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TEST BANK FOR
Critical Thinking, Clinical Reasoning, and Clinical
Judgment A Practical Approach
7th Edition by Rosalinda Alfaro-LeFevre
Chapters 1 - 7, Complete Newest Version
Test Bank For Critical Thinking, Clinical Reasoning, and Clinical Judgment A Practical
Approach 7th Edition – by Rosalinda Alfaro-LeFevre
Paperback ISBN: 9780323581257
eBook ISBN: 9780323594721
Paperback ISBN: 9780323676922
Table of Contents
1. What are Critical Thinking, Clinical Reasoning, and Clinical Judgment?
2. Becoming a Critical Thinker
3. Critical Thinking and Learning Cultures: Teaching, Learning, and Taking Tests
4. Interprofessional Clinical Reasoning, Decision Making, and Judgment
5. Ethical Reasoning, Professionalism, Evidence-Based Practice, and Quality Improvement
6. Practicing Clinical Reasoning, Clinical Judgment, and Decision-making Skills
7. Interprofessional Practice Skills: Communication, Teamwork, and Self-Management NEW
interprofessional collaboration focus!
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Critical Thinking Clinical Reasoning and Clinical Judgment 7th Edition A Practical
Approach Test Bank
Chapter 1. What are Critical Thinking, Clinical Reasoning, and Clinical Judgment?
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Which of the following characteristics do the various definitions of critical thinking have
in common? Critical thinking
1)
Requires reasoned thought
2)
Asks the questions why? or how?
3)
Is a hierarchical process
4)
Demands specialized thinking skills
ANSWER: 1
The definitions listed in the text as well as definitions in Box 2-1 state that critical thinking
requires reasoning or reasoned thinking. Critical thinking is neither linear nor hierarchical. That
means that the steps involved in critical thinking are not necessarily sequential, where mastery of
one step is necessary to proceed to the next. Critical thinking is a purposeful, dynamic, analytic
process that contributes to reasoned decisions and sound contextual judgments.
PTS:1DIF:Moderate high-level question, answer not stated verbatim
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Analysis
2. A few nurses on a unit have proposed to the nurse manager that the process for
documenting care on the unit be changed. They have described a completely new system. Why is
it important for the nurse manager to have a critical attitude? It will help the manager to
1)
Consider all the possible advantages and disadvantages
2)
Maintain an open mind about the proposed change
3)
Apply the nursing process to the situation
4)
Make a decision based on past experience with documentation
ANSWER: 2
A critical attitude enables the person to think fairly and keep an open mind.
PTS:1DIF:ModerateKEY: Nursing process: N/A | Client need: SECE | Cognitive level:
Comprehension
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3. The nurse has just been assigned to the clinical care of a newly admitted patient. To
know how to best care for the patient, the nurse uses the nursing process. Which step would the
nurse probably do first?
1)
Assessment
2)
Diagnosis
3)
Plan outcomes
4)
Plan interventions
ANSWER: 1
Assessment is the first step of the nursing process. The nursing diagnosis is derived from the data
gathered during assessment, outcomes from the diagnosis, and interventions from the outcomes.
PTS:1DIF:Easy
KEY: Nursing process: Assessment | Client need: SECE | Cognitive level: Application
4. Which of the following is an example of theoretical knowledge?
1)
A nurse uses sterile technique to catheterize a patient.
2)
Room air has an oxygen concentration of 21%.
3)
Glucose monitoring machines should be calibrated daily.
4)
An irregular apical heart rate should be compared with the radial pulse.
ANSWER: 2
Theoretical knowledge consists of research findings, facts, principles, and theories. The oxygen
concentration of room air is a scientific fact. The others are examples of practical
knowledgewhat to do and how to do it.
PTS:1DIF:Moderate; high-level question, answer not stated verbatim
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
5. Which of the following is an example of practical knowledge? (Assume all are true.)
1)
The tricuspid valve is between the right atrium and ventricle of the heart.
2)
The pancreas does not produce enough insulin in type 1 diabetes.
3)
When assessing the abdomen, you should auscultate before palpating.
4)
Research shows pain medication given intravenously acts faster than by other routes.
ANSWER: 3
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Practical knowledge is knowing what to do and how to do it, such as how to do an assessment.
The others are examples of theoretical knowledge, anatomy (tricuspid valve), fact (type 1
diabetes), and research (IV pain medication).
PTS:1DIF:Moderate high-level question, answer not stated verbatim
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
6. Which of the following is an example of self-knowledge? The nurse thinks, I know that I
1)
Should take the clients apical pulse for 1 minute before giving digoxin
2)
Should follow the clients wishes even though it is not what I would want
3)
Have religious beliefs that may make it difficult to take care of some clients
4)
Need to honor the clients request not to discuss his health concern with the family
ANSWER: 3
Self-knowledge is being aware of your religious and cultural beliefs and values. Taking the pulse
is an example of practical knowledge. Following client wishes and honoring client requests are
examples of ethical knowledge.
