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Chapter 10: Blended Competencies, Clinical Reasoning, and Processes of Person-Centered Care

Alexandra Bozan 37 perguntas

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  1. 1Read the following patient scenario and identify the step of the nursing process represented by each numbered nursing activity

    Annie seeks the help of the nurse in the student health clinic because she suspects that her roommate, Angela, suffered date rape. She is concerned because Angela chose not to report the rape and does not seem to be coping well.

    (1 - [blank_start]assessing[blank_end]) After talking with Annie, the nurse learns that although Angela blurted out that she had been raped when she first came home, since then she has refused verbalization about the rape ("I don't want to think or talk about it"), has stopped attending all college social activities (a marked change in behavior), and seems to be having nightmares.

    After analyzing the data, the nurse believes that Angela might be experiencing (2 - [blank_start]diagnosing[blank_end]) rape-trauma syndrome: silent reaction. Fortunately, Angela trusts Annie and is willing to come to the student health center for help. A conversation with Angela confirms the nurse's suspicions and problem identification begins.

    The nurse talks further with Angela (3 - [blank_start]outcome[blank_end] [blank_start]identification[blank_end] and [blank_start]planning[blank_end]) to develop some treatment goals and formulate outcomes. The nurse also begins to think about the types of nursing interventions mostly likely to yield the desired outcomes.

    In the initial meeting with Angela (4 - [blank_start]implementing[blank_end]) the nurse encourages her expression of feelings and helps her to identify personal coping strategies and strengths.

    The nurse and Angela decide to meet in 1 week (5 - [blank_start]evaluating[blank_end]) to assess her progress toward achieving targeted outcomes. If she is not making progress, the plan of care might need to be modified.
    1. Aassessing
    2. Bdiagnosing
    3. Coutcome
    4. Didentification
    5. Eplanning
    6. Fevaluating
    7. Gimplementing
  2. 2A female patient who is receiving chemotherapy for breast cancer tells the nurse, "The treatment for this cancer is worse than the disease itself. I'm not going to come for my therapy anymore". The nurse responds by using critical thinking skills to address this patient problem. Which action is the first step the nurse would take in this process?
    1. AThe nurse judges whether the patient database is adequate to address the problem
    2. BThe nurse considers whether or not to suggest a counseling session for the patient
    3. CThe nurse reassesses the patient and decides how best to intervene in her care
    4. DThe nurse identifies several options for intervening in the patient's care and critiques the merit of each option
  3. 3The nursing process ensures that nurses are person centered rather than task centered. Rather than simply approaching a patient to take vital signs, the nurse thinks, "How is Mrs. Barcley today? Are our nursing actions helping her to achieve her goals? How can we better help her? This demonstrates which characteristics of the nursing process?
    1. ASystematic
    2. BInterpersonal
    3. CDynamic
    4. DUniversally applicable in nursing situations
  4. 4An experienced nurse tells a beginning nurse not to bother studying too hard, since most clinical reasoning becomes "second nature" and "intuitive" once you start practicing. What thinking below should underlie the beginning nurse's response?
    1. AIntuitive problem solving comes with years of practice and observation, and novice nurses should base their care on scientific problem solving.
    2. BFor nursing to remain a science, nurses must continue to be vigilant about stamping out intuitive reasoning
    3. CThe emphasis on logical, scientific, evidence-based reasoning has held nursing back for years; it's time to champion intuitive, creative thinking!
    4. DIt's simply a matter of preference; some nurses are logical, scientific thinkers, and some are intuitive, creative thinkers
  5. 5The nurse uses blended competencies when caring for patients in a rehabilitation facility. Which examples of interventions involve cognitive skills?
    1. AThe nurse uses critical thinking skills to plan care for a patient
    2. BThe nurse correctly administers IV saline to a patient who is dehydrated
    3. CThe nurse assists a patient to fill out an informed consent form
    4. DThe nurse learns the correct dosages for patient pain medications
    5. EThe nurse comforts a mother whose baby was born with Down syndrome
    6. FThe nurse uses the proper procedure to catheterize a female patient
  6. 6A nurse uses critical thinking skills to focus on the care plan of an elderly patient who has dementia and needs placement in a long-term care facility. Which statements describe characteristics of this type of critical thinking applied to clinical reasoning?
    1. AIt functions independently of nursing standards, ethics, and state practice acts
    2. BIt is based on the principles of the nursing process, problem solving, and the scientific methods
    3. CIt is driven by patient, family and community needs as well as nurses needs to give competent, efficient care
    4. DIt is not designed to compensate for problems created by human nature, such as medication errors
    5. EIt is constantly re-evaluating, self-correcting, and striving for improvement
    6. FIt focuses on the big picture rather than identifying the key problems, issues, and risks involved with patient care
  7. 7A nurse is caring for a patient who has complications related to type 2 diabetes mellitus. The nurse researches new procedures to care for foot ulcers when developing a plan of care for this patient. Which QSEN competency does this action represent?
    1. APatient-centered care
    2. BEvidence-based practice
    3. CQuality improvement
    4. DInformatics
  8. 8A nurse working in a long-term care facility bases patient care on five caring processes: knowing, being with, doing for, enabling and maintaining belief. This approach to patient care best describes the theory of which theorists?
    1. ATravelbe
    2. BWatson
    3. CBenner
    4. DSwanson
  9. 9A nurse is assessing a 15-year old female patient who is diagnosed with anorexia. Following the assessment, the nurse recommends that the patient meet with a nutritionist. This action best exemplified the use of:
    1. Aclinical judgement
    2. Bclinical reasoning
    3. Ccritical thinking
    4. Dblended competencies
  10. 10The nurse practices using critical thinking indicators (CTIs) when caring for patients in the hospital setting. The best description of CTIs is:
    1. AEvidence-based descriptions of behaviors that demonstrates the knowledge that promotes critical thinking in clinical practice
    2. BEvidence-based descriptions of behaviors that demonstrates the knowledge and skills that promote critical thinking in clinical practice
    3. CEvidence-based descriptions of behaviors that demonstrates the knowledge, characteristics, and skills that promote critical thinking in clinical practice
    4. DEvidence-based descriptions of behaviors that demonstrate the knowledge, characteristics, standards, and skills that promote critical thinking in clinical practice

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UNIT III: Person-Centered Care and the Nursing Process Chapter 10: Blended Competencies, Clinical Reasoning, and Processes of Person-Centered Care
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