

Nurses have developed theories in response to: a. government regulations b. physicians opinions c. changes in health care d. institution policies

c. changes in health care

Reflection-on-action

happens after the patient care occurs

Person

the recipient of nursing care, including individual patients, groups, families, and communities

Grand theory

Abstract and broad in scope, require further clarification through further research

3 interrelated patterns of reasoning per Tanner

Analytic processes Intuition Narrative thinking

Theory

Helps explain an event by: -Defining ideas or concepts -Explaining relationships among the concepts -Predicting outcomes

descriptive theory

Identify circumstances in which a phenomena occur

The theory of goal attainment

Imogene King

A client with a hand fracture, which theory would the nurse appropriately use when providing discharge teaching on ways to bathe, dress, groom, and eat independently? a. Orem's theory b. Peplau's theory c. Nightingale's theory d. Neuman's theory

a. Orem's theory

Which information would the nurse provide about the relationship between nursing theory and nursing research? a. "A single nursing research study is enough to test all the components of a nursing theory." b. "Theory-generating research helps discover and describe relationships of phenomena." c. "Theory-testing research helps determine the accuracy with which a theory describes a phenomenon." d. "The relationship between nursing theory and nursing research builds the scientific knowledge base of nursing." e. "Conducting continuous research activities may cause a hindrance to the acquisition of knowledge and science of nursing."

b. "Theory-generating research helps discover and describe relationships of phenomena." c. "Theory-testing research helps determine the accuracy with which a theory describes a phenomenon." d. "The relationship between nursing theory and nursing research builds the scientific knowledge base of nursing."

A client in the final stage of cancer is very anxious about their disease. The client is showing aggressive behavior toward family members. The nurse comforts and offers compassion and empathy to the client and the family members. Which theoretical principle is the nurse following in this situation? a. Roy's theory b. Watson's theory c. Leininger's theory d. Henderson's theory

b. Watson's theory

Which theory would the nurse follow when providing care for a client from Ireland who is stoic and reporting pain? a. Roy's theory b. Watson's theory c. Leininger's theory d. Benner and Wrubel's theory

c. Leininger's theory

Client A is recovering from heart surgery and needs to adapt to his environment. Client B is in the last stage of cancer. Which of these theories may the nurse use for better health maintenance of both clients? a. Roy's theory for client A and Orem's theory for client B b. Peplau's theory for client A and Roy's theory for client B c. Roy's theory for client A and Henderson's theory for client B d. Henderson's theory for client A and Peplau's theory for client B

c. Roy's theory for client A and Henderson's theory for client B

Nursing

the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations

Tanner: paradigmatic

thinking through propositional arguments

tanner: narrative

thinking through telling and interpreting stories.

Concepts for thinking critically

truth seeking open-mindedness analyticity systematicity self-confidence inquisitiveness maturity

The nurse taught a client scheduled for discharge with heart failure about how medications, diet, and exercise improve activity tolerance. During a follow up visit, the nurse finds the client learned how to adapt the exercise prescription to increase activity tolerance. Which theory did the nurse follow to achieve this positive outcome? a. Roy's theory b. King's theory c. Leininger's theory d. Henderson's theory

a. Roy's theory

Theory of practice is also called

Environmental Adaptation theory

This nurse created Theory of Human Caring: Trans-personal caring

Jean Watson

Practice theory

Narrow in scope for specific patient population

Which level is a student nurse in Benner's Novice to Expert Theory of Clinical Competence?

Novice

Which statement properly reflects Nightingale's theory of nursing? a. Focus of nursing is caring through the environment b. Limits nursing to the administration of medications and treatments. c. Suggests that every nurse would know all about disease process. d. Oriented toward providing fresh air, light, warmth, cleanliness, quite, and adequate nutrition. e. Focuses on helping the client deal w the symptoms and changes in function related to an illness.

a. Focus of nursing is caring through the environment d. Oriented toward providing fresh air, light, warmth, cleanliness, quite, and adequate nutrition. e. Focuses on helping the client deal w the symptoms and changes in function related to an illness. Rationale:Nightingale's theory of nursing focuses on nursing by caring through the environment. Nightingale's theory is oriented toward providing fresh air, light, warmth, cleanliness, quiet, and adequate nutrition. Nightingale's theory focuses on helping the client deal with the symptoms and changes in function related to an illness. Nightingale's theory does not limit nursing to the administration of medications and treatment. Nightingale's theory suggests that nurses do not need to know all about the disease process. which differentiates nursing from medicine.

