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Nur2058 Study Guide Exam
Nursing Now: Chapter 3, 6, 7, 8 Critical Thinking Chapter 1, 2, 4
Nursing Now Chapter 3
- Define Theory and model
- Theory : When attempting to explain relationships between
observed behaviors and their effects on a client’s health. In
nursing, the goal is to describe and explain a particular nursing
action to make a hypothesis.
- Model : is a Hypothetical representation of something that exists
in reality. The
purpose is to explain a complex reality in a systematic and organized
manner.
- Why are theories important in nursing?
In nursing, the goal is to describe and explain a particular nursing action to
make a hypothesis, which predicts the effects on a client’s outcome, such as
improved health or recovery from illness.
- What are the 4 key concepts that nursing theories define?
- Client: or patient is central to all nursing models because the
client who is the primary receipt of nursing care.
- Health: Has change over the years and now health as a
continuum, ranging from
completely healthy state in which there is no disease to completely
unhealth state, which results in death.
- Environment: in nursing models is the physical environment to
the elements
such as living conditions, public sanitation and air and water quality
as well as interpersonal relationships and social interactions.
- Nursing: delineates the function and role of nurses in their
relationships with
clients that affect client’s health
- Know the General Systems Theory (open systems and closed systems)
General Systems Theory is an organized unit with a set of components
that interact and affect each other, a system acts as a whole because of
interdependence of its parts
- Open Systems: free movement of information: environment
- Closed Systems: prevents movement in/out of the system
- Input and Output: is how the system interacts with the environment
- Throughput: process that allows input to be changed
- Feedback Loop : allows the System to monitor its internal
functioning by restricting or increasing input/output and maintain
the high level of functioning.
- Positive Feedback: leads to change within the system
- Negative Feedback: maintains stability (does not produce change)
- Know the Orem Self-Care Model
- Ethics: goes beyond the law, which has as its primary
underlying principle the preservation of society. Usually a
system of value behaviors and beliefs; they serve to protect the
individual’s rights.
- Ethical code: is a written list of a profession’s values and standards
of conduct.
It provides a framework for decision making for the profession.
- ethical dilemma : situation that requires an individual to make a
choice between two equally unfavorable alternatives
- ethical accountability :
- euthanasia : Painless killing of a patient that is suffering from
fatal disease (good or peaceful death)
- autonomy : the right of self-determination, independence and freedom
- beneficence : primary goal of healthcare as doing good for
clients under our care. Holistic approach
- nonmaleficence: that you do no harm to your client, either
intentionally or
unintentionally. Also that you protect from harm those that cannot
protect themselves
- justice: obligation to be fair to all people
- fidelity: obligation of an individual to be faithful to commitments
made to himself or herself and others. The main support for the
concept of accountability.
- Veracity : Is the principle of truthfulness
- advance directive : in the form of a living will or durable power of
attorney for health care, can and should specify which
extraordinary procedures, surgeries, medications, or treatments
can or cannot be used. These directives are often formal
documents that need to be witnessed by two individuals who are
not related to the client.
- living will : Written advance directive that identifies treatments,
procedures, tests,
and so on, that a person wants or does not want should he
or she become unable to make such decisions.
- durable power of attorney for health care : Designates another person
to make
health-care decisions for the client if they become incompetent or
unable to make such decisions.
- abandonment : unilateral severance of the professional relationship with the
client without adequate notice and while the requirement for care still exists.
- Know the process used in ethical decision making
Nursing Process: methodical ethical decision making process
- Collect, Analyze, and Interpret the Data
- State the Dilemma
- Consider the Choices of Action
- Analyze the Advantages and Disadvantages of Each Course of Action.
- Make the Decision and Act on It
- Know the Ethical Systems of Utilitarianism (teleological) and
Deontology. How do they approach ethical dilemma decision making?
- Utilitarianism (teleological) the greatest good for the greatest amount
of people. Draws on past experiences to formulate internal rules to
determine the greatest good
- Deontology : decision making based on moral rules and
unchanging principles.
- Know the basics of the Nursing Code of Ethics
Review pg. 137-139 from ethics book
Nursing Now Chapter 7:
- Define and be able to relate these terms to ethical principles or issues
of nursing:
- Active euthanasia : hastening someone's death through an
act or procedure
- Passive euthanasia : allowing an individual to die without any
extraordinary intervention. (DNR, living will, withdrawal of
care)
- Mercy Killing : The act or practice of killing, for reasons of
mercy, individuals who
have little or no chance of recovery by withholding or discontinuing
life support or by administering a lethal agent.
- Assisted suicide : Providing patient with prescription drugs to
kill themselves.
- Self-determination Act : A federal law that requires all federally
funded institutions to inform clients of their right to
prepare
advance directives.
- Abortion : Termination of human pregnancy
- Genetic Research : Altering genetic material to produce
organisms that differ greatly from their original form, refining
DNA, gene therapy, altering germ cells, cloning cells.
