Chapter 2: Critical Thinking in Health Assessment
The nursing student understands that data analysis is referred to as the diagnostic phase because the end result is the identification of which of the following?
nursing diagnosis
Revising the plan as needed occurs in what part of the nursing process?
Evaluation
A community health nurse provides information to a client with newly diagnosed multiple sclerosis for a support group at the local hospital for clients diagnosed with multiple sclerosis and their families. Providing this information is an example of which of the following?
A referral
A nurse interacts with four different clients one afternoon at the health clinic. The nurse is able to directly assist three of them and makes a referral for the fourth. Which of the following clients should the nurse refer to another professional?
An elderly woman who needs daily therapy sessions to help her walk again after a hip fracture
The nurse has learned that after completing the assessment phase of the nursing process, the next step is the diagnostic phase. What does the diagnostic phase allow for the nurse to do?
Analyze the data
The nursing instructor realizes that the nursing student understands all the criteria necessary for developing expertise when making clinical professional judgments by identifying the following as being a barrier to diagnostic reasoning.
seeing things as only right or wrong
The nurse is collecting data from a client. Which of the following best reflects objective data?
Appearance
An experienced medical-surgical nurse has identified critical thinking as an integral component of diagnostic reasoning. How can the relationship between these two concepts be best described?
Critical thinking is the foundation of the process of diagnostic reasoning.
The nurse collected extensive data during a client assessment and is performing the first step in the process of data analysis. Successful completion of this step requires the nurse to do which of the following?
Differentiate between expected findings and abnormal findings.
A nurse provides care for a client with an elevated temperature. The client is given the prescribed medication and the nurse checks the client's temperature at repeated intervals. What step of the nursing process is the nurse using to determine if the client has achieved the outcome criteria of the treatment?
Evaluation
Essential characteristics for the development of critical thinking skills include all the following except:
Following instructions
In the diagnostic process, what should immediately precede the step of identifying a list of possible nursing diagnoses?
Grouping assessment findings to identify commonalities
The following are selected steps of the diagnostic reasoning process. Place them in the proper sequence from first to last.
Identify abnormal data and strengths Cluster data Draw inferences Propose possible nursing diagnoses Check for defining characteristics
A nursing instructor is describing why data analysis is considered a very difficult step in the nursing process. Which of the following would the instructor identify?
It requires diagnostic reasoning skills.
Which of the following would be most important for a nurse when developing critical thinking skills?
Maintenance of an open mind
A client has been diagnosed with diabetes mellitus, and the nurse knows that the client requires education on the dietary restrictions. What would be an appropriate intervention by the nurse?
Make a referral to the dietician
Your client has been directly admitted from the doctor's office. The only paperwork he has brought with him is his admission orders. You are gathering your admission data when ordered lab work is collected. When documenting your history, physical examination, assessment, and plan, what would you write under the heading "Laboratory Data"?
None currently.
A nurse has completed a comprehensive assessment of a client and has begun the process of data analysis. Data analysis should allow the nurse to produce which direct result?
Nursing diagnoses
The nursing student demonstrates a need for further teaching when she states which of the following?
Patients do not need to understand their problems.
A client presents to the emergency department complaining of new onset chest pain. What is the priority action of the nurse?
Place on cardiac monitor.
The nurse enters an unassigned client's room to investigate an alarm. The client's intravenous (IV) bag is empty and the IV bag on the pole, left by the client's assigned nurse to hang next, is a different solution. What is the nurse's best action?
Review the client's prescribed medication orders
The nurse notes the diagnosis "Readiness for enhanced coping" written on a client's care plan. What type of diagnosis has been identified for the client?
Wellness
A client who is 2 days postoperative reports pain and requests pain medication. After assessing the client's pain level, the nurse decides to give the client oral oxycodone hydrochloride-acetaminophen instead of intravenous morphine. This nurse is doing which step of the nursing process?
implementation
The nursing instructor informs the students that there are pitfalls that decrease the reliability of cues and decrease diagnostic reasoning. The first set of pitfalls is related to the collection of data and includes which of the following?
too many or too few data
