RNSG 1413 - exam 2|Advanced Clinical Nursing Assessment, Diagnostic
Reasoning, Evidence-Based Practice, Patient Safety, Therapeutic
Communication, Critical Thinking, Ethical Decision-Making, Care Planning,
Health Promotion, Disease Prevention, Chronic Illness Management, Acute
Care Interventions, Pharmacology, Pain Management, Infection Control,
Wound Care, IV Therapy, Patient Education, Cultural Competence,
Leadership, Collaboration, Delegation, Clinical Judgment, Quality
Improvement, Patient-Centered Care, Professional Standards, Nursing
Process, Risk Assessment, Nursing Informatics, Self-Care Strategies, Holistic
Care, Interprofessional Practice, Healthcare Policy Integration Exam
Questions Verified and Provided with Complete A+ Graded Rationales
Latest Updated 2026
Mrs. Celia Shirer is a 33-year-old German woman admitted to the medical-surgical unit for management
of a bowel infection secondary to a colostomy. She has had a colostomy and colostomy pouch for 3
years, but she is not compliant in correctly cleaning the area and changing the dressing and pouch as
required. She is placed on antibiotics to fight the infection, intravenous fluids to maintain hydration, and
nonsteroidal antiinflammatory medications for pain.
Lucy is the nursing student assigned to Mrs. Shirer. Lucy's priority in caring for Mrs. Shirer is to educate
the patient about the importance of maintaining hygiene and to promote comfort.
1. Lucy uses an analytical process to determine the cause of Mrs. Shirer's noncompliance. Lucy is using
the process of __________ _____________.
Answer: Diagnostic reasoning
Rationale: Diagnostic reasoning is the analytical process for determining a patient's health problems.
Accurate recognition of a patient's problems is necessary before determining a course of action.
Mrs. Celia Shirer is a 33-year-old German woman admitted to the medical-surgical unit for management
of a bowel infection secondary to a colostomy. She has had a colostomy and colostomy pouch for 3
years, but she is not compliant in correctly cleaning the area and changing the dressing and pouch as
required. She is placed on antibiotics to fight the infection, intravenous fluids to maintain hydration, and
nonsteroidal antiinflammatory medications for pain.
Lucy is the nursing student assigned to Mrs. Shirer. Lucy's priority in caring for Mrs. Shirer is to educate
the patient about the importance of maintaining hygiene and to promote comfort.
,2. Lucy does not approve of Mrs. Shirer's lack of compliance with her medical regimen. However, Lucy
always treats Mrs. Shirer with ____________ and deals with situations justly.
Answer: Fairness
Rationale: Regardless of how the nurse feels about a patient, he or she must always treat the patient
with fairness and justice to promote positive outcomes for him or her.
Mrs. Celia Shirer is a 33-year-old German woman admitted to the medical-surgical unit for management
of a bowel infection secondary to a colostomy. She has had a colostomy and colostomy pouch for 3
years, but she is not compliant in correctly cleaning the area and changing the dressing and pouch as
required. She is placed on antibiotics to fight the infection, intravenous fluids to maintain hydration, and
nonsteroidal antiinflammatory medications for pain.
Lucy is the nursing student assigned to Mrs. Shirer. Lucy's priority in caring for Mrs. Shirer is to educate
the patient about the importance of maintaining hygiene and to promote comfort.
3. Lucy tries several different teaching methods to try to improve Mrs. Shirer's compliance to her
medical regimen. She keeps at the process, hoping to find an approach that works with Mrs. Shirer. Lucy
is demonstrating which attitude for critical thinking?
A. Discipline
B. Risk taking
C. Responsibility
D. Perseverance
E. Accountability
Answer: D
Rationale: To persevere means to keep looking for resources until a successful approach is found. It
leads the nurse to try different communication approaches.
Mrs. Celia Shirer is a 33-year-old German woman admitted to the medical-surgical unit for management
of a bowel infection secondary to a colostomy. She has had a colostomy and colostomy pouch for 3
years, but she is not compliant in correctly cleaning the area and changing the dressing and pouch as
required. She is placed on antibiotics to fight the infection, intravenous fluids to maintain hydration, and
nonsteroidal antiinflammatory medications for pain.
,Lucy is the nursing student assigned to Mrs. Shirer. Lucy's priority in caring for Mrs. Shirer is to educate
the patient about the importance of maintaining hygiene and to promote comfort.
