Chapter 04: Nursing Process and Critical Thinking Test Bank MULTIPLE CHOICE 1. The nurse who uses the nursing process will: a. help reduce the obvious signs of discomfort. b. help the patien... t adhere to the physician’s treatment protocol. c. approach the patient’s disorder in a step-by-step method. d. make all significant nursing care decisions involving patient care. 2. A nurse will arrive at a nursing diagnosis through the nursing process step of: a. planning. b. evaluation. c. research. d. assessment. 3. In the collaborative process of delivering care based on the nursing process, the responsibility of the LPN/LVN is to: a. collect data of health status. b. select a nursing diagnosis. c. organize data to help the RN evaluate patient progress. d. prioritize nursing diagnoses for more effective care. 4. The participants of the planning stage of the nursing process during which the health goals are defined include the: a. RN. b. health team led by the RN. c. health team, the patient, and the patient’s family. d. health team as directed by the physician. 5. When a resident in the nursing home complains of constipation, the nurse performs a digital rectal examination and finds a hard fecal mass. This is an example of: a. implementation. b. nursing diagnosis. c. assessment. d. evaluation. 6. The nurse completing morning assessments on a patient who is sitting up in bed is told by the patient, “I’m having trouble breathing—I can’t seem to get enough air.” The best nursing response is to: a. notify the doctor as soon as he or she comes in later in the morning. b. finish the vital signs for the assigned patients, and then notify the charge nurse. c. reassure the patient, if his blood pressure and pulse are normal. d. notify the charge nurse immediately of the patient’s statement. 7. The order in which the nursing process is approached is: a. planning, assessment, implementation, nursing diagnosis, evaluation. b. nursing diagnosis, evaluation, assessment, implementation, planning. c. assessment, nursing diagnosis, planning, implementation, evaluation. d. evaluation, nursing diagnosis, planning, implementation, assessment. 8. Once the nursing plan has been initiated, the nursing care plan will: a. stay in place until all nursing goals have been met. b. change as the patient’s condition changes. c. remain on the patient record to show progress. d. be given to the patient for final approval. 9. When a patient states, “I can’t walk very well,” the first problem-solving step would be to: a. consider alternatives such as a wheelchair or walker. b. find out what the problem is, such as weakness or poor balance. c. choose the alternative with the best chance of success. d. consider the outcomes of the choices, such as danger of falling with a walker. 10. A student nurse can begin to develop critical thinking skills by means of: a. working with a more experienced nurse. b. questioning every statement made by instructors to be sure of its correctness. c. memorizing class notes for tests and studying all night for big tests. d. listening attentively and focusing on the speaker’s words and meaning. 11. When a nurse prioritizes the patient care, consideration is given to: a. completing assessments before mid-shift. b. considering situations that may result in an alteration of health. c. assuming all health care activities for a group of patients. d. identifying who can assist with the aspect of care. 12. When the nurse checks to see whether a patient has had relief 45 minutes after administering pain medication, the nurse is performing a(n): a. nursing diagnosis. b. implementation. c. assessment. d. evaluation. 13. The activity that is implementation in nursing care is: a. checking the assigned patient’s blood pressure, pulse, and respiration. b. changing the patient’s surgical dressing. c. asking the patient to demonstrate how to give himself medication after teaching him. d. discussing the patient with other team members to establish a care plan. 14. Constant nursing assessments and evaluations of the patient will most likely result in: a. the nursing care plan changing to reflect appropriate priorities. b. small changes in the patient condition being overlooked. c. cluttered and confusing documentation. d. impeded problem solving. 15. The effect of using a scientific problem-solving approach in nursing care will cause decision making to be: a. slowed down considerably by the multiple steps. b. rigid and non-patient oriented. c. improved nursing care outcomes. d. unrelated to the nursing process. 16. An emergency room nurse will give first priority to the patient with the most critical need, which is the patient who: a. is bleeding from a chin laceration. b. complains of a productive cough. c. has a fever of 102° F. d. complains of severe chest pain. 17. When the nurse constructs a nursing approach after careful judgment and sound reasoning, the nurse has used a system of __________. 18. Critical thinking is considered to be the keystone and foundation of the development of _________. 19. The tasks of synthesizing data and linking nursing interventions with patient health problems are enhanced by the process of ________. MULTIPLE RESPONSE 20. Activities considered to be aspects of the implementation step of the nursing process are: (Select all that apply.) a. documentation of care given. b. assembly of supplies. c. analysis of data gathered. d. modification of aspects of the plan. e. evaluation of the patient response. 21. Descriptions of the activities involved in the nursing diagnosis step of the nursing process are: (Select all that apply.) a. determination of potential health problems. b. clustering of related assessments. c. sharing of information with the patient and physician. d. determination of desired outcomes. e. evaluation of probable outcomes. 22. Which of the following items could be the responsibility of the LPN/LVN for a patient’s plan of care? (Select all that apply.) a. Collect data. b. Perform nursing interventions. c. Initiate the plan of care. d. Assist the RN with evaluation of the patient’s response to nursing interventions. e. Document nursing care. 23. A nurse begins rounds on a medical–surgical nursing unit. Review the following patients on her assignment. Prioritize the order in which the patients should be assessed, based on their descriptions. (Separate letters with a comma and space as follows: A, B, C, D.) A. A 22-year-old patient who is awakening from neck surgery. B. An 82-year-old patient who is blind and needs discharge instructions. C. A 44-year-old patient with dehydration from vomiting and diarrhea, who was admitted 3 days ago and who has an IV infusion of fluids. D. A 35-year-old patient admitted for an injury to his left femoral artery, which required surgical repair 8 hours ago following an ice-skating accident. 24. Place the steps of the problem-solving approach in the appropriate order. (Separate letters with a comma and space as follows: A, B, C, D, E.) A. Predict the likelihood of each outcome occurring. B. Choose the alternative with the best chance of success. C. Consider all possible alternatives as the solution to the problem. D. Identify the problem. E. Examine possible outcomes of each alternative. [Show More]
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