NMNC 1110 EXAM 2 QUESTIONS WITH VERIFIED
ANSWERS
Clinical judgment - Answers - an essential skill that involves the interpretation of a
patient's needs, concerns, or health problems and the decision to take action or not, to
use or modify standard approaches, or to improvise new approaches on the basis of a
patient's response
Attitudes for clinical judgement - Answers - confidence, thinking independently, fairness,
responsibility and authority, risk taking, discipline, perseverance, creativity, curiosity,
integrity, and humility.
Confidence - Answers - Learn how to introduce yourself to a patient; speak with
conviction when you begin a treatment or procedure. Do not lead a patient to think that
you are unable to perform care safely. Always be well prepared before performing a
nursing activity. Encourage a patient to ask questions.
Thinking independently - Answers - Read the nursing literature, especially when there
are different views on the same subject. Talk with other nurses and share ideas about
nursing interventions.
Fairness - Answers - Listen to both sides in any discussion. If a patient or family
member complains about a co-worker, listen to the story and speak with the co-worker
as well. If a staff member labels a patient uncooperative, assume the care of that patient
with openness and a desire to meet the patient's needs
Responsibility and authority - Answers - Ask for help if you are uncertain about how to
perform a nursing skill. Refer to a policy and procedure manual to review steps of a skill.
Report any problems immediately. Follow standards of practice in your care.
Risk taking - Answers - If your knowledge causes you to question a health care
provider's order, do so. Be willing to recommend alternative approaches to nursing care
when colleagues are having little success with patients.
Discipline - Answers - Be thorough in whatever you do. Use known scientific and
practice-based criteria for activities such as assessment and evaluation. Take time to be
thorough and manage your time effectively.
Perseverance - Answers - Be cautious of an easy answer. If co-workers give you
information about a patient and some fact seems to be missing, clarify the information
or talk to the patient directly. If problems of the same type continue to occur on a
nursing division, bring co-workers together, look for a pattern, and find a solution.
,Creativity - Answers - Look for different approaches if interventions are not working for a
patient. For example, a patient in pain may need a different positioning or distraction
technique. When appropriate, involve the patient's family in adapting your approaches
to care methods used at home
Curiosity - Answers - Always ask why. A clinical sign or symptom often indicates a
variety of problems. Explore and learn more about a patient so as to make appropriate
clinical judgments.
Integrity - Answers - Recognize when your opinions conflict with those of a patient;
review your position and decide how best to proceed to reach outcomes that will satisfy
everyone. Do not compromise nursing standards or honesty in delivering nursing care.
Humility - Answers - Recognize when you need more information to make a decision.
When you are new to a clinical division, ask for an orientation to the area. Ask
registered nurses (RNs) regularly assigned to the area for assistance with approaches
to care.
Skills for clinical judgement - Answers - Interpretation, analysis, inference, evaluation,
explanation, self- regulation
Interpretation - Answers - Be orderly in collecting data about patients. Apply reasoning
while looking for patterns. Categorize the data (e.g., nursing diagnoses). Gather
additional data or clarify any data if uncertain.
Analysis - Answers - Be open-minded as you look at information about a patient. Do not
make careless assumptions. Does the data reveal a problem or trend that you believe is
true, or are there other options?
Inference - Answers - Look at the meaning and significance of findings. Are there
relationships among findings? Does the data about the patient help you see that a
problem exists?
Evaluation - Answers - Look at all situations objectively. Use criteria (e.g., expected
outcomes, pain characteristics, learning objectives) to determine results of nursing
actions. Reflect on your own behavior.
Explanation - Answers - Support your findings and conclusions. Use knowledge and
experience to choose strategies to use in the care of patients.
Self-regulation - Answers - Reflect on your experiences. Be responsible for connecting
your actions with outcomes. Identify the ways you can improve your own performance.
What will make you believe that you have been successful?
Tanners model of clinical judgement - Answers - Noticing
Interpreting
, Responding
Reflecting
Noticing - Answers - § behind the nurse's eyes are as important as what is in front.
These include the background of the nurse, the nurse's relationship with the patient, and
the context of care
§ Once an issue is noticed, the nurse immediately gathers additional information and
draws on his or her background, including theoretical knowledge, past experiences with
similar patients as well as his or her relationship and knowledge of this particular patient
within the specific context of care, and ethical beliefs about what is right in this situation.
o Interpreting - Answers - § expert nurses draw on a variety of reasoning patterns
(analytic, intuitive, and narrative) to interpret the meaning of what has been noticed
- Analytic
- Intuitive
- narrative
Analytic (interpreting) - Answers - students and novice nurses, or more experienced
nurses encountering unfamiliar situations, tend to rely on analytic reasoning based on
theoretical knowledge
Intuitive (interpreting) - Answers - Expert nurses often use intuitive reasoning based on
unstated but understood knowledge about the patient, the caregiving context, and their
previous experiences
narrative (interpreting) - Answers - reasoning supports deep understanding of
caregiving situations. Nurses hear patients' stories of their experiences with illness, how
they understand their symptoms, what meaning they attribute to their illness, how they
cope with it, and what they hope for resolution. helps nurses understand the specific
patient experience, setting the stage for individualizing care.
Responding - Answers - the nurse uses his or her interpretation to respond to the
particular patient issue through one or more nursing interventions.
Reflecting - Answers - § The clinical judgment model includes two types of reflection:
reflection-in-action and reflection-on-action. Both have significant bearing on clinical
judgment.
How nurses can develop clinical judgement skills - Answers - Deep understanding,
applying concepts to nursing practice, reflective practice, journaling,
Deep understanding - Answers - § This includes theoretical knowledge about the patient
population, relevant physiology and pathophysiology, and potential nursing
interventions.
