Quiz 1

Priority Setting Frameworks Drill 10: An unstable client may be defined as one who fits which of the following descriptions?

A client whose newly placed tracheostomy is producing a large amount of secretions.

What is the nursing process?

ADPIE

What are some characteristics of tactile learners?

Actively explore the active world, easily distracted from learning, and enjoy using the computer

Which do you prioritize: acute or chronic?

Acute

What are some pharmacology-related responsibilities for nurses?

Administering drugs, evaluating therapeutic responses to drugs, promoting client adherence, providing education, and intervening for adverse effects

What does ABC stand for?

Airway, breathing, circulation

What is reactive thinking?

An automatic or knee-jerk reaction to situations

What does the nurse use clinical judgement to do?

Analyze data and related evidence, ascertain the meaning of the data and evidence, apply knowledge to a clinical situation, and determine client outcomes desired and/or achieved as indicated by EBP

What is nursing research?

Answering questions or solving problems by generating, testing, or evaluating knowledge and developing reliable evidence

What are some learning strategies for tactile learners?

Apply classroom knowledge in clinical learning, simulation, create models or displays, practice kits with equipment, and be active during scheduled breaks

What might client need for breathing (in ABCs)?

Artificial ventilation Negative pressure gradient in pleural cavity Chest tube might re-establish negative pressure

Priority Setting Frameworks Drill 2: When using the nursing process priority setting framework, the nurse should always remember to do which of the following first? Develop the client's plan of care. Implement the client's plan of care. Evaluate achievement of client goals. Assess the client

Assess the client

Health literacy?

Assisting patients and their families in reading, understanding, and/or acting on health-care information

What are some strategies for success?

Be prepared, be organized, read effectively, and manage time

What are the nurse's knowledge base?

Biological, physical, social sciences, pathophysiology, and understanding of nursing procedures and skills

Priority Setting Frameworks Drill 3: A nurse is caring for a client who is postoperative and whose airway is patent and respirations are 20 breaths per minute. Which of the following assessments should the nurse conduct in relation to the client's circulatory status? (Select all that apply) Blood pressure Urinary output Amount of intravenous fluids received Skin turgor Pulse

Blood pressure Urinary output Skin turgor Pulse

What might client need for circulation (ABCs)?

Chemical and/or physical cardiac support Resuscitation Supplemental fluids (to re-establish intravascular fluid volume and blood pressure)

Priority Setting Frameworks Drill 8: Which of the following statements explain why the needs of a client with a chronic illness are usually of lower priority than clients with an acute need? Chronically ill clients are usually less ill than clients with acute illnesses. Chronically ill clients have had the opportunity to physically adjust to their illness. Acutely ill clients usually have more needs in relation to safety and security. Acutely ill clients adapt to their illness less effectively because of its temporary nature.

Chronically ill clients have had the opportunity to physically adjust to their illness.

What, out of the five rights of delegation, are these examples of? Nurse leaders and managers must: Assess the needs of the patient population on the unit/department. Identify collective nursing care needs, priorities, and resources. Ensure appropriate staffing and skill mix. Provide sufficient equipment and supplies.

Circumstance

What is interpretation?

Clarifying data and circumstances to determine meaning and significance

Priority Setting Frameworks Drill 7: A nurse is performing triage at a mass casualty event and is selecting a tag for a client who is severely injured and has no potential for survival. Which of the following tags should the nurse apply to the client? Class I Class II Clas III Class IV

Class IV

What does expectant survival potential intel?

Class IV - Injuries are not compatible with life

What does the horizontal helix bar consist of? (10)

Client-centered care, interdisciplinary collaboration, EBP, quality improvement, informatics, and safety, client education, professionalism, leadership, and priority setting

What is it called when a nurse continues to use clinical reasoning to make decisions as the situation changes?

Clinical reasoning

What are some least restrictive intervention?

Close and constant supervision Assessing medications Bed and wheelchair alarms Mattress on floor next to client's bed

What is information management?

