lOMoARcPSD| 63525276
NSG 3100 EXAM 1 – CLINICAL JUDGMENT, SAFETY,
AND HYGIENE 2026 UPDATE | ACCURATE
QUESTIONS AND A+ ANSWERS
Unit 1
Chapter 4: Clinical Judgment in Nursing/ Critical Thinking
What is clinical judgment?
Observation, thinking, prioritizing, planning, acting, and evaluating
What are the skills required for clinical judgment?
Critical thinking - application of knowledge and experience to identify a patient’s problem and choose clinical judgments that
improve patient outcomes
● Thinking ahead - be prepared; read textbooks, research evidence-based care strategies, be aware of clinical resources
(health team)
● Thinking in-action - knowledge and practical experiences; think about multiple options and safe acting simultaneously (identify
risks, prevent spread, assess status, anticipate what is needed for patient care)
● Thinking back - reflect on patient outcomes (what could have been done better? What interventions worked?) ● Be able to
identify subtle cues
Clinical reasoning - ability to focus and filter clinical data to recognize what is most and least important (prioritize and organize
actions/responsibilites) to identify the problem
● Clinical reasoning steps
○ Recognize and define a problem by asking the right questions -> Select the data or info necessary to solve the
problem or answer the questions -> Recognize stated and unstated assumptions. Consider work to identify if
assumptions are true or not -> Formulate and select relevant and/or potential decisions -> Draw a valid, informed
conclusion
What are the key aspects of clinical judgment?
Tanner’s Clinical Judgement Model
● Noticing - based on the context of nurse-patient interaction (relationship, knowledge, expectation, and values)
● Interpreting - analyze the situation and form hypotheses; recognize patterns and use intuition
● Responding - identify potential interventions after interpreting patient data and determining priorities for care ● Reflection -
occur in action or on action
○ Reflection-in-action - nurse’s ability to read the patient -> how does the patient respond to nurse intervention? How
can the interventions be adjusted based on patient assessment?
■ Expected in situations where outcomes for patients are not achieved
○ Reflection-on-action - occurs retrospectively; looks back on experiences (positive and negative)
Lasater’s 11 Dimensions Involved in Clinical Judgement
● Noticing - focused observation, recognizing deviations from expected patterns, information seeking
● Interpreting - prioritizing data, making sense of data
● Responding - Calm/confident manner, clear communication, well-planned interventions/flexibility, being skillful ● Reflecting -
evaluation/self-analysis, commitment to improvement
National Council of State Boards of Nursing (NCSBN) Clinical Judgement Measurement Model
1. Recognize cues
2. Analyze cues
3. Prioritize hypotheses
4. Generate solutions
5. Take actions
6. Evaluate outcomes
What environmental factors influence clinical judgment?
The ratio of experienced to novice nurses and cultural diversity in the health team (increases the ability to make culturally sensitive
judgments)
What is the difference between inductive and deductive reasoning?
Inductive reasoning uses specific facts or details to formulate conclusions (specific to general)
Deductive reasoning involves generating facts from a major theory, generalizations, or premise (general to specific)
, lOMoARcPSD| 63525276
Chapter 25: Safety
What is safety?
Free from physical or psychological harm or injury
How does this apply to patient safety?
Unintentional injuries are the third leading cause of death in the US
What is the National Patient Safety Goals (NPSG)?
● They are implemented by the Joint Commission (TJC) and updated yearly.
● Goals: Improve the accuracy of patient ID, improve safety of medication administration, reduce risk of health-associated
infections (HAIs), reduce harm from falls, prevent pressure ulcers, and help hospitals identify risk in patient populations
What factors affect patient safety?
● Individual factors
○ Neurological - body system functions and lifespan factors
○ Cardiopulmonary - shortness of breath, chest pain, changes in HR and BP
■ Orthostatic hypotension - drop in BP w/ position changes (sitting to standing)
○ Renal hepatic - toxicity due to impaired metabolism and excretion ●
Environmental factors
○ Pollution - contamination of air, land, water, and environment w/ unnatural or harmful substances ○
Lighting - inadequate lighting
○ Communicable diseases - transmittable diseases via body fluids, blood, insect bites ○
Workplace hazards - Depending on the occupation, hazards can vary
■ Occupational Safety and Health Administration (OSHA) - provides workers w/ guidelines to prevent hazards and
reduce injuries
What are the differences in safety concerns amongst different age groups?
● Supine position to reduce the risk of SIDS
● Rear-facing car seats and carriers for toddlers or until the highest weight/height by the car manufacturer
● Kids under 13 years old sit in the backseat w/ seatbelt
● Adults deal w/ financial stressors, work-related demands, and lifestyle balance → implement vacations/relaxation periods and
doctor’s visits for screening (BP, headache, mental health, and lung disease from smoking)
What are the concerns about falls? How to prevent it?
