Fundamentals of Nursing

Nursing

Quiz 10 :

Critical Thinking and Clinical Reasoning

Quiz 10 :

Critical Thinking and Clinical Reasoning

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A client complains of shortness of breath. During assessment the nurse observes that the client has edema of the left leg only. The nurse reviews evidence-based practice literature and reflects on a previous client with the same clinical manifestations. What do these actions represent? 1) Clinical judgment 2) Clinical reasoning 3) Reflection 4) Intuition
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Client in the given case complains of shortness of breath. Nurse has observed edema in left sided leg. Nurse/caregiver now evaluates evidences and identifies similarities in the clinic actions. This is a sign of clinical reasoning.
Clinical judgment can be best explained as the process of making decisions to ensure the correct step to be taken. It is taken on right time such as in case of emergency. Intuition is a feeling or it can be defined as inner sense. It is a way of problem solving approach based on inner sense.
It could not be reflection as reflect is the act of nurses review of the care provided to the patient. It is done to determine the strategies of the future care to be followed.
Hence, the options 1, 3 and 4 are incorrect.
Clinical reasoning is an experienced based technique. Nurse has reviewed evidence based literature. Prior teachings in the care increase the ability of nurse to identify and answer in the queries of patient's care.
Hence, the correct answer is option
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In the clinical reasoning process, the nurse sets and weighs the criteria, examines alternatives, and performs which of the following before implementing a plan? 1) Reexamines the purpose for making the decision. 2) Consults the client and family members to determine their view of the criteria. 3) Identifies and considers various means for reaching the outcomes. 4) Determines the logical course of action should intervening problems arise.
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In the given case, nurse decides particular procedure and performs the action. Reexamining patient for the purpose of making the decision will not be right. It is advised to decide the course of action keeping in mind all the problems eliminating the need of reexamination.
Clients and family are the first one to be consulted so that their views can be taken. They are consulted in priority in purpose setting and criteria determining steps. Proper procedure to be followed is not set until all the participants present their view points.
Hence, the options 1, 2 and 3 are incorrect.
It is important to know the problems which might interfere with the plan of action. Responses according to the plan should also be prepared along with the plan so that any interference can be avoided.
Hence, the correct answer is option
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The nurse is concerned about a client who begins to breathe very rapidly. Which action by the nurse reflects clinical reasoning? 1) Notify the primary care provider. 2) Obtain vital signs and oxygen saturation. 3) Request a chest x-ray. 4) Call the rapid response team.
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The caregiver is concerned about the client who is breathing fast. Clinical reasoning is reflected by her action. Nurse should report the primary care provider in case she is feeling some unusual activity in the patient. It is a part of appropriate nursing action.
Chest X-ray is usually ordered by a physician. It is not ordered in the hospital. So this option cannot be right. Rapid response team is required in case of emergency when nurse is not able to control the circumstances.
Hence, the options 1, 3 and 4 are incorrect.
Caregiver's intuition is just like the sixth sense, the inner feeling which the nurse recognizes cues to reach to the appropriate decisions. The caregiver appropriately obtains vital signs (temp, blood pressure and so on) and oxygen to analyze the patient's respiratory status.
Hence, the correct answer is option
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A client reports feeling hungry, but does not eat when food is served. Using clinical reasoning skills, the nurse should perform which of the following? 1) Assess why the client is not ingesting the food provided. 2) Continue to leave the food at the bedside until the client is hungry enough to eat. 3) Notify the primary care provider that tube feeding may be indicated soon. 4) Believe the client is not really hungry.
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The nurse is teaching a client about wound care during a follow-up visit in the client's home. Which critical thinking attitude causes the nurse to reconsider the plan and supports evidence-based practice when the client states, "I just don't know how I can afford these dressings"? 1) Integrity 2) Intellectual humility 3) Confidence 4) Independence
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Which reasoning process describes the nurse's actions when the nurse evaluates possible solutions for care of an infected wound for optimal client outcomes? 1) Intuition 2) Research process 3) Trial and error 4) Problem solving
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When the nurse considers that a client is from a developing country and may have a positive tuberculosis test due to a prior vaccination, which critical thinking attitude and skill is the nurse practicing? 1) Creating environments that support critical thinking 2) Tolerating dissonance and ambiguity 3) Self-assessment 4) Seeking situations where good thinking is practiced
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The client who is short of breath benefits from the head of the bed being elevated. Because this position can result in skin breakdown in the sacral area, the nurse decides to study the amount of sacral pressure occurring in other positions. What decision making is the nurse engaging in? 1) The research method 2) The trial-and-error method 3) Intuition 4) The nursing process
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W. is a 63-year-old recently retired engineer with a history of irritable bowel syndrome that causes frequent diarrhea and rectal bleeding. His wife is a schoolteacher. In mid-December he comes to the acute care clinic complaining about "not feeling good." You conclude he is having a recurrence of his intestinal problem. Socrates might ask you about the consequences of your conclusion by posing the question "What are the implications of your thinking?" How would you answer? Consider the implications if you are correct and if you are incorrect in your assumption.
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A client with diarrhea also has a primary care provider's order for a bulk laxative daily. The nurse, not realizing that bulk laxatives can help solidify certain types of diarrhea, concludes, "The primary care provider does not know the client has diarrhea." What type of statement is this? 1) A fact 2) An inference 3) A judgment 4) An opinion
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W. is a 63-year-old recently retired engineer with a history of irritable bowel syndrome that causes frequent diarrhea and rectal bleeding. His wife is a schoolteacher. In mid-December he comes to the acute care clinic complaining about "not feeling good." You conclude he is having a recurrence of his intestinal problem. Critical thinkers look for subtle cues. Which cues in this situation require follow-up?
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W. is a 63-year-old recently retired engineer with a history of irritable bowel syndrome that causes frequent diarrhea and rectal bleeding. His wife is a schoolteacher. In mid-December he comes to the acute care clinic complaining about "not feeling good." You conclude he is having a recurrence of his intestinal problem. How would you demonstrate that you are using the critical thinking attitude of "confidence in reasoning"?
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W. is a 63-year-old recently retired engineer with a history of irritable bowel syndrome that causes frequent diarrhea and rectal bleeding. His wife is a schoolteacher. In mid-December he comes to the acute care clinic complaining about "not feeling good." You conclude he is having a recurrence of his intestinal problem. What questions would you ask yourself to check this assumption?
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A client in a cardiac rehabilitation program says to the nurse, "I have to eat a low-sodium diet for the rest of my life, and I hate it!" Which is the most appropriate response by the nurse? 1) "I will get a dietary consult to talk to you before next week." 2) "What do you think is so difficult about following a low-sodium diet?" 3) "At least you survived a heart attack and are able to return to work." 4) "You may not need to follow a low-sodium diet for as long as you think."
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