STUDY GUIDE v
Davis Advantage for Understanding
v v v v
Medical-Surgical Nursing 7th Edition
v v v
By Hopper, Williams, All Chapter's 1 - 57
v v v v v v v
1
,(DavisvAdvantagev forvUnderstandingv Medical-SurgicalvNursing,v 7evLindav Williams,v Paulav Hopper)
Answers
CHAPTER 1 CRITICA v v
tovcollectvappropriatevdata,videntifyvavpatientvproblem,va
vndvdeterminevthevbestvpossiblevplanvofvaction.vClinicalvj
L THINKING,
v
uvdgmentv isv basedv onvgoodv criticalv thinking.
CLINICAL JUDGMENT, ANDTHE NU
v v v
Cue
O
RSING PROCESS
v
Definition:vSignificantvorvrelevantvdata.v Notvallv datav arevcue
sv (relevant),v butv allv cuesv arev data.
AUDIOv CASEv STUDY Collaboration
JanevPracticesv ClinicalvJudgment Definition:v Workingv togetherv withvthev healthv teamv tovimpr
ovev patientv outcomes.
1. Identifyvandvanalyzevcues;vprioritizevhypotheses;vgeneratevsolv
utions;v takev action;v evaluatev outcomes;v repeat. Intervention
2. Janevwasvexhausted,vfailedvavtest,vandvwasvpulledvinvtoo Definition:v Takingv actionv tov carryv outv av plan.
vmanyvdirections.vShevwasvalsovcryingvinvhervcarvandvha
Evaluation
dvpoorv studyv habitsv andv notv enoughv sleep.
3. Jane’svresourcesv includedv avgoodvfriend,vsickvtimev from Definition:vComparingvthevoutcomesvyouvexpectedvwithvav
vwork,v andv wastedv timev betweenv classesv thatv shev couldv
ctualvoutcomes.vDidvthevplanvwork?vWerevexpectedvo
vutcomesv met?
bvetterv utilize.v Yourv resourcesv willv bev different,v butv they
vevxist! Vigilance
4. Criticalv thinking— Definition:v Thev actv ofv beingv attentive,v alert,v andv watchful.
thevwhy:vJanevusesvcriticalvthinkingvtovdeterminevwhyvherv
currentvplanvisn’tvworking.vShevthinksvhonestlyvaboutvh CRITICALv THINKINGv ANDv CLINICALvJUDGMENT
verv poorv studyv habits,v herv time-
managementvproblems,vandvthevimpactvthisvisvhavingvon Criticalv thinkingv andv clinicalv judgmentv bothv followv av similarvfovr
vherv andv herv family. mat.v Bothv followv stepsv fromv collectingv datav tov determin-
Clinicalv judgment— ingv problemsv andv outcomes,v developingv andv takingv actions,v
thev do:v Janev usesv herv thinkingv tovdevelopv andv carryv outv av andvevaluatingv outcomes.v However,v criticalv thinkingv helpsv yo
vuv thinkv aboutvthev problem:v Whatv isv it?v Whyv isv itv happen-
planv thatv usesv herv resourcesv andv providesv morev productivev
ving?v Andv clinicalv judgmentv leadsv youv tov dovsomethingv tov ma
studyv timev andv morev qualityv timev withv herv kids.
vnagev thev problem.
VOCABULARY
CUEv RECOGNITION
SamplevsentencesvwillvvaryOforvthevVocabularyvproblems.
Youvwillvdovmanyvthingsvforveachvindividual,vbutvthevFIRSTthingvisvlvisted
Nursingv process vbelow.
Definition:vAnvorganizingvframeworkvthatvlinksvthinkingvwith
vnursingvactions.vStepsvincludevassessment/datavcollection
1. Sitv thev patientv upright.
,vnursingvdiagnosis,vplanning,vimplementation,vandvevaluati 2. Callv911v whilev runningv acrossv thev street.
ovn. 3. Elevatev thev feetv offv thev bedv byv placingv av pillowv underv the
vcalvesv andv allowingv thev feetv tov hangv offv thev edgev ofv the
Criticalv thinking vpillow.
