PrepU Ch.14; Fundamentals

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. 1. noticing 2. interpreting 3. reflecting 4. responding

1. noticing 2. interpreting 4. responding 3. reflecting

A first-year nursing student has been introduced to the principles of experiential learning and how these will inform learning. When moving through the stages of experiential learning, the student will perform several important steps. Place the steps in the order in which the student will perform them. Use all options. 1. experiment with new concepts in practice 2. formulate new abstract concepts 3. integrate knowledge into transformation 4. accumulate concrete, prior experiences 5. reflect on experiences

4. accumulate concrete, prior experiences 5. reflect on experiences 2. formulate new abstract concepts 1. experiment with new concepts in practice 3. integrate knowledge into transformation

A nurse has gained extensive practice experience and is progressing through the various stages of Hammond's cognitive continuum theory (CCT). To attain the highest level of proficiency within this model, the nurse must: a. accumulate experience in a wide variety of clinical settings. b. uncover and address any personal biases. c. engage in regular, formal, written reviews of practice. d. elicit regular feedback from peers and colleagues.

b. uncover and address any personal biases.

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? a. "It is definitely a clear model, but it does not really capture all of the complexities and the human element of nursing." b. "I agree. The model is elegant for its simplicity and has been clinically linked to better client outcomes." c. "Absolutely. Many of the other models are evidence-based but excessively complex." d. "That model was dominant in nursing for decades but has recently been replaced by more nuanced models."

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

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? a. American Nurses Association b. National Council of State Boards of Nursing c. National League for Nursing d. American Association of Colleges of Nursing

a. American Nurses Association

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? a. National League for Nursing b. Centers for Disease Control and Prevention c. Department of Health and Human Services d. American Association of Colleges and Universities

a. National League for Nursing

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? a. Tanner's clinical judgment model b. California Critical Thinking Disposition Inventory (CCTDI) c. The Lasater clinical judgment rubric d. Developing Nurses' Thinking (DNT) model

a. Tanner's clinical judgment model

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? a. The student nurse thought systematically and reflectively before deciding what to do. b. The student nurse identified every available option before choosing an action. c. The student nurse adopted a position of likely being wrong rather than expecting to be right. d. The student nurse respectfully criticized the actions of student nurses who did not choose the recommended approach.

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

What action by the nurse in a hospital setting best exemplifies the goals of the Interprofessional Education Collaborative (IPEC) core competencies? a. coordinating with the physical therapist to amend a client's activity orders in the plan of care b. administering a medication that was just prescribed by a health care provider c. reporting a sudden decline in a client's status to the health care provider d. taking a course about intimate partner violence that was created by a social worker

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

A community health nurse has recommended a specific, medicated wound-care product to a client with a chronic venous ulcer. A colleague has asserted that the nurse has exceeded the scope of practice. The two nurses should consult resources from what organization to resolve this dispute about the scope of practice? a. National League for Nursing b. American Nurses Association c. American Association of Colleges of Nursing d. National Council of State Boards of Nursing

b. 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? a. Hypothesize the client's most likely diagnoses and challenges. b. Gather objective and subjective assessment data. c. Select the principles that relate most closely to the client's admitting diagnosis. d. Identify a respected nursing theory to inform care.

b. Gather objective and subjective assessment data.

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: a. Rest's model of moral reasoning. b. Interprofessional Education Collaborative (IPEC) core competencies. c. reflection-in-action. d. the American Nurses Association (ANA) Nursing: Scope and Standards of Practice.

b. Interprofessional Education Collaborative (IPEC) core competencies.

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? a. moral sensitivity b. moral judgment/reasoning c. moral motivation/focus d. moral character

b. moral judgment/reasoning

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? a. "It is well-known that nurses begin to 'cut corners' as soon as they graduate." b. "It is best to ignore what you see nurses do in practice and instead focus on what we learned." c. "You should consider some of the factors that might have influenced the nurse's action." d. "Remember that the end result is the important thing, not the way that it's done."

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

A novice nurse has witnessed the value of critical thinking in planning and responding to clients. Which principle should inform the nurse's practice? a. Critical thinking is an innate skill that some nurses possess. b. The concept of clinical judgment has superseded the concept of critical thinking. c. Critical thinking is a skill that can be learned and developed. d. Reliance on intuition is inconsistent with critical thinking.

c. Critical thinking is a skill that can be learned and developed.

