NUR 321 FUNDAMENTALS

During a home health visit, the nurse prepares to instruct a patient on how to perform range-of-motion (ROM) exercises for an injured shoulder. The nurse verifies that the patient took an analgesic 30 minutes before the nurse's arrival. After discussing the purpose for the exercises and demonstrating each one, the nurse has the patient perform them. After two attempts with only the second of three exercises, the patient stops and says, "This hurts too much. I don't see why I have to do this so many times." Which statement by the nurse illustrates the critical thinking attitude of integrity?

"I understand your reluctance, but the exercises are necessary for you to regain function in your shoulder. Let's go a bit more slowly and try to relax."

The nurse is examining a pregnant patient. Which statement by the nurse indicates that the nurse is providing the caring process of maintaining belief according to Swanson's theory of caring?

"Keep faith that you will be a good mother."

A patient is fearful of upcoming surgery and a possible cancer diagnosis. The patient discusses love for the Bible with the nurse, who recommends a favorite Bible verse. Another nurse disagrees with this recommendation. Which response would be appropriate to the nurse who states that there is no place in nursing for spiritual caring?

"Spiritual, mind, and body connections can affect health."

The nurse is teaching a group of nursing students about the use of concept maps in developing critical thinking skills. Which statement is true about concept maps? Select all that apply. One, some, or all responses may be correct.

--Are visual presentations of relationships between problems and interventions --Help to better synthesize relevant data about the patient --Help to form meaningful patterns from diverse patient information

Which activity is involved in the assessment phase of the nursing process? Select all that apply. One, some, or all responses may be correct.

--Asking the patient about the complaint --Inquiring about the patient's current medications --Asking about the patient's past and family medical history

The nurse who is working on a surgical unit is caring for four different patients. Patient A will be discharged home and is in need of instruction about wound care. Patients B and C have returned from the operating room within an hour of each other, and both require monitoring of their vital signs and intravenous (IV) lines. Patient D is resting after physical therapy. Which activity by the nurse represents use of clinical decision-making for these patients? Select all that apply. One, some, or all responses may be correct.

--Consider how to involve patient A in deciding whether to involve the family caregiver in wound care instruction. --Decide which activities can be combined for patients B and C.

Which behavior indicates the nurse's understanding of integrity? Select all that apply. One, some, or all responses may be correct.

--Following the highest standards of practice --Questioning own knowledge and beliefs --Being honest about and willing to accept own mistakes or inadequacies

Which characteristics are a component of critical thinking? Select all that apply. One, some, or all responses may be correct.

-Open-mindedness, continual inquiry, and perseverance -Recognition of an issue, analysis of related information, and formation of conclusions -Imagination and exploration of alternatives, consideration of ethical principles, and informed decision-making

Which technique would the student nurse follow to develop critical thinking skills and bring theory into practice?

REFLECTIVE JOURNALING

Which method would the student nurse use to reflect on and analyze the student's own thoughts, actions, and knowledge?

Reflective journaling

A patient with a sprained ankle is prescribed pain medications. The patient refuses to take the pain medications and insists on receiving acupuncture treatment for pain relief. Which action indicates open-mindedness on the nurse's part? Select all that apply. One, some, or all responses may be correct.

Respecting the patient's view Developing tolerance to differences of opinion

The nurse needs to insert an intravenous (IV) line and measure urine output for a patient. The nurse enters the patient's room and finds the patient weeping. Which action would the nurse perform?

Sit down beside the patient and ask what's wrong.

Which intervention by the nurse indicates that the nurse is actively listening to a patient to create a mutual relationship?

Sitting beside the patient while holding the patient's hand and empathizing with the patient

The nurse is new to a postoperative ward. The nurse finds it difficult to care for the immediate needs of a patient. Which measure would the nurse take to improve caregiving? Select all that apply. One, some, or all responses may be correct.

Spend more time in initial assessment. Observe the patient's behavior and measure physical findings. Constantly assess and monitor patients for health needs.

Which definition describes the knowing component of Swanson's theory of caring?

Striving to understand an event as it has meaning in the life of the patient

The nurse received the Employee of the Year award for knowledge, courage, honesty, and objectivity. Which concept of critical thinking does the nurse possess, according to Facione and Facione?

TRUTH SEEKING

A patient is experiencing paraplegia after a motorcycle accident. How can the nurse involve the family members in patient care?

Teach the family members about caregiving techniques and have them participate in the care.

A patient has undergone throat surgery and is unable to speak. The nurse finds it difficult to interact with the patient. How would the nurse manage this situation?

Use message boards to communicate with the patient.

A patient who received penicillin developed a rash on the right hand. The patient asked the nurse why the rash developed. How would the nurse explain this to the patient?

Use previous knowledge.

A patient complains of nausea and vomiting after consuming food stored for a long time. The nurse suggests that the patient take the antiemetic agent metoclopramide, but the patient asks the nurse if the problem could be managed by taking a ginger supplement. The nurse knows that ginger is equally effective in controlling nausea and vomiting. How would the nurse ensure patient safety? Select all that apply. One, some, or all responses may be correct.

ACCEPT MULTIPLE SOLUTIONS Reflect on the nurse's own judgment. Tell the patient that multiple solutions exist.

The nurse finds that a surgical patient has incision pain, fever, and nausea. Based on the findings, the nurse concludes that the patient has infection at the surgical site. Which critical thinking skill has the nurse applied?

ANALYSIS

A male patient underwent a prostatectomy and expresses that he is experiencing some pain and discomfort. The nursing student examines the patient's wound. Which describes a good critical thinker? Select all that apply. One, some, or all responses may be correct.

ANALYTIC SYSTEMATIC INQUISITIVE

The nurse has worked on an oncology unit for 3 years. One patient has become visibly weaker and states, "I feel funny." The nurse knows how patients often have behavioral changes before developing sepsis when they have cancer. The nurse asks the patient questions to assess thinking skills and notices the patient shivering. The nurse calls the physician and begins the conversation by saying, "I believe the patient is developing sepsis. I want to report symptoms I'm seeing." Which critical thinking concept does the nurse show? Select all that apply. One, some, or all responses may be correct.

ANALYTICITY SELF-CONFIDENCE

A patient with abdominal pain is admitted to the hospital. Which stage of patient care is included in the nursing process? Select all that apply. One, some, or all responses may be correct.

ASSESSMENT NURSING DIAGNOSIS IMPLEMENTATION

A patient who has undergone an appendectomy complains of pain. On assessment, the nurse finds that the patient is anxious, which is increasing the perception of pain. Which nursing intervention is appropriate in this situation?

Administer drugs that relieve anxiety per standing orders.

Which action shown by the registered nurse reflects integrity?

Admitting own mistakes

Which skill is unique to the commitment level of critical thinking?

Anticipating when to make choices without others' assistance

The student nurse is assigned to check the blood pressure of a patient and refers to the manual before doing so. Which level of thinking does this illustrate?

BASIC

A 40-year-old patient is admitted with severe pain in the lower abdomen. A newly hired nurse is assigned to care for this patient. Which level of critical thinking according to Kataoka-Yahiro and Saylor's model would the nurse use? Select all that apply. One, some, or all responses may be correct.

BASIC COMPLEX COMMITMENT

The nurse assessing a patient with genital lesions suspects the patient has multiple sexual partners. How would the nurse obtain more information from the patient? Select all that apply. One, some, or all responses may be correct.

BE HONEST USE FACTS ASK OBJECTIVE QUESTIONS

The nurse attentively listens and touches a patient gently. Which component of Swanson's theory does this action fulfill?

BEING WITH

A patient requires a Foley catheter to be inserted, so the nurse reads the procedure manual for the institution to review how to insert it. Which level of critical thinking is the nurse using?

