Exam 1: NR 226/ NR226 (Latest 2026/
2027 Update) Fundamentals: Patient
Care Guide | Questions & Answers| Grade
A| 100% Correct (Verified Solutions)-
Chamberlain
NR 226 Exam 1 -
While assessing a patient, the nurse observes that the patient's intravenous (IV) line is not
infusing at the ordered rate. The nurse assesses the patient for pain at the IV site, checks
the flow regulator on the tubing, looks to see if the patient is lying on the tubing, checks the
point of connection between the tubing and the IV catheter, and then checks the condition
of the site where the intravenous catheter enters the patient's skin. After the nurse
readjusts the flow rate, the infusion begins at the correct rate. This is an example of:
A. Inference.
B. Diagnostic reasoning.
C. Competency.
D. Problem solving.
D. Problem solving
-This is an example of problem solving. The nurse collects information and tries options until she
is able to find a solution to the slowed infusion rate. The focus is on solving the problem with the
patient's IV and not on solving the patient's health problem; thus this is not the diagnostic
reasoning process.
The nurse sits down to talk with a patient who lost her sister 2 weeks ago. The patient
reports she is unable to sleep, feels very fatigued during the day, and is having trouble at
work. The nurse asks her to clarify the type of trouble. The patient explains she can't
concentrate or even solve simple problems. The nurse records the results of the assessment,
describing the patient as having ineffective coping. This is an example of:
A. Diagnostic reasoning.
,B. Competency.
C. Inference.
D. Problem solving.
A. Diagnostic reasoning
-In this example the nurse collects information about the patient, sees patterns in the data
collected, and makes a nursing diagnosis. This is an example of the diagnostic process.
A nurse has worked on an oncology unit for 3 years. One patient has become visibly weaker
and states, "I feel funny." The nurse knows how patients often have behavior changes
before developing sepsis when they have cancer. The nurse asks the patient questions to
assess thinking skills and notices the patient shivering. The nurse goes to the phone, calls
the physician, and begins the conversation by saying, "I believe that your patient is
developing sepsis. I want to report symptoms I'm seeing." What examples of critical
thinking concepts does the nurse show? (Select all that apply.)
A. Experience
B. Ethical
C. Analyticity
D. Self-confidence
E. Risk taking
C & D.
-Among critical thinking concepts, the nurse shows analyticity (analyzing information, gathering
additional findings, and sensing a problem), and self-confidence (calling the physician, which
shows trust in his own reasoning). The nurse's experience would have influenced the familiarity
of patient symptoms, but in this text experience is considered a component of the critical
thinking model and not a concept. Acting ethically is a critical thinking standard.
.A nurse who is working on a surgical unit is caring for four different patients. Patient A
will be discharged home and is in need of instruction about wound care. Patients B and C
have returned from the operating room within an hour of each other, and both require vital
signs and monitoring of their intravenous (IV) lines. Patient D is resting following a visit by
physical therapy. Which of the following activities by the nurse represent(s) use of clinical
decision making for groups of patients? (Select all that apply.)
,A. Consider how to involve patient A in deciding whether to involve the family caregiver in
wound care instruction.
B. Think about past experience with patients who develop postoperative complications.
C. Decide which activities can be combined for patients B and C.
D. Carefully gather any assessment information and identify patient problems.
A&C
-Considering how to involve patients in decisions and how to combine nursing activities to be
more organized and allow for resolving more than one problem at a time are examples of clinical
decision making for groups of patients. Thinking about past experience with patients is an
example of reflection, an approach to strengthen critical thinking skills. Gathering assessment
information is part of the process of diagnostic reasoning, which should be applied to each
patient.
The surgical unit has initiated the use of a pain-rating scale to assess patients' pain severity
during their postoperative recovery. The registered nurse (RN) looks at the pain flow sheet
to see the pain scores recorded for a patient over the last 24 hours. Use of the pain scale is
an example of which intellectual standard?
A. Deep
B. Relevant
C. Consistent
D. Significant
C. Consistent
-Use of the same pain scale for assessing pain acuity is an example of being consistent.
