NR 224: Fundamentals Final Exam Review
I I I I I
1. Infectious Idisease Istages:
a. Incubation: IInterval Ibetween Ientrance Iof Ipathogen I into Ibody Iand Iappearance Iof
I first Isymptoms I(e.g., Ichickenpox, I14 Ito I16 Idays Iafter Iexposure; Icommon Icold, I1
ItoI2 Idays; I influenza, I1 Ito I4 Idays; I measles, I10 Ito I12 Idays; I mumps, I16 Ito I18 Idays;
IEbola I2 Ito I21 Idays I(CDC, I2015b).
b. Prodromal: IInterval I from Ionset Iof I nonspecific Isigns Iand Isymptoms I(malaise, I low-
grade I fever, I fatigue) Ito I more Ispecific Isymptoms. I (During Ithis Itime
I microorganisms I grow Iand I multiply, Iand Ipatient I may Ibe Icapable Iof Ispreading
Idisease Ito Iothers.) IFor Iexample, I herpes Isimplex Ibegins Iwith I itching Iand I tingling
IatIt he Isite Ibefore Ithe I lesion Iappears.
c. Illness IStage: IInterval I when Ipatient I manifests Isigns Iand Isymptoms Ispecific Ito Itype
of I infection. IFor Iexample, Istrep I throat I is I manifested Iby Isore Ithroat, Ipain, Iand
Iswelling; I mumps I is I manifested Iby Ihigh I fever, Iparotid Iand Isalivary Igland Iswelling.
d. Convalescence: IInterval Iwhen Iacute Isymptoms Iof I infection Idisappear. I(Length Iof
recovery Idepends Ion Iseverity Iof I infection Iand Ipatient's I host Iresistance;
IrecoveryImay Itake Iseveral Idays Ito I months.)
2. What Iare Ithe I normal I levels Iof IWBCs I in Ithe Iblood?
a. 5,000 Ito I10,000 I mm3 Ibut I typically I rises Ito I15,000 Ito I20,000 I mm3 Iand I higher
Iduring I inflammation. IFever I is Icaused Iby Iphagocytic Irelease Iof Ipyrogens
I fromIbacterial Icells, I which Icauses Ia Irise I in Ithe I hypothalamic Iset Ipoint.
3. How Idoes Ithe I nurse Iteach Ipatients Iabout I infection Icontrol?
a. Keep Iit Idry
b. Change Idressing
c. Adequate Idiet
d. Hydration
e. Shower Ibut I no Ibath
4. Risk I factors Ifor Ipatients Iwith Ipneumonia
a. Age
b. Heart I failure
c. Dysphagia
d. Immobility
e. smokers
f. Smokers
g. Immunocompromised
5. How Ito Iassess Ipulse?
a. Palpate Ibilaterally Iexcept I for Icarotid Iartery
6. Rate I for Ipulses: I60-100 Ibpm
7. A Ipatient Iwound I has Ibecome I infected, Iwhat Idoes Ithe I nurse Ido?
a. Assess Iwhite Iblood Icells
b. Temperature
c. Fever
d. Erythema Ior Iredness
e. Swelling
8. Critical Ithinking
,a. Basic Icritical Ithinking I is Iconcrete Iand Ibased Ion Ia Iset Iof Irules Ior Iprinciples, Isuch
IasIt he I guidelines I in Ia I hospital Iprocedure I manual. I The I nurse’s Iapproach I is I not
Iaccurate, Ias Iaccuracy Irequires I use Iof Iall Iof Ithe I facts I(e.g. Ithe Ipatient’s
Idiscomfort).IA Icritical I thinker I is I willing Ito Itake Irisks I in Itrying Idifferent I ways Ito
Isolve Iproblems; I following Ione Ibasic Iapproach I is I not I risk I taking. I This I is Ialso I not
Ian Iexample Iof Ireflection.
b. Discipline I is Ibeing Ithorough I in Iwhatever I you Ido. IUsing Iknown Icriteria I for
assessment Iand Ievaluation, Ias I in I the Icase Iof Ipain, I is Ian Iexample Iof Idiscipline
c. The Icorrect Iorder Iof Ithe Isteps Iof Ithe Iscientific I method Iare: I1. I Identifying I the
Iproblem, I2. ICollecting Idata, I3. IFormulating Ia Iquestion Ior Ihypothesis, I4.