- Confidentiality : Right of the client to expect the communication with a
professional to remain unshared with any other person unless a
medical reason exists or unless the safety of the public is threatened.
- HIPPA : (Health Insurance Portability and Accountability Act of 1996)
is United
States legislation that provides data privacy and security provisions
for safeguarding medical information
- Breach of Confidentiality : Occurs when a client's trust and confidence
are violated by the public revelation of confidential or privileged
- False Imprisonment : when a competent client is confirming or
restrained with intent to prevent him or her from leaving
the hospital.
- Torts : willful act that violates another person’s rights or property.
- Malpractice professional negligence : professionals can be sued
- Define and know
- Criminal Laws : concerned with providing protection for all members of
society
- Civil Laws related to health care provider licenses: nurses involved w/this:
deals with violation of ones rights by an individual
- Be able to identify appropriate and inappropriate things for a nurse to
chart about
patients and their care. (Remember with documentation, only state the
facts! No personal opinion)
SBAR: Situation, background, assessment, recommendation
- Define the following terms
- DNR : Although a DNR instruction may be included in an advance
directive, DNR orders are legally separate from advance directives.
For the health-care professional to be legally protected, there
should be a written order for a “no code” or a DNR order in the
client's chart
- Libel : written communication in which a person makes statements
or uses
language that harms another person’s reputation.
- Slande r spoken communication in which one person discusses
another in terms that harm that person’s reputation.
- Right to Choose : are rights that are based on a fundamental belief in
the dignity
and freedom of humans
- Confidentiality : of information concerning the client must be honored.
- Informed consent : Informed consent is both a legal and an
ethical issue. Informed consent is the voluntary permission
by a client or by the client's designated proxy to carry out a
procedure on the client
Critical Thinking, Clinical Reasoning and Clinical Judgment,
Chapters 1-
- Review definitions of critical thinking, clinical reasoning and
clinical judgment (pages 70- 72 are good resources)
- Define Critical thinking: not accepting information at face value without
carefully evaluating it. You examine assumptions, evaluate evidence
and uncover underlying values and reasons.
- Critical reasoning: A specific term, process you use to think about
the issues at the point of care- for example deciding how to
prevent and manage patient problems.
- Clinical judgement: outcome of both, the conclusion, decision
or opinion you make after thinking about the issue.
- Clinical setting: it challenging, complex, and regulated by laws
and standards
- Review information related to thinking in the clinical setting
To understand important points about thinking in the clinical setting—a
setting that’s challenging, complex, and regulated by laws and standards—
study the
following applied definition.
Critical thinking in nursing—which includes clinical reasoning and clinical
judgment—is purposeful, informed, outcome-focused thinking that:
- Is guided by standards, policies, ethics codes, and laws
(individual state practice acts and state boards of nursing).
- Is driven by patient, family, and community needs, as well as
nurses’ needs to
give competent and efficient care (e.g., streamlining charting to free
nurses for patient care).
- Is based on principles of nursing process, problem-solving, and
the scientific method (requires forming opinions and making
decisions based on evidence).
- Focuses on safety and quality, constantly re-evaluating, self-
correcting, and
striving to improve.
- Carefully identifies the key problems, issues, and risks involved,
including patients, families, and key stakeholders in decision-
making early in the process. Stakeholders are the people who will
be most affected (patients and families) or from whom
requirements will be drawn (e.g., caregivers, insurance companies,
third-party payers, and health care organizations).
- Uses logic, intuition, and creativity and is grounded in
specific knowledge, skills, and experience.
- Calls for strategies that make the most of human potential
and compensate for
problems created by human nature (e.g., finding ways to prevent
errors, using technology, and overcoming the powerful influence
of personal views).
- Review steps of critical thinking. Such as problem solving
and creativity, risk management skills and striving to
improve
- Review behaviors that demonstrate the knowledge, characteristics, and
skills to promote critical thinking
reasons, explanations, and meaning; seeks new information
to broaden understanding.
- ALERT TO CONTEXT: Looks for changes in circumstances that warrant
a need
to modify approaches; investigates thoroughly when situations
warrant precise, in-depth thinking.
- REFLECTIVE AND SELF-CORRECTIVE: Carefully considers meaning
of data and interpersonal interactions, asks for feedback; corrects
own thinking, alert to potential errors by self and others, finds
ways to avoid future mistakes.
- ANALYTICAL AND INSIGHTFUL: Identifies relationships;
expresses deep understanding.
- LOGICAL AND INTUITIVE: Draws reasonable conclusions (if this is
so, then it
follows that because…); uses intuition as a guide; acts on intuition
only with knowledge of risks involved.
- CONFIDENT AND RESILIENT: Expresses faith in ability to reason
and learn; overcomes problems and disappointments.
- HONEST AND UPRIGHT: Looks for the truth, even if it sheds
unwanted light;
demonstrates integrity (adheres to moral and ethical standards;
admits flaws in thinking).