● Types of falls:
○ Accidental, anticipated physiological falls, unanticipated physiological falls ● Risk for falls:
○ Poor vision, cognitive dysfunction, mobility restrictions, orthostatic hypotension, urinary frequency, weakness from the
disease process or therapy, current medications (sedatives, hypnotics, tranquilizers, narcotic analgesics, diuretics) ● How to
prevent falls:
○ Call lights should be placed w/in reach
○ Frequently used items kept close
○ Patients with high fall risk have rooms closer to the nurse station
○ Non-skid socks are worn
○ Handrails placed in bathrooms/hallways
○ Assistive devices
○ Adequate lighting and clutter-free
○ Some patients need 24/7 sitters or virtual care monitors
○ Can have bed alarm with doctor’s order
What are the seizure precautions?
● Pad side rails and put oral suction equipment at the bedside ● During the seizure:
○ Remain w/ patient and call for help
○ Do not restrain the patient
○ If not in bed, lower the patient to the floor and surround with pads for safety
○ Turn the patient to the lateral position
○ Do not put anything in their mouth
○ Move items in the environment
○ Loosen restrictive clothing
○ Provide O2 and suction as needed
○ Prepare seizure meds
○ Time, record, and document seizure to report to MD
How do we address fire hazards?
● Cooking is the leading cause of residential fires
● Fire-fighting “RACE”
○ R- rescue patients
, lOMoARcPSD| 63525276
○ A-activate alarms, alert others/emergency services
○ C- contain fire and smoke (close doors)
○ E- extinguish/evaluate
● PASS
○ Pull
○ Aim
○ Squeeze
○ Sweep
● To prevent fire hazards → nurses should check for faulty or loose wires, anything unusual ● Patient safety in home care
settings
○ Do not use stoves to heat the house
○ Do not use ovens for storing food
○ Do not leave irons face down on iron board
○ Do not smoke or have an open flame if the oxygen is in use in the home
○ Install smoke alarms on every floor
○ Establish fire escape plans
○ Have fire extinguishers
What causes suffocation?
Smothering, choking, and suffocation
What are the purpose and safety precautions of restraints?
Restraints are protective devices used to limit the physical activity of a patient or body part
● Types of restraints:
○ Physical - wrist/ankle, jacket/vest, side rails (leather or cloth cuff restraints, soft belts, mitts, pelvic ties) ■
Lap belt - used to prevent pt from falling out of chairs or wheelchairs
● Pts w/ fall risk but still need mobility
■ Limb restraints - Used to limit the movement of a pt’s arm or leg
● Pts who are pulling at tubes or trying to remove medical devices
■ Mitt restraints - to prevent pts from using their fingers or hands to pull at medical equipment or scratch
themselves
● Used for pts who need less restrictive restraints than limb restraints but still require protection from interfering w/ their
treatment or injuring themselves
■ Vest restraints - to prevent a pt from getting out of bed or a chair while still allowing sme upper body movement
● Commonly used for pts who are at risk of falling or wandering but who need more freedom of movement in their arms
compared to other restraints
■ Roll belt - secure a pt to a bed or gurney while allowing some side-to-side movement
● Often used in situations where pts need to be confined to bed (e.g., ICU pts) but still need the ability to roll or shift slightly
without attempting to get up
○ Chemical - medication
○ Seclusion - isolated room and unable to leave ●
Reasons for using restraints:
○ Avoid and prevent harm to patients and others
○ To provide medically necessary treatments
○ Should be used as a last resort after less restrictive interventions have been used
○ It must be discontinued asap. A doctor’s order is only effective for 24 hours, requires constant monitoring, and must be
updated. It cannot be PRN
● Requires informed consent from patient and/or their family
● Restraint order parameters → PCP order must include reason, timeframe, and type of restraint
How do we prevent medication administration errors?
● Electronic medical records (EMRs)
● Decreased interruptions during administration
● Two RNs checking orders and dosage
● Utilize a smart infusion pump
What are the concerns with overexposure to radiation?
● Can increase health risks for patients and health care professionals, try to minimize exposure during procedures
● X-rays, positron emission tomography (PET), and computed tomography (CT)
What are some examples of procedural errors?
Failure to properly ID patients before care and leaving the bed in an elevated position aftercare
What is the importance of assessments?
● Assessments of safety hazards and potential sources of injuries are the 1st step
● Collect info on the patient’s symptoms, chief complaints, history of environmental hazards/exposure, health history, and fall
risk
What are the different types of poisoning, and how do we implement safety measures?
