WorksheetsNSG 100 Clinical Judgement
Total questions: 44
Worksheet time: 40mins
Name
Class
Date
1.
Critical thinking characteristics include
a)
Considering what is important in a given situation.
b)
Accepting one, established way to provide patient care.
c)
Making decisions based on intuition.
d)
Being able to read and follow physician’s orders.
2.
Which of these patient scenarios is most indicative of critical thinking?
a)
Administering pain relief medication according to what was given last shift
b)
Asking a patient what pain relief methods, pharmacological and nonpharmacological, have worked in the past
c)
Offering pain relief medication based on physician orders
d)
Explaining to the patient that his reports of severe pain are not consistent with the minor procedure that was performed
3.
The critical thinking skill of evaluation in nursing practice can be best described as
a)
Examining the meaning of data.
b)
Reviewing the effectiveness of nursing actions.
c)
Supporting findings and conclusions.
d)
Searching for links between data and the nurse’s assumptions.
4.
The nursing student can best develop critical thinking skills by doing which of the following?
a)
Studying 3 hours more each night
b)
Actively participating in all clinical experiences
c)
Interviewing staff nurses about their nursing experiences
d)
Attending all open skills lab opportunities
5.
The nurse has just been assigned to the clinical care of a newly admitted patient. To know how to best care for the patient, the nurse uses the nursing process. Which step would the nurse probably do first?
a)
assessment
b)
diagnosis
c)
Plan outcomes
d)
Plan interventions
6.
Which of the following is the most important reason for nurses to be critical thinkers?
a)
Nurses need to follow policies and procedures.
b)
Nurses work with other healthcare team members.
c)
Nurses care for clients who have multiple health problems.
d)
Nurses have to be flexible and work variable schedules.
7.
The nurse administering pain medication every 4 hours is an example of which aspect of patient care?
a)
Assessment data
b)
Nursing diagnosis
c)
Patient outcome
d)
Nursing intervention
8.
Which statement about the nursing process is correct?
a)
It was developed from the ANA Standards of Care.
b)
It is a problem-solving method to guide nursing activities.
c)
It is a linear process with separate, distinct steps.
d)
It involves care that only the nurse will give.
9.
The nurse developed a care plan for a patient to help prevent Impaired Skin Integrity. She has made sure that nursing assistive personnel change the patient’s position every 2 hours. In the evaluation phase of the nursing process, which of the following would the nurse do first?
a)
Determine whether she has gathered enough assessment data.
b)
Judge whether the interventions achieved the stated outcomes.
c)
Follow up to verify that care for the nursing diagnosis was given.
d)
Decide whether the nursing diagnosis was accurate for the patient’s condition.
10.
Which of the following is an example of an open-ended question?
a)
Have you had surgery before?
b)
When was your last menstrual period?
c)
What happens when you have a headache?
d)
Do you have a family history of heart disease?
11.
Which situation is the most conducive to conducting a successful interview of an elderly woman whose husband and two children are in the hospital room visiting and watching television? The woman is alert and oriented.
a)
Provide enough chairs so the family and you are able to sit facing the client.
b)
Introduce yourself and ask, “Dear, what name do you prefer to go by?” before asking any questions.
c)
After the family leaves, ask the client if she is comfortable and willing to answer a few questions.
d)
Ask the client if you can talk with her while her family is watching the television.
12.
The nurse is beginning discharge planning for an older adult with left-side weakness. All of the following are important, but which action is most important in ensuring that the discharge plan is successful?
a)
Start planning at admission.
b)
Involve the family members.
c)
Get patient input when making the plan.
d)
Involve the multidisciplinary team.
13.
Which nursing intervention is considered an independent intervention?
a)
Administering 1 L of dextrose 5% in normal saline solution at 100 mL/hour
b)
Encouraging the postoperative client to perform coughing and deep breathing exercises
c)
Explaining his diet to the client; then communicating the teaching with the dietitian
d)
Administering morphine sulfate 2 mg IV to the client with postoperative pain
14.
Which nursing intervention is best individualized to meet the needs of a specific client?
a)
Suction the client every 2 hours per unit policy.
b)
Use incentive spirometry every hour while awake per postoperative protocols.
c)
Institute swallowing precautions.
d)
Move client out of bed to the chair daily; client prefers to be out of bed for dinner.
15.
The nurse is caring for a client who was newly diagnosed with type 2 diabetes mellitus. Which intervention by the nurse best promotes client cooperation with the treatment plan?
a)
Teaching the client that he must lose weight to control his blood sugar
b)
Informing the client he must exercise at least three times per week
c)
Explaining to the client that he must come to the diabetic clinic weekly
d)
Determining the client’s main concerns about his diabetes
16.
When should the nurse collect evaluation data for this expected outcome: Patient will maintain urine output of at least 30 mL/hour?
a)
At the end of the shift
b)
Every 24 hours
c)
Every 4 hours
d)
Every hour
17.
The nurse verifies that he is using only standardized abbreviations in documenting medication information. He recognizes that this fulfills which of the National Patient Safety Goals?
a)
Improve the accuracy of patient identification.
b)
Improve the effectiveness of communication among caregivers.
c)
Improve the safety of using medications.
d)
Accurately and completely reconcile medications across the continuum of care.
18.
The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?
a)
The patient is experiencing multiple illnesses.
b)
The patient uses one medication for an illness several times per day.
c)
The patient uses over-the-counter drugs for an illness.
d)
The patient uses multiple medications simultaneously.
19.
The nurse is reviewing medication errors. Which situation is an example of a medication error?
a)
A patient refuses her morning medications.
b)
A patient receives a double dose of a medication because the nurse did not cut the pill in half.
c)
A patient develops hives after having started an IV antibiotic 24 hours earlier.
d)
A patient complains of severe pain still present 60 minutes after a pain medication was given.
20.
What is the best way for the nurse to make sure that the right patient is receiving a prescribed drug when the patient is alert and oriented?
a)
Ask the patient to state his or her name.
b)
Check the patient’s wrist band.
c)
Look at the patient’s chart.
d)
Have the patient state his or her name and birth date.
21.
Which newly admitted patient would be at the greatest risk for an injury?
a)
An 80-year-old patient
b)
A patient who wears corrective lenses
c)
A patient who has arthritis
d)
A patient who has a history of falls
22.
A senior nurse on a medical unit is aware of the role that she can play in establishing a culture of safety on the unit. What characteristic is most important to care settings that possess a culture of safety?
a)
Anticoagulants, opioids, and insulin are cosigned by two nurses.
b)
Physicians’ orders are entered into a computerized system rather than a handwritten section of patients’ charts.
c)
Nurses feel that they can report errors, near misses, and adverse events without being punished or denounced.
d)
Direct patient care is provided by ADN and baccalaureate nurses rather than practical (vocational) nurses.
23.
The Joint Commission has taken action to encourage healthcare organizations to reduce the incidence and impact of errors. How has the Joint Commission acted to facilitate these improvements in care?
a)
By delineating the scope of practice for registered nurses and practical (vocational) nurses
b)
By providing a forum for patients to report errors and substandard care
c)
By funding safety education in medical schools and nursing schools
d)
By standardizing the measures by which safety in hospitals is gauged
24.
The nurse is following the Joint Commission’s national patient safety goals when giving medications. Based on these goals, how can the nurse improve the accuracy of patient identification?
a)
Use two patient identifiers (neither to be the room number).
b)
Use two patient identifiers (one may be the room number)..
c)
Check the patient’s armband three times.
d)
Say to the patient are you Mrs. Jones?
25.
A nurse is in the hallway assisting a patient to ambulate and hears an alarm sound. What is the best next step for the nurse to take?
a)
Seek out the source of the alarm.
b)
Wait to see if the alarm discontinues.
c)
Ask another nurse to check on the alarm.
d)
Continue ambulating the patient.
26.
A home health nurse is performing a home assessment for safety. Which of the following comments by the patient would indicate a need for further education?
a)
“I will schedule an appointment with a chimney inspector next week.”
b)
“Daylight savings is the time to change batteries on the carbon monoxide detector.”
c)
“If I feel dizzy when using the heater, I need to have it inspected.”
d)
“When it is cold outside in the winter, I can warm my car up in the garage.”
27.
A patient is agitated and confused and keeps getting out of bed and needs to be observed constantly. The best initial nursing intervention is to:
a)
have a family member or friend sit with the patient.
b)
obtain an order for a sedative from the physician.
c)
instruct the nurse’s aide to apply a vest restraint.
d)
make sure the side rails are up and close the door.
28.
A patient who has right-sided weakness following a stroke is admitted to a long-term care facility and exhibits increasing wandering and inability for self-care. To protect the patient from the most frequent cause of injury among the elderly, the nurse’s most efficient intervention would be:
a)
provide a night-light in the bathroom.
b)
keep pathways clear of paper, shoes, and equipment.
c)
apply a personal alarm.
d)
provide hip protectors.
29.
The best way to maintain safety measures relative to helping a patient get into bed is to:
a)
set the bed height at the nurse’s waist level.
b)
make sure that the bed wheels are locked.
c)
place the bed against the wall.
d)
insist that the patient stay in bed.
30.
Aspects of safety culture that contribute to a culture of safety in a health care organization include
a)
communication.
b)
fear of punishment.
c)
malpractice implications.
d)
team nursing.
31.
A sentinel event refers to an event that
a)
could have harmed a patient, but serious harm didn’t occur because of chance.
b)
harms a patient as a result of underlying disease or condition.
c)
harms a patient by omission or commission, not an underlying disease or condition.
d)
signals the need for immediate investigation and response.
32.
The Joint Commission’s national Speak Up® campaign encourages patients to become active and informed participants on the healthcare team. The goal is to:
a)
prevent healthcare errors.
b)
help control the cost of healthcare.
c)
reduce the number of automobile accidents.
d)
provide a forum for people without health insurance.
33.
Which is the most commonly reported incident in hospitals?
a)
Equipment malfunction
b)
Patient falls
c)
Laboratory specimen errors
d)
Treatment delays
34.
Which of the following instructions is most important for the nurse to include when teaching a mother of a 3-year-old about protecting her child against accidental poisoning?
a)
Store medications on countertops out of the child’s reach.
b)
Purchase medication in child-resistant containers
c)
Take medications in front of the child, and explain that they are for adults only.
d)
Never leave the child unattended around medications or cleaning solutions.
35.
A nurse is teaching a group of mothers about first aid. Should poison come in contact with their child’s clothing and skin, which action should the nurse instruct the mothers to take first?
a)
Remove the contaminated clothing immediately.
b)
Flood the contaminated area with lukewarm water.
c)
Wash the contaminated area with soap and water and rinse.
d)
Call the nearest poison control center immediately.
36.
Despite less-restrictive interventions, a patient’s behavior escalates, requiring emergency application of restraints. Which of the following must the nurse do in this situation?
a)
Obtain a physician’s order before applying restraints.
b)
Monitor the patient’s status every 4 hours while restrained.
c)
Release the restraints and check circulation every hour.
d)
Continually reevaluate the patient’s need for restraint.
37.
When educating families on fire safety, it is important to
a)
Have a meeting place outside the home
b)
Account for all members and then exit
c)
Use extension cords to prevent shock
d)
Keep a fire extinguisher in a closet
38.
The nurse is collecting data for a comprehensive assessment. Data that can be seen, heard, or felt by someone other than the person experiencing them are called:
a)
primary
b)
objective
c)
subjective
d)
secondary
39.
The nurse is beginning the introductory portion of the health interview process. This part of the assessment is considered the:
a)
orientation phase.
b)
initiation phase.
c)
working phase.
d)
closure phase.
40.
.The nurse desires to provide care according to the American Nurses Association Code of Ethics. Which of the following is the primary ethical responsibility of the nurse when providing client care?
a)
To do no harm
b)
To do good
c)
Protect the clients’ right to make their own decisions
d)
To tell the truth
41.
What are the two primary methods used to collect data?
a)
Written report by patient and family
b)
Review of the chart and the nurse’s notes
c)
Interview and physical examination
d)
Review of the physician’s orders and the Kardex
42.
The patient is confined to bed rest, which contributes to immobility. What is bed rest considered in this situation?
a)
Contributing to the patient’s recovery
b)
A risk factor
c)
Difficult to maintain
d)
A nursing responsibility
43.
When a nurse selects interventions to assist the patient to meet the needs demonstrated, the nurse is in which phase of the nursing process?
a)
Assessment
b)
Planning
c)
Implementation
d)
Evaluation
44.
A patient is agitated and confused and keeps getting out of bed and needs to be observed constantly. The best initial nursing intervention is to:
a)
have a family member or friend sit with the patient.
b)
obtain an order for a sedative from the physician.
c)
instruct the nurse’s aide to apply a vest restraint.
d)
make sure the side rails are up and close the door.
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