Collecting, analyzing, monitoring, summarizing, and communicating necessary to implement evidence-based practice

What are some nutrition-related responsibilities for nurses?

Counseling, providing nutritional education, providing nutritional screenings, and providing nutritional assessment

What is optimal healing requirement?

Creating and maintaining an environment that fosters healing, is safe and clean, guards patient privacy, engages all the human senses, and considers the experience of the body, mind, and spirit

What is another word for "thinking outside the box"?

Critical thinking

What is the DECIDE model?

Define the problem, if necessary; Establish criteria; Consider the alternatives; Identify the best alternative; Develop and implement a plan of action; and Evaluate and monitor the solution, seek feedback if necessary

What is another name for reflective thinking?

Deliberate thinking

Knowledge and Clinical Judgement Drill 8: Match the critical thinking skill on the left with the term that describes how the nurse uses that skill on the right. In the space provided, place the letter that corresponds with the correct number choice. Click "Submit" when all blanks are filled in. Interpretation, analysis, evaluate, inference, and explanation Describe Justify Assess Conclude Examine

Describe= interpretation Justify= explanation Assess= evaluation Conclude= inference Examine= analysis

What is analysis?

Determining a problem or issue based on assessment data

What is evaluation?

Determining if expected outcomes have or have not been met, and if outcomes have not been met, examining why

Knowledge and Clinical Judgement Drill 6: Which of the following are essential strategies to effectively manage time? (Select all that apply.) Avoid over-estimating time needed for projects. Complete tasks entirely just prior to due date. Develop a written or electronic schedule. Allow time for personal rewards. Study at regular intervals.

Develop a written or electronic schedule. Allow time for personal rewards. Study at regular intervals.

What is evidence-based management?

Developing management strategies informed by rigorous research based on empirical evidence

What is an assignment?

Distribution of work that each staff member is responsible for during a given time period

What is inference?

Drawing conclusions

What are some mathematics-related responsibilities for nurses?

Drug administration, nutritional needs, intake/output, incidence and prevalence rates, morbidity and mortality rates, percentage of weight loss, and body mass index

What are nursing procederes guided by?

EBP

Which is the highest priority: emergent, urgent, nonurgent, and expectant?

Emergent

What is self-regulation?

Examining one's practice for strengths and weaknesses in critical thinking and promoting continuous improvement

True or false: LPN/LVN can assign or delegate to an RN

False. They cannot

True or false: LPNs/LVNs can delegate to a UAP without the direction of a RN

False. They need direction by a nurse

What is care process?

Focusing on how nursing care is provided, including models of care delivery, critical pathways, standardized clinical guidelines, and actual physical care of patients, including assessment, intervention, patient education, timeliness of care, counseling, and leadership and management activities

What is outcomes of care?

Focusing on the results of the nursing care provided and reflecting on the effectiveness of nursing activities

What is structure/care environment?

Focusing on where nursing care is provided, including the physical environment, equipment, staffing, policies and procedures, the organizational culture, and management of the organization

What is clinical practice guidelines?

Following and/or developing guidelines that gather, appraise, and combine evidence to address relevant issues while balancing risk and benefits

What does decision making consist of?

Gathering information Analyzing information and creating alternatives Selecting a preferred alternative Implementing Following up on implementation

How do auditory learners learn best by?

Hearing (verbal repetition, tapes, and lectures)

What must nurse leaders and managers do break down barriers?

Hold all staff accountable to principles addressed in the job description. Provide periodic feedback related to the delegation process. Focus efforts on creating a supportive environment that promotes effective communication and teamwork. Identify strategies to improve the delegation process.

What are some least invasive intervention?

Incontinent clients on bladder routine Incentive spirometers/inhalation treatments Oral or rectal administration of medications

What is self-management?

Increasing the skills and confidence of patients in managing their health problems

What is EBP?

Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.

What are the two types of risk?

Internal and external

What does critical thinking include?

Interpretation Analysis Evaluation Inference Explanation

What does the critical thinking skills include?

Interpretation, analysis, evaluation, inference, and explanation

What is intuitive thinking?