ITestingIt he Iquestion Ior I hypothesis, Iand I5. IEvaluating Iresults Iof Ithe Itest Ior Istudy.
d. The I nurse Irelies Ion Iexperience Iand I the Iability Ito Iadapt Ia Iprocedure Isuch Ias Ia
dressing Ichange I(complex Icritical I thinking) Ito I make I it Isuccessful.
e. A Inurse’s Ispecific Iknowledge Ibase I will I vary Ibut I includes Ibasic I nursing
Ieducation,Icontinuing Ieducation Icourses, Iand Iadditional Icollege Idegrees. IIn
Iaddition, I it I includes Ithe Iknowledge I gained I from Ia I nurse Ireading I the I nursing
I literature, Iand Iacquiring I information Iand Itheory I from Ithe Ibasic Isciences,
Ihumanities, Ibehavioral Isciences, Iand I nursing. INurse’s Iknowledge Ibase Ialso
I involves Ia Idifferent I way Iof I thinking I holistically Iabout Ipatient Iproblems.
f. Reflection, Iusing Ia Ipain Irating Iscale Ito Ibe Iprecise Iand Ispecific, Iand I nursing
assessment I(the I first Istep Iof I the I nursing Iprocess) Iare Iexamples Iof Icritical I thinking
Iskills. I Explaining Ia Iprocedure Ibased Ion Ipolicy I is I not Icritical I thinking I– I however
Iperforming Ia Iprocedure I following Ipolicy I is Ibasic Icritical Ithinking. IOffering
Isupport Ito Ia Icolleague I is Ian I important Iway Ito Iassist Ianother I in I managing Istress
IbutIis I not I a Icritical Ithinking Iskill.
g. Diagnostic Ireasoning Ibegins Iwhen I you I interact I with Ia Ipatient Ior I make Iphysical Ior
behavioral Iobservations. IAn Iexpert I nurse Isees Ithe Icontext Iof Ia Ipatient
IsituationI( e.g., IPatient I lives Ialone, I has I fallen I in Ipast, Iobserves Ipatterns Iand Ithemes
Iand I makes Ia Idiagnostic Idecision
h. Critical Ithinking I is Ia Icontinuous Iprocess Icharacterized Iby Iopen- mindedness,
Icontinual I inquiry, Iand Iperseverance, Icombined Iwith Ia Iwillingness Ito I look Iat
IeachIunique Ipatient Isituation Iand Idetermine I which I identified Iassumptions Iare
Itrue IandIr elevant I(Heffner Iand IRudy, I2008).
i. Critical Ithinking Iencompasses Ithe I following: I Recognizing Ithat Ian I issue
Iexists,Ia nalyzing I information, Ievaluating I information, Iand I making
Iconclusions I(Settersten Iand I Lauer, I2004).
j. Nurses I who Iapply Icritical Ithinking I in I their Iwork I focus Ion Ioptions I for Isolving
Iproblems Iand I making Idecisions Irather Ithan Irapidly Iand Icarelessly I forming
Iquick,Is imple Isolutions.
k. Critical IThinking ISkills:
i. •Interpretation: I Be Iorderly I in Idata Icollection. I Look I for Ipatterns Ito
Icategorize Idata I(e.g., I nursing Idiagnoses I[see IChapter I17]). IClarify Iany
IdataIyou Iare I uncertain Iabout.
, ii. •Analysis: IBe Iopen- minded Ias Iyou I look Iat I information Iabout Ia Ipatient.
IDoInot I make Icareless Iassumptions. I Do Ithe Idata Ireveal Iwhat I you Ibelieve I is
Itrue, Ior Iare Ithere Iother Ioptions?
iii. •Inference: I Look Iat Ithe I meaning Iand Isignificance Iof I findings. IAre Ithere
Irelationships Ibetween I findings? IDo I the Idata Iabout Ithe Ipatient Ihelp I you
IseeIt hat Ia Iproblem Iexists?
iv. •Evaluation: I Look Iat Iall Isituations Iobjectively. IUse Icriteria I(e.g.,
Iexpected Io utcomes, Ipain Icharacteristics, I learning Iobjectives) Ito Idetermine
Iresults IofInursing Iactions. I Reflect Ion I your Iown Ibehavior.
v. •Explanation: ISupport I your I findings Iand Iconclusions. I Use Iknowledge
IandIe xperience Ito Ichoose Istrategies I to I use I in I the Icare Iof Ipatients.
vi. •Self-regulation: IReflect Ion I your Iexperiences. IIdentify Iways Ithat I you
IcanIimprove I your Iown Iperformance. IWhat Iwill I make I you Ibelieve Ithat
Iyou I have Ibeen Isuccessful?
9. Levels Iof Icritical I thinking
a. Level I1 I is I Basic:IAt Ithe Ibasic I level, I nurses Ithink Iconcretely Ion Ithe Ibasis Iof Ia Iset
IofIr ules Ior Iprinciples, I following Ia Istep-by-step Iprocess I without Ideviation I from I the
Iplan. IFollowing I a Iprocedure I step Iby Istep Iwithout Iadjusting Ito Ia Ipatient’s I unique
Ineeds I is Ian Iexample Iof Ibasic Icritical Ithinking.
b. •Level I2 I is IComplex: IComplex Icritical I thinking Ianalyzes Iand Iexamines
IchoicesIindependently. INurses I learn Ito I think Ibeyond Iand Isynthesize Iknowledge.
IIn Icomplex Icritical I thinking, Ia Inurse I learns I that Ialternative Iand Iperhaps
IconflictingIsolutions Iexist.
c. •Level I3 Iis ICommitment: ICommitment I is Ithe I third I level Iof Icritical
Ithinking.IN urses Ianticipate I needs Iand I make Ichoices Iwithout Iassistance I from
Iothers.
10. Five Icomponentsof Icritical I thinking
a. •Level I1 I is IBasic: I At I the Ibasic I level, Inurses I think Iconcretely Ion Ithe Ibasis Iof Ia Iset
Iof Irules Ior Iprinciples, I following Ia Istep-by-step Iprocess Iwithout Ideviation I from
ItheIp lan. IFollowing Ia Iprocedure Istep Iby Istep Iwithout Iadjusting I to Ia Ipatient’s
Iunique I needs I is Ian Iexample Iof Ibasic Icritical I thinking.
b. Level I2 I is IComplex: IComplex Icritical Ithinking Ianalyzes Iand Iexamines Ichoices
independently. INurses I learn Ito I think Ibeyond Iand Isynthesize Iknowledge. IIn
Icomplex Icritical I thinking, Ia I nurse I learns Ithat Ialternative Iand Iperhaps
IconflictingIsolutions Iexist.
c. •Level I3 Iis ICommitment: ICommitment I is Ithe Ithird I level Iof Icritical I thinking.
Nurses Ianticipate I needs Iand I make Ichoices Iwithout Iassistance I from Iothers.
11. Critical IThinkingIAttitudes Ithat Ia Inurse I needs: ISee ITable I15-3, Ip. I200)
a. Confidence
b. Independence
c. Fairness
d. Responsibility
e. Risk Itaking
f. Discipline
I I I I I
1. Infectious Idisease Istages:
a. Incubation: IInterval Ibetween Ientrance Iof Ipathogen I into Ibody Iand Iappearance Iof
I first Isymptoms I(e.g., Ichickenpox, I14 Ito I16 Idays Iafter Iexposure; Icommon Icold, I1
ItoI2 Idays; I influenza, I1 Ito I4 Idays; I measles, I10 Ito I12 Idays; I mumps, I16 Ito I18 Idays;
IEbola I2 Ito I21 Idays I(CDC, I2015b).
b. Prodromal: IInterval I from Ionset Iof I nonspecific Isigns Iand Isymptoms I(malaise, I low-
grade I fever, I fatigue) Ito I more Ispecific Isymptoms. I (During Ithis Itime
I microorganisms I grow Iand I multiply, Iand Ipatient I may Ibe Icapable Iof Ispreading
Idisease Ito Iothers.) IFor Iexample, I herpes Isimplex Ibegins Iwith I itching Iand I tingling
IatIt he Isite Ibefore Ithe I lesion Iappears.
c. Illness IStage: IInterval I when Ipatient I manifests Isigns Iand Isymptoms Ispecific Ito Itype
of I infection. IFor Iexample, Istrep I throat I is I manifested Iby Isore Ithroat, Ipain, Iand
Iswelling; I mumps I is I manifested Iby Ihigh I fever, Iparotid Iand Isalivary Igland Iswelling.
d. Convalescence: IInterval Iwhen Iacute Isymptoms Iof I infection Idisappear. I(Length Iof
recovery Idepends Ion Iseverity Iof I infection Iand Ipatient's I host Iresistance;
IrecoveryImay Itake Iseveral Idays Ito I months.)
2. What Iare Ithe I normal I levels Iof IWBCs I in Ithe Iblood?
a. 5,000 Ito I10,000 I mm3 Ibut I typically I rises Ito I15,000 Ito I20,000 I mm3 Iand I higher
Iduring I inflammation. IFever I is Icaused Iby Iphagocytic Irelease Iof Ipyrogens
I fromIbacterial Icells, I which Icauses Ia Irise I in Ithe I hypothalamic Iset Ipoint.
3. How Idoes Ithe I nurse Iteach Ipatients Iabout I infection Icontrol?
a. Keep Iit Idry
b. Change Idressing
c. Adequate Idiet
d. Hydration
e. Shower Ibut I no Ibath
4. Risk I factors Ifor Ipatients Iwith Ipneumonia
a. Age
b. Heart I failure
c. Dysphagia
d. Immobility
e. smokers
f. Smokers
g. Immunocompromised
5. How Ito Iassess Ipulse?
a. Palpate Ibilaterally Iexcept I for Icarotid Iartery
6. Rate I for Ipulses: I60-100 Ibpm
7. A Ipatient Iwound I has Ibecome I infected, Iwhat Idoes Ithe I nurse Ido?
a. Assess Iwhite Iblood Icells
b. Temperature
c. Fever
d. Erythema Ior Iredness
e. Swelling
8. Critical Ithinking
,a. Basic Icritical Ithinking I is Iconcrete Iand Ibased Ion Ia Iset Iof Irules Ior Iprinciples, Isuch
IasIt he I guidelines I in Ia I hospital Iprocedure I manual. I The I nurse’s Iapproach I is I not
Iaccurate, Ias Iaccuracy Irequires I use Iof Iall Iof Ithe I facts I(e.g. Ithe Ipatient’s
Idiscomfort).IA Icritical I thinker I is I willing Ito Itake Irisks I in Itrying Idifferent I ways Ito
Isolve Iproblems; I following Ione Ibasic Iapproach I is I not I risk I taking. I This I is Ialso I not
Ian Iexample Iof Ireflection.
b. Discipline I is Ibeing Ithorough I in Iwhatever I you Ido. IUsing Iknown Icriteria I for
assessment Iand Ievaluation, Ias I in I the Icase Iof Ipain, I is Ian Iexample Iof Idiscipline
c. The Icorrect Iorder Iof Ithe Isteps Iof Ithe Iscientific I method Iare: I1. I Identifying I the
Iproblem, I2. ICollecting Idata, I3. IFormulating Ia Iquestion Ior Ihypothesis, I4.
ITestingIt he Iquestion Ior I hypothesis, Iand I5. IEvaluating Iresults Iof Ithe Itest Ior Istudy.
d. The I nurse Irelies Ion Iexperience Iand I the Iability Ito Iadapt Ia Iprocedure Isuch Ias Ia
dressing Ichange I(complex Icritical I thinking) Ito I make I it Isuccessful.
e. A Inurse’s Ispecific Iknowledge Ibase I will I vary Ibut I includes Ibasic I nursing
Ieducation,Icontinuing Ieducation Icourses, Iand Iadditional Icollege Idegrees. IIn
Iaddition, I it I includes Ithe Iknowledge I gained I from Ia I nurse Ireading I the I nursing
I literature, Iand Iacquiring I information Iand Itheory I from Ithe Ibasic Isciences,
Ihumanities, Ibehavioral Isciences, Iand I nursing. INurse’s Iknowledge Ibase Ialso
I involves Ia Idifferent I way Iof I thinking I holistically Iabout Ipatient Iproblems.
f. Reflection, Iusing Ia Ipain Irating Iscale Ito Ibe Iprecise Iand Ispecific, Iand I nursing
assessment I(the I first Istep Iof I the I nursing Iprocess) Iare Iexamples Iof Icritical I thinking
Iskills. I Explaining Ia Iprocedure Ibased Ion Ipolicy I is I not Icritical I thinking I– I however
Iperforming Ia Iprocedure I following Ipolicy I is Ibasic Icritical Ithinking. IOffering
Isupport Ito Ia Icolleague I is Ian I important Iway Ito Iassist Ianother I in I managing Istress
IbutIis I not I a Icritical Ithinking Iskill.
g. Diagnostic Ireasoning Ibegins Iwhen I you I interact I with Ia Ipatient Ior I make Iphysical Ior
behavioral Iobservations. IAn Iexpert I nurse Isees Ithe Icontext Iof Ia Ipatient
IsituationI( e.g., IPatient I lives Ialone, I has I fallen I in Ipast, Iobserves Ipatterns Iand Ithemes
Iand I makes Ia Idiagnostic Idecision
h. Critical Ithinking I is Ia Icontinuous Iprocess Icharacterized Iby Iopen- mindedness,
Icontinual I inquiry, Iand Iperseverance, Icombined Iwith Ia Iwillingness Ito I look Iat
IeachIunique Ipatient Isituation Iand Idetermine I which I identified Iassumptions Iare
Itrue IandIr elevant I(Heffner Iand IRudy, I2008).
