,(Davis Advantage for Understanding Medical-Surgical Nursing, 7e Linda Williams, Paula Hopper)
Answers
CHAPTER 1 to collect appropriate data, identify a patient
problem, and determine the best possible plan of
CRITICAL THINKING, action. Clinicaljudgment is based on good critical
CLINICAL JUDGMENT, ANDTHE thinking.
NURSING PROCESS Cue
Definition: Significant or relevant data. Not all data are
cues (relevant), but all cues are data.
AUDIO CASE STUDY Collaboration
Jane Practices Clinical Judgment Definition: Working together with the health team to
improve patient outcomes.
1. Identify and analyze cues; prioritize hypotheses;
generatesolutions; take action; evaluate outcomes; Intervention
repeat. Definition: Taking action to carry out a plan.
2. Jane was exhausted, failed a test, and was pulled in
too many directions. She was also crying in her car and Evaluation
hadpoor study habits and not enough sleep. Definition: Comparing the outcomes you expected with
3. Jane’s resources included a good friend, sick time from actual outcomes. Did the plan work? Were expected
work, and wasted time between classes that she could outcomes met?
better utilize. Your resources will be different, but they Vigilance
exist!
Definition: The act of being attentive, alert, and watchful.
4. Critical thinking—the why: Jane uses critical thinking to
determine why her current plan isn’t working. She thinks
honestly about her poor study habits, her time-
CRITICAL THINKING AND CLINICALJUDGMENT
management problems, and the impact this is having on Critical thinking and clinical judgment both follow a similar
her and her family. format. Both follow steps from collecting data to determin-
Clinical judgment—the do: Jane uses her thinking to ing problems and outcomes, developing and taking actions,
develop and carry out a plan that uses her resources and and evaluating outcomes. However, critical thinking helps
provides more productive study time and more quality you think about the problem: What is it? Why is it happen-
time with her kids. ing? And clinical judgment leads you to do something to
manage the problem.
VOCABULARY
Sample sentences will vary for the Vocabulary problems.
CUE RECOGNITION
Nursing process You will do many things for each individual, but the FIRST
thing is listed below.
Definition: An organizing framework that links thinking with
nursing actions. Steps include assessment/data collection, 1. Sit the patient upright.
nursing diagnosis, planning, implementation,and 2. Call 911 while running across the street.
evaluation. 3. Elevate the feet off the bed by placing a pillow under
Critical thinking thecalves and allowing the feet to hang off the edge of
the pillow.
Definition: The use of those cognitive (knowledge) skills or 4. Check blood glucose and have a glucose source ready.
strategies that increase the probability of a desirable
5. Turn the patient to the side to prevent aspiration.
outcome. Also involves reflection, problem-solving, and
related thinking skills.
Clinical judgment
Definition: The observed outcome of critical thinking and
decision making. A process that uses nursing knowledge
,2 Chapter 1 Answers
CRITICAL THINKING
This is just one possible way to complete a cognitive map.
Could it be low Am I diabetic? Frontal area "Sick" feeling Hard Tylenol helps Hunger makes
blood sugar? it worse
data
scale morning
REVIEW QUESTIONS taking vital signs; data collection is the first step in the
nursing process. (2, 3, 4) are all steps in the nursing
The correct answers are in boldface.
process, for which the registered nurse is responsible;
1. (2) Critical thinking can lead to better outcomes for the the LPN/LVN may assist the registered nurse with these.
patient. (1, 3, 4) may be true but are not the best Nitroglycerin should not be administered withoutfirst
answer. knowing the patient’s blood pressure.
2. (4) is correct. The nurse who can admit to not knowing 7. (2) indicates that the patient is concerned about
something is exhibiting intellectual humility. (1) shows freedomfrom injury and harm. (1) relates to basic needs
expertise but not necessarily intellectual humility; such as air, oxygen, and water. (3) relates to feeling
(2) reporting an error shows intellectual integrity; loved. (4) isrelated to having positive self-esteem.