Definition:v Thev usev ofv thosev cognitivev (knowledge)v skillsv orvs 4. Checkv bloodv glucosev andv havev av glucosev sourcev ready.
trategiesv thatv increasev thev probabilityv ofv av desirablev outcvo 5. Turnv thev patientv tov thev sidev tov preventv aspiration.
me.vAlsov involvesv reflection,vproblem-
solving,v andvrelatedv thinkingv skills.
Clinicalv judgment
Definition:v Thev observedv outcomev ofv criticalv thinkingv andv decv
isionvmaking.vAvprocessv thatvusesv nursingv knowledge
,2 Chapterv 1 Answers
CRITICALv THINKING
Thisvisvjustvonevpossiblevwayvtovcompletevavcognitivev map.
Couldvitvbevlow v v v
v v v
Patient's
v
v
Headache
v Mothervi v v v 1– v v v
vs
v
2v hours
REVIEWv QUESTIONS takingvvitalv signs;v datav collectionv isv thevfirstv stepv inv thevn
ursingv process.v (2,v 3,v 4)v arev allv stepsv inv thev nursingv prvoc
TheOcorrectv answersv arev inv boldface.
ess,v forv whichv thev registeredv nursev isv responsible;v thevLP
1. (2)v Criticalv thinkingv canv leadv tov betterv outcomesv forv the N/LVNv mayv assistv thev registeredv nursev withv these.v Nivtrogl
vpatient.v (1,v 3,v 4)v mayv bev truev butv arev notv thev bestv ans ycerinvshouldv notv bev administeredv withoutvfirstv knowivngv th
wver. ev patient’sv bloodv pressure.
2. (4)visvcorrect.vThevnursevwhovcanvadmitvtovnotvknowinv 7. (2)vindicatesvthatvthevpatientvisvconcernedvaboutvfreedom
gvsomethingvisvexhibitingvintellectualvhumility.v(1)vshows vfromvinjuryvandvharm.v(1)vrelatesvtovbasicvneedsvsuchva
vexpertisev butv notv necessarilyv intellectualv humility; svair,voxygen,vandvwater.v(3)vrelatesvtovfeelingvloved.v(4)
(2) reportingv anv errorv showsv intellectualv integrity; vivsvrelatedv tov havingv positivev self-esteem.
(3) empathizingvisvpositivevbutvdoesvisvnotvevidence 8. (3,v 1,v 2,v 4)v isv thev correctv orderv accordingv tov Maslow.
vofv humility. 9. (5,v 2,v 1,v 4,v 6,v 3)v isv thev correctv order.
3. (3,v 4,v 5,v 1,v 2)v isv thev correctv order. 10. (3)v showsv thev patientv isv actuallyv takingv action.v (1,v 2,v 4
4. (1)visv thev bestv definition.v (2,v3,v 4)v dov notv definev critic )varev allv positivev butv dov notv showv intentv tov takev action.
valvthinkingv butv arev examplesv ofv goodv thinking. 11. (4)visv thev nurse’svanalysisv ofv thevsituation.v(1,v 2)v are
5. (4)v isv correct.v Evaluationv determinesv whetherv goalsv arev ac vdata;v (3)v isv av recommendation.
vhievedv andv interventionsv effective.v (2)v isv thev rolev ofv thevp 12. (1,v2,v3,v4)vshouldvbevpresent.vSincevthevdatavprovidev
hvysician.v (1,v 3)v encompassv datav collectionv andv imple- svonlyvhipvreplacementvasvthevpatient’svproblem,v(5)vth
vmentation,v whichv arev earlierv stepsv inv thev nursingv process vevdietitianv isv notv necessary.
.
6. (1)v isv correct.vThev licensedv practicalv nurse/licensedv voca-
vtionalv nursev (LPN/LVN)v canv collectv data,v whichv include
s
1
, Answers
CHAPTER 2 v
EVIDENCE-BASED PRACTICE
v 1. proof
2. context
AUDIOv CASEv STUDY 3. quality
4. care
Mariev andv Evidence-Basedv Practice 5. randomized
1. Thirdhandv smokev isv thev dangerousv toxinsv ofv smokev thatvl 6. outcomes
vingerv onv hair,v clothing,v furniture,v andv otherv surfacesv inv 7. gold
avnv areav afterv av cigarettev isv putv out.v Mariev learnedv thatv 8. nursing
evxposurev tov thesev toxinsv canv bev neurotoxicv tov children 9. patient’s
v avndv canv triggerv asthmav attacksv inv sensitivev people.
