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A nurse and a student are developing a concept care map for a client with multiple sclerosis. Once finished, what important information can the student glean from the concept map?
- A. Ideas about the client's care and how they are linked and interrelated
- B. A prediction of how effective the client's plan of care will be
- C. Trends and patterns in the client's status over time
- D. A determination of whether the desired outcomes are achieved
Correct Answer: A
Rationale: The student can glean important information pertaining to ideas about the client's care and how these ideas are linked and interrelated. A concept map does not predict how effective the client's plan of care will be. That requires the nurse to evaluate the plan's effectiveness. The concept map also does not provide trends and patterns in the client's status over time. That requires the nurse to assess and document those trends. To determine if desired outcomes are achieved, the nurse needs to reassess the client once the plan of care has been implemented.
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The nurse understands that critical thinking skills are an integral part of nursing practice. Development of these skills requires what from the nurse?
- A. Intention
- B. Experience
- C. Contemplation
- D. Focus on outcomes
Correct Answer: B
Rationale: Nurses develop critical thinking skills through knowledge, experience, and practice. Intention, contemplation, and a focus on outcomes are characteristics of critical thinking. They are not how the nurse develops critical thinking skills.
Which of the following is a true statement about critical thinking according to Alfaro-LeFevre (2010)?
- A. It makes judgments based on conjecture.
- B. It is based on the medical model.
- C. It considers only the client's needs.
- D. It is guided by professional standards and codes of ethics.
Correct Answer: D
Rationale: Critical thinking is guided by professional standards and codes of ethics. It is based on principles of the nursing process and scientific methods. Critical thinking makes judgments based on evidence rather than conjecture. It considers client, family, and community needs.
An RN has developed a plan of care for a client and shares the plan with the LPN. Which intervention(s) can the LPN perform in the implementation phase for this client? Select all that apply.
- A. Provide basic therapeutic and preventive nursing measures.
- B. Provide client and family teaching.
- C. Exchange information with prescribing provider.
- D. Make referrals for ancillary services.
- E. Document care that is provided.
Correct Answer: A,B,E
Rationale: The role of the LPN in the implementation phase is to provide basic therapeutic and preventive nursing measures, provide client education, and record information. Exchanging information with the prescribing provider and making referrals are within the scope of practice of an RN.
The LPN states to an RN, 'I don't know why we have to follow a care plan. No one even uses it, and it just means more paperwork. What's the purpose?' What is the best response by the RN?
- A. I agree with you, and we should talk to the manager about eliminating them from our required paperwork.'
- B. I think it is something we have always done, and we have to continue to use them.'
- C. It helps to provide a systematic method for us to plan and implement care so that we achieve positive outcomes.'
- D. Health care providers use our care plans in order to see what we are doing for the clients.'
Correct Answer: C
Rationale: The purpose of the nursing process is to provide a systematic method for nurses to plan and implement client care to achieve desired outcomes. The nursing process cannot be eliminated from the paperwork because nurses use the process to evaluate and update a client's care. It is an integral part of nursing practice. Stating that the nursing process is something nurses have always done and must continue to do so is a vague and incomplete answer. It does not give a rationale for using the nursing process. Although health care providers may review a nurse's care plan to see what is being done for the client, that is not the reason nurses use the nursing process or create care plans. The client's plan of care guides nursing care and provides a vehicle for assessment, planning, implementation, evaluation, and, if needed, the revision of care.
Which of the following is an important element of implementation?
- A. Client database
- B. Critical thinking
- C. Nursing orders
- D. Documentation
Correct Answer: D
Rationale: An important element of implementation is documentation. The client database includes all the information obtained from the medical and nursing history. Physical examination and diagnostic studies are not an important element of implementation. Critical thinking is intentional, contemplative, and outcome-directed thinking. Developing good critical thinking skills will make nurses more efficient and effective at resolving situations necessitating multiple interventions. Nursing orders are specific nursing directions so that all healthcare team members understand what to do for the client; therefore, they are not an important element of implementation.