Basic critical thinking

The nurse gently touches the shoulder of a patient lying with his eyes closed. When the patient opens his eyes, the nurse smiles and asks how he is feeling. Which kind of touch is this?

CARING

According to R.W. Paul, which intellectual standard would the nurse have for critical thinking? Select all that apply. One, some, or all responses may be correct.

CLEAR PLAUSIBLE COMPLETE

Which attitude is essential for critical thinking? Select all that apply. One, some, or all responses may be correct.

CONFIDENCE FAIRNESS DISCIPLINE CURIOSITY

Use of the pain scale is an example of which intellectual standard?

CONSISTENT

A patient is admitted to the hospital with severe pain in the lower abdomen. The nursing student is assigned to care for this patient. After nursing interventions, the pain did not subside substantially. The nursing student then started looking for different approaches to the patient's pain relief. Which aspect of critical thinking did the nursing student display?

CREATIVITY

Which critical thinking attitude would the nurse possess to identify new solutions to patient-related problems?

CREATIVITY

Which action by the nurse is an example of the skill of self-regulation in clinical practice?

Choosing an alternative way to manage a situation based on experience, while caring for a patient, to achieve better outcomes

The nurse observes a student nurse caring for a patient with diarrhea. Which quality in the student nurse reflects cognitive maturity?

Considering multiple solutions for the patient's condition

Which person-to-person encounter best describes presence?

Conveying closeness and a sense of caring

Which strategy for creating work environments enables nurses to demonstrate caring behaviors?

Creating a setting that allows flexibility and autonomy for staff

Which behavior is included in Watson's 10 carative factors theory? Select all that apply. One, some, or all responses may be correct.

Cultivating sensitivity toward each other Instilling faith and hope about the prognosis to the patient Promoting transpersonal teaching-learning between the nurse and the patient Preserving the patient's human dignity

The nurse speaks with a patient who lost a sister 2 weeks ago. The patient is unable to sleep, feels very fatigued during the day, and is having trouble at work. The nurse asks the patient to clarify the type of trouble. The patient explains she cannot concentrate or even solve simple problems. The nurse records the results of the assessment, describing the patient as having ineffective coping. Of which skill is this an example?

DIAGNOSTIC REASONING

Which will help the nurse apply critical thinking skills in the day-to-day routine in an acute care setting? Select all that apply. One, some, or all responses may be correct.

DISCIPLINE RESPONSIBILITY PERSEVERANCE

The student nurse is nervous while caring for a patient with schizophrenia for the first time. How would the nurse develop confidence while caring for the patient?

Discuss with a nursing instructor.

During the 12-hour shift, a patient had 40 mL of drainage in the surgical drainage collection device. The nurse refers to the written plan of care and notes that the health care provider should be informed when drainage in the device exceeds 100 mL for the day. Which type of action is the nurse performing when observing the drainage volume in the device to determine if it has exceeded the prescribed daily maximum?

EVALUATION

A patient who suffered a massive heart attack passes away. The health care provider asks the nurse to help the patient's spouse to cope with this stressful event. Which dimension of the caring process of enabling would the nurse implement with the spouse? Select all that apply. One, some, or all responses may be correct.

EXPLAINING SUPPORTING GENERATING ALTERNATIVES

Of the five caring processes described by Swanson, which action describes knowing the patient?

Establishing an understanding of a specific patient

Which action does not exemplify critical thinking skills by the nurse?

Explaining the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care

The nurse has been asked to insert a nasogastric tube for a patient who becomes anxious upon seeing the tube. Which nursing intervention would be helpful to manage the patient's anxiety?

Explaining the procedure to gain the patient's confidence

While inserting a nasogastric tube, the nurse finds that the patient is lying at the corner of the bed with arms tensed and extended along the side of the body. Which intervention indicates a task-oriented touch?