10. information
2. Evidence-
basedvpracticev isv consideredv thev goldv standardvofv healthv cvar CLINICALv JUDGMENT
e.
3. Stepv 1:v Askv thev burningv question.v Stepv 2:v Searchv and 1. Byv questioningv thev existingv wayv ofv doingv thingsv tov en
vsurev thatv thev patientv receivesv thev bestv carev possible
vcollectv thev mostv relevantv andv bestv evidencev available.v
Svtepv 3:v Thinkv critically.v Appraisev thev evidencev forv vali 2. Av thoroughv searchv ofv thev literature,v withv thev assistancev of
vthev medicalv librarian,v inv thev areav ofv theirv burningv ques
divty,vrelevancevtovthevsituation,vandvapplicability.
Stepv4:v Measurev thev outcomesv beforev andv afterv institutingvt -vtionv regardingv musicv reducingv preoperativev anxiety.
vhev change.v Stepv 5:v Makev itv happen.v Stepv 6:v Evaluatev th 3. Cumulativev Indexv tov Nursingv andv Alliedv Healthv Literaturv
evpracticev decisionv orv change. ev (CINAHL)v Database,v Joannav Briggsv Institutevevidence-
vbasedv resources,v Cochranev Reviews,v Medline/vPubMed
4. Combinationv therapyv withv av nicotinev patchv andv nicotinev lo
vzengesv workedv best,v althoughv bupropionv (Zyban)v orv varen 4. Measurev patientv outcomesv beforev institutingv thev evidence
ivclinev(Chantix)v andv nicotinev lozengesv workedv well,vtoo.v -
AvCochranev Reviewv foundv thatv advicev andv supportv fromv n basedv changev inv practicev sov comparisonsv canvbev madev aftve
ursvingv staffv canv increasev patients’v successv inv quit- rv implementationv tov determinev ifv thev inter-
tingv smoking,v especiallyv inv av hospitalv setting. ventionv worked
5. Evaluatev thev resultsv tov determinev whetherv thev change
VOCABULARY vmadev av significantv differencev andv ifv itv wasv valuablev invt
vermsv ofv costv andv time
SampleOsentencesv willv varyOforv thev Vocabularyv problems.
1. Evidence- REVIEWv QUESTIONS
basedvpractice:vAvsystematicvprocessvthatvusesvcurrentvevidv Thevcorrectvanswersvarevinvboldface.
encevinvmakingv decisionsv aboutv patientvcare.
2. Evidence- 1. (3)visv correct.v Providingv anv explanationv ofv whyv some-
informedvpractice:vConsiderationvofvpatientvfactorsvalongvw vthingv isv donev promotesv thev understandingv forv whyv itv i
vithvthevusevofvevidencevforvsharedvdecisionvmakingvbetwee svimportantv tov bev donev andv thereforev willv morev likelyv
nvthev health-carev providerv andv thev patient. bvev done.v (1,v2,v 4)v onlyv communicatev thev needv tov perf
3. Randomizedvcontrolledvtrials:vTruevexperimentalvstudiesvin orvmv avtask.v Theyv dovnotvprovidev rationalev forv thev task
v tovpro-
vwhichvasvmanyvfactorsvasvpossiblevthatvcouldvfalselyvcha
v motev understandingv ofv thev importancev ofv thev task.
nvgev thev resultsv arev controlled.
4. Research:vScientificvstudy,vinvestigation,vorvexperimenta- 2. (3)v isv correct.v Evidence-
vtionv tov establishv factsv andv analyzev theirv significance.
basedvnursingvcarevthatvhasvbeenvevaluatedvasvappropriatevf
vorvanvagencyvprovidesvthevbestvandvsafestvpatientvcare.v(1
5. Systematicvreview:vAvreviewvofvrelevantvresearchvusingvg
vuidelines.