Perspective Theory

address nursing interventions for a phenomenon, guide practice change

Middle Range Theory

address specific phenomena and reflect practice

Clinical judgement is ___________ required in all patient interaction.

not

The domain of nursing

provides both practical and theoretical aspects of the discipline

What 5 conclusions did Dr. Christine Tanner's research-based model of clinical judgement in nursing include?

1. Clinical judgement influenced more by nurse's experience/knowledge than objective data 2. Sound clinical judgement relies on knowing the patient and their patterns of responses/engaging w/ patient about their concerns 3. Clinical judgements are influenced by context of situation/culture of patient care settings 4. Nurses use many reasoning approaches including problem solving/reflection to understand and treat unique patient situations 5. Reflection on practice is often triggered by breakdown in clinical judgement and is critical for the development of clinical knowledge and improvement in clinical reasoning.

Clinical Judgement Process Model

1. Noticing 2. Interpreting 3. Responding 4. Reflecting

Which point represents an attribute of nursing theory? A. discipline constitutes a major portion of the knowledge of a theory. B. A nursing theory helps to identify the focus, means, and goals of practice. C. Theories give a perspective to assess the situation of a client and to organize data and methods for analyzing and interpreting information. D. Theory and scientific inquiry do not go hand in hand because they fail to provide guidelines for decision making, problem solving, and nursing interventions. E. Application of nursing theory in practice depends on the knowledge of nursing and other theoretical models, how they relate to one another, and their use in designing nursing interventions.

B. A nursing theory helps to identify the focus, means, and goals of practice. C. Theories give a perspective to assess the situation of a client and to organize data and methods for analyzing and interpreting information. E. Application of nursing theory in practice depends on the knowledge of nursing and other theoretical models, how they relate to one another, and their use in designing nursing interventions.

Which statement about nursing theories is correct? a. Prescriptive theories do not provide guidance for specific nursing interventions. b. Descriptive theories describe, relate, and in some situations predict, nursing phenomena. c. Middle-range theories provide the structural framework for broad, abstract ideas about nursing. d. Grand theories are action-oriented and test the validity and predictability of a nursing intervention.

B. Descriptive theories describe, relate, and in some situations predict, nursing phenomena.

This nurse developed a self-care deficits model

Dorothea Oream

T OR F Nursing theories are standardized and do not change over time.

False

Which nursing theorist devised the Theory of practice?

Florence Nightingale

Who was the first nursing theorist?

Florence Nightingale

Nursing theory

Is a conceptualization of some aspect of nursing Describes, explains, predicts, and/or prescribes nursing care

A nurse ensures that each pt's room is clean, ventilated and free of clutter. which theorist's work is the nurse practicing in this example?

Nightingale

Nursing Metaparadigm

Person Health Environment/ situation Nursing

Components of nursing theory

Phenomenon concepts Definitions Assumptions

A process of human interactions between nurse and client whereby each perceives the other and the situation, and through communication, they set goals, explore means, and agree on means to achieve goals.

The theory of goal attainment

Which statement describes leininger's theory? a. Incorporate the client's cultural traditions, values, and beliefs into the plan of care. b. Determine why a client is unable to meet biological, psychological, developmental, or social needs. c. Determine which demands are causing problems for a client and assess how well he or she is adapting to them. d. Establish effective nurse-client communication when obtaining nursing histories, providing education, or counseling clients and their families.

a. Incorporate the client's cultural traditions, values, and beliefs into the plan of care.

Which statement does NOT reflect the effect of applying the Roy adaptation model to improve the functional status of clients with heart failure? a. Use of literature resources supports practical-based nursing interventions. b. A client may learn techniques to improve the ability to adapt to an illness or condition. c. Involve a client's support system to increase the client's ability to use adaptive techniques. d. Nursing theories support theory-based nursing practices and define the specific interventions for clients.

a. Use of literature resources supports practical-based nursing interventions. Rationale: When using a nursing theory like Roy's adaptation model, the nurse would remember that using literature resources supports theory-based nursing intervention, and not practical-based ones. The nurse would remember that by applying Roy Adaptation Model, clients may learn techniques to improve his or her ability to adapt to an illness or condition. When using Roy's adaptation model, the nurse would remember that involving a client's support system helps in increasing the client's ability to use adaptive techniques. When using Roy's adaptation model, the nurse would remember that nursing theories support theory-based nursing practices and define the specific interventions for clients.

