Chapter 13, Blended Competencies Clinical Reasoning and Processes of Person
Centered Care
Test Bank, Chapter Assignments, Discussions Plus Case Studies and Answers
Fundamentals of Nursing: The Art and Science of Person-Centered Care (10th Edition Taylor)
1. The nurse uses evidence-based practice findings in the development of a care plan. This
is an example of which type of nursing skill?
A. Cognitive skill
B. Technical skill
C. Interpersonal skill
D. Ethical or legal skill
Answer: A
Rationale: The nurse is demonstrating the use of cognitive skills, which are characterized
by identifying scientific rationales for the client's plan of care, selecting nursing
interventions that are most likely to yield the desired outcomes, and using critical
thinking to solve problems. Technical skills focus on manipulating equipment skillfully to
produce a desired outcome. Interpersonal skills are used to establish and maintain a
caring relationship. Ethically and legally skilled nurses conduct themselves in a manner
consistent with their personal moral code and professional role responsibilities.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Management of Care
Integrated Process: Nursing Process
Reference: p. 350
2. A nurse has come on day shift and is assessing the client's intravenous setup. The nurse
notes that there is a mini-bag of the client's antibiotic hanging as a piggyback, but that the
bag is still full. The nurse examines the client's medication administration record (MAR)
and concludes that the night nurse likely hung the antibiotic but failed to start the
infusion. As a result, the antibiotic is 3 hours late and the nurse has consequently filled
out an incident report. In doing so, the nurse has exhibited which type of skills?
A. Ethical/legal skills
B. Technical skills
C. Interpersonal skills
D. Cognitive skills
Answer: A
Rationale: Reporting problems and unacceptable practices is an aspect of ethical/legal
skills. Technical skills enable the safe performance of kinesthetic tasks while interpersonal
,skills are the manifestations of caring. Cognitive skills encompass knowledge and critical
thinking.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Safety and Infection Control
Integrated Process: Nursing Process
Reference: p. 358
3. A client who has been admitted to the hospital for the treatment of a gastrointestinal
bleed requires a transfusion of packed red blood cells. Which aspect of the nurse's
execution of this order demonstrates technical skill?
A. Starting a new, large-gauge intravenous site on the client and priming the infusion
tubing
B. Understanding the Rh system that underlies the client's blood type
C. Ensuring that informed consent has been obtained and properly filed in the client's
chart
D. Explaining the process that will be involved in preparing and administering the
transfusion
Answer: A
Rationale: Performing tasks that require manual dexterity is a manifestation of technical
skills. Explaining the transfusion process largely depends on interpersonal skills, whereas
understanding the theory behind blood types is indicative of cognitive skills. Informed
consent lies within the domain of legal/ethical skills.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Apply
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Integrated Process: Nursing Process
Reference: p. 354
4. In which situation would the nurse be most justified in implementing trial-and-error
problem solving?
A. The nurse is attempting to landmark the apical pulse for a client whose BMI higher
than 30.
B. The nurse is attempting to determine the range of motion of a client's hip joint
following hip surgery.
C. The nurse is attempting to determine which as-needed analgesic to offer a client who
is in pain.
D. The nurse is attempting to determine whether a client has a swallowing deficit after
experiencing a stroke.
,Answer: A
Rationale: Trial-and-error problem solving can be dangerous to the client. Testing range
of motion by trial-and-error could result in dislocation; trial-and-error drug
administration could result in over- or undermedicating; trial-and-error assessment of a
potential swallowing deficit could result in aspiration. Each of these situations warrants
more systematic problem solving. Trial-and-error landmarking of an anatomically
difficult point, such as the apex of a client's heart, does not pose a threat to the client and
a reasonable amount of "hunting" for the apical pulse may be necessary.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Management of Care
Integrated Process: Nursing Process
Reference: p. 362
5. What nursing organization first legitimized the use of the nursing process?
A. National League for Nursing
B. American Nurses Association
C. International Council of Nursing
D. State Board of Nursing
Answer: B
Rationale: Although the term "nursing process" was first used by Lydia Hall in 1955, and
nursing theorists delineated specific steps in a process approach to nursing, use of the
nursing process was legitimized in 1973, when the American Nurses Association's
Congress for Nursing Practice developed Standards of Practice to guide nursing
performance. The National League for Nursing is a national organization for faculty
nurses and leaders in nurse education. The International Council of Nurses is a federation
of more than 130 national nurses associations. State boards of nursing accredit nursing
