Final Exam: RNSG 1137 Final Exam
A class of nursing students is in their first semester of nursing school. The instructor explains that one of
the changes they will undergo while in nursing school is learning to "think like a nurse." What is the most
current model of this thinking process?
A) Critical-thinking Model
B) Nursing Process Model
C) Clinical Judgment Model
D) Active Practice Model - ANSWER:C) Clinical Judgment Model
The nursing student 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/legal skill - ANSWER:A) Cognitive skill
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 patient'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 three hours late and the
nurse has consequently filled out an incident report. In doing so, the nurse has exhibited which of the
following?
A) Ethical/legal skills
B) Technical skills
C) Interpersonal skills
D) Cognitive skills - ANSWER:A) Ethical/legal skills
What is a systematic way to form and shape one's thinking?
A) Critical thinking
B) Intuitive thinking
C) Trial-and-error
D) Interpersonal values - ANSWER:A) Critical Thinking
,What step in the nursing process is most closely associated with cognitively skilled nurses?
A) Assessing
B) Planning
C) Implementing
D) Evaluating - ANSWER:B) Planning
Members of the staff on a hospital unit are critical of a client's family, who has different cultural beliefs
about health and illness. A student assigned to the patient does not agree, based on her care of the
client and family. What critical thinking attitude is the student demonstrating?
A) Being curious and persevering
B) Being creative
C) Demonstrating confidence
D) Thinking independently - ANSWER:D) Thinking independently
Tanner's Clinical Judgement Model (NOTICING) - ANSWER:-recognizing a potential issue, perceptually
grasping the situation
Tanner's Clinical Judgement Model (REFLECTING) - ANSWER:SAME AS REMEMBERING: attending to
patient's responses to nursing action while in the process of acting
Tanner's Clinical Judgement Model (INTERPRETING) - ANSWER:-reasoning pattern, analytical, intuitive,
narrative, developing a sufficient understanding of the situation
Tanner's Clinical Judgement Model (OBSERVATION & INTERPRETATION) - ANSWER:hallmarks of trained
nursing practice
Tanner's Clinical Judgement Model (RESPONDING) - ANSWER:deciding on the court of action deemed
appropriate for the situation, which may include, NO IMMEDIATE ACTION
Reflection IN action - ANSWER:-happens in real time while care is occurring
-refers to nurses' ability to "read" the patient—how he or she is responding to the nursing intervention
and adjust the interventions based on that assessment.
Reflection ON action - ANSWER:-occurs after the fact and involves thinking through a situation that has
occurred in the past
-showing what nurses gain from their experience contributes to their ongoing clinical knowledge
development and their capacity for clinical judgment in future situations.
Supports the idea that nurses engage in a complex process of clinical reasoning when caring for patients.
Nurses draw on personal knowledge and experience from various situations and consider the contextual
background of the clinical culture. - ANSWER:CLINICAL JUDGEMENT MODEL
,Critical thinking concepts, when used in the Nursing Process, will result in________________. -
ANSWER:Clinical judgement
clinical judgement - ANSWER:refers to the nurse's interpretation and inferences that influence his/her
actions in a care-giving setting.
clinical judgement are influenced by.... - ANSWER:the context in which the situation occurs and the
culture of the nursing care unit
Five conclusions of the CLINICAL JUDGEMENT MODEL - ANSWER:(1) Clinical judgments are more
influenced by what nurses bring to the situation than the objective data about the situation at hand;
(2) Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of
responses, as well as an engagement with the patient and his or her concerns;
(3) Clinical judgments are influenced by the context in which the situation occurs and the culture of the
nursing care unit;
(4) Nurses use a variety of reasoning patterns alone or in combination; and
(5) Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the
development of clinical knowledge and improvement in clinical reasoning.
A care conference has been organized for a patient with complex medical and psychosocial needs. When
applying the principles of critical thinking to this patient's care planning, the nurse should most
exemplify what characteristic?
A) Willingness to observe behaviors
B) A desire to utilize the nursing scope of practice fully
C) An ability to base decisions on what has happened in the past
D) Openness to various viewpoints - ANSWER:D) openness to various veiwpoints
Achieving adequate pain management for a postoperative patient will require sophisticated critical
thinking skills by the nurse. What are the potential benefits of critical thinking in nursing? Select all that
apply.
