Chapter 14: Clinical Judgment Exam
Questions With Verified Answers
A group of student nurses has been encouraged by their instructors to be intentional and
deliberate about applying clinical decision-making models to their practice. A student tells a
colleague, "The model that makes the most sense to me is the information-processing model,
because it seems the most straightforward." How should the colleague best respond to this
student?
-"That model was dominant in nursing for decades but has recently been replaced by more
nuanced models."
-"Absolutely. Many of the other models are evidence-based but excessively complex."
-"It is definitely a clear model, but it does not really capture all of the complexities and the
human element of nursing."
-"I agree. The model is elegant for its simplicity and has been clinically linked to better client
outcomes." - answer✔"It is definitely a clear model, but it does not really capture all of the
complexities and the human element of nursing."
Explanation:
The information-processing model is attractive by virtue of its simplicity and linear nature.
However, there is no significant drive to apply this model to nursing practice, because nursing is
psychosocially complex and cannot be reduced to a simple equation of input and output. For this
reason, it has never been predominant in nursing, even in past decades. It has not been proven to
achieve better client outcomes in the literature.
A novice nurse is being mentored by a more experienced nurse who is able to recognize small
but significant client cues and process large amounts of data in a short time. What conclusion(s)
should the novice nurse draw about the more experienced nurse's practice? Select all that apply.
-The nurse is able to rely on intuition more than critical thinking.
-The nurse has well-developed situational awareness.
-The nurse is able to rely on reflection-in-action rather than reflection-on-action.
-The nurse has a high capacity for cognitive load.
-The nurse is able to apply the steps of the Clinical Judgment and Measurement Model (CJMM)
simultaneously. - answer✔The nurse has a high capacity for cognitive load.
The nurse has well-developed situational awareness.
Explanation:
Cognitive load refers to the amount of information a person can hold in their memory at one
time; this nurse is able to hold large amounts of data and process them quickly. The ability to
discern subtle cues is associated with situational awareness. The six steps of the Clinical
Judgment and Measurement Model are linear, and not normally applied at a single point in time.
Intuition is more developed in experienced nurses, but this is a component of critical thinking
rather than an alternative to it. Reflection-in-action and reflection-on-action are both used by
experienced nurses in Tanner's clinical judgment model.
A nurse is navigating a busy morning on a hospital unit and is struggling to finish the necessary
tasks in the time available. In response, the nurse has assigned morning hygiene tasks for two
clients to an unlicensed assistive personnel (UAP). What QSEN competency is this nurse
exemplifying?
-client-centered care
-safety
-teamwork and collaboration
-informatics
-quality improvement
-evidence-based practice - answer✔teamwork and collaboration
Explanation:
Although this action is consistent with all the QSEN competencies, delegation is a practical
example of the competency of collaboration and teamwork in the clinical setting.
A hospital client who requires assistance with hygiene has expressed a preference for receiving a
bed bath after lunch rather than in the morning. The nurse has consequently changed the nursing
care plan. The nurse's action reflects which QSEN competency?
-client-centered care
-empathic care
-accountability and adaptability
-quality improvement - answer✔client-centered care
Explanation:
Adjusting a client's care in response to the client's preferences or abilities is indicative of client-
centered care. Quality improvement is focused more broadly on systems and processes.
Empathic care and accountability and adaptability are not QSEN competencies.
A novice nurse has witnessed the value of critical thinking in planning and responding to clients.
Which principle should inform the nurse's practice?
-The concept of clinical judgment has superseded the concept of critical thinking.
-Critical thinking is an innate skill that some nurses possess.
-Reliance on intuition is inconsistent with critical thinking.
-Critical thinking is a skill that can be learned and developed. - answer✔Critical thinking is a
skill that can be learned and developed.
Explanation:
Critical thinking is a learned skill—like many other nursing skills—that can be developed with
learning and practice. It is not characterized as an innate characteristic that some possess and that
others do not. Critical thinking is foundational to clinical judgment, and it can include intuition
as a component.
A student nurse has been challenged to apply the principles of critical thinking during laboratory
simulations. What characteristic of the student nurse's actions suggests that the student nurse
engaged in critical thinking?
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