Nursing Process and Clinical Reasoning

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Questions and Answers

What is the primary focus of the nursing process?

Medication administration

Patient assessment

Problem solving and decision making (correct)

Documentation and record keeping

What is the purpose of collecting and validating data in the nursing process?

To evaluate the effectiveness of care

To create a treatment plan

To develop a nursing diagnosis

To establish a database of the patient's responses to healthcare concerns (correct)

What is the difference between subjective and objective data?

Subjective data is obtained from the patient, while objective data is obtained from secondary sources

Subjective data is a patient's report of their symptoms, while objective data is a measurable observation (correct)

Subjective data is a measurable observation, while objective data is a patient's report of their symptoms

Subjective data is obtained from secondary sources, while objective data is obtained from the patient

What is the primary source of data in the nursing process?

The patient themselves Signup and view all the answers

What is the directive approach to interviewing used for?

Gathering information when time is limited Signup and view all the answers

What is a key characteristic of the nursing process?

It is a systematic and cyclical approach Signup and view all the answers

What is the primary purpose of nursing diagnosis?

To identify health risks and strengths Signup and view all the answers

What is the role of NANDA in nursing diagnosis?

To organize nursing diagnoses into different categories Signup and view all the answers

What is the outcome of the diagnosing step in the nursing process?

Identification of patient problems, risks, and strengths Signup and view all the answers

What is included in a nursing diagnosis?

Etiology, diagnostic label, and evidence Signup and view all the answers

Why is a combination of directive and nondirective approaches usually appropriate during an information-gathering interview?

To achieve a balance between directive and nondirective approaches Signup and view all the answers

What is the primary purpose of the evaluation phase in the nursing process?

To determine whether to continue, modify or terminate the plan of care. Signup and view all the answers

What should the nurse do when a client's goal is partially met?

Modify the care plan to better address the client's needs. Signup and view all the answers

During the evaluation phase, what type of data does the nurse collect?

Objective data related to client outcomes. Signup and view all the answers

What is an example of critical thinking in the nursing process?

Looking at alternatives for wound care when a client's stasis ulcer is not improving. Signup and view all the answers

What is the outcome of the nursing process when a client's goal is met?

The care plan is terminated. Signup and view all the answers

What is the difference between the assessment and evaluation phases in the nursing process?

The assessment phase focuses on identifying client needs, while the evaluation phase focuses on evaluating client outcomes. Signup and view all the answers

Study Notes

Nondirective Approach to Interviewing

Allows the patient to control the purpose, subject matter, and pacing of the interview
Combines with directive approach to create a balanced information-gathering interview

Nursing Process

Cyclic, goal-oriented, and dynamic in nature
Directed and person-centered, focusing on problem-solving and decision-making
Interpersonal and collaborative, universally applicable, and systematic
A component of the RN Standards of Practice, involving clinical reasoning and patient assessment

Nursing Diagnosis

Consists of diagnostic label, etiology (cause), and evidence
Diagnostic label from NANDA (North American Nursing Diagnosis Association)
NANDA developed a nursing classification to organize nursing diagnoses into categories

Patient Assessment

Collects data, organizes and validates data, and documents data
Purpose: establishes a database of patient's responses to healthcare concerns or illness and their ability to manage healthcare needs

Data Collection

Types of data: subjective (e.g., patient's statement of pain) and objective (e.g., heart rate)
Sources of data: primary (patient) and secondary (family, healthcare professionals, records, and reports)
Data collection methods: observation (using senses of vision, smell, hearing, and touch)

Directive Approach to Interviewing

Highly structured, eliciting specific information
Nurse establishes purpose, controls the interview, and patient responds to questions
Used to gather and give information when time is limited

Evaluating

Collects data related to outcomes and compares data with outcomes
Relates nursing actions to patient goals/outcomes, drawing conclusions about problem status
Purpose: determines whether to continue, modify, or terminate the plan of care

Outcomes

Goal met, goal partially met, or goal unmet

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Description

Test your knowledge of the nursing process, its characteristics, and the clinical reasoning cycle. Learn about patient assessment, data collection, and decision making in nursing practice.