LEMONE AND BURKE'S MEDICAL-
SURGICAL NURSING
CLINICAL REASONING IN PATIENT CARE
7TH EDITION
AUTHOR(S)GERENE BAULDOFF RN,
PHD, FAAN; PAULA GUBRUD;
MARGARET CARNO
TEST BANK
1. MCQ
Clinical Scenario:
A newly licensed nurse is reviewing clinical reasoning with a
,preceptor during orientation on a busy adult medical-surgical
unit.
Question Stem:
Which statement best describes clinical reasoning in nursing?
Answer Options:
A. Following the nursing process in the same exact order for
every patient
B. Using cue recognition, analysis, and judgment to choose
patient-centered actions
C. Completing all documentation before seeing the patient
D. Relying primarily on instinct when the patient appears stable
Correct Answer:
B
Detailed Rationale:
Clinical reasoning is a dynamic thinking process in which the
nurse gathers cues, interprets data, prioritizes concerns, and
selects actions that fit the patient’s situation. It is patient-
centered and changes as new information appears. This is the
foundation of safe practice and the Clinical Judgment
Measurement Model.
Incorrect Option Analysis:
A: Incorrect because the nursing process is useful, but real
clinical reasoning is not rigid or identical for every patient.
This reflects a common misconception that nursing is
, purely algorithmic. Safety risk: oversimplification can delay
recognition of deterioration.
C: Incorrect because documentation does not replace
assessment. This reflects task-focused thinking instead of
patient-focused thinking. Safety risk: important cues may
be missed.
D: Incorrect because intuition alone is not a safe substitute
for evidence and assessment. This reflects informal
decision-making without validation. Safety risk: unstable
patients may be underrecognized.
Nursing Process Linkage:
Assessment
Clinical Judgment Competencies (NCJMM):
Recognize Cues; Analyze Cues
Clinical Reasoning Focus:
Cue Recognition
Difficulty Level:
Easy
Bloom’s Cognitive Level:
Understand
NCLEX Client Needs Category:
Management of Care
, Key Learning Objective:
Identify clinical reasoning as a structured, cue-based decision
process that supports safe patient care.
2. SATA
Clinical Scenario:
A hospital team is updating a unit protocol to reduce
preventable complications.
Question Stem:
Which actions reflect evidence-based practice (EBP)? Select all
that apply.
Answer Options:
A. Searching current research and clinical guidelines
B. Using the same procedure because “we have always done it
this way”
C. Considering the patient’s values and preferences in the plan
of care
D. Evaluating patient outcomes after implementing the change
E. Accepting a single colleague’s opinion as sufficient evidence
Correct Answers:
A, C, D
Detailed Rationale:
EBP combines the best available evidence, clinical expertise,
and patient preferences. Nurses should use trustworthy
SURGICAL NURSING
CLINICAL REASONING IN PATIENT CARE
7TH EDITION
AUTHOR(S)GERENE BAULDOFF RN,
PHD, FAAN; PAULA GUBRUD;
MARGARET CARNO
TEST BANK
1. MCQ
Clinical Scenario:
A newly licensed nurse is reviewing clinical reasoning with a
,preceptor during orientation on a busy adult medical-surgical
unit.
Question Stem:
Which statement best describes clinical reasoning in nursing?
Answer Options:
A. Following the nursing process in the same exact order for
every patient
B. Using cue recognition, analysis, and judgment to choose
patient-centered actions
C. Completing all documentation before seeing the patient
D. Relying primarily on instinct when the patient appears stable
Correct Answer:
B
Detailed Rationale:
Clinical reasoning is a dynamic thinking process in which the
nurse gathers cues, interprets data, prioritizes concerns, and
selects actions that fit the patient’s situation. It is patient-
centered and changes as new information appears. This is the
foundation of safe practice and the Clinical Judgment
Measurement Model.
Incorrect Option Analysis:
A: Incorrect because the nursing process is useful, but real
clinical reasoning is not rigid or identical for every patient.
This reflects a common misconception that nursing is
, purely algorithmic. Safety risk: oversimplification can delay
recognition of deterioration.
C: Incorrect because documentation does not replace
assessment. This reflects task-focused thinking instead of
patient-focused thinking. Safety risk: important cues may
be missed.
D: Incorrect because intuition alone is not a safe substitute
for evidence and assessment. This reflects informal
decision-making without validation. Safety risk: unstable
patients may be underrecognized.
Nursing Process Linkage:
Assessment
Clinical Judgment Competencies (NCJMM):
Recognize Cues; Analyze Cues
Clinical Reasoning Focus:
Cue Recognition
Difficulty Level:
Easy
Bloom’s Cognitive Level:
Understand
NCLEX Client Needs Category:
Management of Care
, Key Learning Objective:
Identify clinical reasoning as a structured, cue-based decision
process that supports safe patient care.
2. SATA
Clinical Scenario:
A hospital team is updating a unit protocol to reduce
preventable complications.
Question Stem:
Which actions reflect evidence-based practice (EBP)? Select all
that apply.
Answer Options:
A. Searching current research and clinical guidelines
B. Using the same procedure because “we have always done it
this way”
C. Considering the patient’s values and preferences in the plan
of care
D. Evaluating patient outcomes after implementing the change
E. Accepting a single colleague’s opinion as sufficient evidence
Correct Answers:
A, C, D
Detailed Rationale:
EBP combines the best available evidence, clinical expertise,
and patient preferences. Nurses should use trustworthy
