ATI LPN
Fundamentals of Nursing: The Art and Science of Person-Centered Care Tenth, North American Edition
Chapter 14 Questions
Question 1 of 5
The development of clinical judgment requires intentional focus and a willingness to grow and change both personally and professionally. How can a nursing student best foster the development of clinical judgment?
Correct Answer: C
Rationale: Each nursing student is in charge of their learning, including integrating feedback from exams, clinical experiences, simulations, and other assignments-reflecting on what has been learned and integrating new learning. Adaptability is key. Classroom and clinical learning presents information in myriad ways and in different settings. Students should learn what they can from each situation and adapt their studying style as needed. Nursing knowledge, like patient care, is rarely straightforward and clear. Picking up on cues, emphasizing the correct element, answering the question being asked, and maintaining a person-centered focus that is individualized and nuanced requires practice and time. Students must give themselves the space and grace needed to learn and apply information in various situations. There is a reciprocity in learning that requires and inward and outward combination. Engagement with others and the environment is essential for shaping thinking and development of clinical judgment.
Question 2 of 5
Nursing students and those studying other health sciences (medicine, pharmacy, physical therapy, etc.) are often engaged in competency-based education. What is the value of competency-based education?
Correct Answer: C
Rationale: The definition of a competency included in the Nursing: Scope and Standards of Practice (ANA, 2021) identified includes knowledge, skills, abilities, and judgment. Competency-based education is more than a checklist and often requires repeated exposure to concepts for mastery in a variety of contexts. Although the delivery of education can flex to meet the needs of students, testing is standardized to address core competencies. Competency-based education is very direct and concrete; the development of competence requires clinical judgment.
Question 3 of 5
Nursing programs prepare students for safe clinical practice. As a student nurse, why is a basic understanding of NCSBN's Clinical Judgment Measurement Model (CJMM) important? Select all that apply.
Correct Answer: A,B,D,E
Rationale: Nurses in the United States must pass NCLEX prior to being issued a license to practice as a professional nurse.
To help students achieve this goal, nurse educators model course exams on the NCSBN's NCLEX test plan in terms of content and style. Understanding the why (rationale for actions) is often helpful when students are engaged in studying, working to apply the information they have learned, and developing test-taking strategies. There is overlap between the models and processes identified as foundational to nursing education, which demonstrates the importance of fundamental concepts. A deep understanding of theoretical and philosophical models is not necessary for student nurses.
Question 4 of 5
A student nurse walks into a patient room, introduces themselves, and begins to complete a full head-to-toe assessment. The clinical faculty member enters the room, introduces themselves, and asks the student to step out of the room for a moment. The student meets the faculty member in the hallway and is asked to identify 15 cues or observations they noted during their initial contact with the patient and the patient's environment. Although the student is unable to reach 15 observations, the faculty guides the student to recognize the linen on the floor, old dinner tray on the windowsill, empty water pitcher, twisted oxygen tubing, the patient's pallor, and several other things requiring action. What is the value of engaging in this kind of activity with students in the clinical setting?
Correct Answer: A
Rationale: The case represents a concrete example of how students develop situational awareness and how that awareness develops with experience. Cognitive load management occurs in many ways; the use of mental images may not facilitate cognitive load management. Although an environmental scan is important, it is generally not documented in the EHR. Patient satisfaction is not the priority when completing the initial assessment; rapport formation, solid assessments, and good patient outcomes are associated with patient satisfaction.
Question 5 of 5
A nursing program uses Tanner's Clinical Judgment Model, a research-based model that accounts for differences in the patient, environment, and individual student nurse. What makes Tanner's reflection step unique?
Correct Answer: B
Rationale: Reflection drives the clinical judgment cycle and allows for the integration of new knowledge that will inform future situations. Reflection is as important in Tanner's model as the other elements of noticing, interpreting, and responding. The focus of the model is the development of clinical judgment, rather than rapid decision making; as clinical judgment is developed, decision making improves and may lead to better patient outcomes. Tanner's model is cyclic, not linear; although bias may be addressed as part of the development of clinical judgment, it is not the focus.