Exam (elaborations)
4. Taking the Next Steps, Clinical Reasoning
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- Nursing Tests
- Institution
- Albany Memorial School Of Nursing
4. Taking the Next Steps, Clinical Reasoning
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Chapter 04: Taking the Next Steps: Clinical ReasoningMULTIPLE CHOICE
1. After the subjective and objective data have been prioritized, the next step is to: a. order
laboratory tests.
b. formulate a problem list.
c. initiate appropriate referrals.
d. initiate therapy.
ANS: B
After the data have been prioritized and a presumed diagnosis is made, the next step is to
consider the appropriate laboratory tests, imaging studies, or specialty consultations.
DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process evaluating
MSC: Safe and Effective Care: Management of Care
2. New findings of unknown causes are:
a. problems to be noted on the problem list.
b. deferred for subsequent visits.
c. diagnosed before physical examination.
d. reserved for specialists.
ANS: A
New findings of unknown causes are added to the problem list, but do not let them become a
red herring that distracts your attention from the central issues.
DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process diagnosis MSC:
Safe and Effective Care: Management of Care
3. Which is an accepted method of making a diagnosis?
, a. Relying on intuition
b. Making maximal use of laboratory tests
c. Using first assumptions
d. Using algorithms
ANS: D
Methods to make a diagnosis include recognizing patterns, sampling the universe, and using
algorithms. Do not rely on intuition, extensive use of laboratory findings, or always going
with your first assumptions.
DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process diagnosis MSC:
Safe and Effective Care: Management of Care
4. The adage ha c mm blem cc c mm l ad i e he ac i i e :
a. al a diag e he a ie s problem in terms of what their practice usually sees.
b. refer any uncommon complaints to specialists as soon as possible.
c. not consider more than one diagnosis unless necessary.
d. examine uncommon problems critically before assuming that the issue is an unusual
presentation of a common problem.
ANS: C
This adage is to guide the practitioner to pay attention to unexpected or unusual findings but
not to consider more than one diagnosis unless necessary and to favor the simplest hypothesis
when competing hypotheses exist.
DIF: Cognitive Level: Analyzing (Analysis) OBJ: Nursing process diagnosis
MSC: Safe and Effective Care: Management of Care
5. The most important guide to sequencing actions should be:
a. probability and utility.
b. assumption and intuition.
c. costs and risks of procedures.
d. reimbursement potential and patient acceptance.
ANS: A
Although all choices are relevant, the prioritized guide is to select actions based on an
e. ima e f he babili f cce f ll achie i g he a ie g al a d he ili f
implementation.
DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process diagnosis MSC:
Safe and Effective Care: Management of Care
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