PTS:1DIFifficult; high-level question, answer not stated verbatim | V1, high-level question,
answer not stated verbatim
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
7. Which of the following is the most important reason for nurses to be critical thinkers?
1)
Nurses need to follow policies and procedures.
2)
Nurses work with other healthcare team members.
3)
Nurses care for clients who have multiple health problems.
4)
Nurses have to be flexible and work variable schedules.
ANSWER: 3
Critical thinking is essential for client care, particularly when the care is complex, involving
numerous health issues. Following policies and procedures does not necessarily require critical
thinking, and working with others or being flexible and working different schedules do not
necessarily require critical thinking.
PTS:1DIF:Moderate; high-level question, answer not stated verbatim
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
8. The nurse administering pain medication every 4 hours is an example of which aspect of
patient care?
1)
Assessment data
2)
Nursing diagnosis
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3)
Patient outcome
4)
Nursing intervention
ANSWER: 4
Interventions are activities that will help the patient achieve a goal, such as administering painrelieving medication. An example of assessment data might be, Patient reports pain is a 5 on a 1
to 10 scale. The nursing diagnosis would be Pain. The nurse might define the patient outcome in
this scenario as, The patient will state the level of pain is less than 4.
PTS:1DIF:Moderate; high-level question, answer not stated verbatim
KEY: Nursing process: Interventions | Client need: SECE | Cognitive level: Application
9. How does nursing diagnosis differ from a medical diagnosis? A nursing diagnosis is
1)
Terminology for the clients disease or injury
2)
A part of the clients medical diagnosis
3)
The clients presenting signs and symptoms
4)
A clients response to a health problem
ANSWER: 4
A nursing diagnosis is the clients response to actual or potential health problems.
PTS:1DIF:ModerateKEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level:
Recall
10. Which statement about the nursing process is correct?
1)
It was developed from the ANA Standards of Care.
2)
It is a problem-solving method to guide nursing activities.
3)
It is a linear process with separate, distinct steps.
4)
It involves care that only the nurse will give.
ANSWER: 2
The nursing process is a problem-solving process that guides nursing actions. The ANA
organizes its Standards of Care around the nursing process, but the process was not developed
from the standards. The nursing process is cyclical and involves care the nurses give or delegate
to other members of the healthcare team.
PTS:1DIF:EasyKEY:Nursing process: N/A | Client need: SECE | Cognitive level: Recall
11. What do critical thinking and the nursing process have in common?
1)
They are both linear processes used to guide ones thinking.
2)
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They are both thinking methods used to solve a problem.
3)
They both use specific steps to solve a problem.
4)
They both use similar steps to solve a problem.
ANSWER: 2
Critical thinking and the nursing process are ways of thinking that can be used in problem
solving (although critical thinking can be used beyond problem-solving applications). Neither
method of thinking is linear. The nursing process has specific steps; critical thinking does not.
PTS:1DIFifficultKEY: Nursing process: N/A | Client need: SECE | Cognitive level: Analysis
12. A nurse admits a patient to the unit after completing a comprehensive interview and
physical examination. To develop a nursing diagnosis, the nurse must now
1)
Analyze the assessment data
2)
Consult standards of care
3)
Decide which interventions are appropriate
4)
Ask the clients perceptions of her health problem
ANSWER: 1
The basis of the nursing diagnosis is the assessment data. Standards of care are referred to when
establishing nursing interventions. Customizing interventions personalizes nursing care. Asking
the patient about her perceptions is a method to validate whether the nurse has chosen the correct
nursing diagnosis and would probably have been done during the comprehensive assessment.
PTS: 1 DIF: Moderate KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level:
Application
13. The nurse developed a care plan for a patient to help prevent Impaired Skin Integrity.
She has made sure that nursing assistive personnel change the patients position every 2 hours. In
the evaluation phase of the nursing process, which of the following would the nurse do first?
1)
Determine whether she has gathered enough assessment data.
2)
Judge whether the interventions achieved the stated outcomes.
3)
Follow up to verify that care for the nursing diagnosis was given.
4)
Decide whether the nursing diagnosis was accurate for the patients condition.
ANSWER: 2
The evaluation phase judges whether the interventions were effective in achieving the desired
outcomes and helped to alleviate the nursing diagnosis. This must be done before examining the
nursing process steps and revising the care plan.
PTS:1DIF:Moderate
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14. In caring for a patient with comorbidities, the nurse draws upon her knowledge of
diabetes and skin integrity. In a spirit of inquiry, she looks up the latest guidelines for providing
skin care and includes them in the plan of care. The nurse provides skin care according to the
procedural guidelines and begins regular monitoring to evaluate the effectiveness of the
interventions. These activities are best described as
1)
Full-spectrum nursing
2)
Critical thinking
3)
Nursing process
4)
Nursing knowledge
ANSWER: 1
Full-spectrum nursing (1) involves the use of critical thinking, nursing knowledge, nursing
process, and patient situation. Although the other answers are important for planning and
delivering nursing care, they do not reflect all the nurse has demonstrated.