- AUTONOMOUS/RESPONSIBLE: Self-directed, self-disciplined,
and accepts accountability.
- CAREFUL AND PRUDENT: Seeks help as needed; suspends or revises
judgment as indicated by new or incomplete data.
- OPEN AND FAIR-MINDED: Shows tolerance for different
viewpoints; questions how own viewpoints are influencing
thinking.
- SENSITIVE TO DIVERSITY: Expresses appreciation of human
differences
related to values, culture, personality, or learning style preferences;
adapts to preferences when feasible.
- CREATIVE: Offers alternative solutions and approaches; comes
up with useful ideas.
- REALISTIC AND PRACTICAL: Admits when things aren’t feasible; looks
for useful solutions.
- PROACTIVE: Anticipates consequences, plans ahead, acts
on opportunities.
- COURAGEOUS: Stands up for beliefs, advocates for others,
doesn’t hide from challenges.
- PATIENT AND PERSISTENT: Waits for right moment; perseveres
to achieve best
results.
- FLEXIBLE: Changes approaches as needed to get the best results.
- HEALTH-ORIENTED: Promotes a healthy lifestyle; uses
healthy behaviors to manage stress.
- IMPROVEMENT-ORIENTED (SELF, PATIENTS, SYSTEMS): Self—Identifies
learning needs; finds ways to overcome limitations, seeks out new
knowledge. Patients—Promotes health; maximizes function,
comfort, and convenience.
Systems—Identifies risks and problems with health care systems;
promotes safety, quality, satisfaction, and cost containment.
- NOTE: This list is the ideal—no one is perfect
- What are the benefits of being sensitive to personality types?
- What is Emotional Intelligence? How can you develop
emotional intelligence? Definition: Knowing how to recognize
and manage emotions to get positive results.
- Connect with emotions. Put your feelings into words and,
through dialogue, help others to do the same (“I feel…
because….” If you’re trying to connect with others’ emotions, ask
“What are your thoughts and feelings on this?”). Never assume
you know what someone else is feeling. Never expect others to
know what you’re feeling.
- Accept true feelings for what they are. No one’s to blame for
what he or she feels.
- Learn mood management. Recognize the importance of
connecting with how emotions are affecting thinking. Learn to
manage feelings like anger, anxiety, fear, and discouragement.
- Don’t be too concerned with isolated events. Patterns
of behavior are what matter. Don’t sweat the small
stuff.
- Keep in mind that emotions are “catching.” If you’re depressed,
you may trigger depression in someone else. If you’re
enthusiastic, you may trigger enthusiasm.
- Pay attention to stress levels. When the going gets rough, take time
out, focus on the positives, find a sense of humor, play a game, or
take a walk.
- What are different learning styles and learning strategies?
Learning Preference Strategies to Promote Learning
relationships.
Draw boxes and circles around key concepts; use
arrows when you make diagrams and maps.
Pace up and down while reciting information to
yourself; ride a bicycle while listening to an
audio educational program.
Record the information you’re trying to learn,
and listen to what you recorded while
exercising (e.g., riding a bike).
Write key words in the air; use your fingers to
help you remember (bend the forefinger as you
memorize a concept, and then bend the next for
the next concept, and so on).
Change positions frequently while studying; take
frequent short breaks involving activity.
Study in a rocking chair; play background music.
Learn best by moving, doing, experiencing, or
experimenting. For example, you’d rather play with a
syringe and inject a dummy before reading the
procedure.
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about leaving tomorrow?”
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Open Ended Questions from All Chapters
Chapter 3
- Know what nurse theorist was primarily concerned with developing a
nursing model that helped to balance impersonal parts of nursing
(technological, scientific) with the personal and interpersonal aspects of
care because she wanted to recognize the client and family spiritual
beliefs.
- According to Jean Watson’s model, all but which of the following are
important in the
practice of nursing:
- Know the type of theory that is less comprehensive and more
focused, yet not as specific or concrete as some theories.
- An Advanced directive is a legal document in which a clients’ wishes
about health care
are written in the case they are unable to make decisions for themselves,
this document is can be called (Select all that apply)
- What is to protect client from harm known as
- Know the two top states for organ donors
- Know what the primary function of an ethical code is.
- Know what is the best definition of the ethical principle of nonmaleficence is.
- Identify the term used when an ethical situation arises in which
there is a choice between two equally unfavorable alternatives.
Chapter 8
- Identify the situation in which a nurse would likely be charged
with negligence.
- Know what is the underlying legal concept that protects health-
care professionals under the Good Samaritan Act.
Critical Thinking, Clinical Reasoning, and Clinical Judgment, Chapters 1
- Know what would not be appropriate to chart.
- Know what description Critical thinking involves.
- True or False The American Nurses Association (ANA) standards state
that the nursing process serves as a critical thinking model which
makes it a major tool for clinical reasoning.
- Be able to Identify an example that displays critical thinking.
