NR224 EXAM 1
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While assessing a patient, the nurse ob-
serves the patient's 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 D. Problem Solving
the IV 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:
A. inference
B. Diagnostic reasoning
C. Competency
D. Problem solving
The nurse sits down to talk with a patient
who lost her sister 2 weeks ago. The
patient reports she is unable to sleep,
feels very fatigued during the day, and is
having trouble at work. The nurse asks
her to clarify the type of trouble. The pa-
tient explains she can't concentrate or
even solve simple problems. The nurse A. Diagnostic reasoning
records the results of the assessment,
describing the patient as having ineffec-
tive coping. This is an example of :
A. diagnostic reasoning
B. Competency
C. Inference
D. Problem Solving
A patient on a surgical unit develops
sudden shortness of breath and a drop
in BP. The staff respond, but the patient
dies 30 minutes later. the manager on
the nursing unit calls the staff involved in
the emergency response together, The
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staff discusses what occurred over the
30 minute time frame, the actions tak-
en, and whether other steps should have
been implemented. The nurses in this
situation are: C. Conducting reflective practice
A. problem solving
B. showing humility
C. conducting reflective practice
D. Exercising responsibility
A nurse has worked on an oncology unit
for 3 years. One patient has become visi-
bly weaker and states, "I feel funny". The
nurse knows how patients often have be-
havior 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 goes to the phone, calls the
physician, and begins the conversation C. Analyticity
by saying, "I believe that your patient is D. Self confidence
developing sepsis. I want to report symp-
toms I'm seeing." What examples of crit-
ical thinking concepts does the nurse
show? (Select all that apply)
A. Experience
B. Ethical
C. Analyticity
D. Self-confidence
E. Risk taking
A 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 vital signs and
monitoring of their intravenous (IV) lines.
Patient D is resting following a visit by
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physical therapy. Which of the following
activities by the nurse represent(s) use
of clinical decision making for groups of
patients? (Select all that apply.)
A. consider how to involve patient A in
deciding whether to involve the family
caregiver in wound care instruction A&C
B. Think about past experience with pa-
tients who develop postoperative compli-
cations
C. Decide which activities can be com-
bined for patients B and C
D. Carefully gather any assessment info
and identify patient problems
The surgical unit has initiated the use
of a pain-rating scale to assess pa-
tients' pain severity during their postop-
erative recovery. The registered nurse
(RN) looks at the pain flow sheet to see
the pain scores recorded for a patient
over the last 24 hours. Use of the pain C
scale is an example of which intellectual
standard?
A. deep
B. Relevant
C. Consistent
D. Significant
During a home health visit the nurse pre-
pares to instruct a patient in how to per-
form range-of-motion (ROM) exercises
for an injured shoulder. The nurse ver-
ifies that the patient took an analgesic
30 minutes before arrival at the patient's
home. After discussing the purpose for
the exercises and demonstrating each
one, the nurse has the patient perform
them. After two attempts with only the
, NR224 EXAM 1
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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." The nurse applies the crit-
ical thinking attitude of integrity in which
of the following actions?"
A. "I understand your reluctance, but the
exercises are necessary for you to regain
A
function in your shoulder. Let's go a bit
more slowly and try to relax"
B. "I see that you're uncomfortable. I'll
call your doctor to decide the next step."
C. "Show me exactly where your pain is
and rate it for me on a scale of 0 to 10."
D. "Is anything else bothering you? Other
than the pain, is there any other reason
you might not want to do the exercises?"
The nurse cared for a 14-year-old with
renal failure who died near the end of the
work shift. The health care team tried for
45 minutes to resuscitate the child with
no success. The family was devastated
by the loss, and, when the nurse tried
to talk with them, the mother said, "You
can't make me feel better; you don't know
what it's like to lose a child." Which of
the following examples of journal entries
might best help the nurse reflect and B, C, & D
think about this clinical experience? (Se-
lect all that apply.)
A. Data entry of the time of day, who was
present, and the condition or the child
B. Description of the efforts to restore the
child's BP, what was used, and questions
about the child's response
C. The meaning the experience had for
the nurse with respect to her understand-
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