PTS:1DIFifficultKEY: Nursing process: N/A | Client need: PHSI | Cognitive level: Analysis
15. The nurse is preparing to admit a patient from the emergency department. The
transferring nurse reports that the patient is obese. The nurse has been overweight at one time
and works very hard now to maintain a healthy weight. She immediately thinks, I know I tend to
feel negatively about obese people; I figure if I can stop eating, they should be able to. I must
remember how very difficult that is and be very careful not to be judgmental of this patient. This
best illustrates
1)
Theoretical knowledge
2)
Self-knowledge
3)
Using reliable resources
4)
Use of the nursing process
ANSWER: 2
Self-knowledge is self-understandingawareness of ones beliefs, values, biases, and so on. That
best describes the nurses awareness that her bias can affect her patient care. Theoretical
knowledge consists of information, facts, principles, and theories in nursing and related
disciplines; it consists of research findings and rationally constructed explanations of
phenomena. Using reliable resources is a critical thinking skill. The nursing process is a
problem-solving process consisting of the steps of assessing, diagnosing, planning outcomes,
planning interventions, implementing, and evaluating. The nurse has not yet met this patient, so
she could not have begun the nursing process.
PTS:1DIFifficult KEY: Nursing process: N/A | Client need: PHSI | Cognitive level:
Comprehension
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Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. Which aspects of healthcare are affected by a clients culture? Select all that apply.
1)
How the clients views healthcare
2)
How the client views illness
3)
How the client will pay for healthcare services
4)
The types of treatments the client will accept
5)
When the client will seek healthcare services
6)
The environment where the healthcare services are provided
7)
The ease of accessibility of healthcare services
ANSWER: 1, 2, 4, 5
Culture affects clients view of health and healthcare. It influences how they will define illness,
when they will seek healthcare, and what treatments are acceptable in their culture. How services
are paid for is related to economic status. Regardless of culture, anyone can be affected by
previous healthcare experiences, the environment in which healthcare is provided, and
accessibility of services.
PTS:1DIF:Moderate
KEY:Nursing process: N/A | Client need: SECE | Cognitive level: Recall
Matching
Match the critical thinking attitude on the left with the appropriate example on the right.
1) Reading the instruction manual of a new glucose monitoring machine
2) Asking for help with a procedure because you have not done it before
3) Obtaining the latest research about a new diagnostic procedure even though the articles are
difficult to find
4) Questioning the reason for a new staffing policy
5) Realizing your feelings about alternative medicine may interfere with the care you give a
patient
6) Asking a patients feelings about his cancer diagnosis
7) Questioning your feelings when a patients family requests withholding nutrition for a
terminally ill client
1. Independent thinking
2. Intellectual curiosity
3. Intellectual humility
4. Intellectual empathy
5. Intellectual courage
6. Intellectual perseverance
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1. ANSWER: 4 PTS: 1 DIF: Difficult
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
2. ANSWER: 1 PTS: 1 DIF: Difficult
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
3. ANSWER: 2 PTS: 1 DIF: Difficult
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
4. ANSWER: 6 PTS: 1 DIF: Difficult
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
5. ANSWER: 7 PTS: 1 DIF: Difficult
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
6. ANSWER: 3 PTS: 1 DIF: Difficult
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
Match the terms from the critical thinking model in your text with the correct example.
1) I wonder if my values about quality of life have affected my thinking.
2) What should I have done differently?
3) I need to talk with the client to make sure the family gave me the correct information.
4) I have been through a situation like this before.
5) There are several interventions that would work in this situation.
6) I need to follow the steps in the procedure manual.
7. Contextual awareness
8. Inquiry
9. Considering alternatives
10. Analyzing assumptions
11. Reflecting skeptically
7.ANSWER:4PTS:1DIFifficul
t
8.ANSWER:3PTS:1DIFifficul
t
9.ANSWER:5PTS:1DIFifficul
t
10.ANSWER:1PTS:1DIFiffic
ult
11.ANSWER:2PTS:1DIFiffic
ult
Chapter 2. Becoming a Critical Thinker
MULTIPLE CHOICE
1. The nurse who uses the nursing process will:
a.
help reduce the obvious signs of discomfort.
b.
help the patient adhere to the physicians treatment protocol.
c.
approach the patients disorder in a step-by-step method.
d.
make all significant nursing care decisions involving patient
care.
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ANSWER: C
The nursing process is a collaborative process used throughout the patients stay. It is an
organized method for identifying and meeting patient needs in a step-by-step manner.
2. A nurse will arrive at a nursing diagnosis through the nursing process step of:
a.
planning.
b.
evaluation.
c.
research.
d.
assessment.
ANSWER: D
As a result of the nursing assessment, a nursing diagnosis is established.