During a home health visit the nurse prepares to instruct a patient in how to perform
range-of-motion (ROM) exercises for an injured shoulder. The nurse verifies that the
patient took an analgesic 30 minutes before arrival at the patient's home. After discussing
the purpose for the exercises and demonstrating each one, the nurse has the patient
perform them. After two attempts with only the second of three exercises, the patient stops
and says, "This hurts too much. I don't see why I have to do this so many times." The nurse
applies the critical thinking attitude of integrity in which of the following actions?
A. "I understand your reluctance, but the exercises are necessary for you to regain function
, in your shoulder. Let's go a bit more slowly and try to relax."
B. "I see that you're uncomfortable. I'll call your doctor to decide the next step."
C. "Show me exactly where your pain is and rate it for me on a scale of 0 to 10."
D. "Is anything else bothering you? Other than the pain, is there any other reason you
might not want to do the exercises?"
A. "I understand your reluctance, but the exercises are necessary for you to regain function in
your shoulder. Let's go a bit more slowly and try to relax."
-The nurse reviews the position of requiring exercises to restore function and decides to try a
different approach to proceed, which is an example of integrity. In calling the doctor for the next
step, the nurse does not reinforce the importance of exercises, which is likely the standard of care
for this type of patient. In asking the location and strength of the pain the nurse is interpreting
further to determine if any other physical problems are developing. In attempting to learn if any
other underlying problems exist, the nurse is showing curiosity.
The nurse cared for a 14-year-old with renal failure who died near the end of the work
shift. The health care team tried for 45 minutes to resuscitate the child with no success. The
family was devastated by the loss, and, when the nurse tried to talk with them, the mother
said, "You can't make me feel better; you don't know what it's like to lose a child." Which
of the following examples of journal entries might best help the nurse reflect and think
about this clinical experience? (Select all that apply.)
A. Data entry of time of day, who was present, and condition of the child
B. Description of the efforts to restore the child's blood pressure, what was used, and
questions about the child's response
C. The meaning the experience had for the nurse with respect to her understanding of
dealing with a patient's death
D. A description of what the nurse said to the mother, the mother's response, and how the
nurse might approach the situation differently in the future
B, C, & D
-The nurse can reflect on the effects of the treatment and what was difficult or confusing about
the outcome. The nurse reviews the meaning of the experience to help improve understanding of
personal comfort and competence in dealing with death and how to respond in the future. The
2027 Update) Fundamentals: Patient
Care Guide | Questions & Answers| Grade
A| 100% Correct (Verified Solutions)-
Chamberlain
NR 226 Exam 1 -
While assessing a patient, the nurse observes that the patient's intravenous (IV) line is not
infusing at the ordered rate. The nurse assesses the patient for pain at the IV site, checks
the flow regulator on the tubing, looks to see if the patient is lying on the tubing, checks the
point of connection between the tubing and the IV catheter, and then checks the condition
of the site where the intravenous catheter enters the patient's skin. After the nurse
readjusts the flow rate, the infusion begins at the correct rate. This is an example of:
A. Inference.
B. Diagnostic reasoning.
C. Competency.
D. Problem solving.
D. Problem solving
-This is an example of problem solving. The nurse collects information and tries options until she
is able to find a solution to the slowed infusion rate. The focus is on solving the problem with the
patient's IV and not on solving the patient's health problem; thus this is not the diagnostic
reasoning process.
The nurse sits down to talk with a patient who lost her sister 2 weeks ago. The patient
reports she is unable to sleep, feels very fatigued during the day, and is having trouble at
work. The nurse asks her to clarify the type of trouble. The patient explains she can't
concentrate or even solve simple problems. The nurse records the results of the assessment,
describing the patient as having ineffective coping. This is an example of:
A. Diagnostic reasoning.
,B. Competency.
C. Inference.
D. Problem solving.
A. Diagnostic reasoning
-In this example the nurse collects information about the patient, sees patterns in the data
collected, and makes a nursing diagnosis. This is an example of the diagnostic process.
A nurse has worked on an oncology unit for 3 years. One patient has become visibly weaker
and states, "I feel funny." The nurse knows how patients often have behavior changes
before developing sepsis when they have cancer. The nurse asks the patient questions to
assess thinking skills and notices the patient shivering. The nurse goes to the phone, calls
the physician, and begins the conversation by saying, "I believe that your patient is
developing sepsis. I want to report symptoms I'm seeing." What examples of critical
thinking concepts does the nurse show? (Select all that apply.)
