Chapter 10 and 11 K&E

A nurse educator has always believed that lectures with focused outlines are the best way to present theory content in class. A colleague, who teaches the same group of students, but a different subject, utilizes group work and in-class activities to teach difficult content and finds that students perform as well, or better, on their tests. The first educator in this situation is starting to rethink her position. What behavior is the first educator demonstrating? 1. Integrity 2. Perseverance 3. Fair-mindedness 4. Humility

1. Integrity

The nurse manager determines that a new staff nurse is demonstrating characteristics of a critical thinker. What did the manager observe the nurse perform? Standard Text: Select all that apply. 1. Listening with empathy to a client who recently has been diagnosed. 2. Waiting for the medical team to determine the focus of the clients supportive care. 3. Questioning a medication order that does not appear to meet the clients needs for pain management. 4. Exhibiting a willingness to try alternate methods of addressing a clients care needs. 5. Practicing nursing in a culturally competent fashion.

1. Listening with empathy to a client who recently has been diagnosed. 3. Questioning a medication order that does not appear to meet the clients needs for pain management. 4. Exhibiting a willingness to try alternate methods of addressing a clients care needs. 5. Practicing nursing in a culturally competent fashion.

The nurse is conducting an interview with a new client. Which actions indicate that the nurse is implementing effective communication guidelines? Standard Text: Select all that apply. 1. Looking directly at the client to ensure good eye contact 2. Managing the conversation to avoid periods of silence 3. Providing personal experiences to help the client focus 4. Sitting in a chair next to the client who is in bed 5. Keeping arms unfolded and in a relaxed position

1. Looking directly at the client to ensure good eye contact 4. Sitting in a chair next to the client who is in bed 5. Keeping arms unfolded and in a relaxed position

During a clinical conference, a staff nurse states that critical thinking is essential when providing client care. What additional statements should this nurse make to support the use of critical thinking? Standard Text: Select all that apply. 1. Patient acuity is so much greater than it was even 10 years ago. 2. Care delivery systems are only as good as the nurses delivering care. 3. Nurses have always relied on commonsense thinking to provide quality, appropriate nursing care. 4. With health care being so expensive, nursing has to take on responsibility to keep the costs controlled. 5. My practice involves caring for clients who require care that didnt even exist when I went to school.

1. Patient acuity is so much greater than it was even 10 years ago. 2. Care delivery systems are only as good as the nurses delivering care. 4. With health care being so expensive, nursing has to take on responsibility to keep the costs controlled. 5. My practice involves caring for clients who require care that didnt even exist when I went to school.

A seasoned nurse uses past experiences and knowledge gained from previous care situations to care for a client with complex health issues. Which attribute of critical thinking is this nurse practicing? 1. Reflection 2. Context 3. Dialogue 4. Time

1. Reflection

A nurse is performing an initial assessment on a new admission. What information should the nurse consider as being a part of the database? Standard Text: Select all that apply. 1. Reports from physical therapy the client received as an outpatient 2. Documentation of the nurses physical assessment 3. Physicians orders 4. A list of current medications 5. Information about the clients cultural preferences 6. Discharge instructions

1. Reports from physical therapy the client received as an outpatient 2. Documentation of the nurses physical assessment 4. A list of current medications 5. Information about the clients cultural preferences

Unlicensed assistive personnel measure a newly admitted clients vital signs to be: temperature = 99.3(F), respirations = 26, pulse = 98 bpm, and blood pressure = 200/146. What should the nurse do to validate this data? 1. Retake the vital signs. 2. Call the physician. 3. Continue with the physical assessment as soon as possible. 4. Report the findings to the charge nurse.