Is an instant understanding of knowledge without supporting evidence and/or based upon a background of similar situations

Why is intuitive thinking rejected by some?

It is abstract and seems irrational

What is explanation?

Justifying actions with evidence

What is negative about reactive thinking?

Leads to vague or inaccurate reasoning, sloppy and superficial thinking, and poor nursing practice

What types of injuries does emergent consist of?

Life threatening injuries

What are some characteristics of auditory learners?

Like to talk things through, like listening to others, dislikes working quietly for extended periods of time, and easily distracted by noise and silence.

What is the decision making grid-analysis?

List options and factors on a table or grid and assign a numeric score to each option to indicate poor to very good or not likely to very likely.

What does safety and security consist of?

Living in safe environment Adequate income Shelter from environmental elements

What does love and belonging consist of?

Love Affection Relationships

What does physiology and pathology allow nurses to do?

Make appropriate nursing judgements, project client needs, and anticipate changes

Priority Setting Frameworks Drill 4: Which of the following can be used to help to determine the priority risk of a client who has multiple risks? (Select all that apply.) Maslow's Hierarchy of Needs Client's perception of priority risk Determining the complication that poses the highest risk Assessment of airway, breathing, and circulation needs Number of licensed and unlicensed nurses on RN's team

Maslow's Hierarchy of Needs Determining the complication that poses the highest risk Assessment of airway, breathing, and circulation needs

When is survival potential used?

Mass casualty situations when resources are scarce Client least likely to survive = lowest priority Client with severe injuries (but potential to survive with treatment) = highest priority

What is the relationship with quality improvement?

Monitoring and evaluating workflow and work processes using benchmarks to measure practice against established standards

What must a delegate have?

Must also have the appropriate education and skills to carry out the activity

What must a delegator have?

Must have the appropriate qualifications, education, and authority to delegate per the state nurse practice act

Do UAP's require nursing knowledge/judgement?

NO

No threat to life even with delayed treatment

Nonurgent

Which type of survival potential is less serious and less extensive injuries?

Nonurgent

Knowledge and Clinical Judgement Drill 1: Nursing knowledge is based on which of the following? (Select all that apply.) Intuition Nursing research Provider's recommendations Discipline-specific research Agency policies

Nursing research Discipline-specific research

What is care coordination?

Organizing the components of the plan of care, coordinating the implementation of the plan of care, advocating for the delivery of dignified human care, and documenting the coordination of care

What are some delegator-related barriers?

Overdelegation Underdelegation Lacking willingness to do the task Lacking skill or comfort with the skill required for the task Feeling overworked or perception of an unfair assignment Feeling physically unable to do the work Lack of guidelines that address who can delegate and what tasks can be delegated Lack of policies that protect nurses from inappropriate assignments and delegation of inappropriate nursing activities or responsibilities Poor staffing levels Absence of processes for validation of competencies for delegation

What does physiology needs consist of it?

Oxygenation Circulation Nutrition Elimination Fluid balance Activity and exercise Rest and sleep

How does self-actualization needs consist of?

Personal growth Fulfilling own potential

Knowledge and Clinical Judgement Drill 3: The ability to predict client needs and anticipate changes in the health status of a client stems from knowledge of which of the following topics? Nutrition Mathematics Legal and ethical issues Physiology and pathophysiology

Physiology and pathophysiology

Knowledge and Clinical Judgement Drill 4: Match the learning strategies in the right column with its appropriate style of learning in the left column. In the space provided, place the letter that corresponds to the correct number. Note each style will be matched to two strategies. Click "Submit" when all the blanks are filled in. Match visual, auditory, and tactile with below Practice skills in nursing lab Place information on a timeline Use a tape recorder in class Create songs or mnemonics Organize notes in an outline Develop models or displays

Practice skills in nursing lab = tactile Place information on a timeline = visual Use a tape recorder in class = auditory Create songs or mnemonics = auditory Organize notes in an outline = visual Develop models or displays = tactile

What does delegation require?

Problem-solving skills, critical-thinking skills, and clinical judgment

What is superveillance?