ANSWERS
Clinical judgment - Answers - an essential skill that involves the interpretation of a
patient's needs, concerns, or health problems and the decision to take action or not, to
use or modify standard approaches, or to improvise new approaches on the basis of a
patient's response
Attitudes for clinical judgement - Answers - confidence, thinking independently, fairness,
responsibility and authority, risk taking, discipline, perseverance, creativity, curiosity,
integrity, and humility.
Confidence - Answers - Learn how to introduce yourself to a patient; speak with
conviction when you begin a treatment or procedure. Do not lead a patient to think that
you are unable to perform care safely. Always be well prepared before performing a
nursing activity. Encourage a patient to ask questions.
Thinking independently - Answers - Read the nursing literature, especially when there
are different views on the same subject. Talk with other nurses and share ideas about
nursing interventions.
Fairness - Answers - Listen to both sides in any discussion. If a patient or family
member complains about a co-worker, listen to the story and speak with the co-worker
as well. If a staff member labels a patient uncooperative, assume the care of that patient
with openness and a desire to meet the patient's needs
Responsibility and authority - Answers - Ask for help if you are uncertain about how to
perform a nursing skill. Refer to a policy and procedure manual to review steps of a skill.
Report any problems immediately. Follow standards of practice in your care.
Risk taking - Answers - If your knowledge causes you to question a health care
provider's order, do so. Be willing to recommend alternative approaches to nursing care
when colleagues are having little success with patients.
Discipline - Answers - Be thorough in whatever you do. Use known scientific and
practice-based criteria for activities such as assessment and evaluation. Take time to be
thorough and manage your time effectively.
Perseverance - Answers - Be cautious of an easy answer. If co-workers give you
information about a patient and some fact seems to be missing, clarify the information
or talk to the patient directly. If problems of the same type continue to occur on a
nursing division, bring co-workers together, look for a pattern, and find a solution.
,Creativity - Answers - Look for different approaches if interventions are not working for a
patient. For example, a patient in pain may need a different positioning or distraction
technique. When appropriate, involve the patient's family in adapting your approaches
to care methods used at home
Curiosity - Answers - Always ask why. A clinical sign or symptom often indicates a
variety of problems. Explore and learn more about a patient so as to make appropriate
clinical judgments.
Integrity - Answers - Recognize when your opinions conflict with those of a patient;
review your position and decide how best to proceed to reach outcomes that will satisfy
everyone. Do not compromise nursing standards or honesty in delivering nursing care.
Humility - Answers - Recognize when you need more information to make a decision.
When you are new to a clinical division, ask for an orientation to the area. Ask
registered nurses (RNs) regularly assigned to the area for assistance with approaches
to care.
Skills for clinical judgement - Answers - Interpretation, analysis, inference, evaluation,
explanation, self- regulation
Interpretation - Answers - Be orderly in collecting data about patients. Apply reasoning
while looking for patterns. Categorize the data (e.g., nursing diagnoses). Gather
additional data or clarify any data if uncertain.
Analysis - Answers - Be open-minded as you look at information about a patient. Do not
make careless assumptions. Does the data reveal a problem or trend that you believe is
true, or are there other options?
Inference - Answers - Look at the meaning and significance of findings. Are there
relationships among findings? Does the data about the patient help you see that a
problem exists?
Evaluation - Answers - Look at all situations objectively. Use criteria (e.g., expected
outcomes, pain characteristics, learning objectives) to determine results of nursing
actions. Reflect on your own behavior.
Explanation - Answers - Support your findings and conclusions. Use knowledge and
experience to choose strategies to use in the care of patients.
Self-regulation - Answers - Reflect on your experiences. Be responsible for connecting
your actions with outcomes. Identify the ways you can improve your own performance.
What will make you believe that you have been successful?
Tanners model of clinical judgement - Answers - Noticing
Interpreting
, Responding
Reflecting
Noticing - Answers - § behind the nurse's eyes are as important as what is in front.
These include the background of the nurse, the nurse's relationship with the patient, and
the context of care
§ Once an issue is noticed, the nurse immediately gathers additional information and
draws on his or her background, including theoretical knowledge, past experiences with
similar patients as well as his or her relationship and knowledge of this particular patient
within the specific context of care, and ethical beliefs about what is right in this situation.
o Interpreting - Answers - § expert nurses draw on a variety of reasoning patterns
(analytic, intuitive, and narrative) to interpret the meaning of what has been noticed
- Analytic
- Intuitive
- narrative
Analytic (interpreting) - Answers - students and novice nurses, or more experienced
nurses encountering unfamiliar situations, tend to rely on analytic reasoning based on
theoretical knowledge
Intuitive (interpreting) - Answers - Expert nurses often use intuitive reasoning based on
unstated but understood knowledge about the patient, the caregiving context, and their
previous experiences
narrative (interpreting) - Answers - reasoning supports deep understanding of
caregiving situations. Nurses hear patients' stories of their experiences with illness, how
they understand their symptoms, what meaning they attribute to their illness, how they
cope with it, and what they hope for resolution. helps nurses understand the specific
patient experience, setting the stage for individualizing care.
Responding - Answers - the nurse uses his or her interpretation to respond to the
particular patient issue through one or more nursing interventions.
Reflecting - Answers - § The clinical judgment model includes two types of reflection:
reflection-in-action and reflection-on-action. Both have significant bearing on clinical
judgment.
How nurses can develop clinical judgement skills - Answers - Deep understanding,
applying concepts to nursing practice, reflective practice, journaling,
Deep understanding - Answers - § This includes theoretical knowledge about the patient
population, relevant physiology and pathophysiology, and potential nursing
interventions.