1. Retake the vital signs.

A client is coming in to the clinic for the first time. In order for the nurse to allow the client the most comfort during the interview, what should the nurse do? 1. Sit next to the client, a few feet apart. 2. Sit behind a desk. 3. Stand at the side of the clients chair. 4. Stand at the counter to take notes during the interview

1. Sit next to the client, a few feet apart.

The staff nurse is helping a new graduate understand the relationship between care concepts and planned interventions. What value would it be for the staff nurse to encourage the new graduate to use a concept map? Standard Text: Select all that apply. 1. Used to highlight key areas 2. Provides a visual representation 3. Can be quicker than taking notes 4. Takes years to study how to create 5. Aids in developing critical thinking

1. Used to highlight key areas 2. Provides a visual representation 3. Can be quicker than taking notes 5. Aids in developing critical thinking

The nurse educator assigns students an activity to implement Socratic questioning in their daily lives. Which question provided by a student demonstrates this reasoning technique? 1. What makes you think cramming for a test is an ineffective way to study? 2. What other ways of studying could you implement? 3. If you didnt study for your test, what is the probability you will fail? 4. If you study all the unit outcomes, what effect will that have?

1. What makes you think cramming for a test is an ineffective way to study?

The nurse questions the practice of administering rectal suppositories to residents in a long-term care facility at bedtime, rather than earlier in the day. When told that this is the best time for staff and thats the routine that has been practiced for a long time, the nurse continues to research whether there would be a better time, especially in the best interest of the residents. Which critical thinking attitude is this nurse demonstrating? 1. Confidence 2. Perseverance 3. Curiosity 4. Integrity

3. Curiosity

A client in the emergency department has a non-lifethreatening wound. The unit is busy with other clients, families, and people in the waiting room. How should the nurse conduct an interview with this client? 1. Have the client wait until the department quiets down, as the wound is not too serious. 2. Tell the client to wait in the waiting room and fill out the paperwork. 3. Draw curtains around the client and nurse to provide as much privacy as possible. 4. Make sure the clients back is to the rest of the room so as not to be heard by passersby.

3. Draw curtains around the client and nurse to provide as much privacy as possible.

While preparing a client for a procedure, the nurse notes that the client has become unresponsive and respirations have become shallow. What type of assessment should the nurse complete at this time? 1. Initial assessment 2. Problem-focused assessment 3. Emergency assessment 4. Time-lapsed assessment

3. Emergency assessment

The nurse decides to seek wound care alternatives for a clients stasis ulcer that is not healing after treatment for 2 weeks. In which phase of the nursing process is the nurse functioning? 1. Diagnosis 2. Implementation 3. Evaluation 4. Assessment

3. Evaluation

The nurse is assessing a clients level of pain. Which open-ended question should the nurse use for this situation? 1. Is your pain worse at night? 2. What brought you to the clinic? 3. How has the pain impacted your life? 4. Youre feeling down about having pain, arent you?

3. How has the pain impacted your life?

The student is learning the steps of the nursing process. What is the first thing that the student should realize about the purpose of this process? 1. Deliver care to a client in an organized way. 2. Implement a plan that is close to the medical model. 3. Identify client needs and deliver care to meet those needs. 4. Make sure that standardized care is available to clients

3. Identify client needs and deliver care to meet those needs.

The nurse provides a back rub to a client after administering a pain medication with the hope that these two actions will help decrease the clients pain. Which phase of the nursing process is this nurse implementing? 1. Assessment 2. Diagnosis 3. Implementation 4. Evaluation

3. Implementation

The nurse suspects that a client with a history of injuries is a victim of abuse. What did the nurse use to come to this conclusion? 1. Observation of cues 2. Validation 3. Inference 4. Judgment

3. Inference

A client complaining of shortness of breath has no pallor, cyanosis, or use of accessory muscles with respirations. The clients respiratory rate is 16 breaths per minute. The nurse is concerned that the clients report and the physical findings conflict. Which standard of critical thinking is the nurse using? 1. Clarity 2. Accuracy 3. Logical reasoning 4. Significance

3. Logical reasoning

Family of a client demonstrating confusion state that this is not the clients usual behavior. How should the nurse document this data? 1. Inference 2. Subjective data 3. Objective data 4. Secondary subjective data

3. Objective data

While caring for a client of a different culture, the nurse becomes disturbed when the clients spouse makes all the decisions about care and treatments. What behavior is this nurse demonstrating? 1. Inference 2. Judgment 3. Opinion 4. Evaluation

3. Opinion

The nurse is admitting an infant to the care area. The parents and grandmother are present. What should the nurse use as the best source of data for this client? 1. Medical record from the childs birth 2. Grandmother 3. Parents 4. Admitting physician

3. Parents

The nurse completes collecting data from a client and determines a list of problems. Which step in the nursing process should the nurse perform next? 1. Assess 2. Diagnose 3. Plan 4. Evaluate

3. Plan

A nurse has worked in the trauma critical care area for several years. Which noise may become indiscriminate for this particular nurse? 1. A client with audible breathing 2. Moaning of a client in pain 3. Whirring of ventilators 4. Co-orkers discussing their clients conditions

3. Whirring of ventilators

A client has been using the call light routinely throughout the evening. Upon entering the room, the nurse observes the following details. Organize them according to priority sequencing (1 is first priority; 5 is least priority). Standard Text: Click and drag the options below to move them up or down. Choice 1. The family is at the bedside. Choice 2. The IV pump is running on battery. Choice 3. The ECG monitor shows tachycardia. Choice 4. The client reports being restless. Choice 5. O2 tubing is not attached to wall regulator.

Choice 3. The ECG monitor shows tachycardia. Choice 4. The client reports being restless. Choice 5. O2 tubing is not attached to wall regulator. Choice 2. The IV pump is running on battery. Choice 1. The family is at the bedside.

A new client has been admitted to the care area. How soon should the nurse plan to complete a physical assessment on this patient? 1. 1 hour 2. 12 hours 3. 48 hours 4. 24 hours

4. 24 hours

A client with a PhD in epidemiology has been to numerous physicians and has had numerous laboratory tests, all of which were abnormal, and exploratory surgery, but no one is able to explain the etiology of his problem. The client also states that he has a rare form of a neurological disorder. Which statement should the nurse make that demonstrates critical thinking? 1. Why dont you just tell your physician what you think you have? 2. Did you bring your prior tests and results with you, so we dont repeat anything? 3. If you know what you have, what do you want from us? 4. Describe what tests youve had and explain the symptoms of this disorder.

4. Describe what tests youve had and explain the symptoms of this disorder.

The staff nurse asks why unlicensed assistive personnel are responsible for stocking the unit refrigerator with refreshments when dietary personnel place the items on the shelf in the kitchen. What characteristic of critical thinking is this nurse demonstrating? 1. Curiosity 2. Clinical reasoning 3. Setting priorities 4. Developing rationales

4. Developing rationales

Prior to providing client care, the nurse reviews previous shift charting and the responses to nursing interventions. Which decision-making action is the nurse using? 1. Set the criteria 2. Examine alternatives 3. Implement 4. Evaluate the outcome

4. Evaluate the outcome

A client recovering from a stroke does not want to perform prescribed shoulder exercises. What should the nurse say to the client that demonstrates critical thinking with creativity? 1. Youll only get worse if you dont do these exercises. 2. As soon as you get these into your routine, youll feel better. 3. Your physician wouldnt have ordered these if they werent important. 4. Heres a marker. See how many circles you can make on this board in 10 minutes.

4. Heres a marker. See how many circles you can make on this board in 10 minutes.

The nurse documents: Client avoids eye contact and gives only vague, nonspecific answers to direct questioning by the professional staff. Is quite animated (laughs aloud, smiles, uses hand gestures) in conversation with spouse. Which method of data collection does this documentation demonstrate? 1. Examining 2. Interviewing 3. Listening 4. Observing

4. Observing

The nurse systematically tries a variety of products to help with healing of a clients wound. Which problemsolving method is the nurse using? 1. Intuition 2. Scientific method 3. Research process 4. Trial and error

4. Trial and error

During an assessment interview, the client states that an elective surgical procedure will not be done because it does not fit into the clients life goals. Into which of Gordons functional health patterns should the nurse identify this clients comment? 1. Cognitive/perceptual pattern 2. Coping/stress-tolerance pattern 3. Health-perception/health-management pattern 4. Value/belief pattern

4. Value/belief pattern

A client has been admitted for acute dehydration, secondary to nausea and diarrhea. When is the best time for the nurse to conduct this clients interview? 1. As soon as the client gets to the floor 2. After the client has settled in and been oriented to the room 3. When the family is available to help 4. After the client has been medicated

2. After the client has settled in and been oriented to the room

While listening to a client describe current symptoms, the nurse considers the clients entire situation. Which attribute of critical thinking is the nurse practicing? 1. Reflection 2. Context 3. Dialogue 4. Time

2. Context

While conducting a dressing change, the nurse notes a new area of skin breakdown that was caused from the tape used to secure the dressing. In which phase of the nursing process is the nurse working? 1. Assessment 2. Diagnosis 3. Implementation 4. Evaluation

1. Assessment

A student nurse resists when encouraged to be creative when providing client care. What should the nurse educator say to encourage this student to be creative? 1. Creativity allows unique solutions to unique problems. 2. Not all your answers are going to be from your textbook. 3. Creativity makes nursing more fun. 4. Youll get bored if you dont learn to be creative.

1. Creativity allows unique solutions to unique problems.

A client is experiencing a productive cough, audible coarse crackles, elevated temperature of 102.3F, chills, and body aches. What did the nurse use to determine that this patient is experiencing respiratory compromise? 1. Deductive reasoning 2. Inductive reasoning 3. Socratic questioning 4. Critical analysis

1. Deductive reasoning

The nurse is reviewing the nursing process with a firstyear nursing student. What should the nurse explain as being the purpose of the diagnosis phase? Standard Text: Select all that apply. 1. Develop a list of problems. 2. Identify client strengths. 3. Develop a plan. 4. Specify goals and outcomes. 5. Identify problems that can be prevented.

1. Develop a list of problems. 2. Identify client strengths. 5. Identify problems that can be prevented.

The nurse is greeting a newly admitted client. What statement should the nurse make to establish rapport with this client? 1. Hello, Im your nurse and Ill be taking care of you today. 2. Youre luckythere are no students on the unit today. 3. Good morning, is there anything you need right now? 4. Hi. If you need anything, put on your call light.

1. Hello, Im your nurse and Ill be taking care of you today.

The nurse is completing a health history with a client who has complications from chronic asthma. Which open-ended question should the nurse use? 1. How would you describe your sleep pattern? 2. Can you describe your coughing pattern? 3. Is there anything that makes your breathing worse? 4. What medications are you on?

1. How would you describe your sleep pattern?

The nurse has just completed an admission interview with a new client. Which nursing statement indicates that the interview is in the closing phase? 1. Im going to set up your physical assessment now. Do you have any questions? 2. Tell me more about how you feel. 3. Could you give examples of what types of other treatments youve had? 4. Is there anything youre worried about?

1. Im going to set up your physical assessment now. Do you have any questions?

Parents ask why invasive diagnostic tests were prescribed for their ill child. The nurse has just gotten out of report and has not had a chance to review additional information. What should the nurse respond to the parents? 1. Im not sure I can answer your question just now. 2. Its a good idea to listen to what your physician wants. 3. Your childs doctor is the best there is. I dont see why you wouldnt follow his advice. 4. Maybe you should get another opinion if youre not comfortable with your doctor.

1. Im not sure I can answer your question just now.

The nurse implements a quicker way to set up and initiate an intravenous infusion while still following safe practice. Which attitude of critical thinking is this nurse practicing? 1. Independence 2. Intellectual courage to challenge the status quo or rituals 3. Integrity 4. Confidence

1. Independence

The nurse desires to improve critical thinking skills when providing client care. On which attributes should the nurse focus when developing these skills? Standard Text: Select all that apply. 1. Independence 2. Egocentricity 3. Intellectual humility 4. Fair-mindedness 5. Confidence 6. Perseverance

1. Independence 3. Intellectual humility 4. Fair-mindedness 5. Confidence 6. Perseverance

The nurse is providing care to a group of clients. For which situation would the nurses use of critical thinking be a priority? 1. Administering IV push meds to critically ill clients 2. Educating a home health client about treatment options 3. Teaching new parents car seat safety 4. Assisting an orthopedic client with the proper use of crutches

2. Educating a home health client about treatment options

A client complaining of extreme low back pain is pale and diaphoretic and walks bent at the waist. Before taking vital signs, the nurse suspects that the blood pressure and heart rate will be elevated. What thought process did the nurse use to come to this conclusion? 1. Fact 2. Inference 3. Judgment 4. Opinion

2. Inference

The nurse who just moved from an urban area to a sparsely populated rural area understands that certain customs and practices the nurse follows may be quite foreign to the people in the new area. Which attitude of critical thinking is the nurse demonstrating? 1. Fair-mindedness 2. Insight into egocentricity 3. Intellectual humility 4. Intellectual courage to challenge the status quo and rituals

2. Insight into egocentricity

A clinical instructor senses that a student has been struggling with clinical skills learned in lab. To combat this, the educator pairs the student with a staff nurse who has clients with a variety of treatments and cares. Which type of problem solving is the instructor using? 1. Trial and error 2. Intuition 3. Research process 4. Experience

2. Intuition

The nurse enters the room of a critically ill child after sensing that something isnt right. Once the nurse determines the child is stable, the nurse continues to perform a check of all the lines and equipment in the room and finds that the last IV solution hung by the previous nurse was not the correct solution. Which problemsolving method did this nurse use? 1. Trial and error 2. Intuition 3. Judgment 4. Scientific method

2. Intuition

During an assessment, a client who is not very talkative appears pale, diaphoretic, and restless in the bed, and says leave me alone. Which subjective data should the nurse document? 1. Restlessness 2. Leave me alone 3. Not talkative 4. Pale and diaphoretic

2. Leave me alone

A client with unstable cardiac dysrhythmias has orders for medications, one of which is by oral route, the other by IV delivery. The nurse realizes that the IV route would be fastest, but is also concerned about the side effects that this drug may produce and the fact that the client has never taken the drug, so any adverse effect is unknown. Which part of the decision-making process is the nurse using? 1. Identify the purpose 2. Seek alternatives 3. Project 4. Implement

2. Seek alternatives

A nurse has been assigned a new client who cannot speak English. How should the nurse facilitate communication with this client? 1. Have a member of the housekeeping staff who speaks the same language translate. 2. Use the translation services supplied by the hospital. 3. Make sure a family member who does speak English is available. 4. Conduct the interview using hand gestures.

2. Use the translation services supplied by the hospital.

During an initial interview, the client says I dont understand why I have to have surgery; Im really not that sick or in pain right now. How should the nurse respond to the client? 1. Its OK to be worried. Surgery is a big step. 2. What kind of questions do you have about your surgery? 3. I think these are things you should be asking your doctor. 4. Have you had surgery before?

2. What kind of questions do you have about your surgery?

A newly admitted client is angry because nursing staff continue to ask the same questions. What should the nurse respond to this client? 1. In order to make sure all of your information is complete, I need to ask these questions. 2. Youre right. Let me know if theres anything you need right now. 3. Ill be done shortly, just give me a few more minutes. 4. You shouldnt be upset. Were only doing our jobs.

2. Youre right. Let me know if theres anything you need right now.