A novice nurse has received feedback from a peer that describes the nurse as lacking situational awareness. What observation by the peer likely led to this conclusion? a. The nurse expresses frustration with clients who are vague or indecisive in their reports. b. The nurse is unaware of the specifics of the nursing scope of practice and code of ethics. c. The nurse has difficulty identifying the less obvious changes in clients' conditions. d. The nurse committed a medication error by administering an immediate-release opioid rather than an extended-release opioid.

c. The nurse has difficulty identifying the less obvious changes in clients' conditions.

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? a. The nurse's awareness of ethical and moral issues in nursing becomes heightened. b. The nurse influences the ways that care is organized and provided. c. The nurse integrates experience and reflections into new forms of practice. d. The nurse's actions influence other nurses and nursing students who are less skilled.

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

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? a. by reducing the amount of time elapsed from previous experiences to new experiences b. by eliciting input from a trusted professional mentor c. by engaging in frequent and thoughtful reflection d. by gaining the widest possible variety of learning experiences

c. by engaging in frequent and thoughtful reflection

A novice nurse is committed to becoming skilled in clinical judgment. Before exercising sound clinical judgment, the nurse must develop: a. intuition. b. reflection-on-action. c. situational awareness. d. complete moral character.

c. situational awareness.

A nurse has used Tanner's clinical judgment model to frame the response to a challenging clinical situation. When enacting the final step of this process, what will the nurse do? a. Self-examine for bias. b. Evaluate outcomes. c. Advocate for change. d. Reflect on-action.

d. Reflect on-action.

A junior nursing student has learned that clinical and simulation performance will be measured according to the Lasater Clinical Judgment Rubric. This student is in a curriculum that subscribes to what model of clinical judgment? a. The California Critical Thinking Disposition Inventory (CCTDI) b. The Developing Nurses' Thinking (DNT) model c. Benner's novice-to-expert model d. Tanner's clinical judgment model

d. Tanner's clinical judgment model

Which description clearly indicates that the nurse is applying Tanner's Clinical Judgment Model (CJM) in clinical practice? a. The nurse prioritizes the needs of the client, followed by the family, the support network, and the community. b. The nurse consistently follows a sequence of assessing, diagnosing, intervening, and evaluating. c. The nurse demonstrates situational awareness by reconciling competing demands according to risk and immediacy. d. The nurse engages in a near-constant cycle of noticing, interpreting, and reflecting.

d. The nurse engages in a near-constant cycle of noticing, interpreting, and reflecting.

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? a. The nurse has developed moral sensitivity and moral judgment. b. The nurse has expanded beyond the American Nurses Association scope of practice. c. The nurse demonstrates ethical practice according to Rest's four-component model of moral reasoning. d. The nurse is an expert, according to Benner's novice-to-expert model of development.

d. 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? a. The nurse is unsure how to frame feedback to a preceptor student. b. The nurse is seeking guidance on QSEN competencies. c. The nurse needs to provide updated NCLEX information to a group of students. d. The nurse is unsure whether a particular intervention is in the nursing scope of practice.

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

A nurse is distraught that she failed to intervene promptly in a situation where a client's status declined sharply. The client was becoming agitated and aggressive. The nurse states, "There was just too much going on, all at once, and I basically froze and then panicked." What interpretation of this event is most accurate? a. The nurse's situational awareness increased throughout the event. b. The nurse failed to understand the importance of clinical judgment and clinical reasoning. c. The nurse applied inductive reasoning at a time when deductive reasoning would have been preferable. d. The speed and complexity of the situation overwhelmed the nurse's cognitive load.

d. The speed and complexity of the situation overwhelmed the nurse's cognitive load.

A nurse is navigating a busy morning on a hospital unit and is struggling to finish the necessary tasks in the time available. In response, the nurse has assigned morning hygiene tasks for two clients to an unlicensed assistive personnel (UAP). What QSEN competency is this nurse exemplifying? a. quality improvement b. informatics c. safety d. evidence-based practice e. teamwork and collaboration f. client-centered care

e. teamwork and collaboration