NUR 155 Exam 1-study guide- top score-2023-2024
Critical Thinking:
What are your responsibilities as a nurse?
• Recognize health problems
• Anticipate and plan for problems
• Initiate actions to ensure appropriate and timely treatment, patient safety, and optimal
health outcomes
Critical thinking defined
• Intentional higher-level reasoning
• Influenced by knowledge, experience, skills, attitudes, and interpersonal skills
• Used as a guide for rational judgment and action
• Takes time and practice to develop
Critical thinking attitudes
• Independence – think for themselves
• Fair-mindedness – assesses all viewpoints
• Insight into egocentricity – biases
• Intellectual humility – knows the limit of
one’s own knowledge
• Intellectual courage to challenge status
quo
• Integrity – apply the same rigorous
standards of proof to their own knowledge and beliefs as they apply to the knowledge and
beliefs of others
• Perseverance – show perseverance in finding effective solutions to the client and nursing
problems
• Confidence – leads to trustworthy conclusions
• Curiosity – the mind of a critical thinker is filled with questions
Diagnostic reasoning
• Making sense of the data you collected
• Requires critical thinking
• Improves with experience, knowledge, and skill
• Requires the creation of a diagnostic (working) hypothesis
• Consider what is important in a given situation
,Four components of diagnostic reasoning
• Cues (ex. Pt staggers into ER)
• Diagnostic “working” hypothesis (ex. Pt is intoxicated)
• Data collection to support hypothesis (ex. No alcohol on breath, clammy skin,
diaphoretic, disoriented, blood glucose level is critical at 61)
• Evaluating hypothesis (ex. Pt isn’t intoxicated, pt is hypoglycemic and requires
immediate intervention to prevent life-threatening complications)
Critical thinking techniques
Critical Thinking – is the process of intentional higher-level thinking to define a pts problem,
examine the evidence-based practice in caring for the pt, and make choices in the delivery of
care
Critical Reasoning – is the cognitive process that uses thinking strategies to gather and analyze
pt information, evaluate the relevance of the information, and decide on possible nursing actions
to improve the pts physiological and psychosocial outcomes
Critical Analysis – is the application of a set of questions to a particular situation or idea to
determine essential information and ideas and discard unimportant information and ideas
Socratic Questioning – is a technique one can use to look beneath the surface, recognize and
examine assumptions, search for inconsistencies, examine multiple points of view, and
differentiate what one knows from what one merely believes
Inductive Reasoning – generalizations are formed from a set of facts or observations
Deductive Reasoning – is reasoning from general premise to the specific conclusion
Nursing Process – is a systematic, rational method of planning and providing individualized
nursing care. It begins with assessment of the pt and use of clinical reasoning to identify pt
problems.
Clinical Judgment – is a decision-making process to ascertain the right nursing action to be
implemented at the appropriate time in the pt’s care
Cognitive Processes – are the thinking processes based on the knowledge of aspects of client
care, cognitive skills are learned through reading and applying health-related literature
Metacognitive Processes – include reflective thinking and awareness of the skills learned by the
nurse in caring for the pt, the nurse reflects on the pt’s status, and through the use of critical
thinking skills determines the most effective plan of care
,Problem solving techniques
• Trial & Error – in which a number of approaches are tried until a solution is found (least
effective, pt could suffer harm)
• Intuition – is a problem-solving approach that relies on a nurse’s inner sense, 6th sense,
hunch, instinct, feeling, or suspicion (experience improves intuition)
• Research process – evidence-based decisions and care, what do we know works best vs
what we’ve always done (pursue answers to pt care problems through research)
Concept mapping
• Concept maps provide an opportunity to “see” thinking
• The map maker’s prior knowledge influences what is portrayed on the concept map
Something to think about
• Nurses are responsible for a unique dimension of healthcare – “the diagnosis and
treatment of human responses to actual or potential health problems”
• Nurses use knowledge from other disciplines
• Nurses deal with change in stressful environments
• Nurses make important decisions
Nursing process
• Is a systematic, rational method of planning and providing individualized nursing care
• Its purposes are to identify a pt’s health status and actual or potential health care
problems or needs, to establish plans to meet identified needs, and to deliver specific
nursing interventions to meet those needs
• The pt may be an individual, a family, a community, or a group
The nursing process is…
Systematic – the nursing process has an ordered sequence of activities and each activity depends
on the accuracy of the activity that precedes it and influences the activity following it
, Dynamic – the nursing process has great interaction and overlapping among the activities and
each activity is fluid and flows into the next activity
Client Centered – the nursing process ensures that nurses are client-centered rather than task-
centered
Goal-Directed – the nursing process is a means for nurses and clients to work together to identify
specific goals and to match them with the appropriate nursing actions
Universally applicable – the nursing process allows nurses to practice nursing with well or ill
people, young or old, in any type of practice setting
ADPIE
A – assessment
D – diagnosis
P – planning
I – implementation
E – evaluation
Assessment
• Collect data
• Organize data
• Validate data
• Document data
Diagnosis
• Analyze data
• Identify health problems, risks, and strengths
• Formulate diagnostic statements
Planning
• Prioritize problems/diagnoses
• Formulate goals/desired outcomes
• Select nursing interventions
• Write nursing interventions
Implementation
• Reassess the pt
• Determine the nurse’s need for assistance
• Implement the nursing interventions
• Supervise delegated care
• Document nursing activities
Evaluation
Critical Thinking:
What are your responsibilities as a nurse?