3. In the collaborative process of delivering care based on the nursing process, the responsibility
of the LPN/LVN is to:
a.
collect data of health status.
b.
select a nursing diagnosis.
c.
organize data to help the RN evaluate patient progress.
d.
prioritize nursing diagnoses for more effective care.
ANSWER: A
The LPN/LVN collects data of the patients health status to assist the RN in selecting a nursing
diagnosis.
4. The participants of the planning stage of the nursing process during which the health goals are
defined include the:
a.
RN.
b.
health team led by the RN.
c.
health team, the patient, and the patients family.
d.
health team as directed by the physician.
ANSWER: C
The planning stage during which the health goals are defined are best shared by the entire health
team, the patient, and the patients family for the optimum outcome.
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5. When a resident in the nursing home complains of constipation, the nurse performs a digital
rectal examination and finds a hard fecal mass. This is an example of:
a.
implementation.
b.
nursing diagnosis.
c.
assessment.
d.
evaluation.
ANSWER: C
The examination to confirm and affirm the complaint of constipation is an assessment.
6. The nurse completing morning assessments on a patient who is sitting up in bed is told by the
patient, Im having trouble breathingI cant seem to get enough air. The best nursing response is
to:
a.
notify the doctor as soon as he or she comes in later in the
morning.
b.
finish the vital signs for the assigned patients, and then notify
the charge nurse.
c.
reassure the patient, if his blood pressure and pulse are normal.
d.
notify the charge nurse immediately of the patients statement.
ANSWER: B
The nurse should finish the assessment in order to confirm the complaint and inform the charge
nurse.
7. The order in which the nursing process is approached is:
a.
planning, assessment, implementation, nursing diagnosis,
evaluation.
b.
nursing diagnosis, evaluation, assessment, implementation,
planning.
c.
assessment, nursing diagnosis, planning, implementation,
evaluation.
d.
evaluation, nursing diagnosis, planning, implementation,
assessment.
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ANSWER: C
The order of assessment, nursing diagnosis, planning, implementation, and evaluation sets up a
basis for an organized approach to nursing care.
8. Once the nursing plan has been initiated, the nursing care plan will:
a.
stay in place until all nursing goals have been met.
b.
change as the patients condition changes.
c.
remain on the patient record to show progress.
d.
be given to the patient for final approval.
ANSWER: B
The nursing care plan is always a work in progress and will change as the patient condition
changes.
9. When a patient states, I cant walk very well, the first problem-solving step would be to:
a.
consider alternatives such as a wheelchair or walker.
b.
find out what the problem is, such as weakness or poor
balance.
c.
choose the alternative with the best chance of success.
d.
consider the outcomes of the choices, such as danger of falling
with a walker.
ANSWER: B
Defining the problem clearly assists in the interventions to reduce the problem.
10. A student nurse can begin to develop critical thinking skills by means of:
a.
working with a more experienced nurse.
b.
questioning every statement made by instructors to be sure of
its correctness.
c.
memorizing class notes for tests and studying all night for big
tests.
d.
listening attentively and focusing on the speakers words and
meaning.
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ANSWER: D
Critical thinking involves foundation skills such as effective reading and writing and attentive
listening.
11. When a nurse prioritizes the patient care, consideration is given to:
a.
completing assessments before mid-shift.
b.
considering situations that may result in an alteration of health.
c.
assuming all health care activities for a group of patients.
d.
identifying who can assist with the aspect of care.
ANSWER: B
Priority setting includes addressing health-endangering situations and physiological needs first.
12. When the nurse checks to see whether a patient has had relief 45 minutes after administering
pain medication, the nurse is performing a(n):
a.
nursing diagnosis.
b.
implementation.
c.
assessment.
d.
evaluation.
ANSWER: D
Evaluation is the step in which the nurse determines whether the plan and interventions are
effective or need to be modified.
MSC: NCLEX: Physiological Integrity: basic care and comfort
13. The activity that is implementation in nursing care is:
a.
checking the assigned patients blood pressure, pulse, and
respiration.
b.
changing the patients surgical dressing.
c.
asking the patient to demonstrate how to give himself
medication after teaching him.
d.
discussing the patient with other team members to establish a
care plan.
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ANSWER: B
Changing a dressing that is soiled is a nursing intervention performed to meet a patients need.
Checking vital signs is assessment. Demonstrating medication administration is evaluation.
Discussing the patient with other team members is planning.
14. Constant nursing assessments and evaluations of the patient will most likely result in:
a.
the nursing care plan changing to reflect appropriate priorities.
b.
small changes in the patient condition being overlooked.
c.
cluttered and confusing documentation.
d.
impeded problem solving.
ANSWER: A
Continued assessment and evaluation are necessary; reprioritizing and reorganizing activities
occur in response to the patients changing condition.
15. The effect of using a scientific problem-solving approach in nursing care will cause decision
making to be:
a.
slowed down considerably by the multiple steps.
b.
rigid and non-patient oriented.
c.
improved nursing care outcomes.
d.
unrelated to the nursing process.
ANSWER: C
A scientific problem-solving approach is most likely to result in positive patient outcomes.
16. An emergency room nurse will give first priority to the patient with the most critical need,
which is the patient who:
a.
is bleeding from a chin laceration.
b.
complains of a productive cough.
c.
has a fever of 102 F.
d.
complains of severe chest pain.
ANSWER: D
Because the chance of a bad outcome is highest for the patient with chest pain, it is most
appropriate to assess this patient first.
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COMPLETION
17. When the nurse constructs a nursing approach after careful judgment and sound reasoning,
the nurse has used a system of
.
ANSWER:
critical thinking
Critical thinking is a concept in which decisions are made using solidly based judgments and
reasoning.
18. Critical thinking is considered to be the keystone and foundation of the development of
.
ANSWER:
clinical judgment
Clinical judgment is built on the ability to think critically.
19. The tasks of synthesizing data and linking nursing interventions with patient health problems
are enhanced by the process of
.
ANSWER:
concept mapping
Concept mapping is a method to promote critical thinking by visualizing relationships between
patient health problems and effective intervention.
MULTIPLE RESPONSE
20. Activities considered to be aspects of the implementation step of the nursing process are:
(Select all that apply.)
a.
documentation of care given.
b.
assembly of supplies.
c.
analysis of data gathered.
d.
modification of aspects of the plan.
e.
evaluation of the patient response.
ANSWER: A, B
Documentation of care and assembly of supplies are nursing interventions performed during the
implementation step of the nursing process.
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21. Descriptions of the activities involved in the nursing diagnosis step of the nursing process
are: (Select all that apply.)
a.
determination of potential health problems.
b.
clustering of related assessments.
c.
sharing of information with the patient and physician.
d.
determination of desired outcomes.
e.
evaluation of probable outcomes.
ANSWER: A, B
During the nursing diagnosis step, assessment data are analyzed and clustered to determine
health problems, and appropriate nursing diagnoses are selected.
22. Which of the following items could be the responsibility of the LPN/LVN for a patients plan
of care? (Select all that apply.)
a.
Collect data.
b.
Perform nursing interventions.
c.
Initiate the plan of care.
d.
Assist the RN with evaluation of the patients response to
nursing interventions.
e.
Document nursing care.
ANSWER: A, B, D
Registered nurses are officially responsible for the initiation of nursing care plans for each
patient, but the LPN/LVN assists with each part of the care plan. The LPN/LVN is often
responsible for data collection to assist the RN with the assessment phase.
OTHER
23. A nurse begins rounds on a medicalsurgical nursing unit. Review the following patients on
her assignment. Prioritize the order in which the patients should be assessed, based on their
descriptions. (Separate letters with a comma and space as follows: A, B, C, D.)
A. A 22-year-old patient who is awakening from neck surgery.
B. An 82-year-old patient who is blind and needs discharge instructions.
C. A 44-year-old patient with dehydration from vomiting and diarrhea, who was admitted 3 days
ago and who has an IV infusion of fluids.
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D. A 35-year-old patient admitted for an injury to his left femoral artery, which required surgical
repair 8 hours ago following an ice-skating accident.
ANSWER:
A, D, C, B
Nursing priorities need to address patients with life-threatening concerns first. A patient just
awakening from neck surgery needs to be assessed first because of the concerns of tracheal
swelling. A patient with a compromised limb is the next priority. The patient on IV fluids for
dehydration is next. The patient for discharge is the last priority.
24. Place the steps of the problem-solving approach in the appropriate order. (Separate letters
with a comma and space as follows: A, B, C, D, E.)
A. Predict the likelihood of each outcome occurring.
B. Choose the alternative with the best chance of success.
C. Consider all possible alternatives as the solution to the problem.
D. Identify the problem.
E. Examine possible outcomes of each alternative.
ANSWER:
D, C, E, A, B
The problem-solving approach requires that a problem be clearly identified, all possible
alternative solutions be examined, outcomes of solutions be considered, probability of outcome
occurring be predicted, and the best alternative be chosen.
Chapter 3. Critical Thinking and Learning Cultures: Teaching, Learning, and Taking Tests
MULTIPLE CHOICE
1. A nurse working in an immigrant community is aware that different racial, religious, and
social groups have their own integrated patterns of human behavior that include language,
thoughts, communication, action, values, and institutions. This is known as the groups:
a.
values.
c.
culture.
b.
morals.
d.
tradition.
ANSWER: C
Culture is comprised of a series of integrated patterns of human behaviors that include language,
thought, communication, actions, customs, beliefs, and values as well as institutions of racial,
ethnic, religious, or social groups. While humans share many of the same characteristics, they are
also uniquely different according to these specific patterns of identity. Traditions, values, and
morals can be a part of ones culture.
PTS: 1 DIF: Comprehension REF: CULTURE
2. During a class on cultural beliefs, the instructor would most likely explain that these beliefs
are:
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a.
conscious and unconscious.
c.
reality.
b.
hereditary.
d.
genetic.
ANSWER: A
Cultural beliefs can be conscious or unconscious and serve as points of reference to guide the
outlook and decisions of individuals. They are neither hereditary nor genetic, but they can be
learned through association with family and relatives.
PTS: 1 DIF: Comprehension REF: CULTURE
3. A nursing instructor tests students on their understanding of the concept of values. Which
response by a student indicates that further teaching is needed?
a.
Values provide a set of rules by which to live.
b.
Values guide actions and decisions.
c.
Values hinder problem solving and give direction to life.
d.
Values influence how people react to others.
ANSWER: C
Values perform important functions in our lives and the way in which we view and interact with
the world around us. Some important functions of values are that they provide a set of rules to
live by; guide actions and decisions; give direction to peoples lives and help them to solve
problems (not hinder problem solving); influence how individuals perceive and react to others;
help determine basic attitudes concerning personal, social, and philosophical issues; reflect an
individuals identity; and provide a basis for self-evaluation.
PTS: 1 DIF: Application REF: CULTURE
4. A group of nurses have recently been hired at your hospital. Because the nurses are from a
different country, they would most likely experience which of the following?
a.
Ambivalence
c.
Hoarding of tradition in ethnic
groups
b.
Improved lifestyle
d.
Culture shock
ANSWER: D
Culture shock can occur when an individual immigrates to a different country with a different
culture. This can occur when the values and beliefs upheld by the new culture are radically
different from the individuals native culture.
PTS: 1 DIF: Application REF: CULTURE
5. Registered nurses can be identified as which of the following within health care professionals?
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a.
Culture
c.
Group
b.
Subculture
d.
Organization
ANSWER: B
Smaller groups within a culture are called subcultures. Subcultures may consist of professional
and occupational affiliations (nurses), nationality or race, age groups, gender, socioeconomic
factors, political viewpoints, and/or sexual orientation.
PTS: 1 DIF: Comprehension REF: CULTURE
6. You are completing a survey which poses questions regarding your genetic traits and physical
characteristics. The information that is being asked is related to which of the following?
a.
Culture
c.
Race
b.
Acculturation
d.
Cultural ethnicity
ANSWER: C
Race describes a geographical or global population that is distinguished by its physical
characteristics such as skin color or facial features or other genetic traits. Cultural ethnicity
identifies a person based upon racial, tribal, linguistic, religious, national, or cultural groups.
Acculturation concerns the loss of cultural identity into the new or more dominant cultural
group.
PTS: 1 DIF: Comprehension REF: RACE AND ETHNICITY
7. A nurse is working in an environment where a large portion of the clients appear to be of the
same race; however, the nurse is aware that within each broad category of race are numerous
cultural groups. Why is this important for the nurse to recognize?
a.
For demographic data collection
b.
Different cultural groups have different views of health-related illness
practices for care
c.
To prevent racism from occurring on the unit among the patients
d.
To provide the best care possible according to their heritage and traditions
ANSWER: B
While the clients may appear to be of the same race, their culture and views of health-related
illness practices may be quite different. For example, there are subcultures such as the different
Native America tribes broadly categorized as Native American, or the subcultures that comprise
the term Hispanic (i.e., Caribbean, Cuban, Guatemalan, Puerto Rican, Mexican, and Central and
South American peoples).
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PTS: 1 DIF: Application REF: POPULATION GROUPS
8. You attend a conference on health disparities. You learn different techniques for assisting
victims of health disparities using problem-solving activities. Which problem-solving activity
identified by one of the conference participants would indicate that further clarification is
necessary?
a.
Increasing health care knowledge of the community
b.
Seeking health care access
c.
Breaking down barriers and traditions to western medicine
d.
Serving as a role model for new nurses
ANSWER: C
Victims of health disparities include those subcultures or people who have been separated from
the mainstream, resulting in decreased access to health care and higher rates of mortality and
morbidity. Some ways in which nurses can help these groups are by increasing the health care
knowledge of the community, seeking health care access, breaking down barriers and ensuring
access to education and care (not breaking down barriers and traditions to western medicine),
and serving as role models for new nurses.
PTS: 1 DIF: Analysis REF: HEALTH CARE DISPARITY
9. You are working in a clinic with a culturally diverse client base and wish to provide culturally
competent care. Which is not necessarily a component in the process of culturally competent
care?
a.
Cultural awareness
c.
Cultural organizations
b.
Cultural knowledge
d.
Cultural desire
ANSWER: C
Culturally competent care is an integration of knowledge, attitudes, and skills that enhances
cross-cultural communication and effective interactions. This type of care is a process that
combines the elements of cultural awareness, cultural knowledge, cultural skills, cultural
encounters (not cultural organizations), and cultural desire.
PTS: 1 DIF: Comprehension
REF: CULTURAL COMPETENCE
10. A nursing instructor asks a group of students if they can identify some nursing theories and
models that have been developed to assist nurses in the delivery of culturally competent care.
Which response by a student would indicate that further teaching is needed?
a.
Leiningers Transcultural Nursing
b.
Purnells Model for Cultural Competence
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c.
Campinha-Bacotes Process of Cultural Competence
d.
Giger and Morrisons Model for Transcultural Awareness
ANSWER: D
Several nursing theories and models have been developed to help nurse leaders prevent
workplace difficulties when working with people who are different due to age, ethnicity, race,
culture, or religion. Some of these theories and models are Leiningers Transcultural Nursing,
Purnells Model for Cultural Competence, Campinha-Bacotes Process of Cultural Competence in
the Delivery of Health Care Service, and Giger and Davidhizars Transcultural Assessment Model
(not Giger and Morrisons Model for Transcultural Awareness)..
PTS: 1 DIF: Application REF: CULTURAL COMPETENCE
11. A nursing instructor teaches students that according to DeRosa and Kochuras (2006) article
entitled Implement Culturally Competent Health Care in your Workplace, cultures have different
patterns of verbal and nonverbal communication. Which response by a student, when tested on
this material, will indicate to the instructor that further teaching is necessary?
a.
Conversational style
c.
Eye contact
b.
Personal behavior
d.
Subject matter
ANSWER: B
DeRosa and Kochura (2006, October) noted four potential differences in communication among
different cultures. They identified personal space (not personal behavior), conversational style
(i.e., silence may be taken as a sign of respect or acknowledgment), eye contact (in some
cultures, direct eye contact can be viewed as a sign of disrespect), and subject matter (some
subjects are taboo in certain cultures).
PTS: 1 DIF: Analysis REF: EVIDENCE FROM THE LITERATURE
12. You are conducting an in-service on organizational culture. Which response regarding the
important components of organizational culture would indicate that further clarification is
needed?
a.
Vision statement
c.
Resource allocation and reward
b.
Relative diversity
d.
Degree of change
ANSWER: A
Organizational culture is a system of shared beliefs and values that actively influences the
behavior of an organization. Five primary components are values (the foundation for the
organization, they guide behavior and express the organizations philosophy), relative diversity
(by having an organizational culture, some degree of similarity is assumed, but the amount of
deviation tolerated from this similarity differs), resource allocation and reward(distribution of
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monies and resources tells people what and who is valued in the organization), degree of change
(fast-paced organizations differ from slower-paced ones and how they react to change), and
strength of the culture (how much influence the culture exerts). Vision statement is not a
component of organizational culture.
PTS: 1 DIF: Analysis REF: ORGANIZATIONAL SOCIALIZATION
13. Perceptions of the nurses role in health care can vary according to culture. For example, In
some Asian cultures, when a nurse assists with bathing or feeding, the family may perceive the
nurses actions as which of the following?
a.
Rude behavior
b.
Dedication to the patient
c.
Respect and an attempt to help the patient
d.
Demonstration of attentiveness to the patients physical comfort needs
ANSWER: A
According to Mattson (2009), in Asian countries, where families are very involved in patient
care, it would be considered rude for the nurse to assist in bathing or feeding a patient. However,
in American health care facilities, if the nurse does not ensure that these services are done, staff
members could view this nurse as a slacker who is not completing his job duties.
PTS: 1 DIF: Analysis
REF: DIFFERENT PERCEPTIONS OF THE NURSES ROLE
14. You are working with staff from different cultures and are aware of the importance of
realizing that there may be different perceptions of a variety of aspects inherent in the health care
regime. Which of the following is not one of these potential areas of differing perception?
a.
Staff responsibilities
c.
Locus of control
b.
Role of the health care
d.
Time orientation
practitioner
ANSWER: B
Working with staff from a variety of cultures brings with it differing perceptions of the health
care regime and its inherent elements. Some potential areas of difference are differing
perceptions of staff responsibilities, the role of the nurse, (not the health care practitioner), locus
of control, time orientation, educational differences, and language differences.
PTS: 1 DIF: Comprehension
REF: WORKING WITH STAFF FROM DIFFERENT CULTURES
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15. A nurse manager conducts an in-service on techniques to facilitate multicultural
communication. Which technique suggested by one of the nurses would indicate to the nurse
manager that further clarification is needed?
a.
Avoiding the use of slang terms
b.
Recognizing that educational backgrounds in nursing may be vastly different
c.
Providing your coworker with resources that may help to reinforce verbal
communication
d.
Avoiding using I statements when offering constructive criticism
ANSWER: D
Some techniques that may help to facilitate communication among multicultural workers include
avoiding the use of slang terms; recognizing that your coworker probably has an educational
background in nursing that is different from yours; providing your coworker with resources such
as written protocols and procedures to reinforce your verbal communication. When providing
constructive criticism you should try to use I statements instead of you statements. It is also
important to remember to praise your coworkers competency in technical skills to inspire selfconfidence.
PTS: 1 DIF: Analysis
REF: IMPROVING COMMUNICATION ON THE TEAM
16. A nursing instructor has just completed a lecture on how Jamieson and OMara (1991)
established a program to help nurse managers manage a diverse staff. The instructor then asked
the group to identify the steps put forth by Jamieson and OMara. Which comment by an
individual would indicate that further teaching is needed?
a.
Determine which cultural groups are represented on staff.
b.
Understand the organizations values and goals.
c.
Decide how to manage conflict.
d.
Analyze present conditions within the organization
ANSWER: C
Jamieson and OMaras (1991) six-step plan for nurse managers who work with a culturally
diverse staff are to determine which cultural groups are represented on staff, understand the
organizations values and goals, decide on what is best for the future of the organization (not only
decide how to manage conflict), analyze present conditions within the organization, plan ways to
reach the desired future state and decide how to manage transitions, and evaluate the results.
PTS: 1 DIF: Analysis REF: MANAGERIAL RESPONSIBILITIES
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17. A nurse preceptor is working with a new graduate nurse and asks if the nurse knows the
different generations that comprise the current workforce that the new graduate nurse managers
may have to supervise. The preceptor would recognize that clarification is needed if the new
graduate identified which of the following as one of the generations?
a.
Baby Boomers
c.
GenXers
b.
Pre-millennials
d.
Echo Boomers
ANSWER: B
The preceptor would need to clarify that none of the generations are known as pre-millennials.
The four distinct generations that make up the current workforce include the traditionals (born
before 1940); the baby boomers (born between 1940 and 1960); generation X, or genXers (born
between 1960 and 1980); and generation Y, or echo boomers/millennials (born after 1980).
PTS: 1 DIF: Analysis REF: GENERATIONAL PERCEPTIONS
18. You notice that one of your nursing colleagues has an impaired ability to integrate meaning
and purpose in life through her own connectedness with others, self, music, nature, or a higher
power. Your colleague is most likely experiencing which of the following?
a.
Spiritual distress
c.
Depression
b.
Philosophical distress
d.
Schizoid personality disorder
ANSWER: A
Spiritual distress is a recognized nursing diagnosis that consists of an impaired ability to
integrate meaning and purpose in life through an individuals connectedness with self, others, art,
music, literature, nature, or a higher power. In order to relieve this distress, it is expected that
individuals will reconnect with those items/elements that they consider to be important (i.e.,
meditation, prayer, religious services or rituals, communing with nature or animals, sharing of
self, or caring for others) in order to return to meaning and purpose in life. Depression consists of
a variety of symptoms that interfere with the ability to work, eat, sleep, and function in activities
that once brought pleasure. Schizoid personality disorder consists of a pattern of indifference to
social relationships and a limited range of emotional expression and experience.
PTS: 1 DIF: Comprehension REF: SPIRITUAL DISTRESS
19. The nurse manager wants to motivate a 55-year-old staff nurse. Taking the nurses age into
consideration, which type of motivation would be most effective for this nurse?
a.
Sending the nurse a letter on a job well done
b.
Giving public acknowledgement and reward for good performance
c.
Telling the nurse of opportunities for growth and development
d.
Emphasizing the importance and significance of the nurses work
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ANSWER: B
Staff nurses who are 55 years old would be considered being from the Baby Boomer generation.
The most effective means of motivating nurses in this age group would be to give public
acknowledgement and reward for good performance.
PTS: 1 DIF: Analysis REF: GENERATIONAL PERCEPTIONS
20. During a Community Health clinical, a students asks the instructor, What is meant by health
disparities? The instructor would be correct in responding that health disparities refer to:
a.
differences in each individuals response to illness and disease states, which is
reflective of cultural beliefs.
b.
differences in types of care an individual receives based on whether the
individual pays for health care with personal funds, private insurance, or
federal assistance.
c.
the different beliefs and values that individuals express based on age and
ethnicity.
d.
differences in health risks and health status measures that reflect the poorer
health status that is found disproportionately in certain population groups.
ANSWER: D
The term health disparities refers to differences in health risks and health status measures that
reflect the poorer health status that is found disproportionately in certain population groups.
These health disparities include differences in the occurrence of illness, disease, and death
among minorities and other vulnerable populations in the United States.
PTS: 1 DIF: Application REF: HEALTH DISPARITIES
21. One of the nurses on your unit tells you that his grandmother, who speaks no English, was
recently admitted to the hospital with a heart condition. The nurses caring for the grandmother
have labeled her a difficult patient. The nurse further explains that the grandmother immigrated
from China just 6 months ago and generally only interacts with family members and close family
friends. You hypothesize that the grandmother is most likely experiencing which of the
following?
a.
Cultural intensity
c.
Cultural stereotyping
b.
Culture shock
d.
Cultural incompetence
ANSWER: B
The nurses grandmother is most likely experiencing culture shock. Many patients experience
culture shock because of the unfamiliar sounds and sights and strangers they come in contact
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SOLUTION MANUAL EMAIL ME
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CHAPTERS IN PDF FORMAT