)vOpinionsv mayv notv bev basedv on
Davis Advantage for Understanding
v v v v
Medical-Surgical Nursing 7th Edition
v v v
By Hopper, Williams, All Chapter's 1 - 57
v v v v v v v
1
,(DavisvAdvantagev forvUnderstandingv Medical-SurgicalvNursing,v 7evLindav Williams,v Paulav Hopper)
Answers
CHAPTER 1 CRITICA v v
tovcollectvappropriatevdata,videntifyvavpatientvproblem,va
vndvdeterminevthevbestvpossiblevplanvofvaction.vClinicalvj
L THINKING,
v
uvdgmentv isv basedv onvgoodv criticalv thinking.
CLINICAL JUDGMENT, ANDTHE NU
v v v
Cue
O
RSING PROCESS
v
Definition:vSignificantvorvrelevantvdata.v Notvallv datav arevcue
sv (relevant),v butv allv cuesv arev data.
AUDIOv CASEv STUDY Collaboration
JanevPracticesv ClinicalvJudgment Definition:v Workingv togetherv withvthev healthv teamv tovimpr
ovev patientv outcomes.
1. Identifyvandvanalyzevcues;vprioritizevhypotheses;vgeneratevsolv
utions;v takev action;v evaluatev outcomes;v repeat. Intervention
2. Janevwasvexhausted,vfailedvavtest,vandvwasvpulledvinvtoo Definition:v Takingv actionv tov carryv outv av plan.
vmanyvdirections.vShevwasvalsovcryingvinvhervcarvandvha
Evaluation
dvpoorv studyv habitsv andv notv enoughv sleep.
3. Jane’svresourcesv includedv avgoodvfriend,vsickvtimev from Definition:vComparingvthevoutcomesvyouvexpectedvwithvav
vwork,v andv wastedv timev betweenv classesv thatv shev couldv
ctualvoutcomes.vDidvthevplanvwork?vWerevexpectedvo
vutcomesv met?
bvetterv utilize.v Yourv resourcesv willv bev different,v butv they
vevxist! Vigilance
4. Criticalv thinking— Definition:v Thev actv ofv beingv attentive,v alert,v andv watchful.
thevwhy:vJanevusesvcriticalvthinkingvtovdeterminevwhyvherv
currentvplanvisn’tvworking.vShevthinksvhonestlyvaboutvh CRITICALv THINKINGv ANDv CLINICALvJUDGMENT
verv poorv studyv habits,v herv time-
managementvproblems,vandvthevimpactvthisvisvhavingvon Criticalv thinkingv andv clinicalv judgmentv bothv followv av similarvfovr
vherv andv herv family. mat.v Bothv followv stepsv fromv collectingv datav tov determin-
Clinicalv judgment— ingv problemsv andv outcomes,v developingv andv takingv actions,v
thev do:v Janev usesv herv thinkingv tovdevelopv andv carryv outv av andvevaluatingv outcomes.v However,v criticalv thinkingv helpsv yo
vuv thinkv aboutvthev problem:v Whatv isv it?v Whyv isv itv happen-
planv thatv usesv herv resourcesv andv providesv morev productivev
ving?v Andv clinicalv judgmentv leadsv youv tov dovsomethingv tov ma
studyv timev andv morev qualityv timev withv herv kids.
vnagev thev problem.
VOCABULARY
CUEv RECOGNITION
SamplevsentencesvwillvvaryOforvthevVocabularyvproblems.
Youvwillvdovmanyvthingsvforveachvindividual,vbutvthevFIRSTthingvisvlvisted
Nursingv process vbelow.
Definition:vAnvorganizingvframeworkvthatvlinksvthinkingvwith
vnursingvactions.vStepsvincludevassessment/datavcollection
1. Sitv thev patientv upright.
,vnursingvdiagnosis,vplanning,vimplementation,vandvevaluati 2. Callv911v whilev runningv acrossv thev street.
ovn. 3. Elevatev thev feetv offv thev bedv byv placingv av pillowv underv the
vcalvesv andv allowingv thev feetv tov hangv offv thev edgev ofv the
Criticalv thinking vpillow.
