Chapter 14- Clinical Judgement

A nurse is applying Tanner's clinical judgment model to the care they provide. What action characterizes the firststep in this process? noticing what is significant about the client's status and circumstances clustering data into meaningful groups speculating about the likely causes for the client's health challenges partnering with the client and with other members of the care team

noticing what is significant about the client's status and circumstances

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 sensitivity moral judgment/reasoning moral motivation/focus moral character

moral judgment/reasoning

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 bestrespond 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." "Absolutely. Many of the other models are evidence-based but excessively complex." "That model was dominant in nursing for decades but has recently been replaced by more nuanced models." "I agree. The model is elegant for its simplicity and has been clinically linked to better client outcomes."

"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." "It is well-known that nurses begin to 'cut corners' as soon as they graduate." "Remember that the end result is the important thing, not the way that it's done." "It is best to ignore what you see nurses do in practice and instead focus on what we learned."

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

A nursing student has set the goal of becoming more skilled and confident in clinical judgment and clinical reasoning. What action(s) will the nurse perform to acheive the goal? Select all that apply. Be continually aware of ethical issues and ethical responsibilities. Perform personal reflection during and after new experiences. Learn to trust intuition, when appropriate to the complexity of the situation. Adopt a systematic framework for practicing and evaluating clinical judgment. Reflect on mistakes as well as successes.

(ALL) Be continually aware of ethical issues and ethical responsibilities. Perform personal reflection during and after new experiences. Learn to trust intuition, when appropriate to the complexity of the situation. Adopt a systematic framework for practicing and evaluating clinical judgment. Reflect on mistakes as well as successes.

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. 1noticing 2interpreting 3responding 4reflecting

1noticing 2interpreting 3responding 4reflecting

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 National League for Nursing American Association of Colleges of Nursing National Council of State Boards of Nursing

American Nurses Association

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

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

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 The Joint Commission National League for Nursing National Councili of State Boards of Nursing

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. the American Nurses Association (ANA) Nursing: Scope and Standards of Practice. Rest's model of moral reasoning. reflection-in-action.

Interprofessional Education Collaborative (IPEC) core competencies.

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? American Association of Colleges and Universities National League for Nursing Centers for Disease Control and Prevention Department of Health and Human Services

National League for Nursing

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. Reassess the client during the next visit, after ensuring the client's safety. Continue to monitor the client throughout the home visit. Reflect on the nature of the visit after leaving the client's home.

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. Perform reflection on-action to better prepare for arranging supports for the client. Corroborate the assessment findings with the client. Elicit guidance from an expert nurse in light of the psychosocial nature of the client's challenges.

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 The Lasater clinical judgment rubric Developing Nurses' Thinking (DNT) model California Critical Thinking Disposition Inventory (CCTDI)

Tanner's clinical judgment model

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. The nurse is highly regarded by peers and colleagues. The nurse readily accepts the most complex client assignments. The nurse has been providing care for over 10 years in the same setting.

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. The nurse demonstrates ethical practice according to Rest's four-component model of moral reasoning. The nurse has developed moral sensitivity and moral judgment. The nurse has expanded beyond the American Nurses Association scope of practice.

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

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. The nurse demonstrates ethical practice according to Rest's four-component model of moral reasoning. The nurse has developed moral sensitivity and moral judgment. The nurse has expanded beyond the American Nurses Association scope of practice.

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

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? The speed and complexity of the situation overwhelmed the nurse's cognitive load. The nurse applied inductive reasoning at a time when deductive reasoning would have been preferable. The nurse's situational awareness increased throughout the event. The nurse failed to understand the importance of clinical judgment and clinical reasoning.

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

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 by gaining the widest possible variety of learning experiences by eliciting input from a trusted professional mentor by reducing the amount of time elapsed from previous experiences to new experiences

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 quality improvement empathic care accountability and adaptability

client-centered care