A Patient-Centered Nursing
Process Approach
11th Edition
• Author(s)Linda McCuistion
TEST BANK
,Question 1
Difficulty: Easy
Question Type: Multiple Choice (MCQ)
Question:
A nurse is preparing to administer a newly prescribed
medication. Which nursing action best demonstrates the
Recognize Cues (Assessment) step of the Clinical Judgment
Measurement Model (CJMM)?
A. Administering the medication as prescribed
B. Reviewing the patient's allergies, vital signs, and laboratory
results
C. Evaluating the patient's response after the medication is
given
D. Revising the plan of care after discussing outcomes with the
provider
Correct Answer: B
Rationale: Recognizing cues involves collecting relevant
assessment data before making clinical decisions. Reviewing
allergies, vital signs, and laboratory results helps identify factors
that may affect medication safety.
,Question 2
Difficulty: Moderate
Question Type: Select All That Apply (SATA)
Question:
A nurse is assessing a patient before administering an
antihypertensive medication. Which findings are examples of
recognizing cues?
A. Blood pressure is 88/54 mm Hg.
B. The patient reports dizziness when standing.
C. The nurse decides to withhold the medication.
D. Serum potassium is 5.9 mEq/L.
E. The nurse contacts the provider regarding assessment
findings.
Correct Answer: A, B, D
Rationale: Recognizing cues involves identifying objective and
subjective assessment findings. Withholding the medication
and notifying the provider occur after assessment during
analysis and intervention.
Question 3
Difficulty: Moderate
, Question Type: Multiple Choice (MCQ)
Question:
A patient prescribed insulin has a blood glucose level of 48
mg/dL and is diaphoretic and confused. Which action reflects
the Analyze Cues step?
A. Administer oral glucose.
B. Determine that the patient's symptoms are most likely
caused by hypoglycemia.
C. Reassess blood glucose after treatment.
D. Document the intervention.
Correct Answer: B
Rationale: Analyzing cues requires interpreting assessment
findings to identify the underlying clinical problem. Determining
that hypoglycemia is the likely cause guides appropriate
intervention.
Question 4
Difficulty: Moderate
Question Type: NGN Clinical Judgment
Question: