Chapter 5 Critical Thinking, Decision Making, And The Nursing Process

Chapter 5  Critical Thinking, Decision Making, And The Nursing Process

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A group of nurses were discussing the nursing process and realized that the term process to describe nursing was first used in:
a.
1955 by Lydia Hall.
c.
1961 by Ida Orlando.
b.
1855 by Florence Nightingale.
d.
1967 by Yura and Walsh.

ANS: A
Lydia Hall first referred to nursing as a “process” in a journal article written in 1955, but it was not until the late 1960s that the term began to be widely used. Orlando in 1961 referred to the “nursing process” as a series of steps. Yura and Walsh identified the original four steps of the nursing process. Florence Nightingale did not refer to client care as being conducted through the use of the nursing process.

PTS: 1 DIF: Analysis REF: The Nursing Process: Historical Perspective

2. A seasoned nurse tells a colleague that she went to nursing school before nursing diagnosis existed. When was nursing diagnosis added as a separate and distinct step in the nursing process?
a.
1959
c.
1974
b.
1963
d.
1985

ANS: C
Even though the term nursing diagnosis was first used in 1953, it was not until after the first meeting of the North American Nursing Diagnosis Association, or NANDA, that nursing diagnosis was added as a separate and distinct step in the nursing process. Prior to this date, nursing diagnosis was included as a natural conclusion to the assessment step of the process. The other choices are incorrect.

PTS: 1 DIF: Analysis REF: The Nursing Process: Historical Perspective

3. The nurse is beginning to plan care for a newly admitted client. The nurse will apply which of the following steps in the nursing process?
a.
Assessment, planning, and evaluation
b.
Assessing, planning, implementing, and evaluating
c.
Assessment, analysis, planning, implementation, and evaluation
d.
Assessment, diagnosis, outcome identification and planning, implementation, and evaluation

ANS: D
Currently, the steps in the nursing process are assessment, diagnosis, outcome identification and planning, implementation, and evaluation. The previous steps were: assessing, planning, implementing, and evaluating. The other choices are incorrect.

PTS: 1 DIF: Application REF: The Nursing Process: Historical Perspective

4. The nurse is assessing a client. Which data are considered data from a primary source?
a.
The client’s spouse tells the nurse the client seems upset.
b.
The client reports right lower quadrant pain.
c.
The physician describes the client as being overanxious.
d.
The lab report shows an elevated white cell count.

ANS: B
The client is considered as being the primary source of data. The choice that reflects the client as providing the data is “the client reports right lower quadrant pain.” The other choices are secondary sources of data.

PTS: 1 DIF: Analysis REF: Assessment

5. The nurse is documenting data provided from a client. Which of the following is an example of subjective data?
a.
The client states, “My head hurts.”
b.
The laboratory report shows an elevated white cell count.
c.
The client weighs 148 pounds.
d.
The nurse hears bilateral sounds.

ANS: A
Subjective data are gathered by interacting with the client and include feelings, perceptions, and concerns. An example of subjective data is “the client states, ‘my head hurts.’” The other choices are objective data and are incorrect.

PTS: 1 DIF: Application REF: Assessment