4. Lucy asks Mrs. Shirer, "Why do you think it's difficult for you to manage your colostomy and
colostomy bag as indicated?" Lucy is expressing integrity by asking Mrs. Shirer this question.
A. True
B. False
Answer: B
Rationale: Curiosity involves asking patients why they do the things they do. Curiosity motivates the
nurse to investigate a clinical situation.
A nurse enters a patient's room at the beginning of a shift to assess his condition following a blood
transfusion. The nurse cared for the patient on the previous day as well. The patient has several issues
he wishes to share with the nurse, who takes time to explore each issue. The nurse also assesses the
patient and finds no signs or symptoms of a reaction to the blood product. The nurse observed the
patient the prior day and sees a change in his behavior—a reluctance to get out of bed and ambulate.
Which of the following actions improve the nurse's ability to make clinical decisions about this patient?
(Select all that apply.)
1. Working the same shift each day
2. Spending time during the patient assessment
3. Knowing the early mobility protocol guidelines
4. Caring for the patient on consecutive days
5. Knowing the pattern of patient behavior about ambulation
Answer: 2, 4, 5.
Clinical decision making is enhanced by spending enough time during patient assessments and knowing
a patient's typical behaviors (which is reinforced when a nurse is assigned to a patient on consecutive
days). Working the same shift does not mean the nurse will care for the same patient. Knowledge about
the mobility protocol is helpful, but clinical decisions center on the needs of an individual patient (e.g.,
whether a patient meets the criteria for a mobility protocol and how well the patient has advanced so
far).
, Match the concepts for a critical thinker on the left with the application of the term on the right,
Concepts for Critical Thinkers
___ 1. Truth seeking
___ 2. Open-mindedness
___ 3. Analyticity
___ 4. Systematicity
Term Application
a. Anticipate how a patient might respond to a treatment.
b. Organize assessment on the basis of patient priorities.
c. Be objective in asking patient questions.
d. Be tolerant of the patient’s views and beliefs.
Answer: 1c, 2d, 3a, 4b.
A nurse has seen many cancer patients struggle with pain management because they are afraid of
becoming addicted to the medicine. Pain control is a priority for cancer care. By helping patients focus
on their values and beliefs about pain control, a nurse can best make clinical decisions. This is an
example of:
Reasoning, Evidence-Based Practice, Patient Safety, Therapeutic
Communication, Critical Thinking, Ethical Decision-Making, Care Planning,
Health Promotion, Disease Prevention, Chronic Illness Management, Acute
Care Interventions, Pharmacology, Pain Management, Infection Control,
Wound Care, IV Therapy, Patient Education, Cultural Competence,
Leadership, Collaboration, Delegation, Clinical Judgment, Quality
Improvement, Patient-Centered Care, Professional Standards, Nursing
Process, Risk Assessment, Nursing Informatics, Self-Care Strategies, Holistic
Care, Interprofessional Practice, Healthcare Policy Integration Exam
Questions Verified and Provided with Complete A+ Graded Rationales
Latest Updated 2026
Mrs. Celia Shirer is a 33-year-old German woman admitted to the medical-surgical unit for management
of a bowel infection secondary to a colostomy. She has had a colostomy and colostomy pouch for 3
years, but she is not compliant in correctly cleaning the area and changing the dressing and pouch as
required. She is placed on antibiotics to fight the infection, intravenous fluids to maintain hydration, and
nonsteroidal antiinflammatory medications for pain.
Lucy is the nursing student assigned to Mrs. Shirer. Lucy's priority in caring for Mrs. Shirer is to educate
the patient about the importance of maintaining hygiene and to promote comfort.
1. Lucy uses an analytical process to determine the cause of Mrs. Shirer's noncompliance. Lucy is using
the process of __________ _____________.
Answer: Diagnostic reasoning
Rationale: Diagnostic reasoning is the analytical process for determining a patient's health problems.
Accurate recognition of a patient's problems is necessary before determining a course of action.
Mrs. Celia Shirer is a 33-year-old German woman admitted to the medical-surgical unit for management
of a bowel infection secondary to a colostomy. She has had a colostomy and colostomy pouch for 3
years, but she is not compliant in correctly cleaning the area and changing the dressing and pouch as
required. She is placed on antibiotics to fight the infection, intravenous fluids to maintain hydration, and
nonsteroidal antiinflammatory medications for pain.