Process of observing and staying attuned to the patient's status and staff performance and following up on any problems

Nurses use knowledge to critically think and make sound judgement to do what?

Promote health, prevent disease, and empower others

What are part of QSEN?

Provide patient-centered care Work in interdisciplinary teams Employ EBP Apply quality improvement Utilize informatics Safety

What is cultural competence?

Providing acceptable cultural care and respecting the differences in patient values, preferences, and expressed needs

What are the five principles of safety culture?

Providing leadership Respecting human limits in the design process Promoting effective team functioning Anticipating the unexpected Creating a learning environment

What is empowerment?

Providing patients with access to information, support, resources, and opportunities that allow them to optimize their health and take part in decision making

What are nursing procedures designed to do?

Providing safe, high-quality care

Knowledge and Clinical Judgement Drill 2: The horizontal bars of patient-centered care, interdisciplinary collaboration, evidence-based practice, quality improvement, informatics and safety in the ATI Helix of Success were significantly influenced by which of the following? American Nurses' Association (ANA) National League for Nursing (NLN) Quality and Safety Education for Nurses (QSEN) National Comprehensive Licensure Exam for Nursing (NCLEX)

Quality and Safety Education for Nurses (QSEN)

What is SWOT analysis?

Rate factors by Strengths, Weaknesses, Opportunities, and Threats

What are some learning strategies for auditory learners?

Read text aloud, use a tape recorder in class, read summary of notes, create songs or mnemonics, study in groups, and explain the information being read aloud

Knowledge and Clinical Judgement Drill 7: Foundational knowledge is represented by which of the following types of thinking? (Select all that apply.) Recall Analysis Interpretation Evaluation Comprehension

Recall Comprehension

What is advocacy?

Representing and/or speaking for patients when they cannot speak for themselves

What is the characteristics of recalling information?

Requires remembering informationthat has been previously learned Does not require an understanding of the information or how it can be used

Where does EBP use evidence from?

Research for nursing best practices

What out of the five rights of delegation, are these examples of? Nurse leaders and managers must: Establish organizational standards consistent with state laws to ensure educational requirements and competencies of RNs, LPN/LVNs, and UAPs. Ensure competence standards related to delegation are integrated into organizational policies. Routinely assess performance of RN, LPN/LVN, and UAP. Initiate steps to remedy any failure to meet standards.

Right person

What are the five rights of delegation?

Right tall Right person Right circumstance Right direction/communication Right supervision

What does sound clinical judgement help ensure?

Safe care, high-quality, and client-centered care

What does self-esteem needs consist of?

Self respect Personal worth Social recognition

Priority Setting Frameworks Drill 1: Place the levels of Maslow's Hierarchy in the order in which they appear on the pyramid beginning with the level on the bottom of the pyramid at the bottom of the list and level at the apex of the pyramid at the top of the list. Safety and security Self-actualization Physiological Love and belonging Self-esteem

Self-actualization Self-esteem Love and belonging Safety and security Physiological

What does Maslow's Hierarchy of Needs Consist of?

Self-actualization Self-esteem Love and belonging Safety and security Physiology

What are the five characteristics of high-reliability organizations?

Sensitivity to operations Reluctance to simplify Preoccupation with failure Deference to expertise Resilience

Knowledge and Clinical Judgement Drill 10: Clinical reasoning requires the nurse to be able to do which of the following? Perform nursing skills based on best practice standards. Separate higher from lower level thinking. Use learning strategies that are appropriate for learning style. Separate relevant from irrelevant data.

Separate relevant from irrelevant data.

What are some characteristics of visual learners?

Sit at the front, avoiding visual obstructions. Take detailed notes.

What are the steps of meaningful readings?

Skim, read actively, ask questions, stop and think, and review periodically

Knowledge and Clinical Judgement Drill 5: List and describe the five steps that should be taken to improve reading comprehension and retention.

Skim, reading assignments actively, ask questions, stop and think, and periodically review

What might client need for airway (in ABCs)?