schools.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Remember
Client Needs: Safe, Effective Care Environment: Management of Care
Integrated Process: Nursing Process
Reference: p. 364
6. Which group of terms best describes the nursing process?
A. Nursing goals, medical terminology, linear
B. Nurse-centered, single focus, blended skills
, C. Patient-centered, systematic, outcome-oriented
D. Family-centered, single point in time, intuitive
Answer: C
Rationale: The nursing process is a patient-centered, systematic, outcome-oriented
method of caring that provides a framework for nursing practice. It is nursing practice in
action. It is not nurse- or family-centered. It is focused on client, not nursing, goals. It has
multiple foci, not just one focus. Although the nursing process is presented as an orderly
and linear progression of steps, in reality, there is great interaction and overlapping
among the five steps. No single step in the nursing process is a one-time phenomenon;
each step flows into the next step. In some nursing situations, all five stages occur almost
simultaneously. Nursing practice requires the use of blended competencies, not blended
skills. The nursing process is systematic, not intuitive.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Understand
Client Needs: Safe, Effective Care Environment: Management of Care
Integrated Process: Nursing Process
Reference: p. 366
7. A client comes to the emergency department reporting severe chest pain. The nurse
asks the client questions and takes vital signs. Which step of the nursing process is the
nurse demonstrating?
A. Assessing
B. Diagnosing
C. Planning
D. Implementing
Answer: A
Rationale: Assessment, the systematic and continuous collection and communication of
data, such as asking questions and obtaining vital signs, allows analysis of data to identify
problems and strengths of clients, which is diagnosing. During outcome identification and
planning, the nurse and client mutually identify expected outcomes and agree on nursing
interventions necessary to meet these outcomes. The nurse implements the care plan,
adapting it to each person, documenting nursing actions and client responses. After
implementation, the nurse and client evaluate the effectiveness of the plan based on
achievement of outcomes, and determine whether the plan should be continued,
modified, or terminated.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Apply
Centered Care
Test Bank, Chapter Assignments, Discussions Plus Case Studies and Answers
Fundamentals of Nursing: The Art and Science of Person-Centered Care (10th Edition Taylor)
1. The nurse uses evidence-based practice findings in the development of a care plan. This
is an example of which type of nursing skill?
A. Cognitive skill
B. Technical skill
C. Interpersonal skill
D. Ethical or legal skill
Answer: A
Rationale: The nurse is demonstrating the use of cognitive skills, which are characterized
by identifying scientific rationales for the client's plan of care, selecting nursing
interventions that are most likely to yield the desired outcomes, and using critical
thinking to solve problems. Technical skills focus on manipulating equipment skillfully to
produce a desired outcome. Interpersonal skills are used to establish and maintain a
caring relationship. Ethically and legally skilled nurses conduct themselves in a manner
consistent with their personal moral code and professional role responsibilities.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Management of Care
Integrated Process: Nursing Process
Reference: p. 350
2. A nurse has come on day shift and is assessing the client's intravenous setup. The nurse
notes that there is a mini-bag of the client's antibiotic hanging as a piggyback, but that the
bag is still full. The nurse examines the client's medication administration record (MAR)
and concludes that the night nurse likely hung the antibiotic but failed to start the
infusion. As a result, the antibiotic is 3 hours late and the nurse has consequently filled
out an incident report. In doing so, the nurse has exhibited which type of skills?
A. Ethical/legal skills
B. Technical skills
C. Interpersonal skills
D. Cognitive skills
Answer: A
Rationale: Reporting problems and unacceptable practices is an aspect of ethical/legal
skills. Technical skills enable the safe performance of kinesthetic tasks while interpersonal
,skills are the manifestations of caring. Cognitive skills encompass knowledge and critical
thinking.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Safety and Infection Control
Integrated Process: Nursing Process
Reference: p. 358
3. A client who has been admitted to the hospital for the treatment of a gastrointestinal
bleed requires a transfusion of packed red blood cells. Which aspect of the nurse's
execution of this order demonstrates technical skill?
