Nursing Assessment and Clinical Judgment
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Questions and Answers

What type of data involves expressed feelings, emotions, and self-report about a health condition?

  • Objective data
  • Qualitative data
  • Quantitative data
  • Subjective data (correct)
  • What is the phase in nursing where the nurse determines the patient's goal and sets priorities for interventions?

  • Diagnosis
  • Evaluation
  • Intervention
  • Planning (correct)
  • Which of the following is NOT part of a nurse's role regarding patient diagnosis?

  • Using critical thinking skills to make clinical judgments
  • Sharing clinical judgments with healthcare team members
  • Providing direct hands-on patient care (correct)
  • Making a professional medical diagnosis
  • During which phase of the nursing process are nursing diagnoses prioritized to establish a sequence of care?

    <p>Planning</p> Signup and view all the answers

    What is considered the 'actionable part of the process' in patient care according to the text?

    <p>Intervention</p> Signup and view all the answers

    In what phase do nurses use critical thinking skills to make clinical judgments they share with the healthcare team members?

    <p>Diagnosis</p> Signup and view all the answers

    What is the primary goal of the termination phase in the nurse-client relationship?

    <p>To summarize achieved goals and discuss discharge plans</p> Signup and view all the answers

    Which technique of therapeutic communication involves beginning a conversation with a broad question?

    <p>Broad opening remarks</p> Signup and view all the answers

    What is the purpose of reflection as a therapeutic communication technique?

    <p>To reflect questions back to the patient for open conversation</p> Signup and view all the answers

    Why is sharing observations an important technique in therapeutic communication?

    <p>To allow the patient to clarify their thoughts and feelings</p> Signup and view all the answers

    Which therapeutic communication technique prompts patients to open up and share their thoughts?

    <p>Open-ended questions</p> Signup and view all the answers

    In therapeutic communication, what does offering self refer to?

    <p>Making oneself available to the patient</p> Signup and view all the answers

    What is the main focus of the pre-orientation phase in the nurse-client relationship?

    <p>Reviewing the patient's chart</p> Signup and view all the answers

    In which phase of the nurse-client relationship is educating the patient and evaluating progress towards goals typically done?

    <p>Working phase</p> Signup and view all the answers

    What is a key aspect of the orientation phase in the nurse-client relationship?

    <p>Establishing rapport and setting goals</p> Signup and view all the answers

    During the working phase of the nurse-client relationship, what is a primary responsibility of the nurse?

    <p>Evaluate progress towards goals</p> Signup and view all the answers

    Which activity is NOT typically done during the pre-orientation phase of the nurse-client relationship?

    <p>Setting mutually agreed-upon goals</p> Signup and view all the answers

    What distinguishes effective verbal and nonverbal communication in a nurse-patient interaction?

    <p>Ensuring harmonious and healing outcomes</p> Signup and view all the answers

    Study Notes

    Assessment

    • Pain level is assessed on a scale of 1 to 10 through patient self-reporting
    • Assessment involves expressing feelings, emotions, and self-report about a health condition

    Diagnosis

    • Nurses do not make a professional diagnosis of a specific disease or medical condition
    • Nurses use critical thinking skills to make clinical judgments and share with healthcare team members

    Planning

    • The nurse determines the patient's goal and sets priorities for interventions
    • Patients have multiple nursing diagnoses, and prioritizing them establishes a sequence of care

    Interventions

    • Interventions provide continuity to patient care and involve both direct and indirect patient care
    • Direct care involves hands-on assistance to help the patient reach their goals

    Therapeutic Nurse-Client Relationship

    • Defined as a helping relationship based on mutual trust, respect, and nurturing faith and hope
    • Involves assisting with the patient's physical, emotional, and spiritual needs through knowledge and skill
    • Develops when the nurse and patient come together in the moment, resulting in harmony and healing

    Phases of the Nurse-Client Relationship

    • Pre-orientation phase: preparing for the meeting, reviewing the patient's chart, and examining thoughts and feelings
    • Orientation phase: introductions, establishing rapport, boundaries, and patient confidentiality
    • Working phase: gathering data, identifying and practicing problem-solving skills, and providing education
    • Termination phase: summarizing goals, discussing new coping mechanisms, and discharge plans

    Therapeutic Communication

    • A collection of techniques prioritizing the physical, mental, and emotional well-being of patients
    • Nurses provide support and information while maintaining professional distance and objectivity
    • Techniques include:
      • Broad opening remarks
      • Open-ended questions
      • Sharing observations
      • Clarification/validation
      • Reflection
      • Offering self

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    Description

    Explore the process of gathering patient data through verbal communication and assessing symptoms to make clinical judgments in nursing practice. Learn how nurses use critical thinking skills to contribute to healthcare team decisions.

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