Nur 155 study exam guide with complete verified solutions

Which thinking skill belongs to the responding step in Tanner's? Providing the priority care determined Which thinking skill does the nurse use when determining if pain medication administered was effective? Evaluating data Which factors influence a nurse's ability to predict and manage complications? The nurses experience level The nurses knowledge level Which thinking skill is demonstrated when reviewing the patients chart performing a physical assessment, interviewing family and reviewing drs progress notes? Gathering complete and accurate data Which action in the following situation demonstrates using the critical judgement skill? Mowing the grass a day earlier because the forecast calls for rain How does a person best apply thinking skill of clustering, when preparing for vacation? Organizing a list of items for the trip Which thinking skill requires the nurse to collect information in a detailed method from various sources Gathering accurate data An employee notices a wallet in the restroom with a large amount of cash. Following policy, they take it to the main office. Which thinking skill is the employee demonstrating Using legal and ethical guidelines parent has been helping their two children with homework and determines that one is improving while the other is still doing poorly. Which thinking skill is the parent using in this situation? Comparing and contrasting A nurse is caring for a 56 yr old patient diagnosed with hypertension. The nurse completes the Epworth sleepiness scale and the patient scores an 11. Which action will the nurse take? Ask pt about their lifestyle Subject data Pt complains Nursing assistant reports patient's urine drainage bag appears to be infected. How will the nurse determine accuracy and reliability of this information Contact the physician, request an order for a urine culture 76 yr old from a long-term care facility is admitted with confusion and a large bump on their forehead. What action will the nurse take first? Conduct a focused neuro assessment Which question will the nurse ask to best identify signs and symptoms? What has changed Which thinking skill belongs to the interpreting step in Tanner's? Comparing and contrasting Which thinking skill does the nurse use when grouping similar information to help identify a problem? Clustering related info A Nurse is caring for elderly patient. The patient states he's been trying to lose weight over the past 3 months but he's gained 15 lbs. What is the nurse's next action Conduct a patient interview and research the patient's chart to identify possible reasons for weight gain. Which step in Tanner's model of clinical judgement involves processing information understanding the situation and planning interventions? Interpreting The nurse is assigned to a patient with increased memory loss, confusion and at a high risk of wandering off the unit. What action will the nurse take at the beginning of the shift? Develop a plan to ensure frequent checks on this patient with the nursing assistants and other staff for safety. How do the Spices tool and Epworth sleepiness scale assist nurses in caring for older adults? They both collect signs and symptoms to identify potential risks. A thinking skill, evaluating data, what is the reason that assessment data is collected again after actions have been performed? To determine the effectiveness of the actions and see if outcomes were acceptable A nurse is caring for a patient with a sudden change in health status while collecting data, which thinking skill will the nurse use to determine what information is meaningful to the patient's condition? Distinguishing relevant from irrelevant A driver enters a zone where the speed limit drops from 55 to 35. The driver glances at all the gauges on the dashboard, then gathers information from the speedometer to determine what to do next. Which thinking skill is the driver using in this situation? Distinguishing relevant from irrelevant The LPN is assisting the RN in data collection, how can the LPN collect complete and accurate data? Assess the patients eating, sleeping and socialization patterns. Which thinking skill does the nurse use when identifying subjective data and objective data do not match? Recognizing inconsistencies Nurse enters patient's room, finds him tearful, holding his hands in his lap and gazing downward. Using tanner's, what action will the nurse take Ask the patient if something is troubling him. Which task can a nurse delegate to a nursing assistant? Assisting the client with a complete bedbath The nurse is caring for a patient with asthma during the exam, the nurse first focuses attention on the respiratory system and then includes all body systems. Which step in tanner's model of clinical judgement is this nurse demonstrating Assessing systemically and comprehensively. Millie Larson is an elderly patient who lives at home alone. She takes multiple medications, has financial concerns, suffers from stress incontinence, pain in her knees and is at risk for falls. She has social connections in the community through her church, cooks her own meals, tends to her garden and has weekly visits by her family. How will the nurse appropriately cluster related information? At risk for falls, pain in the knees, multiple medications Which thinking skill does the nurse use when deciding which data relates to the matter at hand? Distinguishing relevant from irrelevant Which question will the nurse consider to best predict potential complications What are the risks identified and how can I prevent a problem Which thinking skill does the nurse use when reflecting on a situation in determining what did and did not work? Evaluating and correcting thinking Which is an example of objective data a nurse might document? patient was noted to have loose, watery stool. Which statement accurately describes thinking skill evaluating and correcting thinking? corresponds to reflecting on how the situation was handled