prep Chapter 14: Clinical Judgment

A nurse is applying Tanner's clinical judgment model in the care of a postpartum client. Which action by the nurse will constitute the first step in this process?

noticing the significant aspects of the client's condition

The nurse is applying the Clinical Judgment Measurement Model (CJMM) to the care of a client who has been expressing anxiety. The nurse has recognized and analyzed the various cues that the client is exhibiting, has prioritized hypotheses that may explain the client's anxiety, and is now generating possible solutions. In this particular stage of the CJMM, the nurse is demonstrating which component of Rest's framework of moral reasoning?

moral judgment/reasoning

The nurse is applying Tanner's Clinical Judgment Model in the care of a client. Building off the context and background information, place the components of the model in the correct sequence. Use all options.

noticing interpreting responding reflecting

A group of student nurses has been encouraged by their instructors to be intentional and deliberate about applying clinical decision-making models to their practice. A student tells a colleague, "The model that makes the most sense to me is the information-processing model, because it seems the most straightforward." How should the colleague best respond to this student?

"It is definitely a clear model, but it does not really capture all of the complexities and the human element of nursing."

A nursing student observed a staff nurse change a client's IV dressing. During post-conference, the student remarked to a classmate, "The nurse did not even follow the process we learned in lab!" What is the classmate's most appropriate response?

"You should consider some of the factors that might have influenced the nurse's action."

A nurse is conscientious in applying the Quality and Safety Education for Nurses (QSEN) competencies to the provision of clinical care. To enact the value of quality improvement, the nurse should perform what action?

Advocate for changes to shift handoff so that the process is more efficient.

A nurse has recommended a regimen of over-the-counter medications for a client who has seasonal allergies. A colleague contends that the nurse has exceeded the scope of nursing practice by recommending medications to a client. To resolve this difference of opinion, the nurses should consult resources from what organization?

American Nurses Association

An experienced nurse has received a new client and will apply the principles of inductive reasoning in the care-planning process. What action will the nurse perform first when applying this form of clinical reasoning?

Gather objective and subjective assessment data

The nurse is participating in a client conference for a client who has complex health needs. The client's psychiatrist, occupational therapist, and social worker are also participating in the conference. The nurse is most clearly demonstrating the values of what organization?

Interprofessional Education Collaborative

A skilled nurse is providing care for a client with mental health needs who is recovering from a stroke. The client is experiencing dysphagia (difficulty swallowing), so the nurse is working together with the speech-language pathologist (SLP) to ensure the client's cooperation with a swallowing assessment. This nurse's action best demonstrates:

Interprofessional Education Collaborative (IPEC) core competencies

A nursing student is excited to begin the first semester of the program and has learned that the competencies embedded in the program include human flourishing, nursing judgment, professional identity, and spirit of inquiry. What is the source of these competencies?

National League for Nursing

A nurse is applying cognitive continuum theory (CCT) to the care that is provided on a geriatric care unit. To strengthen the intuitive aspect of this theory, the nurse will perform what action?

Reflect on any biases that the nurse may have.

The community nurse has entered a client's home and noticed that the client is agitated and exhibits restless body language. The nurse has interpreted these behaviors as a sharp departure from the client's usual behavior and has discerned that the behavior is related to a recent family conflict. Within Tannner's model of clinical judgment, what will the nurse do next?

Respond by selecting the appropriate interventions.

The public health nurse is performing a postpartum home visit to a first-time parent who describes themselves as "awfully anxious." In alignment with Tanner's model of clinical judgment, the nurse has taken notice of the subjective and objective data that are relevant to the client's state of mind. Before responding by providing interventions, which action will the nurse take?

Systematically interpret the meaning of the assessment data.

A nurse has entered a client's home and noticed the client's disheveled state and several fall risks in the home. The nurse has interpreted these data as indications of a need for increased home support for the client and responded by arranging for care. The nurse reflected on the client's response to this suggestion, as well as reflected on the course of this interaction after the fact. The nurse has most clearly exemplified what model?

Tanner's clinical judgment model

A novice nurse has been growing in skill, largely as a result of experiential learning in the clinical setting. Within the model of experiential learning, what outcome would most clearly indicate that the nurse has achieved the stage of transformation?

The nurse integrates experience and reflections into new forms of practice.

A community health nurse has a reputation that is described as "stellar" by peers and colleagues. Apart from the nurse's years of experience, the nurse's skillfulness is the attribute most described by others. According to cognitive continuum theory (CCT), what characteristic of the nurse suggests that the nurse has achieved the highest level of competence?

The nurse is able to apply intuition to complex clinical scenarios.

A student nurse who is soon to graduate is completing a preceptorship with a nurse who has many years of clinical experience. The student has marveled at the nurse's ability to derive meaning from complex and rapidly changing situations, relying heavily on nurse intuition. What characteristic of this nurse does this ability demonstrate most clearly?

The nurse is an expert, according to Benner's novice-to-expert model of development.

For which scenario will the nurse consult resources from the American Nurses Association?

The nurse is unsure whether a particular intervention is in the nursing scope of practice.

A student nurse has been challenged to apply the principles of critical thinking during laboratory simulations. What characteristic of the student nurse's actions suggests that the student nurse engaged in critical thinking?

The student nurse thought systematically and reflectively before deciding what to do.

A nursing student is moving through a curriculum that emphasizes the value of experiential learning. The nursing student is consciously linking previous experiences with new and transformative practices. How will the nursing student link experiences with transformative behaviors?

by engaging in frequent and thoughtful reflection

A hospital client who requires assistance with hygiene has expressed a preference for receiving a bed bath after lunch rather than in the morning. The nurse has consequently changed the nursing care plan. The nurse's action reflects which QSEN competency?

client-centered care

What action by the nurse in a hospital setting best exemplifies the goals of the Interprofessional Education Collaborative (IPEC) core competencies?

coordinating with the physical therapist to amend a client's activity orders in the plan of care

The nurse is describing a clinical encounter, stating, "I entered the room, gathered assessment data, and then provided the interventions specified in standard operating procedures." The nurse is applying which conceptualization of clinical decision-making?

information-processing model

A nursing student is midway through a nursing curriculum that is based on the principles of experiential learning. Within this model, what aspect of the student's experience will form the starting point for learning?

prehension

The community health nurse is participating in a debrief about a critical incident that involved a physical altercation with the client in the client's home. When applying Tanner's model of clinical judgment to this situation, the debriefing exercise constitutes what component of the model?

reflection on-action