A. Experience
B. Ethical
C. Analyticity
D. Self-confidence
E. Risk taking
C & D.
-Among critical thinking concepts, the nurse shows analyticity (analyzing information, gathering
additional findings, and sensing a problem), and self-confidence (calling the physician, which
shows trust in his own reasoning). The nurse's experience would have influenced the familiarity
of patient symptoms, but in this text experience is considered a component of the critical
thinking model and not a concept. Acting ethically is a critical thinking standard.
.A nurse who is working on a surgical unit is caring for four different patients. Patient A
will be discharged home and is in need of instruction about wound care. Patients B and C
have returned from the operating room within an hour of each other, and both require vital
signs and monitoring of their intravenous (IV) lines. Patient D is resting following a visit by
physical therapy. Which of the following activities by the nurse represent(s) use of clinical
decision making for groups of patients? (Select all that apply.)
,A. Consider how to involve patient A in deciding whether to involve the family caregiver in
wound care instruction.
B. Think about past experience with patients who develop postoperative complications.
C. Decide which activities can be combined for patients B and C.
D. Carefully gather any assessment information and identify patient problems.
A&C
-Considering how to involve patients in decisions and how to combine nursing activities to be
more organized and allow for resolving more than one problem at a time are examples of clinical
decision making for groups of patients. Thinking about past experience with patients is an
example of reflection, an approach to strengthen critical thinking skills. Gathering assessment
information is part of the process of diagnostic reasoning, which should be applied to each
patient.
The surgical unit has initiated the use of a pain-rating scale to assess patients' pain severity
during their postoperative recovery. The registered nurse (RN) looks at the pain flow sheet
to see the pain scores recorded for a patient over the last 24 hours. Use of the pain scale is
an example of which intellectual standard?
A. Deep
B. Relevant
C. Consistent
D. Significant
C. Consistent
-Use of the same pain scale for assessing pain acuity is an example of being consistent.
During a home health visit the nurse prepares to instruct a patient in how to perform
range-of-motion (ROM) exercises for an injured shoulder. The nurse verifies that the
patient took an analgesic 30 minutes before arrival at the patient's home. After discussing
the purpose for the exercises and demonstrating each one, the nurse has the patient
perform them. After two attempts with only the second of three exercises, the patient stops
and says, "This hurts too much. I don't see why I have to do this so many times." The nurse
applies the critical thinking attitude of integrity in which of the following actions?
A. "I understand your reluctance, but the exercises are necessary for you to regain function
, in your shoulder. Let's go a bit more slowly and try to relax."
B. "I see that you're uncomfortable. I'll call your doctor to decide the next step."
C. "Show me exactly where your pain is and rate it for me on a scale of 0 to 10."
D. "Is anything else bothering you? Other than the pain, is there any other reason you
might not want to do the exercises?"
A. "I understand your reluctance, but the exercises are necessary for you to regain function in
your shoulder. Let's go a bit more slowly and try to relax."
-The nurse reviews the position of requiring exercises to restore function and decides to try a
different approach to proceed, which is an example of integrity. In calling the doctor for the next
step, the nurse does not reinforce the importance of exercises, which is likely the standard of care
for this type of patient. In asking the location and strength of the pain the nurse is interpreting
further to determine if any other physical problems are developing. In attempting to learn if any
other underlying problems exist, the nurse is showing curiosity.
The nurse cared for a 14-year-old with renal failure who died near the end of the work
shift. The health care team tried for 45 minutes to resuscitate the child with no success. The
family was devastated by the loss, and, when the nurse tried to talk with them, the mother
said, "You can't make me feel better; you don't know what it's like to lose a child." Which
of the following examples of journal entries might best help the nurse reflect and think
about this clinical experience? (Select all that apply.)
A. Data entry of time of day, who was present, and condition of the child
B. Description of the efforts to restore the child's blood pressure, what was used, and
questions about the child's response
C. The meaning the experience had for the nurse with respect to her understanding of
dealing with a patient's death
D. A description of what the nurse said to the mother, the mother's response, and how the
nurse might approach the situation differently in the future
B, C, & D
-The nurse can reflect on the effects of the treatment and what was difficult or confusing about
the outcome. The nurse reviews the meaning of the experience to help improve understanding of
personal comfort and competence in dealing with death and how to respond in the future. The