i. Critical Ithinking Iencompasses Ithe I following: I Recognizing Ithat Ian I issue
Iexists,Ia nalyzing I information, Ievaluating I information, Iand I making
Iconclusions I(Settersten Iand I Lauer, I2004).
j. Nurses I who Iapply Icritical Ithinking I in I their Iwork I focus Ion Ioptions I for Isolving
Iproblems Iand I making Idecisions Irather Ithan Irapidly Iand Icarelessly I forming
Iquick,Is imple Isolutions.
k. Critical IThinking ISkills:
i. •Interpretation: I Be Iorderly I in Idata Icollection. I Look I for Ipatterns Ito
Icategorize Idata I(e.g., I nursing Idiagnoses I[see IChapter I17]). IClarify Iany
IdataIyou Iare I uncertain Iabout.
, ii. •Analysis: IBe Iopen- minded Ias Iyou I look Iat I information Iabout Ia Ipatient.
IDoInot I make Icareless Iassumptions. I Do Ithe Idata Ireveal Iwhat I you Ibelieve I is
Itrue, Ior Iare Ithere Iother Ioptions?
iii. •Inference: I Look Iat Ithe I meaning Iand Isignificance Iof I findings. IAre Ithere
Irelationships Ibetween I findings? IDo I the Idata Iabout Ithe Ipatient Ihelp I you
IseeIt hat Ia Iproblem Iexists?
iv. •Evaluation: I Look Iat Iall Isituations Iobjectively. IUse Icriteria I(e.g.,
Iexpected Io utcomes, Ipain Icharacteristics, I learning Iobjectives) Ito Idetermine
Iresults IofInursing Iactions. I Reflect Ion I your Iown Ibehavior.
v. •Explanation: ISupport I your I findings Iand Iconclusions. I Use Iknowledge
IandIe xperience Ito Ichoose Istrategies I to I use I in I the Icare Iof Ipatients.
vi. •Self-regulation: IReflect Ion I your Iexperiences. IIdentify Iways Ithat I you
IcanIimprove I your Iown Iperformance. IWhat Iwill I make I you Ibelieve Ithat
Iyou I have Ibeen Isuccessful?
9. Levels Iof Icritical I thinking
a. Level I1 I is I Basic:IAt Ithe Ibasic I level, I nurses Ithink Iconcretely Ion Ithe Ibasis Iof Ia Iset
IofIr ules Ior Iprinciples, I following Ia Istep-by-step Iprocess I without Ideviation I from I the
Iplan. IFollowing I a Iprocedure I step Iby Istep Iwithout Iadjusting Ito Ia Ipatient’s I unique
Ineeds I is Ian Iexample Iof Ibasic Icritical Ithinking.
b. •Level I2 I is IComplex: IComplex Icritical I thinking Ianalyzes Iand Iexamines
IchoicesIindependently. INurses I learn Ito I think Ibeyond Iand Isynthesize Iknowledge.
IIn Icomplex Icritical I thinking, Ia Inurse I learns I that Ialternative Iand Iperhaps
IconflictingIsolutions Iexist.
c. •Level I3 Iis ICommitment: ICommitment I is Ithe I third I level Iof Icritical
Ithinking.IN urses Ianticipate I needs Iand I make Ichoices Iwithout Iassistance I from
Iothers.
10. Five Icomponentsof Icritical I thinking
a. •Level I1 I is IBasic: I At I the Ibasic I level, Inurses I think Iconcretely Ion Ithe Ibasis Iof Ia Iset
Iof Irules Ior Iprinciples, I following Ia Istep-by-step Iprocess Iwithout Ideviation I from
ItheIp lan. IFollowing Ia Iprocedure Istep Iby Istep Iwithout Iadjusting I to Ia Ipatient’s
Iunique I needs I is Ian Iexample Iof Ibasic Icritical I thinking.
b. Level I2 I is IComplex: IComplex Icritical Ithinking Ianalyzes Iand Iexamines Ichoices
independently. INurses I learn Ito I think Ibeyond Iand Isynthesize Iknowledge. IIn
Icomplex Icritical I thinking, Ia I nurse I learns Ithat Ialternative Iand Iperhaps
IconflictingIsolutions Iexist.
c. •Level I3 Iis ICommitment: ICommitment I is Ithe Ithird I level Iof Icritical I thinking.
Nurses Ianticipate I needs Iand I make Ichoices Iwithout Iassistance I from Iothers.
11. Critical IThinkingIAttitudes Ithat Ia Inurse I needs: ISee ITable I15-3, Ip. I200)
a. Confidence
b. Independence
c. Fairness
d. Responsibility
e. Risk Itaking
f. Discipline