Explaining the procedure to the patient

A child tells the nurse, "My father abuses me every day after drinking alcohol. It makes me feel so depressed." The nurse then speaks with both the parents. Which critical thinking attitude is the nurse showing?

FAIRNESS

The postoperative patient expresses to the nursing student that he is experiencing some pain and discomfort. The nursing student examines the patient's wound. The patient also tells the nurse that another nurse visited him a while ago but was rude and did not pay any attention to him. The nursing student apologizes and assures him that his needs are fulfilled. The student speaks to the co-worker and manages the situation. Which attitude for critical thinking did the nursing student display here?

FAIRNESS

The nurse is assessing a patient with bowel infection secondary to a colostomy. The nurse learns that the patient has not followed the care recommendations received upon discharge. Which critical thinking attitude is appropriate for the nurse to exhibit when dealing with this patient? Select all that apply. One, some, or all responses may be correct.

FAIRNESS INTEGRITY CONFIDENCE

The nurse wants to experiment with a new intervention on a patient. How would the nurse confirm the effectiveness of this intervention in an ethical manner? Select all that apply. One, some, or all responses may be correct.

Follow evidence-based practice. Focus on the patient's values and beliefs related to the new intervention.

A patient admitted to a hospital is very depressed and wants to share personal concerns with the nurse. Which action would the nurse execute to be a good listener? Select all that apply. One, some, or all responses may be correct.

Give complete attention to the patient. Maintain good eye contact with the patient. Be silent and listen to the patient.

A patient is admitted to the hospital for treatment of lymphoma. The nurse enters the patient's room to find the patient worried and depressed. According to the caring principles, which action would the nurse perform? Select all that apply. One, some, or all responses may be correct.

Greet the patient and gently touch the patient's shoulder. Make good eye contact and sit next to the patient. Ask the patient about any concerns and listen to complaints patiently.

Which nursing intervention indicates a protective touch for a patient with a major injury after an accident?

Holding the patient while assisting with walking

A devout Christian patient suffers from an anxiety disorder. Which type of information would the nurse avoid providing to the patient pertaining to the religious aspect of connectedness?

IMPERSONAL

An elderly debilitated patient is confined to bed. The patient has reduced libido, is unable to eat, and is incontinent of urine. Which intervention would be the priority for this patient?

IMPROVE SKIN INTEGRITY

Which component can restrict the student nurse's ability to move from a basic level to a complex level of critical thinking? Select all that apply. One, some, or all responses may be correct.

INEXPERIENCE INFLEXIBLE ATTITUDE WEAK COMPETENCY

If the nurse only practices the curative regimen prescribed by the health care provider while dealing with patients, which aspect of Watson's transpersonal caring theory does the nurse fail to apply?

INTENTION TO CARE

Which factor would enhance patient-centered care? Select all that apply. One, some, or all responses may be correct.

Increasing the number of staff members Allowing autonomy over nursing practices

Which process from Watson's carative theory would the nurse include when working with a patient who is depressed as a result of a serious medical diagnosis? Select all that apply. One, some, or all responses may be correct.

Instilling faith and hope Expressing feelings Developing a trusting relationship

Which behaviors by the nurse are included in the process of listening?

Interpreting and understanding what the patient means

The nurse obtains a patient's complete history and assesses him thoroughly. Which process of Swanson's theory is the nurse using?

KNOWING

The nurse is caring for a patient with diabetes mellitus. The nurse uses diagnostic reasoning to determine the patient's health problems. Which parameter would the nurse include when using diagnostic reasoning for this patient? Select all that apply. One, some, or all responses may be correct.

LIGHT-HEADEDNESS WEAKNESS BLURRED VISION

A patient complains of lower abdominal pain, which is a dull ache and does not radiate. The patient expresses that he might be suffering from a heart attack. However, the nurse is convinced that the patient is not having a heart attack. How would the nurse act in this situation? Select all that apply. One, some, or all responses may be correct.

Look at this situation objectively. Use criteria to educate the patient. Support the findings and conclusion.