Definition:v Thev usev ofv thosev cognitivev (knowledge)v skillsv orvs 4. Checkv bloodv glucosev andv havev av glucosev sourcev ready.
trategiesv thatv increasev thev probabilityv ofv av desirablev outcvo 5. Turnv thev patientv tov thev sidev tov preventv aspiration.
me.vAlsov involvesv reflection,vproblem-
solving,v andvrelatedv thinkingv skills.
Clinicalv judgment
Definition:v Thev observedv outcomev ofv criticalv thinkingv andv decv
isionvmaking.vAvprocessv thatvusesv nursingv knowledge
,2 Chapterv 1 Answers
CRITICALv THINKING
Thisvisvjustvonevpossiblevwayvtovcompletevavcognitivev map.
Couldvitvbevlow v v v
v v v
Patient's
v
v
Headache
v Mothervi v v v 1– v v v
vs
v
2v hours
REVIEWv QUESTIONS takingvvitalv signs;v datav collectionv isv thevfirstv stepv inv thevn
ursingv process.v (2,v 3,v 4)v arev allv stepsv inv thev nursingv prvoc
TheOcorrectv answersv arev inv boldface.
ess,v forv whichv thev registeredv nursev isv responsible;v thevLP
1. (2)v Criticalv thinkingv canv leadv tov betterv outcomesv forv the N/LVNv mayv assistv thev registeredv nursev withv these.v Nivtrogl
vpatient.v (1,v 3,v 4)v mayv bev truev butv arev notv thev bestv ans ycerinvshouldv notv bev administeredv withoutvfirstv knowivngv th
wver. ev patient’sv bloodv pressure.
2. (4)visvcorrect.vThevnursevwhovcanvadmitvtovnotvknowinv 7. (2)vindicatesvthatvthevpatientvisvconcernedvaboutvfreedom
gvsomethingvisvexhibitingvintellectualvhumility.v(1)vshows vfromvinjuryvandvharm.v(1)vrelatesvtovbasicvneedsvsuchva
vexpertisev butv notv necessarilyv intellectualv humility; svair,voxygen,vandvwater.v(3)vrelatesvtovfeelingvloved.v(4)
(2) reportingv anv errorv showsv intellectualv integrity; vivsvrelatedv tov havingv positivev self-esteem.
(3) empathizingvisvpositivevbutvdoesvisvnotvevidence 8. (3,v 1,v 2,v 4)v isv thev correctv orderv accordingv tov Maslow.
vofv humility. 9. (5,v 2,v 1,v 4,v 6,v 3)v isv thev correctv order.
3. (3,v 4,v 5,v 1,v 2)v isv thev correctv order. 10. (3)v showsv thev patientv isv actuallyv takingv action.v (1,v 2,v 4
4. (1)visv thev bestv definition.v (2,v3,v 4)v dov notv definev critic )varev allv positivev butv dov notv showv intentv tov takev action.
valvthinkingv butv arev examplesv ofv goodv thinking. 11. (4)visv thev nurse’svanalysisv ofv thevsituation.v(1,v 2)v are
5. (4)v isv correct.v Evaluationv determinesv whetherv goalsv arev ac vdata;v (3)v isv av recommendation.
vhievedv andv interventionsv effective.v (2)v isv thev rolev ofv thevp 12. (1,v2,v3,v4)vshouldvbevpresent.vSincevthevdatavprovidev
hvysician.v (1,v 3)v encompassv datav collectionv andv imple- svonlyvhipvreplacementvasvthevpatient’svproblem,v(5)vth
vmentation,v whichv arev earlierv stepsv inv thev nursingv process vevdietitianv isv notv necessary.
.
6. (1)v isv correct.vThev licensedv practicalv nurse/licensedv voca-
vtionalv nursev (LPN/LVN)v canv collectv data,v whichv include
s
1
, Answers
CHAPTER 2 v
EVIDENCE-BASED PRACTICE
v 1. proof
2. context
AUDIOv CASEv STUDY 3. quality
4. care
Mariev andv Evidence-Basedv Practice 5. randomized
1. Thirdhandv smokev isv thev dangerousv toxinsv ofv smokev thatvl 6. outcomes
vingerv onv hair,v clothing,v furniture,v andv otherv surfacesv inv 7. gold
avnv areav afterv av cigarettev isv putv out.v Mariev learnedv thatv 8. nursing
evxposurev tov thesev toxinsv canv bev neurotoxicv tov children 9. patient’s
v avndv canv triggerv asthmav attacksv inv sensitivev people.
