STUDY GUIDE
Davis Advantage for Understanding
Medical-Surgical Nursing 7th Edition
By Hopper, Williams, All Chapter's 1 - 57
1
,(DavisrAdvantagerforrUnderstandingrMedical-SurgicalrNursing,r7erLindarWilliams,rPaularHopper)
Answers
CHAPTER 1 r
torcollectrappropriaterdata,ridentifyrarpatientrproblem,randrde
terminertherbestrpossiblerplanrofraction.rClinicalrjudgmentrisrb
CRITICAL THINKING,r
asedronrgoodrcriticalrthinking.
CLINICAL JUDGMENT, ANDTHE
r r r r
Cue
r
NURSING PROCESS r
Definition:rSignificantrorrrelevantrdata.rNotrallrdatarare
cuesr(relevant),rbutrallrcuesrarerdata.
AUDIOr CASEr STUDY Collaboration
Janer Practicesr Clinicalr Judgment Definition:rWorkingrtogetherrwithrtherhealthrteamrtorimpro
verpatientroutcomes.
1. Identifyrandranalyzercues;rprioritizerhypotheses;rgeneratersolutio
ns;rtakeraction;revaluateroutcomes;rrepeat. Intervention
2. Janerwasrexhausted,rfailedrartest,randrwasrpulledrinrtoormanyrdi Definition:rTakingractionrtorcarryroutrarplan.
rections.rSherwasralsorcryingrinrherrcarrandrhadrpoorrstudyrhabit
Evaluation
srandrnotrenoughrsleep.
3. Jane’srresourcesrincludedrargoodrfriend,rsickrtimerfromrwork,ra Definition:rComparingrtheroutcomesryourexpectedrwithractualr
ndrwastedrtimerbetweenrclassesrthatrshercouldrbetterrutilize.rY outcomes.rDidrtherplanrwork?rWererexpectedroutcomesrme
ourrresourcesrwillrberdifferent,rbutrtheyrexist! t?
4. Criticalrthinking— Vigilance
therwhy:rJanerusesrcriticalrthinkingrtordeterminerwhyrherrcurren Definition:rTheractrofrbeingrattentive,ralert,randrwatchful.
trplanrisn’trworking.rSherthinksrhonestlyraboutrherrpoorrstudyr
habits,rherrtime- CRITICALrTHINKINGr ANDr CLINICALrJUDGMENT
rmanagementrproblems,randrtherimpactrthisrisrhavingronrherran
drherrfamily. Criticalrthinkingrandrclinicalrjudgmentrbothrfollowrarsimilarrformat.r
Clinicalrjudgment— Bothrfollowrstepsrfromrcollectingrdatartordetermin-
ringrproblemsrandroutcomes,rdevelopingrandrtakingractions,randreva
therdo:rJanerusesrherrthinkingrtordeveloprandrcarryroutrarplanrthatr
usesrherrresourcesrandrprovidesrmorerproductiverstudyrtimerandr luatingroutcomes.rHowever,rcriticalrthinkingrhelpsryourthinkraboutrt
morerqualityrtimerwithrherrkids. herproblem:rWhatrisrit?rWhyrisritrhappen-
ring?rAndrclinical rjudgmentrleadsryourtordorsomethingrtormanagerthe
VOCABULARY rproblem.
SamplersentencesrwillrvaryrforrtherVocabularyrproblems. CUEr RECOGNITION
Nursingr process Yourwillrdormanyrthingsrforreachrindividual,rbutrtherFIRSTrthingrisrlistedrbel
Definition:rAnrorganizingrframeworkrthatrlinksrthinkingrwithrnursi ow.
ngractions.rStepsrincluderassessment/datarcollection,rnursingrdi
agnosis,rplanning,rimplementation,randrevaluation. 1. Sitrtherpatientrupright.
2. Callr911rwhilerrunningracrossrtherstreet.
Criticalrthinking 3. Elevatertherfeetroffrtherbedrbyrplacingrarpillowrunderrthercalvesra
Definition:rTheruserofrthosercognitiver(knowledge)rskillsrorrstrate ndrallowingrtherfeetrtorhangroffrtheredgerofrtherpillow.
giesrthatrincreasertherprobabilityrofrardesirableroutcome.rAlsorin 4. Checkrbloodrglucoserandrhaverarglucosersourcerready.
volvesrreflection,rproblem-solving,randrrelatedrthinkingrskills. 5. Turnrtherpatientrtorthersidertorpreventraspiration.
