Chapter 7: The Nursing Process and Standards of Practice
A benefit of the implementation of clinical pathways is evidenced when the patient states:
a. I know my doctors and nurses really care about me.
b. My medication has really helped lessen my symptoms.
c. I have hopes that I will be able to lead a productive, healthy life.
d. My care team has really helped me manage most of my problems. - ansD
(Clinical pathways are tools that among other things promote interdisciplinary care thus providing for holistic
care of the patient. The remaining options do not involve the additional recognized benefits of clinical
pathways that include cost effectiveness and access to patient status reports.)
A depressed patient shares with the nurse that he, has been thinking about ending it all. Based on NANDA
recommendations, the nurse:
a. Implements suicide precautions for this patient
b. Includes Risk for Self Harm to the patients care plan
c. Documents regarding the patients safety every 15 minutes
d. Reviews the patients chart for references to past incidences of hopeless - ansB
(NANDA states that a nurse is able to change any actual diagnosis on the NANDA list to a risk diagnosis if the
problem has not occurred yet. The remaining options, although not inappropriate, do not related to NANDA.)
A nurse best shows an understanding of the role of evidence-based research in achieving therapeutic patient
care outcomes when:
, a. Subscribing to and reading a monthly psychiatric research nursing journal
b. Working on a committee to revise current facility policies regarding the use of chemical restraints
c. Registering to attend a psychiatric workshop on newly developed psychotropic medication therapies
d. Asking an experienced staff member to review the interventions being proposed for a newly admitted
patient - ansB
(Evidence-based practice is based on evidence and scientific principles that have been developed through
research. The more closely clinical practice reflects relevant research, the more likely it is that patients will
receive the best available care. The option that infers action directed at implementing the research is the one
that shows best understanding. Reliance only on experience is not reflective of quality nursing care.)
A nurse shows effective critical thinking skills directed towards nursing care of a cognitively impaired patient
who continues to socially isolate by:
a. Clearly stating that the patient must socially interact once daily
b. Documenting that the patient continues to resist socialization
c. Asking the patient to identify which unit activity they are willing to attend
d. Suggesting that staff take the patient with them when running errands off the unit - ansD
(Critical thinking in this case involves the creation of alternative solutions to a problem that was not resolved by
conventional methods. The remaining options, although not inappropriate, do not show critical thinking skills.)
A nurse shows the best understanding of the legal importance of the patients chart when stating:
a. You always document in ink and never erase or use white out in the nursing notes.
b. Its a document that shows proof that the patient received care that met the expected standards.
A benefit of the implementation of clinical pathways is evidenced when the patient states:
a. I know my doctors and nurses really care about me.
b. My medication has really helped lessen my symptoms.
c. I have hopes that I will be able to lead a productive, healthy life.
d. My care team has really helped me manage most of my problems. - ansD
(Clinical pathways are tools that among other things promote interdisciplinary care thus providing for holistic
care of the patient. The remaining options do not involve the additional recognized benefits of clinical
pathways that include cost effectiveness and access to patient status reports.)
A depressed patient shares with the nurse that he, has been thinking about ending it all. Based on NANDA
recommendations, the nurse:
a. Implements suicide precautions for this patient
b. Includes Risk for Self Harm to the patients care plan
c. Documents regarding the patients safety every 15 minutes
d. Reviews the patients chart for references to past incidences of hopeless - ansB
(NANDA states that a nurse is able to change any actual diagnosis on the NANDA list to a risk diagnosis if the
problem has not occurred yet. The remaining options, although not inappropriate, do not related to NANDA.)
A nurse best shows an understanding of the role of evidence-based research in achieving therapeutic patient
care outcomes when:
, a. Subscribing to and reading a monthly psychiatric research nursing journal
b. Working on a committee to revise current facility policies regarding the use of chemical restraints
c. Registering to attend a psychiatric workshop on newly developed psychotropic medication therapies
d. Asking an experienced staff member to review the interventions being proposed for a newly admitted
patient - ansB
(Evidence-based practice is based on evidence and scientific principles that have been developed through
research. The more closely clinical practice reflects relevant research, the more likely it is that patients will
receive the best available care. The option that infers action directed at implementing the research is the one
that shows best understanding. Reliance only on experience is not reflective of quality nursing care.)
A nurse shows effective critical thinking skills directed towards nursing care of a cognitively impaired patient
who continues to socially isolate by:
a. Clearly stating that the patient must socially interact once daily
b. Documenting that the patient continues to resist socialization
c. Asking the patient to identify which unit activity they are willing to attend
d. Suggesting that staff take the patient with them when running errands off the unit - ansD
(Critical thinking in this case involves the creation of alternative solutions to a problem that was not resolved by
conventional methods. The remaining options, although not inappropriate, do not show critical thinking skills.)
A nurse shows the best understanding of the legal importance of the patients chart when stating:
a. You always document in ink and never erase or use white out in the nursing notes.
b. Its a document that shows proof that the patient received care that met the expected standards.