10. information
2. Evidence-
basedvpracticev isv consideredv thev goldv standardvofv healthv cvar CLINICALv JUDGMENT
e.
3. Stepv 1:v Askv thev burningv question.v Stepv 2:v Searchv and 1. Byv questioningv thev existingv wayv ofv doingv thingsv tov en
vsurev thatv thev patientv receivesv thev bestv carev possible
vcollectv thev mostv relevantv andv bestv evidencev available.v
Svtepv 3:v Thinkv critically.v Appraisev thev evidencev forv vali 2. Av thoroughv searchv ofv thev literature,v withv thev assistancev of
vthev medicalv librarian,v inv thev areav ofv theirv burningv ques
divty,vrelevancevtovthevsituation,vandvapplicability.
Stepv4:v Measurev thev outcomesv beforev andv afterv institutingvt -vtionv regardingv musicv reducingv preoperativev anxiety.
vhev change.v Stepv 5:v Makev itv happen.v Stepv 6:v Evaluatev th 3. Cumulativev Indexv tov Nursingv andv Alliedv Healthv Literaturv
evpracticev decisionv orv change. ev (CINAHL)v Database,v Joannav Briggsv Institutevevidence-
vbasedv resources,v Cochranev Reviews,v Medline/vPubMed
4. Combinationv therapyv withv av nicotinev patchv andv nicotinev lo
vzengesv workedv best,v althoughv bupropionv (Zyban)v orv varen 4. Measurev patientv outcomesv beforev institutingv thev evidence
ivclinev(Chantix)v andv nicotinev lozengesv workedv well,vtoo.v -
AvCochranev Reviewv foundv thatv advicev andv supportv fromv n basedv changev inv practicev sov comparisonsv canvbev madev aftve
ursvingv staffv canv increasev patients’v successv inv quit- rv implementationv tov determinev ifv thev inter-
tingv smoking,v especiallyv inv av hospitalv setting. ventionv worked
5. Evaluatev thev resultsv tov determinev whetherv thev change
VOCABULARY vmadev av significantv differencev andv ifv itv wasv valuablev invt
vermsv ofv costv andv time
SampleOsentencesv willv varyOforv thev Vocabularyv problems.
1. Evidence- REVIEWv QUESTIONS
basedvpractice:vAvsystematicvprocessvthatvusesvcurrentvevidv Thevcorrectvanswersvarevinvboldface.
encevinvmakingv decisionsv aboutv patientvcare.
2. Evidence- 1. (3)visv correct.v Providingv anv explanationv ofv whyv some-
informedvpractice:vConsiderationvofvpatientvfactorsvalongvw vthingv isv donev promotesv thev understandingv forv whyv itv i
vithvthevusevofvevidencevforvsharedvdecisionvmakingvbetwee svimportantv tov bev donev andv thereforev willv morev likelyv
nvthev health-carev providerv andv thev patient. bvev done.v (1,v2,v 4)v onlyv communicatev thev needv tov perf
3. Randomizedvcontrolledvtrials:vTruevexperimentalvstudiesvin orvmv avtask.v Theyv dovnotvprovidev rationalev forv thev task
v tovpro-
vwhichvasvmanyvfactorsvasvpossiblevthatvcouldvfalselyvcha
v motev understandingv ofv thev importancev ofv thev task.
nvgev thev resultsv arev controlled.
4. Research:vScientificvstudy,vinvestigation,vorvexperimenta- 2. (3)v isv correct.v Evidence-
vtionv tov establishv factsv andv analyzev theirv significance.
basedvnursingvcarevthatvhasvbeenvevaluatedvasvappropriatevf
vorvanvagencyvprovidesvthevbestvandvsafestvpatientvcare.v(1
5. Systematicvreview:vAvreviewvofvrelevantvresearchvusingvg
vuidelines.
)vOpinionsv mayv notv bev basedv on
