R&S EXAM 2 Study Guide – 50 Questions
Define critical thinking. What are the steps of this process? Explain what is involved in each step.
o Critical thinking is the ability to focus thinking to get the needed result
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R&S EXAM 2 Study Guide – 50 Questions
Define critical thinking. What are the steps of this process? Explain what is involved in each step.
o Critical thinking is the ability to focus thinking to get the needed results in various situations; deliberate, informed thought.
purposeful, informed, outcomes focused thinking…[that] applies logic, intuition, creativity and is grounded in specific
knowledge, skills, and experience
Composite of knowledge, attitudes and skills that yields the ability to assess a situation using open-ended questions
about facts/assumptions and use personal judgment and problem-solving to decide how to deal with it.
o Steps: (fluid and changing; dynamic) – gathering data, analyzing the data, choosing an action, implementing that action, and
evaluating the outcomes of the course of action
Describe the value systems of clients. How can nurses best deal with different value systems?
o Values affect all aspects of care and as such, the nurse needs to assess what is important to the client (cultural assessment,
psychosocial assessment, etc.) and work with the client to integrate this into the plan of care
Factors that can help support this: ethical priniciples (autonomy, nonmaleficence, beneficence, veracity, paternalism,
respect, justice, and fidelity), institutional policy, personal judgment, trusted co-workers, institutional ethics
committees, and legal precedent.
Describe the different steps of the nursing process. What is involved in each step?
o Assessment – to collect and record data to provide the information needed to:
Predict, prevent, detect, manage, and resolve problems, issues, and risks
Clarify expected outcomes of care
ID individualized interventions to achieve outcomes, promote health, and attain optimum function
o Diagnosis/outcome identification – to clarify realistic expected outcomes, and the problems, risks, or issues that must be
managed to achieve the outcomes
ID s/sx that may indicate need for referral
R/O or include suspected problems
Decide what need to be managed to obtain outcomes
Recognize health states that are satisfactory but could be improved
Reflect
o Planning – ensure that there’s a comprehensive, recorded, outcome-focused plan that’s tailored to individual patient and
circumstances
Specify short-term and long-term goals
Monitor and manage priority problems, issues, and risks
Promote optimum comfort, function, independence, and health
Coordinate care and include pts as partners in decision-making and care
ID what interventions must be managed by RN and what can be delegated
Achieve desired outcomes safely, efficiently, and cost-effectively
Include teaching
Provide a record that can be used to monitor progress and communicate care
o Implementing – put plan into action
Assess pt to determine if interventions are appropriate/pt is ready
Prioritize, delegate, and coordinate cares
Prepare the environment and equipment for safety, comfort, and convenience
Perform interventions and reassess
Make immediate changes as needed and update plan if needed
Record pt data and responses
o Evaluating – determine where pt stands in relation to desired outcomes’ consider how process can be improved
Assess pt status to determine whether expected outcomes have been met and what factors promoted or inhibited
success of plan
Plan for ongoing assessment, improvement, and pt independence
Discharge pt or modify plan as needed
What is the difference between subjective and objective? Give examples of each.
o Subjective: based on/influenced by personal feeling, tastes, or opinions
The moon is pretty; my pain is at a 7.
o Objective: facts that are not influenced by feelings or opinions
Earth is a planet; the client has vomited 200cc in the last hour.
Review the process on resolving problems. What are the different steps? What is the best approach?
o Steps:
Define the problem, issue, or situation
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R&S EXAM 2 Study Guide – 50 Questions
Gather data
Analyze the data
Develop solutions and options
Select a solution with a desired outcome
Implement the solution
Evaluate the result
o TEACH (time (root cause), exposure (learn from others), assistance (members of team investigate), creativity (brainstorm), hit it
(implement))
o Best approach: depends on the situation but all data gathered should be accurate, relevant, valid, and timely including both
objective and subjective data.
What is involved in making a high-quality decision?
o The phases of making a high-quality decision include:
Defining objectives
Generating options
Identifying advantages and disadvantages of each option
Ranking the options
Selecting the option most likely to achieve the predefined objectives
Implementing the option, and
Evaluating the result.
o Achieves predefined goals, objectives, and outcomes
What is involved in brainstorming? What is the goal?
o Brainstorming involves listing all ideas as stated without critique or discussion.
The group leader or facilitator should encourage people to tag onto or spin off ideas from those already suggested.
Ideas should not be judged, nor should the relative merits or disadvantages of the ideas be discussed at this time.
o GOAL: to generate ideas, no matter how seemingly unrealistic or absurd; the emphasis is on the volume of ideas generated, not
necessarily the quality
Solutions may be superficial and fail to solve the problem.
Group brainstorming also takes longer, and the logistics of getting people together may pose a problem.
Define different decision styles (i.e. autocratic, democratic, etc.). Give examples of each
o Autocratic:
A leader/manager that makes decisions independent of the input or participation of others.
This has been referred to as the “decide and announce” approach, an authoritative style; more rapid and appropriate
in crisis situations
EX: a nurse gives orders about who needs to do CPR during a code
o Democratic/Participative:
A leader/manager involves the appropriate personnel in the decision-making process
Take more time, but are better when there is likely to be conflict, if the problem is unstructured, or if the manager
doesn’t have the knowledge/skill to solve the problem
EX: involving the interdisciplinary team to make decisions that affect patient care or seeking representation on a task
force
Define the decision making process. What are the different steps?
o Decision making is a purposeful and goal-directed effort that uses a systematic process to choose among options; the
identification and selection of options/alternatives.
o Steps: See high-quality decision
Listing options, identifying the pros and cons of each, ranking them, and selecting the best one
What are characteristics of a good nursing decision maker?
o Ability to think critically
o Self-aware
o Reflects on past situations
o Creative
o Possesses professional judgment
o Good communication skills
o Conflict resolution and mediation skills
o Knowledge of the vagaries of group dynamics
o Ability to foster an environment conducive to effective problem solving, decision making, and creative thinking
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