Chapter 4: The Nursing Process: Critical Thinking and Decision Making - Nurselytic

Questions 26

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Study Guide for Fundamentals of Nursing Care: Concepts, Connections & Skills

Chapter 4 : The Nursing Process: Critical Thinking and Decision Making Questions

Question 1 of 5

In which step of the nursing process are priorities set?

Correct Answer: C

Rationale: Planning involves setting priorities for nursing diagnoses and determining goals and interventions to address the patient's needs.

Question 2 of 5

In which step of the nursing process do you label problems?

Correct Answer: B

Rationale: Diagnosis is the step where nurses analyze assessment data to identify and label patient problems as nursing diagnoses.

Question 3 of 5

Which step of the nursing process is most associated with action?

Correct Answer: D

Rationale: Implementation is the action-oriented step where nurses carry out the planned interventions to address patient needs.

Question 4 of 5

You enter the room to find your patient ashen and gasping for breath. Which part of the nursing process should you perform, formally or informally, in the first 5 minutes?

Correct Answer: F

Rationale: In an emergency, nurses perform all steps of the nursing process rapidly: assessing the patient's condition, diagnosing the problem, planning immediate actions, implementing interventions, and evaluating their effectiveness.

Question 5 of 5

You are caring for a male patient who had a total hip replacement 3 days earlier. You have not cared for the patient before and are assessing him to establish a baseline of information about his health status. The patient states he felt feverish during the night and broke into a sweat. You check his temperature readings from the previous night and see that it was 99.2?°F at midnight and 98.2?°F at 6 a.m. It now is 99?°F. Which of the following actions represents the best response to his statement and gives the best explanation for the action as it relates to critical thinking?

Correct Answer: C

Rationale: Assessing for signs and symptoms of infection (
C) is the best response as it involves critical thinking by validating the patient's subjective complaint with objective data, ensuring a thorough evaluation of a potential postoperative complication.

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