NSG 3100 EXAM 1 – CLINICAL JUDGMENT, SAFETY,
AND HYGIENE 2026 UPDATE | ACCURATE
QUESTIONS AND A+ ANSWERS
Unit 1
Chapter 4: Clinical Judgment in Nursing/ Critical Thinking
What is clinical judgment?
Observation, thinking, prioritizing, planning, acting, and evaluating
What are the skills required for clinical judgment?
Critical thinking - application of knowledge and experience to identify a patient’s problem and choose clinical judgments that
improve patient outcomes
● Thinking ahead - be prepared; read textbooks, research evidence-based care strategies, be aware of clinical resources
(health team)
● Thinking in-action - knowledge and practical experiences; think about multiple options and safe acting simultaneously (identify
risks, prevent spread, assess status, anticipate what is needed for patient care)
● Thinking back - reflect on patient outcomes (what could have been done better? What interventions worked?) ● Be able to
identify subtle cues
Clinical reasoning - ability to focus and filter clinical data to recognize what is most and least important (prioritize and organize
actions/responsibilites) to identify the problem
● Clinical reasoning steps
○ Recognize and define a problem by asking the right questions -> Select the data or info necessary to solve the
problem or answer the questions -> Recognize stated and unstated assumptions. Consider work to identify if
assumptions are true or not -> Formulate and select relevant and/or potential decisions -> Draw a valid, informed
conclusion
What are the key aspects of clinical judgment?
Tanner’s Clinical Judgement Model
● Noticing - based on the context of nurse-patient interaction (relationship, knowledge, expectation, and values)
● Interpreting - analyze the situation and form hypotheses; recognize patterns and use intuition
● Responding - identify potential interventions after interpreting patient data and determining priorities for care ● Reflection -
occur in action or on action
○ Reflection-in-action - nurse’s ability to read the patient -> how does the patient respond to nurse intervention? How
can the interventions be adjusted based on patient assessment?
■ Expected in situations where outcomes for patients are not achieved
○ Reflection-on-action - occurs retrospectively; looks back on experiences (positive and negative)
Lasater’s 11 Dimensions Involved in Clinical Judgement
● Noticing - focused observation, recognizing deviations from expected patterns, information seeking
● Interpreting - prioritizing data, making sense of data
● Responding - Calm/confident manner, clear communication, well-planned interventions/flexibility, being skillful ● Reflecting -
evaluation/self-analysis, commitment to improvement
National Council of State Boards of Nursing (NCSBN) Clinical Judgement Measurement Model
1. Recognize cues
2. Analyze cues
3. Prioritize hypotheses
4. Generate solutions
5. Take actions
6. Evaluate outcomes
What environmental factors influence clinical judgment?
The ratio of experienced to novice nurses and cultural diversity in the health team (increases the ability to make culturally sensitive
judgments)
What is the difference between inductive and deductive reasoning?
Inductive reasoning uses specific facts or details to formulate conclusions (specific to general)
Deductive reasoning involves generating facts from a major theory, generalizations, or premise (general to specific)
, lOMoARcPSD| 63525276
Chapter 25: Safety
What is safety?
Free from physical or psychological harm or injury
How does this apply to patient safety?
Unintentional injuries are the third leading cause of death in the US
What is the National Patient Safety Goals (NPSG)?
● They are implemented by the Joint Commission (TJC) and updated yearly.
● Goals: Improve the accuracy of patient ID, improve safety of medication administration, reduce risk of health-associated
infections (HAIs), reduce harm from falls, prevent pressure ulcers, and help hospitals identify risk in patient populations
What factors affect patient safety?
● Individual factors
○ Neurological - body system functions and lifespan factors
○ Cardiopulmonary - shortness of breath, chest pain, changes in HR and BP
■ Orthostatic hypotension - drop in BP w/ position changes (sitting to standing)
○ Renal hepatic - toxicity due to impaired metabolism and excretion ●
Environmental factors
○ Pollution - contamination of air, land, water, and environment w/ unnatural or harmful substances ○
Lighting - inadequate lighting
○ Communicable diseases - transmittable diseases via body fluids, blood, insect bites ○
Workplace hazards - Depending on the occupation, hazards can vary
■ Occupational Safety and Health Administration (OSHA) - provides workers w/ guidelines to prevent hazards and
reduce injuries
What are the differences in safety concerns amongst different age groups?
● Supine position to reduce the risk of SIDS
● Rear-facing car seats and carriers for toddlers or until the highest weight/height by the car manufacturer
● Kids under 13 years old sit in the backseat w/ seatbelt
● Adults deal w/ financial stressors, work-related demands, and lifestyle balance → implement vacations/relaxation periods and
doctor’s visits for screening (BP, headache, mental health, and lung disease from smoking)
What are the concerns about falls? How to prevent it?
● Types of falls:
○ Accidental, anticipated physiological falls, unanticipated physiological falls ● Risk for falls:
○ Poor vision, cognitive dysfunction, mobility restrictions, orthostatic hypotension, urinary frequency, weakness from the
disease process or therapy, current medications (sedatives, hypnotics, tranquilizers, narcotic analgesics, diuretics) ● How to
prevent falls:
○ Call lights should be placed w/in reach
○ Frequently used items kept close
○ Patients with high fall risk have rooms closer to the nurse station
○ Non-skid socks are worn
○ Handrails placed in bathrooms/hallways
○ Assistive devices
○ Adequate lighting and clutter-free
○ Some patients need 24/7 sitters or virtual care monitors
○ Can have bed alarm with doctor’s order
What are the seizure precautions?
● Pad side rails and put oral suction equipment at the bedside ● During the seizure:
○ Remain w/ patient and call for help
○ Do not restrain the patient
○ If not in bed, lower the patient to the floor and surround with pads for safety
○ Turn the patient to the lateral position
○ Do not put anything in their mouth
○ Move items in the environment
○ Loosen restrictive clothing
○ Provide O2 and suction as needed
○ Prepare seizure meds
○ Time, record, and document seizure to report to MD
How do we address fire hazards?
● Cooking is the leading cause of residential fires
● Fire-fighting “RACE”
○ R- rescue patients
, lOMoARcPSD| 63525276
○ A-activate alarms, alert others/emergency services
○ C- contain fire and smoke (close doors)
○ E- extinguish/evaluate
● PASS
○ Pull
○ Aim
○ Squeeze
○ Sweep
● To prevent fire hazards → nurses should check for faulty or loose wires, anything unusual ● Patient safety in home care
settings
○ Do not use stoves to heat the house
○ Do not use ovens for storing food
○ Do not leave irons face down on iron board
○ Do not smoke or have an open flame if the oxygen is in use in the home
○ Install smoke alarms on every floor
○ Establish fire escape plans
○ Have fire extinguishers
What causes suffocation?
Smothering, choking, and suffocation
What are the purpose and safety precautions of restraints?
Restraints are protective devices used to limit the physical activity of a patient or body part
● Types of restraints:
○ Physical - wrist/ankle, jacket/vest, side rails (leather or cloth cuff restraints, soft belts, mitts, pelvic ties) ■
Lap belt - used to prevent pt from falling out of chairs or wheelchairs
● Pts w/ fall risk but still need mobility
■ Limb restraints - Used to limit the movement of a pt’s arm or leg
● Pts who are pulling at tubes or trying to remove medical devices
■ Mitt restraints - to prevent pts from using their fingers or hands to pull at medical equipment or scratch
themselves
● Used for pts who need less restrictive restraints than limb restraints but still require protection from interfering w/ their
treatment or injuring themselves
■ Vest restraints - to prevent a pt from getting out of bed or a chair while still allowing sme upper body movement
● Commonly used for pts who are at risk of falling or wandering but who need more freedom of movement in their arms
compared to other restraints
■ Roll belt - secure a pt to a bed or gurney while allowing some side-to-side movement
● Often used in situations where pts need to be confined to bed (e.g., ICU pts) but still need the ability to roll or shift slightly
without attempting to get up
○ Chemical - medication
○ Seclusion - isolated room and unable to leave ●
Reasons for using restraints:
○ Avoid and prevent harm to patients and others
○ To provide medically necessary treatments
○ Should be used as a last resort after less restrictive interventions have been used
○ It must be discontinued asap. A doctor’s order is only effective for 24 hours, requires constant monitoring, and must be
updated. It cannot be PRN
● Requires informed consent from patient and/or their family
● Restraint order parameters → PCP order must include reason, timeframe, and type of restraint
How do we prevent medication administration errors?
● Electronic medical records (EMRs)
● Decreased interruptions during administration
● Two RNs checking orders and dosage
● Utilize a smart infusion pump
What are the concerns with overexposure to radiation?
● Can increase health risks for patients and health care professionals, try to minimize exposure during procedures
● X-rays, positron emission tomography (PET), and computed tomography (CT)
What are some examples of procedural errors?
Failure to properly ID patients before care and leaving the bed in an elevated position aftercare
What is the importance of assessments?
● Assessments of safety hazards and potential sources of injuries are the 1st step
● Collect info on the patient’s symptoms, chief complaints, history of environmental hazards/exposure, health history, and fall
risk
What are the different types of poisoning, and how do we implement safety measures?