A. Starting a new, large-gauge intravenous site on the client and priming the infusion
tubing
B. Understanding the Rh system that underlies the client's blood type
C. Ensuring that informed consent has been obtained and properly filed in the client's
chart
D. Explaining the process that will be involved in preparing and administering the
transfusion
Answer: A
Rationale: Performing tasks that require manual dexterity is a manifestation of technical
skills. Explaining the transfusion process largely depends on interpersonal skills, whereas
understanding the theory behind blood types is indicative of cognitive skills. Informed
consent lies within the domain of legal/ethical skills.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Apply
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Integrated Process: Nursing Process
Reference: p. 354
4. In which situation would the nurse be most justified in implementing trial-and-error
problem solving?
A. The nurse is attempting to landmark the apical pulse for a client whose BMI higher
than 30.
B. The nurse is attempting to determine the range of motion of a client's hip joint
following hip surgery.
C. The nurse is attempting to determine which as-needed analgesic to offer a client who
is in pain.
D. The nurse is attempting to determine whether a client has a swallowing deficit after
experiencing a stroke.
,Answer: A
Rationale: Trial-and-error problem solving can be dangerous to the client. Testing range
of motion by trial-and-error could result in dislocation; trial-and-error drug
administration could result in over- or undermedicating; trial-and-error assessment of a
potential swallowing deficit could result in aspiration. Each of these situations warrants
more systematic problem solving. Trial-and-error landmarking of an anatomically
difficult point, such as the apex of a client's heart, does not pose a threat to the client and
a reasonable amount of "hunting" for the apical pulse may be necessary.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Management of Care
Integrated Process: Nursing Process
Reference: p. 362
5. What nursing organization first legitimized the use of the nursing process?
A. National League for Nursing
B. American Nurses Association
C. International Council of Nursing
D. State Board of Nursing
Answer: B
Rationale: Although the term "nursing process" was first used by Lydia Hall in 1955, and
nursing theorists delineated specific steps in a process approach to nursing, use of the
nursing process was legitimized in 1973, when the American Nurses Association's
Congress for Nursing Practice developed Standards of Practice to guide nursing
performance. The National League for Nursing is a national organization for faculty
nurses and leaders in nurse education. The International Council of Nurses is a federation
of more than 130 national nurses associations. State boards of nursing accredit nursing
schools.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Remember
Client Needs: Safe, Effective Care Environment: Management of Care
Integrated Process: Nursing Process
Reference: p. 364
6. Which group of terms best describes the nursing process?
A. Nursing goals, medical terminology, linear
B. Nurse-centered, single focus, blended skills
, C. Patient-centered, systematic, outcome-oriented
D. Family-centered, single point in time, intuitive
Answer: C
Rationale: The nursing process is a patient-centered, systematic, outcome-oriented
method of caring that provides a framework for nursing practice. It is nursing practice in
action. It is not nurse- or family-centered. It is focused on client, not nursing, goals. It has
multiple foci, not just one focus. Although the nursing process is presented as an orderly
and linear progression of steps, in reality, there is great interaction and overlapping
among the five steps. No single step in the nursing process is a one-time phenomenon;
each step flows into the next step. In some nursing situations, all five stages occur almost
simultaneously. Nursing practice requires the use of blended competencies, not blended
skills. The nursing process is systematic, not intuitive.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Understand
Client Needs: Safe, Effective Care Environment: Management of Care
Integrated Process: Nursing Process
Reference: p. 366
7. A client comes to the emergency department reporting severe chest pain. The nurse
asks the client questions and takes vital signs. Which step of the nursing process is the
nurse demonstrating?
A. Assessing
B. Diagnosing
C. Planning
D. Implementing
Answer: A
Rationale: Assessment, the systematic and continuous collection and communication of
data, such as asking questions and obtaining vital signs, allows analysis of data to identify
problems and strengths of clients, which is diagnosing. During outcome identification and
planning, the nurse and client mutually identify expected outcomes and agree on nursing
interventions necessary to meet these outcomes. The nurse implements the care plan,
adapting it to each person, documenting nursing actions and client responses. After
implementation, the nurse and client evaluate the effectiveness of the plan based on
achievement of outcomes, and determine whether the plan should be continued,
modified, or terminated.
Question format: Multiple Choice
Chapter 13: Blended Competencies, Clinical Reasoning and Processes of Person-Centered
Care
Cognitive Level: Apply
