Clinical Judgement ATI
A nurse is reviewing methods created to assist nurses in using evidence-based practice Which of the following is a NCSBN model that can assist the nurse with critical thinking and decision making? a. Clinical judgment b. Critical thinking c. Clinical reasoning d. SMART goal
a. Clinical judgement The Clinical Judgment Model was developed to assist nurses in using evidence-based practice to think critically and make decisions.
A nurse is reviewing the concept of critical thinking with a newly licensed nurse. Which of the following statements should the nurse make?
Critical thinking is the foundation for clinical decision making Critical thinking is considered a higher order of thinking that is the foundation for clinical decision making. It is a critical component of nursing care and is used in each step of the nursing process to enhance client care.
A nurse asks a client to rate their current level of pain using a scale of 0 to 10 after administering pain medication 30 min ago. Which of the following steps of the nursing process is the nurse performing? a. Evaluation b. Implementation c. Analysis d. Planning
a. Evaluation The nurse is using the evaluation step of the nursing process by collecting subjective data from the client using an established pain scale to compare the client's current pain level to their original level of pain.
A charge nurse is preparing to discuss critical thinking skills with a group of newly licensed nurses. Which of the following skills should the nurse plan to include in the discussion? (Select all that apply.) a. Inspection b. Implementation c. Inference d. Creativity e. Inductive reasoning
c. inference, d. creativity, e. inductive reasoning Inspection is incorrect. Inspection is part of the assessment step of the RN nursing process in which the nurse observes the client for expected and unexpected findings. Implementation is incorrect. Implementation is the fourth step of the nursing process that involves taking action to provide nursing care as outlined in the client's plan of care. Inference is correct. Inference is a skill that is associated with critical thinking that the nurse can use as part of higher-level thinking. Creativity is correct. Creativity is a skill that is associated with critical thinking. The nurse can use creativity as a part of higher-level thinking to critically analyze problems and develop solutions. Inductive reasoning is correct. Inductive reasoning is a skill that is associated with critical thinking that the nurse can use as a part of higher-level thinking.
A nurse is caring for a client who has been wheezing. The nurse asks as assistive personnel to use a stethoscope and listen to the client's lung sounds to determine if their wheezing has improved. This is an example of which of the following concepts? a. Delegation of the right circumstance b. Delegation of the wrong task c. Delegation to the right person d. Delegation of the wrong time
b. Delegation of the wrong task Delegating an AP to use a stethoscope and listen to lung sounds is inappropriate as it is not within the range of function of an AP. This action involves clinical reasoning and should be delegated to a nurse.
A nurse at an urgent care clinic is auscultating the lungs of a client who reports a cough and shortness of breath. Which of the following steps of the nursing process is the nurse using?
Assessment The nurse should identify auscultating a client's lungs as being part of the assessment step of the nursing process because the nurse is collecting data from the client. Auscultating the client's lung sounds is part of a physical assessment.
In what order should an RN perform the steps of the nursing process?
Assessment, analysis, planning, implementation, evaluation
A nurse is caring for a client who is in an acute care facility. The nurse should recognize that the client's care requires clinical reasoning when it is complicated by which of the following factors? (Select all that apply.) a. Complex clinical situations b. Ongoing client and family concerns c. Cost of health care d. Decreased need for advanced health care practitioner intervention e. Availability of computerized medical records
a. Complex clinical situation b. ongoing client and family concerns Complex clinical situations is correct. Clinical reasoning is necessary when determining the prioritization of important clinical issues over issues that can wait. For example, clients who have broken bones as well as a compromised airway need their airway to be stabilized prior to setting broken bones. Correct prioritization is a key part of clinical reasoning in complex care settings. Ongoing client and family concerns is correct. Client and family concerns complicate the clinical situation of the client's care, making clinical reasoning a necessity. Clients and family members can reveal important pieces of information as they express their concerns. The nurse needs to carefully listen to everything that clients and their families say to collect information that might be useful in providing optimal care to the client. Cost of health care is incorrect. In some cases, the benefits of the health care interventions can be much less than the cost of those interventions. For example, a client who has terminal cancer might not benefit from medication or surgery and, by receiving either form of care, the client would incur further costs without receiving a benefit. Decreased need for advanced health care practitioner intervention is incorrect. A decreased need for advanced health care practitioner intervention would not complicate the client's care and could help to simplify it. The need for fewer interventions would not require clinical reasoning because the health care decisions would be less complex. Availability of computerized medical records is incorrect. Computerized medical records can assist nurses by providing quick access to client information and clinical resources which can streamline, rather than complicate, clinical reasoning.
A charge nurse is planning to discuss factors that can influence the clinical decision-making process in client care with a newly licensed nurse. Which of the following factors should the charge nurse include? (Select all that apply.) a. Appropriate delegation b. Cost of client care c. Available resources d. Awareness of client status e. Support from other staff
c. Available resources, d. awareness of client status, e. support from other staff Appropriate delegation is incorrect. Although appropriate delegation is a necessary part of daily nursing practice, it is not a factor that can influence the clinical decision-making process, which is used as the framework for developing the plan of care. Cost of client care is incorrect. Cost is not considered a factor that can influence the decision-making process, which is used as the framework for developing the plan of care. Available resources is correct. Resources are factors that can influence the decision-making process, which is used as the framework for developing the plan of care. Awareness of client status is correct. The nurse's awareness of the client's status is a factor that can influence the decision-making process, which is used as the framework for developing the plan of care. Support from other staff is correct. The availability of support from other staff is a factor that can influence the decision-making process, which is used as the framework for developing the plan of care.
A nurse is developing a goal for a client to ambulate with assistance at least once by the end of the shift. The nurse should identify that this is an example of which of the following steps of the nursing process? a. Evaluation b. Implementation c. Analysis d. Planning
d. Planning In the planning step of the nursing process, the nurse develops interventions to treat or manage the client's identified problems. The plan of care guides the treatment of the client and should be modified as the client's condition changes. In this scenario, the nurse is making goals for the client regarding ambulation.