Exam (elaborations)
Brunner and Suddarth Q and A with rationales
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lOMoARcPSD|22054142PTS: 1 REF: p. 12
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
NOT: Multiple Choice
13. A recent nursing graduate is aware of the differences between nursing actions
that are independent and nursing actions that are interdependent. A nurse
performs an interdependent nursing intervention when performing which of the
om
following actions?
A. Auscultating a client's apical heart rate during an admission assessment
B. Providing mouth care to a client who is unconscious following a cerebrovascular
accident
.c
C. Administering an IV bolus of normal saline to a client with hypotension
D. Providing discharge teaching to a postsurgical client about the rationale for a
course of oral antibiotics
ks
an
ANS: C
Rationale: Although many nursing actions are independent, others are
tb
interdependent, such as carrying out prescribed treatments; administering
medications and therapies; collaborating with other health care team members to
es
accomplish specific, expected outcomes; and to monitor and manage potential
complications. Irrigating a wound, administering pain medication, and
administering IV fluids are interdependent nursing actions and require a health care
bt
provider's order. An independent nursing action occurs when the nurse assesses a
client's heart rate, provides discharge education, or provides mouth care.
PTS: 1 REF: p. 19
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
NOT: Multiple Choice
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, lOMoARcPSD|22054142
D. "You signed the informed consent documents prior to the treatment."
ANS: A
Rationale: Telling the truth (veracity) is one of the basic principles of nursing
culture. Three ethical dilemmas in clinical practice that can directly conflict with this
principle are the use of placebos (nonactive substances used for treatment), not
revealing a diagnosis to a client, and revealing a diagnosis to persons other than
the client with the diagnosis. The nurse is following the guidelines of the research
study, so re-educating the client about the study is the best the nurse can do.
om
Saying "What difference does it make?" or "You signed informed consent
documents" is not helpful because these statements are not supportive. While it is
true that the nurse does not know what treatment the client received, this
statement is also not supportive.
.c
PTS: 1 REF: p. 28
ks
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
an
KEY: Integrated Process: Communication and Documentation | Integrated Process:
Nursing Process
BLM: Cognitive Level: Analyze NOT: Multiple Choice
tb
16. A care conference has been organized for a client with complex medical and
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psychosocial needs. When applying the principles of critical thinking to this client's
care planning, the nurse should most exemplify what characteristic?
A. Willingness to observe behaviors
bt
B. A desire to utilize the nursing scope of practice fully
C. An ability to base decisions on what has happened in the past
D. Openness to various viewpoints
ANS: D
Rationale: Willingness and openness to various viewpoints are inherent in critical
thinking; these allow the nurse to reflect on the current situation. An emphasis on
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, lOMoARcPSD|22054142
the past, willingness to observe behaviors, and a desire to utilize the nursing scope
of practice fully are not central characteristics of critical thinkers.
PTS: 1 REF: p. 11 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
17. The nurse cites a list of skills that support critical thinking in clinical situations.
The nurse should describe skills in which of the following domains? Select all that
om
apply.
A. Self-esteem
B. Self-regulation
C. Inference
.c
D. Autonomy
E. Interpretation
ks
ANS: B, C, E
an
Rationale: Skills needed in critical thinking include interpretation, analysis,
evaluation, inference, explanation, and self-regulation. Self-esteem and autonomy
tb
would not be on the list because they are not skills.
es
PTS: 1 REF: p. 11 NAT: Client Needs: Psychosocial Integrity
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
bt
NOT: Multiple Select
18. The nurse is providing care for a client with chronic obstructive pulmonary
disease (COPD). The nurse's most recent assessment reveals an SaO2 of 89%. The
nurse is aware that part of critical thinking is determining the significance of data
that have been gathered. What characteristic of critical thinking is used in
determining the best response to this assessment finding?
A. Extrapolation
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, lOMoARcPSD|22054142
involvement of the ethics committee. Acting independently in the role of mediator
likely goes beyond the nurse's skill and scope of practice. The primary health care
provider likely cannot resolve this issue independently. Assertiveness on the part of
the client may or may not be beneficial.
PTS: 1 REF: p. 29
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
om
22. The nurse is caring for a client with cancer who is undergoing genetic testing.
The nurse explains that genetic testing will affect which aspects of the client's care?
Select all that apply.
.c
A. Screening for genetic mutations
B. Diagnosing the specific type of cancer
ks
C. Providing information on prognosis
D. Choosing specific treatments
E. Predicting lifespan
an
ANS: A, C, D
tb
Rationale: Advances in genetic testing have improved the process of screening for
genetic mutations in cancer cells, diagnosing specific types of cancer, and choosing
es
specific treatments for certain types of cancers. Genetic testing does not provide
information on prognosis nor does it predict lifespan.
bt
PTS: 1 REF: p. 8
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Select
23. A group of students have been challenged to prioritize ethical practice when
working with a marginalized population. How should the students best understand
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