Lucy is the nursing student assigned to Mrs. Shirer. Lucy's priority in caring for Mrs. Shirer is to educate
the patient about the importance of maintaining hygiene and to promote comfort.
,2. Lucy does not approve of Mrs. Shirer's lack of compliance with her medical regimen. However, Lucy
always treats Mrs. Shirer with ____________ and deals with situations justly.
Answer: Fairness
Rationale: Regardless of how the nurse feels about a patient, he or she must always treat the patient
with fairness and justice to promote positive outcomes for him or her.
Mrs. Celia Shirer is a 33-year-old German woman admitted to the medical-surgical unit for management
of a bowel infection secondary to a colostomy. She has had a colostomy and colostomy pouch for 3
years, but she is not compliant in correctly cleaning the area and changing the dressing and pouch as
required. She is placed on antibiotics to fight the infection, intravenous fluids to maintain hydration, and
nonsteroidal antiinflammatory medications for pain.
Lucy is the nursing student assigned to Mrs. Shirer. Lucy's priority in caring for Mrs. Shirer is to educate
the patient about the importance of maintaining hygiene and to promote comfort.
3. Lucy tries several different teaching methods to try to improve Mrs. Shirer's compliance to her
medical regimen. She keeps at the process, hoping to find an approach that works with Mrs. Shirer. Lucy
is demonstrating which attitude for critical thinking?
A. Discipline
B. Risk taking
C. Responsibility
D. Perseverance
E. Accountability
Answer: D
Rationale: To persevere means to keep looking for resources until a successful approach is found. It
leads the nurse to try different communication approaches.
Mrs. Celia Shirer is a 33-year-old German woman admitted to the medical-surgical unit for management
of a bowel infection secondary to a colostomy. She has had a colostomy and colostomy pouch for 3
years, but she is not compliant in correctly cleaning the area and changing the dressing and pouch as
required. She is placed on antibiotics to fight the infection, intravenous fluids to maintain hydration, and
nonsteroidal antiinflammatory medications for pain.
,Lucy is the nursing student assigned to Mrs. Shirer. Lucy's priority in caring for Mrs. Shirer is to educate
the patient about the importance of maintaining hygiene and to promote comfort.
4. Lucy asks Mrs. Shirer, "Why do you think it's difficult for you to manage your colostomy and
colostomy bag as indicated?" Lucy is expressing integrity by asking Mrs. Shirer this question.
A. True
B. False
Answer: B
Rationale: Curiosity involves asking patients why they do the things they do. Curiosity motivates the
nurse to investigate a clinical situation.
A nurse enters a patient's room at the beginning of a shift to assess his condition following a blood
transfusion. The nurse cared for the patient on the previous day as well. The patient has several issues
he wishes to share with the nurse, who takes time to explore each issue. The nurse also assesses the
patient and finds no signs or symptoms of a reaction to the blood product. The nurse observed the
patient the prior day and sees a change in his behavior—a reluctance to get out of bed and ambulate.
Which of the following actions improve the nurse's ability to make clinical decisions about this patient?
(Select all that apply.)
1. Working the same shift each day
2. Spending time during the patient assessment
3. Knowing the early mobility protocol guidelines
4. Caring for the patient on consecutive days
5. Knowing the pattern of patient behavior about ambulation
Answer: 2, 4, 5.
Clinical decision making is enhanced by spending enough time during patient assessments and knowing
a patient's typical behaviors (which is reinforced when a nurse is assigned to a patient on consecutive
days). Working the same shift does not mean the nurse will care for the same patient. Knowledge about
the mobility protocol is helpful, but clinical decisions center on the needs of an individual patient (e.g.,
whether a patient meets the criteria for a mobility protocol and how well the patient has advanced so
far).
, Match the concepts for a critical thinker on the left with the application of the term on the right,
Concepts for Critical Thinkers
___ 1. Truth seeking
___ 2. Open-mindedness
___ 3. Analyticity
___ 4. Systematicity
Term Application
a. Anticipate how a patient might respond to a treatment.
b. Organize assessment on the basis of patient priorities.
c. Be objective in asking patient questions.
d. Be tolerant of the patient’s views and beliefs.
Answer: 1c, 2d, 3a, 4b.
A nurse has seen many cancer patients struggle with pain management because they are afraid of
becoming addicted to the medicine. Pain control is a priority for cancer care. By helping patients focus
on their values and beliefs about pain control, a nurse can best make clinical decisions. This is an
example of:
