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CRITICAL THINKING NUR 200 HONDROS, 200 EXAM 1
CRITICAL
THINKING EXAM | 144 QUESTIONS AND ANSWERS(A+
SOLUTION GUIDE)
Clinical judgment - ANSWER - >"Thinking Like A Nurse". integral to the Safety of pt. Interpretation or conclusion about a patient's needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient's response. clinical reasoning - ANSWER - >is the thinking process by which a nurse reaches a clinical judgement. an iterative process of noticing, interpreting, and responding- reasoning in transition with a fine attunement to the patient and how the patient responds to the nurses action evidence-based practice - ANSWER - >clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences Tanner's Model - ANSWER - >Noticing
Interpreting Responding Reflecting noticing (tanners model) - ANSWER - >identify s/s, gather complete and accurate data, assessing systematically and comprehensively, *predicting (and managing) potential complications, identifying assumptions factors that influence "Noticing" - ANSWER - >-intrapersonal characteristics of the nurse
- theoretical and experiential knowledge of the nurse
- knowing the patient
- context or environment of care analytic reasoning (interpreting) - ANSWER - >based on theoretical knowledge. nurse makes a hypothesis or best guess about the pt care situation and then tests. typically students and novice nurses intuitive reasoning (interpreting) - ANSWER - >based on unstated but understood knowledge about the pt, the care giving context, and their previous experiences. typically expert nurse.
nursing process - ANSWER - >Assessment Diagnosis Planning Implementation Evaluation assessment (nursing process) - ANSWER - > 1 - collection of info from primary source (pt) and secondary (family, friends, health professionals, medical record). 2 - interpretation and validation of data to ensure a complete data base subjective and objective Cue and Inference (assessment) - ANSWER - >Cue is information that you obtain through use of senses. Inference is your judgment or interpretation of these cues. diagnosis (nursing process) - ANSWER - >clinical judgment concerning a human response to health conditions/ life process, or vulnerability. Educated judgment about health concern. use NANDA. used to make care plan Types of Nursing Diagnoses (diagnosis) - ANSWER - >Actual Risk Possible Wellness
Syndrome 3 part nursing diagnosis (diagnosis) - ANSWER - >P:problem; ex impaired physical mobility E: etiology/ related factor; ex incisional pain S: symptom or defining characteristics; ex evidence by restricted turning and positioning planning (nursing process) - ANSWER - >collaborates with pt, family, and the rest of the health care team to determine the urgency of the identified problems and prioritizes patients needs. care plan (planning) - ANSWER - >Assessment, nursing diagnosis, interventions, evaluation care plan for each diagnosis. patients involved with planning. increase communication between staff. goals and expected outcomes need to be S.M.A.R.T specific, measurable, attainable, realistic, timed. goal (planning) - ANSWER - >broad statement that describes a desired change in a pt conditions, perception, or behavior. ex "pt will understand postoperative risks"
successful. if the pt is improving. reassessment. care plan revision, discontinue/modify. document results. RN responsibilities - ANSWER - >Safety, PT outcomes, PT education nursing process compared to tanners model - ANSWER - >1. assessment= noticing
- nursing diagnosis & planning= interpretation
- implementation= responding
- evaluation= reflecting Benners stages of clinical competence - ANSWER - >links the concepts of professional identity Stage 1: Novice Stage 2: Advanced Beginner Stage 3: Competent Stage 4: Proficient Stage 5: Expert Stage 1; novice (benners) - ANSWER - >beginner, no experience. lacks confidence. continual verbal and physical cues. takes a prolonged time, unable to use discretionary judgment.
Stage 2: advanced beginners (benners) - ANSWER - >marginally acceptable performance, has prior experience in actual situations. skillful in parts of practice, occasional cues. may be delayed in time. knowledge developing. Stage 3: competent (benners) - ANSWER - >same or similar job 2 - 3 years. demonstrates efficiency, coordinated and confident. plan established based on considerable conscious abstract, analytic contemplation of the problem. conscious, deliberate planning; helps achieve efficiency and organization. completed in suitable time without cues. Stage 4: proficient (benners) - ANSWER - >see and understand situation as a whole. learn from experiences, what to expect from a situation, how the plan needs to be modified. decision making becomes less labored. the nurse has perspective on existing attributes and aspects of the situation Stage 5: the expert (benners) - ANSWER - >intuitive grasp, zeroes in on the accurate problem without wasteful consideration. has deep understanding of the total situation. performance is fluid and flexible and highly proficient. Fulmer SPICES tool - ANSWER - >assessing older adults that focuses on six common "marker conditions": sleep problems,
- attitudes
- standards knowledge base (critical thinking) - ANSWER - >prepares you to better anticipate and identify patients problems by understanding their origin and nature. varies according to education, initiative, experience. experience (critical thinking) - ANSWER - >necessary to acquire clinical decision making skills. learn from observing, sensing, talking with patients and families, and reflecting actively on all experiences. competency (critical thinking) - ANSWER - >in practice you will apply critical thinking components during each step of the nursing process. general critical thinking, specific critical thinking- nursing process attitudes (critical thinking) - ANSWER - >guidelines for how to approach a problem or decision making situation. confidence, independence, fairness, responsibility, risk taking, discipline, perseverance, creativity, curiosity, integrity, humility standards (critical thinking) - ANSWER - >intellectual standards- a principle for rational thought- used for nursing process Professional standard- ethical criteria for nursing judgement,
evidence based criteria used for evaluation, and criteria for professional responsibility ANA Standards of Professional Nursing Practice - ANSWER >standard of care provided to patients.
- Includes identifying and acknowledging expertise of those inside and outside nursing profession
- Includes referring client to others in order to meet client's needs priority setting of patient care - ANSWER - >is the ordering of nursing diagnosis or patient problems using notions of urgency and importance to establish a preferential order for nursing interventions. "Treat the cause before the symptom." RRT (Rapid Response Team) - ANSWER - >prevent/ minimize deterioration of a pt Complete assessment - ANSWER - >A review and physical examination of all body systems, for stable patients only spices - ANSWER - >is an efficient and effective instrument for obtaining the information necessary to prevent health alterations in the older adult patient. this acronym for the
Database - ANSWER - >Completed health history and physical examination, large store or bank of info sleep - ANSWER - >S is for _____ disorders S in SPICES - ANSWER - >Sleep disorders clinical reasoning - ANSWER - >is the thinking process by which a nurse reaches a clinical judgement. an iterative process of noticing, interpreting, and responding- reasoning in transition with a fine attunement to the patient and how the patient responds to the nurses action clinical reasoning - ANSWER - >is the thinking process by which a nurse reaches a clinical judgement. an iterative process of noticing, interpreting, and responding- reasoning in transition with a fine attunement to the patient and how the patient responds to the nurses action clinical reasoning - ANSWER - >is the thinking process by which a nurse reaches a clinical judgement. an iterative process of noticing, interpreting, and responding- reasoning in transition with a fine attunement to the patient and how the patient responds to the nurses action
Psychosocial history - ANSWER - >Psychological and social factors problems - ANSWER - >P is for _______ with eating or feeding P in SPICES - ANSWER - >Problems with eating or feeding evidence-based practice - ANSWER - >clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences evidence-based practice - ANSWER - >clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences evidence-based practice - ANSWER - >clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences 1st method of data collection - ANSWER - >Interiew patient, health history. Patient is your primary source incontinence - ANSWER - >I is for _________ I in SPICES - ANSWER - >Incontinence
comprehensively, *predicting (and managing) potential complications, identifying assumptions noticing (tanners model) - ANSWER - >identify s/s, gather complete and accurate data, assessing systematically and comprehensively, *predicting (and managing) potential complications, identifying assumptions noticing (tanners model) - ANSWER - >identify s/s, gather complete and accurate data, assessing systematically and comprehensively, *predicting (and managing) potential complications, identifying assumptions Concepts of clinical judgment - ANSWER - >1. Safety
- Healthcare quality
- Leadership
- Patient education
- Evidence
- Professionalism
- Care coordination evidence - ANSWER - >E is for ___________ of falls objective data (noticing) - ANSWER - >information that is seen, heard, felt, or smelled by an observer; signs
objective data (noticing) - ANSWER - >information that is seen, heard, felt, or smelled by an observer; signs objective data (noticing) - ANSWER - >information that is seen, heard, felt, or smelled by an observer; signs E in SPICES - ANSWER - >Evidence of falls Analytic reasoning - ANSWER - >Situation is unfamiliar skin - ANSWER - >S is for __________ breakdown S in SPICES - ANSWER - >Skin breakdown subjective data (noticing) - ANSWER - >things a person tells you about that you cannot observe through your senses; symptoms subjective data (noticing) - ANSWER - >things a person tells you about that you cannot observe through your senses; symptoms subjective data (noticing) - ANSWER - >things a person tells you about that you cannot observe through your senses; symptoms
- context or environment of care factors that influence "Noticing" - ANSWER - >-intrapersonal characteristics of the nurse
- theoretical and experiential knowledge of the nurse
- knowing the patient
- context or environment of care Narrative reasoning - ANSWER - >Situation to patient experience with illness. 0 - 7 - ANSWER - >it is unlikely that you are abnormally sleepy Interpret - ANSWER - >Clustering related data, recognizing inconsistencies, checking accuracy and reliability, compare and contrast data,distinguish relevant from irrelevant information,determining the importance of information, judging how much ambiguity is acceptable, using legal ethical and professional guidelines, predicting and managing potential complications Interpreting (tanners) - ANSWER - >comparing and contrast data, clustering related information, recognizing inconsistencies, checking accuracy, distinguishing relevant from irrelevant, determine importance of info, judge how much ambiguity is
acceptable (ie b/p dt condition), determine legal ethical professional guidelines, (predicting and) *managing potential complications Interpreting (tanners) - ANSWER - >comparing and contrast data, clustering related information, recognizing inconsistencies, checking accuracy, distinguishing relevant from irrelevant, determine importance of info, judge how much ambiguity is acceptable (ie b/p dt condition), determine legal ethical professional guidelines, (predicting and) *managing potential complications Interpreting (tanners) - ANSWER - >comparing and contrast data, clustering related information, recognizing inconsistencies, checking accuracy, distinguishing relevant from irrelevant, determine importance of info, judge how much ambiguity is acceptable (ie b/p dt condition), determine legal ethical professional guidelines, (predicting and) *managing potential complications Noticing - ANSWER - >1. Identify signs and symptoms
- Complete and accurate date
- Assessing systemically and comprehensively
- Predicting and managing patient complications
- Identifying assumptions