• Recognize health problems
• Anticipate and plan for problems
• Initiate actions to ensure appropriate and timely treatment, patient safety, and optimal
health outcomes
Critical thinking defined
• Intentional higher-level reasoning
• Influenced by knowledge, experience, skills, attitudes, and interpersonal skills
• Used as a guide for rational judgment and action
• Takes time and practice to develop
Critical thinking attitudes
• Independence – think for themselves
• Fair-mindedness – assesses all viewpoints
• Insight into egocentricity – biases
• Intellectual humility – knows the limit of
one’s own knowledge
• Intellectual courage to challenge status
quo
• Integrity – apply the same rigorous
standards of proof to their own knowledge and beliefs as they apply to the knowledge and
beliefs of others
• Perseverance – show perseverance in finding effective solutions to the client and nursing
problems
• Confidence – leads to trustworthy conclusions
• Curiosity – the mind of a critical thinker is filled with questions
Diagnostic reasoning
• Making sense of the data you collected
• Requires critical thinking
• Improves with experience, knowledge, and skill
• Requires the creation of a diagnostic (working) hypothesis
• Consider what is important in a given situation
,Four components of diagnostic reasoning
• Cues (ex. Pt staggers into ER)
• Diagnostic “working” hypothesis (ex. Pt is intoxicated)
• Data collection to support hypothesis (ex. No alcohol on breath, clammy skin,
diaphoretic, disoriented, blood glucose level is critical at 61)
• Evaluating hypothesis (ex. Pt isn’t intoxicated, pt is hypoglycemic and requires
immediate intervention to prevent life-threatening complications)
Critical thinking techniques
Critical Thinking – is the process of intentional higher-level thinking to define a pts problem,
examine the evidence-based practice in caring for the pt, and make choices in the delivery of
care
Critical Reasoning – is the cognitive process that uses thinking strategies to gather and analyze
pt information, evaluate the relevance of the information, and decide on possible nursing actions
to improve the pts physiological and psychosocial outcomes
Critical Analysis – is the application of a set of questions to a particular situation or idea to
determine essential information and ideas and discard unimportant information and ideas
Socratic Questioning – is a technique one can use to look beneath the surface, recognize and
examine assumptions, search for inconsistencies, examine multiple points of view, and
differentiate what one knows from what one merely believes
Inductive Reasoning – generalizations are formed from a set of facts or observations
Deductive Reasoning – is reasoning from general premise to the specific conclusion
Nursing Process – is a systematic, rational method of planning and providing individualized
nursing care. It begins with assessment of the pt and use of clinical reasoning to identify pt
problems.
Clinical Judgment – is a decision-making process to ascertain the right nursing action to be
implemented at the appropriate time in the pt’s care
Cognitive Processes – are the thinking processes based on the knowledge of aspects of client
care, cognitive skills are learned through reading and applying health-related literature
Metacognitive Processes – include reflective thinking and awareness of the skills learned by the
nurse in caring for the pt, the nurse reflects on the pt’s status, and through the use of critical
thinking skills determines the most effective plan of care
,Problem solving techniques
• Trial & Error – in which a number of approaches are tried until a solution is found (least
effective, pt could suffer harm)
• Intuition – is a problem-solving approach that relies on a nurse’s inner sense, 6th sense,
hunch, instinct, feeling, or suspicion (experience improves intuition)
• Research process – evidence-based decisions and care, what do we know works best vs
what we’ve always done (pursue answers to pt care problems through research)
Concept mapping
• Concept maps provide an opportunity to “see” thinking
• The map maker’s prior knowledge influences what is portrayed on the concept map
Something to think about
• Nurses are responsible for a unique dimension of healthcare – “the diagnosis and
treatment of human responses to actual or potential health problems”
• Nurses use knowledge from other disciplines
• Nurses deal with change in stressful environments
• Nurses make important decisions
Nursing process
• Is a systematic, rational method of planning and providing individualized nursing care
• Its purposes are to identify a pt’s health status and actual or potential health care
problems or needs, to establish plans to meet identified needs, and to deliver specific
nursing interventions to meet those needs
• The pt may be an individual, a family, a community, or a group
The nursing process is…
Systematic – the nursing process has an ordered sequence of activities and each activity depends
on the accuracy of the activity that precedes it and influences the activity following it
, Dynamic – the nursing process has great interaction and overlapping among the activities and
each activity is fluid and flows into the next activity
Client Centered – the nursing process ensures that nurses are client-centered rather than task-
centered
Goal-Directed – the nursing process is a means for nurses and clients to work together to identify
specific goals and to match them with the appropriate nursing actions
Universally applicable – the nursing process allows nurses to practice nursing with well or ill
people, young or old, in any type of practice setting
ADPIE
A – assessment
D – diagnosis
P – planning
I – implementation
E – evaluation
Assessment
• Collect data
• Organize data
• Validate data
• Document data
Diagnosis
• Analyze data
• Identify health problems, risks, and strengths
• Formulate diagnostic statements
Planning
• Prioritize problems/diagnoses
• Formulate goals/desired outcomes
• Select nursing interventions
• Write nursing interventions
Implementation
• Reassess the pt
• Determine the nurse’s need for assistance
• Implement the nursing interventions
• Supervise delegated care
• Document nursing activities
Evaluation