Clinicalrjudgment
Definition:rTherobservedroutcomerofrcriticalrthinkingrandrdecisionr
making.rArprocessrthatrusesrnursingrknowledge
,2 Chapterr1 Answers
CRITICALr THINKING
Thisrisrjustronerpossiblerwayrtorcompleterarcognitivermap.
Couldritrberlow Amr Ir diabetic? Frontalrarea "Sick"r feeling Hard Tylenolrhelps Hungerrmakes
bloodrsugar? itrworse
Patient's Whererisrit? Quality Aggravatingr and
perception alleviatingr factors
Foodr helps
Headache
Usefulr other Severity Timing
data
Sometimesr feel Motherris 7–8r onr 0–10 Lastsr1–2rhours Beforermeals Earlyrinrthe
sickr tor stomach diabetic scale oncer starts morning
REVIEWr QUESTIONS takingrvitalrsigns;rdatarcollectionrisrtherfirstrsteprinrthernursingr
process.r(2,r3,r4)rarerallrstepsrinrthernursingrprocess,rforrwhichr
Thercorrectranswersrarerinrboldface.
therregisteredrnurserisrresponsible;rtherLPN/LVNrmayrassistrth
1. (2)rCriticalrthinkingrcanrleadrtorbetterroutcomesrforrtherpatient erregisteredrnurserwithrthese.rNitroglycerinrshouldrnotrberadmi
.r(1,r3,r4)rmayrbertruerbutrarernotrtherbestranswer. nisteredrwithoutrfirstrknowingrtherpatient’srbloodrpressure.
2. (4)risrcorrect.rThernurserwhorcanradmitrtornotrknowingrsomet 7. (2)rindicatesrthatrtherpatientrisrconcernedraboutrfreedomrfromri
hingrisrexhibitingrintellectualrhumility.r(1)rshowsrexpertiserbutr njuryrandrharm.r(1)rrelatesrtorbasicrneedsrsuchrasrair,roxygen,ra
notrnecessarilyrintellectualrhumility; ndrwater.r(3)rrelatesrtorfeelingrloved.r(4)risrrelatedrtorhavingrpos
(2) reportingranrerrorrshowsrintellectualrintegrity; itiverself-esteem.
(3) empathizingrisrpositiverbutrdoesrisrnotrevidencerofrhu 8. (3,r1,r2,r4)risrthercorrectrorderraccordingrtorMaslow.
mility. 9. (5,r2,r1,r4,r6,r3)risrthercorrectrorder.
3. (3,r4,r5,r1,r2)risrthercorrectrorder. 10. (3)rshowsrtherpatientrisractuallyrtakingraction.r(1,r2,r4)rarerallr
4. (1)risrtherbestrdefinition.r(2,r3,r4)rdornotrdefinercriticalrthinki positiverbutrdornotrshowrintentrtortakeraction.
ngrbutrarerexamplesrofrgoodrthinking. 11. (4)risrthernurse’sranalysisrofrthersituation.r(1,r2)rarerdata;r(
5. (4)risrcorrect.rEvaluationrdeterminesrwhetherrgoalsrarerachieved 3)risrarrecommendation.
randrinterventions reffective.r(2)risrtherrolerofrtherphysician.r(1,r3)r 12. (1,r2,r3,r4)rshouldrberpresent.rSincertherdatarprovidesronlyrhi
encompassrdatarcollectionrandrimple- prreplacementrasrtherpatient’srproblem,r(5)rtherdietitianrisrno
rmentation,rwhichrarerearlierrstepsrinrthernursingrprocess. trnecessary.
6. (1)risrcorrect.rTherlicensedrpracticalrnurse/licensedrvoca-
rtionalrnurser(LPN/LVN) rcanrcollectrdata,rwhichrincludes
1
, Answers
CHAPTER 2 r
EVIDENCE-BASEDr PRACTICE
EVIDENCE-BASED PRACTICE r 1. proof
2. context
AUDIOr CASEr STUDY 3. quality
4. care
Marier andr Evidence-Basedr Practice 5. randomized
1. Thirdhandrsmokerisrtherdangerousrtoxinsrofrsmokerthatrlingerr 6. outcomes
onrhair,rclothing,rfurniture,randrotherrsurfacesrinranrarearafterra 7. gold
rcigaretterisrputrout.rMarierlearned rthatrexposurertorthesertoxi 8. nursing
nsrcanrberneurotoxicrtorchildrenrandrcanrtriggerrasthmarattacks 9. patient’s
rinrsensitiverpeople.
10. information
2. Evidence-
basedrpracticerisrconsideredrthergoldrstandardrofrhealthrcare. CLINICALr JUDGMENT
3. Stepr1:rAskrtherburningrquestion.rStepr2:rSearchrandrcollectr
thermostrrelevantrandrbestrevidenceravailable.rStepr3:rThinkr 1. Byrquestioningrtherexistingrwayrofrdoingrthingsrtorensurerth
critically.rAppraisertherevidencerforrvalidity,rrelevancertorth atrtherpatientrreceivesrtherbestrcarerpossible
ersituation,randrapplicability. 2. Arthoroughrsearchrofrtherliterature,rwithrtherassistancerofrtherme
Stepr4:rMeasurertheroutcomesrbeforerandrafterrinstitutingrthercha dicalrlibrarian,rinrtherarearofrtheirrburningrques-
rtionrregardingrmusicrreducingrpreoperativeranxiety.
nge.rStepr5:rMakeritrhappen.rStepr6:rEvaluatertherpracticerdecisio
nrorrchange. 3. CumulativerIndexrtorNursingrandrAlliedrHealthrLiteraturer(CI
4. Combinationrtherapyrwithrarnicotinerpatchrandrnicotinerlozenge NAHL)rDatabase,rJoannarBriggsrInstituterevidence-
srworkedrbest,ralthoughrbupropionr(Zyban)rorrvarenicliner(Chan basedrresources,rCochranerReviews,rMedline/rPubMed
tix)randrnicotinerlozengesrworkedrwell,rtoo.rArCochranerReview 4. Measurerpatientroutcomesrbeforerinstitutingrtherevidence-
rfoundrthatradvicerandrsupportrfromrnursingrstaffrcanrincreaserpat basedrchangerinrpracticersorcomparisonsrcanrbermaderafterrimp
ients’rsuccessrinrquit- lementationrtordeterminerifrtherinter-rventionrworked
rtingrsmoking,respeciallyrinrarhospitalrsetting. 5. Evaluatertherresultsrtordeterminerwhetherrtherchangermadera
rsignificantrdifferencerandrifritrwasrvaluablerinrtermsrofrcostran
VOCABULARY drtime
SamplersentencesrwillrvaryrforrtherVocabularyrproblems. REVIEWr QUESTIONS
1. Evidence- Thercorrectranswersrarerinrboldface.
basedrpractice:rArsystematicrprocessrthatrusesrcurrentrevidenceri
nrmakingrdecisionsraboutrpatientrcare. 1. (3)risrcorrect.rProvidingranrexplanationrofrwhyrsome-
2. Evidence- rthingrisrdonerpromotesrtherunderstandingrforrwhy ritrisrimport
informedrpractice:rConsiderationrofrpatientrfactorsralongrwithrth antrtorberdonerandrthereforerwillrmorerlikelyrberdone.r(1,r2,r4
eruserofrevidencerforrsharedrdecisionrmakingrbetweenrtherhealth- )ronlyrcommunicatertherneedrtorperformrartask.rTheyrdornotrpr
carerproviderrandrtherpatient. oviderrationalerforrthertaskrtorpro-
rmoterunderstandingrofrtherimportancerofrthertask.
3. Randomizedrcontrolledrtrials:rTruerexperimentalrstudiesrinrwhi
chrasrmanyrfactorsrasrpossiblerthatrcouldrfalselyrchangertherresul 2. (3)risrcorrect.rEvidence-
tsrarercontrolled. basedrnursingrcarerthatrhasrbeenrevaluatedrasrappropriaterforranra
4. Research:rScientificrstudy,rinvestigation,rorrexperimenta- gencyrprovidesrtherbestrandrsafestrpatientrcare.r(1)rOpinionsrmay
rnotrberbasedron
rtionrtorestablishrfactsrandranalyzertheirrsignificance.
5. Systematicrreview:rArreviewrofrrelevantrresearchrusingrguideli
nes.