(3) empathizing is positive but does is not evidence 8. (3, 1, 2, 4) is the correct order according to Maslow.
of humility. 9. (5, 2, 1, 4, 6, 3) is the correct order.
3. (3, 4, 5, 1, 2) is the correct order. 10. (3) shows the patient is actually taking action. (1, 2, 4)
4. (1) is the best definition. (2, 3, 4) do not define critical are all positive but do not show intent to take action.
thinking but are examples of good thinking. 11. (4) is the nurse’s analysis of the situation. (1, 2) are
5. (4) is correct. Evaluation determines whether goals are data; (3) is a recommendation.
achieved and interventions effective. (2) is the role of the 12. (1, 2, 3, 4) should be present. Since the data
physician. (1, 3) encompass data collection and imple- provides only hip replacement as the patient’s
mentation, which are earlier steps in the nursing process. problem, (5) thedietitian is not necessary.
6. (1) is correct. The licensed practical nurse/licensed voca-
tional nurse (LPN/LVN) can collect data, which includes
1
, Answers
CHAPTER 2 EVIDENCE-BASED PRACTICE
EVIDENCE-BASED PRACTICE 1. proof
2. context
3. quality
AUDIO CASE STUDY 4. care
Marie and Evidence-Based Practice 5. randomized
6. outcomes
1. Thirdhand smoke is the dangerous toxins of smoke that
linger on hair, clothing, furniture, and other surfaces in 7. gold
an area after a cigarette is put out. Marie learned that 8. nursing
exposure to these toxins can be neurotoxic to children 9. patient’s
and can trigger asthma attacks in sensitive people. 10. information
2. Evidence-based practice is considered the gold
standardof health care. CLINICAL JUDGMENT
3. Step 1: Ask the burning question. Step 2: Search and 1. By questioning the existing way of doing things to
collect the most relevant and best evidence ensure that the patient receives the best care
available.Step 3: Think critically. Appraise the possible
evidence for validity, relevance to the situation, and 2. A thorough search of the literature, with the assistance of
applicability. the medical librarian, in the area of their burning ques-
Step 4: Measure the outcomes before and after instituting tion regarding music reducing preoperative anxiety.
the change. Step 5: Make it happen. Step 6: Evaluate the 3. Cumulative Index to Nursing and Allied Health
practice decision or change. Literature (CINAHL) Database, Joanna Briggs Institute
4. Combination therapy with a nicotine patch and nicotine evidence-based resources, Cochrane Reviews, Medline/
lozenges worked best, although bupropion (Zyban) or PubMed
varenicline (Chantix) and nicotine lozenges worked well, 4. Measure patient outcomes before instituting the
too. A Cochrane Review found that advice and support evidence-based change in practice so comparisons can
from nursing staff can increase patients’ success in quit- be made after implementation to determine if the
ting smoking, especially in a hospital setting. inter-vention worked
5. Evaluate the results to determine whether the change
VOCABULARY made a significant difference and if it was valuable
Sample sentences will vary for the Vocabulary problems. interms of cost and time
1. Evidence-based practice: A systematic process that uses REVIEW QUESTIONS
current evidence in making decisions about patient care.
2. Evidence-informed practice: Consideration of patient The correct answers are in boldface.
factors along with the use of evidence for shared decision 1. (3) is correct. Providing an explanation of why some-
making between the health-care provider and the thing is done promotes the understanding for why it is
patient. important to be done and therefore will more likely be
3. Randomized controlled trials: True experimental studies done. (1, 2, 4) only communicate the need to perform a
in which as many factors as possible that could falsely task. They do not provide rationale for the task to pro-
change the results are controlled. mote understanding of the importance of the task.
4. Research: Scientific study, investigation, or experimenta- 2. (3) is correct. Evidence-based nursing care that has been
tion to establish facts and analyze their significance. evaluated as appropriate for an agency provides the
5. Systematic review: A review of relevant research using best and safest patient care. (1) Opinions may not be
guidelines. based on