Temporary oral or artificial airway (tracheostomy or endotracheal tube) Supplemental oxygen

What does clinical judgement consider?

The client's needs when deciding to take an action, or modifying an intervention based on the client's response

What is clinical judgement?

The decision made regarding a course of action based on a critical analysis of data when nursing knowledge is applied to a clinical situation

Knowledge and Clinical Judgement Drill 9: Which of the following statements describe what clinical judgment is? The decision made regarding the course of action a nurse will take to solve a client problem. The use of a set of cognitive skills that support higher level thinking. The ability to recall data and determine if it is within or outside the expected parameters. The process of analyzing all the elements of a clinical situation to determine their relevance.

The decision made regarding the course of action a nurse will take to solve a client problem.

What is clinical reasoning?

The mental process used when analyzing the elements of a clinical situation and using analysis to make a decision

Priority Setting Frameworks Drill 6: Interventions that are least invasive are desirable because of which of the following? (Select all that apply.) The number of organisms introduced into the body is reduced. The risk of developing antibiotic resistant microbes is increased. The incidence of hospital acquired infections will be increased. The client's immune system may be compromised due to the stress of the illness. The use of equipment that penetrates the body's natural barriers increases the client's risk for infection.

The number of organisms introduced into the body is reduced The client's immune system may be compromised due to the stress of the illness The use of equipment that penetrates the body's natural barriers increases the client's risk for infection

What can nurses not delegate and to who?

The nursing process to LPN, LVN, and UAPs. Task that is not in the scope of practice of the delegate

What does right circumstance include?

The patient setting, available resources, and other relevant factors

What does reflective thinking require?

Thoughtful personal self-assessment, analysis, and synthesis of strengths

What is supervision?

To provide guidance or direction, oversight, evaluation, and follow-up

How do tactile learners learn best?

Touching (projects, concept maps, simulations, and role-playing)

True or false: RNs can delegate to other RNs, LPNs/LVNs, and UAPs

True

True or false: ethnical issues may or may not be supported by legal requirements

True

True or false: for expectant survival potential, potential for survival does not exist, even with treatment

True

True or false: least invasive/restrictive is one of the priority frameworks

True

What is the characteristics of comprehending information?

Understand the knowledge retrieved Verbalize or use it in some manner Understanding is another term used for comprehension

What is reflective thinking?

Understanding using one's own personal experiences and knowledge Involves assessing what is known, what needs to be known, and how to bridge the gap between the two

Which do you prioritize: unstable or stable

Unstable

Which do you prioritize: urgent or nonurgent?

Urgent

Priority Setting Frameworks Drill 9: Which of the following priority setting frameworks is being applied by a nurse who has decided to hang a client's intravenous antibiotic within 30 minutes of the time specified instead of giving another client their PRN pain medication? Least invasive Airway, breathing, circulation Urgent vs. nonurgent Safety and risk reduction

Urgent vs. nonurgent

What is class II survival potential and what types of injuries does it consist of?

Urgent- serious and extensive injuries

What are some learning strategies for visual learners?

Use charts/outlines, view videos, read books/pamphlets (highlight important words and information), place information on a timeline/diaphragm, and organize notes in an outline (create a powerpoint or handout)

What is quality improvement?

Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continually improve the quality and safety of health care systems

What is informatics?

Use information and technology to communicate, manage knowledge, mitigate error, and support decision making.

Priority Setting Frameworks Drill 5: A nurse is caring for a client who is confused and disoriented. The client has been getting out of the wheelchair when in her room and going into the bathroom without assistance. Which of the following interventions would be the least restrictive but most effective to use with this client? Wrist only restraints Wheelchair alarm Mattress beside the bed Mild sedative

Wheelchair alarm

When is critical thinking use?

When analyzing client issues and problems

What are some ways that visual learners learn best?

Written word, pictures, graphs, diagrams, and mental visualizations

What is delegation based on?

patient needs potential for harm stability of a patient's condition complexity of the task predictability of the outcome

What are the two types of decision making?

patient-care decisions and condition-of-work decisions