The nurse finds a patient weeping in the hospital room. When asked why, the patient starts talking about the disease and related problems. Which listening behavior would the nurse perform? Select all that apply. One, some, or all responses may be correct.

MAINTAIN EYE CONTACTS GIVE COMPLETE ATTENTION TO THE PATIEN BE SILENT AND LISTEN TO THE PATIENT CAREFULLY

A patient is admitted to a hospital after a miscarriage. The nurse offers the patient realistic optimism. Which process of care does this demonstrate?

MAINTAINING BELIEF

While caring for a patient in the home, the nurse ensures a hygienic environment, a proper diet, and recreation. Which carative factor of Watson is the nurse following through this intervention?

MEETING HUMAN NEEDS

Which description is true of spiritual caring? Select all that apply. One, some, or all responses may be correct.

Mobilizes hope for the patient and the nurse Recognizes that caring relationships connect humans to each other Helps the patient understand the illness, symptoms, or emotions

The nurse wishes to use critical thinking skills in clinical practice. Which trait is an obstacle to the development of critical thinking? Select all that apply. One, some, or all responses may be correct.

OVERCONFIDENCE BAISED VIEWS FAILURE TO ACCEPT MISTAKES

While assessing a patient, the nurse observes that the patient's intravenous (IV) line is not infusing at the ordered rate. The nurse assesses the patient for pain at the IV site, checks the flow regulator on the tubing, looks to see if the patient is lying on the tubing, checks the point of connection between the tubing and the IV catheter, and then checks the condition of the site where the intravenous catheter enters the patient's skin. After the nurse readjusts the flow rate, the infusion begins at the correct rate. This is an example of

PROBLEM SOLVING

Which action would demonstrate a caring touch? Select all that apply. One, some, or all responses may be correct.

Positioning the patient comfortably Comforting the patient and holding the patient's hands Engaging in a conversation with the patient

A patient is admitted to the hospital for treatment of breast cancer. The nurse assigned to this patient implements Watson's caring theory. Which carative factor would embody this theory? Select all that apply. One, some, or all responses may be correct.

1. EXPRESSING FEELINGS 2. INSTILLING FAITH AND HOPE 3. DEVELOPING A TRUST RELATIONSHIP

The nurse follows the scientific method to determine the cause of a drug's side effect. In which order would the nurse perform the steps of the scientific method?

1. IDENTIFY THE PROBLEM 2. COLLECT DATA FROM DIFFERENT RESOURCES 3. FORMULATE QUESTIONS OR HYPOTHESES 4. TEST THE QUESTIONS OR HYPOTHESES 5. EVALUATE RESULTS OF THE TEST OR STUDY

Arrange the steps of the scientific method in the correct sequence.

1. IDENTIFY THE PROBLEM 2. COLLECTING DATA 3. FORMULATE A QUESTION OR HYPTHESIS 4. TESTING THE QUESTION OR HYPOTHESIS 5. EVALUATE RESULTS OF THE STUDY

Arrange the steps of the scientific method of critical thinking in the correct order.

1. IDENTIFYING THE PROBLEM 2. COLLECTING ESSENTIAL DATA 3. FORMULATING QUESTION 4. REQUESTING DIAGNOSTIC TESTS 5. DIAGNPSING THE PROBLEM

The nurse has instructed the assistive personnel (AP) on the tasks that need to be performed, including getting patient A out of bed, collecting a urine specimen from patient B, and checking vital signs on patient C, who is scheduled to go home. Which scenario is an example of successful delegation? Select all that apply. One, some, or all responses may be correct.

1. The nurse explains to the AP the approach to use in getting the patient up and why the patient has activity limitations. 2. The nurse sees the AP preparing to help a patient out of bed, goes to assist, and thanks the AP for her efforts to get the patient up early. 3. The nurse offers support to the AP when needed but allows her to complete patient care tasks without constant oversight.