Theory is essential to nursing practice because: a. contributes to nursing knowledge and guides nursing practice b. provides a way of getting correct v.s c. helps create protective laws for patients d. explains collaboration of different disciplines

a. contributes to nursing knowledge and guides nursing practice

Clinical judgement is an aspect of nursing in _________ settings.

all

Which theory category would include a theory that describes a phenomena such as a grief and caring? a. Grand theories b. Descriptive theories c. Prescriptive theories d. Middle-range theories

b. Descriptive theories

Which statement correctly describes the domain of nursing? a. The domain is the perspective of nursing only and not all professions. b. The domain of nursing provides both a practical and theoretical aspect of the discipline. c. The domain provides the subject, central concepts, values and beliefs, phenomena of interest, and central problems of a paradigm. d. The domain is the knowledge of nursing practice as well as the knowledge of nursing history, nursing theory, education, and research. e. The domain of nursing gives nurses a comprehensive perspective that allows them to identify and treat client's health care needs at all levels and in all health care settings.

b. The domain of nursing provides both a practical and theoretical aspect of the discipline. d. The domain is the knowledge of nursing practice as well as the knowledge of nursing history, nursing theory, education, and research. e. The domain of nursing gives nurses a comprehensive perspective that allows them to identify and treat client's health care needs at all levels and in all health care settings.

Which statement indicates an understanding of Nightingale's theory? a. "Nightingale's theory suggests nurses need to know all about the disease process." b. "The theory posits the idea that nursing is limited only to the administration of medications and treatments." c. "Nightingale's theory deals with visionary principles that include areas of practice, research, and education." d. "Nightingale's theory deals with descriptive theories that provides nurses with a way to think about clients and their environment." e. "Nightingale's theory focuses on the fact that nursing is caring through the environment and helping the client deal with symptoms related to illness."

c. "Nightingale's theory deals with visionary principles that include areas of practice, research, and education." d. "Nightingale's theory deals with descriptive theories that provides nurses with a way to think about clients and their environment." e. "Nightingale's theory focuses on the fact that nursing is caring through the environment and helping the client deal with symptoms related to illness."

According to Watson's theory, in which practice is the nurse least likely to engage? a. Caring for a client in an almost spiritual way b. Focusing on the people who are supporting the client c. Curing the disease before engaging in care for the client d. Promoting transpersonal teaching and learning with the client.

c. Curing the disease before engaging in care for the client

Which nursing action reflects Leininger's caring theory in practice? a. The nurse supports and accepts the client's feelings. b. The nurse promotes beauty, comfort, dignity, and peace. c. The nurse learns culturally specific behaviors to meet the client's needs. d. The nurse believes that every caring process has subparts that should be considered while creating an effective strategy.

c. The nurse learns culturally specific behaviors to meet the client's needs. Rational: Leininger's caring theory states the importance of understanding cultural behaviors in providing effective nursing care. According to Watson's transpersonal caring theory, the nurse should support and accept the client's feelings. It also states that the supportive, protective, and corrective mental environment should be provided to create a healing environment. It implies that the nurse should provide comfort, dignity, and peace to the client. Swanson's theory states that the caring process has definitions and subdimensions that serve as the basis for the nursing process.

Which theory helps the pediatric nurse design appropriate therapeutic play intervention for ill toddlers? a. Grand theories b. Peplau's theory c. Descriptive theory d. Interdisciplinary theory

d. Interdisciplinary theory

Reflection-in-action

happens in real time while care is occuring

Environment/situation

includes all possible conditions affecting patients and the settings in which their health care needs occur

Clinical Judgement Definition

is an interpretation or conclusion about a patient's needs, concerns, or health health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropritate by the patient's response.

Developing Clinical Judgement

knowledge or deep understanding, learning to recognize patterns, apply concepts to nursing practice, skillful responding, reflective practice

Created a nursing theory defining stages of nursing clinical expertise

patricia benner