A) Enhancing the nurse's clinical decision making
B) Identifying the patient's individual preferences
C) Planning the best nursing actions to assist the patient
D) Increasing the accuracy of the nurse's judgments
E) Helping identify the patient's priority needs - ANSWER:A) Enhancing the nurse's clinical decision
making
C) Planning the best nursing actions to assist the patient
D) Increasing the accuracy of the nurse's judgments
, E) Helping identify the patient's priority needs
The nursing instructor cites a list of skills that support critical thinking in clinical situations. The nurse
should describe skills in which of the following domains? Select all that apply.
A) Self-esteem
B) Self-regulation
C) Inference
D) Autonomy
E) Interpretation - ANSWER:B) Self-regulation
C) Inference
E) Interpretation
A nurse sees a patient with a diagnosis of anorexia nervosa and orders a diet/nutrition consult. What
clinical reasoning skill is used? - ANSWER:CLINICAL JUDGEMENT
The nurse is providing care for a patient with chronic obstructive pulmonary disease (COPD). The nurse's
most recent assessment reveals an SaO2 of 89%. The nurse is aware that part of critical thinking is
determining the significance of data that have been gathered. What characteristic of critical thinking is
used in determining the best response to this assessment finding?
A) Extrapolation
B) Inference
C) Characterization
D) Interpretation - ANSWER:D) Interpretation
A nurse uses critical thinking every day when going through the nursing process. Which of the following
is an outcome of critical thinking in nursing practice?
A) A comprehensive plan of care with a high potential for success
B) Identification of the nurse's preferred goals for the patient
C) A collaborative basis for assigning care
D) Increased cost efficiency in health care - ANSWER:A) A comprehensive plan of care with a high
potential for success
Nurses apply critical thinking to clinical reasoning and judgment in their nursing practice every day.
Which of the following are characteristics of this practice? Select all that apply.
A) It is guided by standards, policies and procedures, ethics codes, and laws.
B) It is based on principles of nursing process, problem solving, and the scientific method.
C) It carefully identifies the key problems, issues, and risks involved.
A class of nursing students is in their first semester of nursing school. The instructor explains that one of
the changes they will undergo while in nursing school is learning to "think like a nurse." What is the most
current model of this thinking process?
A) Critical-thinking Model
B) Nursing Process Model
C) Clinical Judgment Model
D) Active Practice Model - ANSWER:C) Clinical Judgment Model
The nursing student 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/legal skill - ANSWER:A) Cognitive skill
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 patient'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 three hours late and the
nurse has consequently filled out an incident report. In doing so, the nurse has exhibited which of the
following?
A) Ethical/legal skills
B) Technical skills
C) Interpersonal skills
D) Cognitive skills - ANSWER:A) Ethical/legal skills
What is a systematic way to form and shape one's thinking?
A) Critical thinking
B) Intuitive thinking
C) Trial-and-error
D) Interpersonal values - ANSWER:A) Critical Thinking
,What step in the nursing process is most closely associated with cognitively skilled nurses?
A) Assessing
B) Planning
C) Implementing
D) Evaluating - ANSWER:B) Planning
Members of the staff on a hospital unit are critical of a client's family, who has different cultural beliefs
about health and illness. A student assigned to the patient does not agree, based on her care of the
client and family. What critical thinking attitude is the student demonstrating?
A) Being curious and persevering
B) Being creative
C) Demonstrating confidence
D) Thinking independently - ANSWER:D) Thinking independently
Tanner's Clinical Judgement Model (NOTICING) - ANSWER:-recognizing a potential issue, perceptually
grasping the situation
Tanner's Clinical Judgement Model (REFLECTING) - ANSWER:SAME AS REMEMBERING: attending to
patient's responses to nursing action while in the process of acting
Tanner's Clinical Judgement Model (INTERPRETING) - ANSWER:-reasoning pattern, analytical, intuitive,
narrative, developing a sufficient understanding of the situation
Tanner's Clinical Judgement Model (OBSERVATION & INTERPRETATION) - ANSWER:hallmarks of trained
nursing practice
Tanner's Clinical Judgement Model (RESPONDING) - ANSWER:deciding on the court of action deemed
appropriate for the situation, which may include, NO IMMEDIATE ACTION
Reflection IN action - ANSWER:-happens in real time while care is occurring
-refers to nurses' ability to "read" the patient—how he or she is responding to the nursing intervention
and adjust the interventions based on that assessment.
Reflection ON action - ANSWER:-occurs after the fact and involves thinking through a situation that has
occurred in the past
-showing what nurses gain from their experience contributes to their ongoing clinical knowledge
development and their capacity for clinical judgment in future situations.
Supports the idea that nurses engage in a complex process of clinical reasoning when caring for patients.
Nurses draw on personal knowledge and experience from various situations and consider the contextual
background of the clinical culture. - ANSWER:CLINICAL JUDGEMENT MODEL
,Critical thinking concepts, when used in the Nursing Process, will result in________________. -
ANSWER:Clinical judgement
clinical judgement - ANSWER:refers to the nurse's interpretation and inferences that influence his/her
actions in a care-giving setting.
clinical judgement are influenced by.... - ANSWER:the context in which the situation occurs and the
culture of the nursing care unit
Five conclusions of the CLINICAL JUDGEMENT MODEL - ANSWER:(1) Clinical judgments are more
influenced by what nurses bring to the situation than the objective data about the situation at hand;
(2) Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of
responses, as well as an engagement with the patient and his or her concerns;
(3) Clinical judgments are influenced by the context in which the situation occurs and the culture of the
nursing care unit;
(4) Nurses use a variety of reasoning patterns alone or in combination; and
(5) Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the
development of clinical knowledge and improvement in clinical reasoning.
A care conference has been organized for a patient with complex medical and psychosocial needs. When
applying the principles of critical thinking to this patient's care planning, the nurse should most
exemplify what characteristic?
A) Willingness to observe behaviors
B) A desire to utilize the nursing scope of practice fully
C) An ability to base decisions on what has happened in the past
D) Openness to various viewpoints - ANSWER:D) openness to various veiwpoints
Achieving adequate pain management for a postoperative patient will require sophisticated critical
thinking skills by the nurse. What are the potential benefits of critical thinking in nursing? Select all that
apply.
A) Enhancing the nurse's clinical decision making
B) Identifying the patient's individual preferences
C) Planning the best nursing actions to assist the patient
D) Increasing the accuracy of the nurse's judgments
E) Helping identify the patient's priority needs - ANSWER:A) Enhancing the nurse's clinical decision
making
C) Planning the best nursing actions to assist the patient
D) Increasing the accuracy of the nurse's judgments
, E) Helping identify the patient's priority needs
The nursing instructor cites a list of skills that support critical thinking in clinical situations. The nurse
should describe skills in which of the following domains? Select all that apply.
A) Self-esteem
B) Self-regulation
C) Inference
D) Autonomy
E) Interpretation - ANSWER:B) Self-regulation
C) Inference
E) Interpretation
A nurse sees a patient with a diagnosis of anorexia nervosa and orders a diet/nutrition consult. What
clinical reasoning skill is used? - ANSWER:CLINICAL JUDGEMENT
The nurse is providing care for a patient with chronic obstructive pulmonary disease (COPD). The nurse's
most recent assessment reveals an SaO2 of 89%. The nurse is aware that part of critical thinking is
determining the significance of data that have been gathered. What characteristic of critical thinking is
used in determining the best response to this assessment finding?
A) Extrapolation
B) Inference
C) Characterization
D) Interpretation - ANSWER:D) Interpretation
A nurse uses critical thinking every day when going through the nursing process. Which of the following
is an outcome of critical thinking in nursing practice?
A) A comprehensive plan of care with a high potential for success
B) Identification of the nurse's preferred goals for the patient
C) A collaborative basis for assigning care
D) Increased cost efficiency in health care - ANSWER:A) A comprehensive plan of care with a high
potential for success
Nurses apply critical thinking to clinical reasoning and judgment in their nursing practice every day.
Which of the following are characteristics of this practice? Select all that apply.
A) It is guided by standards, policies and procedures, ethics codes, and laws.
B) It is based on principles of nursing process, problem solving, and the scientific method.
C) It carefully identifies the key problems, issues, and risks involved.
