STUDY GUIDE EXAM 1 1
NR446 Study Guide to Accompany Exam 1
(Chapters 1-6 and 20)
This document is meant to guide you in your preparation for the exam. You are responsible for
all of the content covered in the lessons, readings, and course work.
Chapter 1:
Critical thinking: Characteristics of a critical thinker
Insight
Intuition
Empathy
Willingness to take action
o Initiative
o Inspiration
o Energy
o Positive Attitude
o Communication Skills
o Respect
o Problem-solving and Critical-thinking skills
Pg. 3 in ATI 6.0
Decision Making and Problem Solving:
Decision Making: complex, cognitive process of choosing a particular course of action;
the thought process of selecting a logical choice from available options.
Problem Solving: part of a decision making; systematic process focusing on analyzing a
difficult situation involving higher-order reasoning and evaluation.
Critical Thinking: the mental process of actively and skillfully conceptualizing,
applying, analyzing, synthesizing, and evaluating information to reach an answer or
conclusion.
o Uses reason to make informed decisions
o Often requires one to think outside of the box
Clinical Reasoning: integrating and applying different types of knowledge to weigh
evidence, critically think about arguments, and reflect upon the process used to arrive
at diagnosis.
Clinical Judgement: the decision made regarding a course of action based on a critical
analysis of data.
o Modify interventions based on client’s response
o Determine client outcomes desired/achieved
,STUDY GUIDE EXAM 1 2
Heuristics vs. formal structure in problem solving
Heuristics:
o Shortcut mental strategies that help simplify information
o Discrete and often unconscious process for problem solving
o Allows for quick problem solving based on experiences
o Uses “trial and error” or “rule of thumb”
A structured approach to problem solving and decision making
increases clinical reasoning
Traditional (formal) structure in Problem Solving
o Effective Model
o Weaknesses
Time is needed for proper implementation
Lack of initial objective-setting step
o Identify the problem
o Gather data to identify the causes and consequences of the problem
o Explore alternative solutions
o Evaluate each alternative
o Select appropriate solution
Decision-making happens here
o Implement Solution
o Evaluate results
Critical elements used in decision making (POSSIBLE SATA ON EXAM)
State a clear objective
Gather data carefully
Take the time necessary
Use an evidence-based approach
Generate many alternatives
Think Logically
Choose and act decisively
Learning strategies to increase critical thinking (i.e. case studies, simulation, etc.)
Case Studies:
o Provide stories that impart learning
Often unfold over time
Simulations:
o Provide opportunities for learning w/no risk to patients or organizational
performance
Problem-based learning (PBL):
, STUDY GUIDE EXAM 1 3
o Provides opportunities for learners to address and learn from authentic
problems vicariously
Often in small groups
Comparing the decision making process with the nursing process
MANAGERIAL DECISION-MAKING MODEL:
o Determine the decision and the desired outcome (set objectives)
o Research and identify options
o Compare and contrast these options and their consequences
o Make a decision
o Implement an action plan
o Evaluate Results
NURSING PROCESS: A PROBLEM-SOLVING AND DECISION-MAKING MODEL
o ASSESS
o DIAGNOSE
o PLAN
o IMPLEMENT
o EVALUATE
Book table 1.1
DECISION-MAKING PROCESS SIMPLIFIED NURSING PROCESS
IDENTIFY THE DECISION ASSESS
COLLECT DATA
IDENTIFY CRITERIA FOR DECISION PLAN
IDENTIFY ALTERNATIVES
CHOOSE ALTERNATIVE IMPLEMENT
IMPLEMENT ALTERNATIVE
EVALUATE STEPS IN DECISION EVALUATE
EBP in decision making
Keep abreast of the evidence
Use Multiple sources of evidence
Use evidence to support clinical interventions and teaching strategies
Find established sources of evidence
Implement and evaluate nationally sanctioned clinical practice guidelines
Question and challenge nursing traditions
Dispel myths and traditions not supported by evidence
Collaborate w/other nurses locally and globally
Interact w/other disciplines to bring nursing evidence to the table
NR446 Study Guide to Accompany Exam 1
(Chapters 1-6 and 20)
This document is meant to guide you in your preparation for the exam. You are responsible for
all of the content covered in the lessons, readings, and course work.
Chapter 1:
Critical thinking: Characteristics of a critical thinker
Insight
Intuition
Empathy
Willingness to take action
o Initiative
o Inspiration
o Energy
o Positive Attitude
o Communication Skills
o Respect
o Problem-solving and Critical-thinking skills
Pg. 3 in ATI 6.0
Decision Making and Problem Solving:
Decision Making: complex, cognitive process of choosing a particular course of action;
the thought process of selecting a logical choice from available options.
Problem Solving: part of a decision making; systematic process focusing on analyzing a
difficult situation involving higher-order reasoning and evaluation.
Critical Thinking: the mental process of actively and skillfully conceptualizing,
applying, analyzing, synthesizing, and evaluating information to reach an answer or
conclusion.
o Uses reason to make informed decisions
o Often requires one to think outside of the box
Clinical Reasoning: integrating and applying different types of knowledge to weigh
evidence, critically think about arguments, and reflect upon the process used to arrive
at diagnosis.
Clinical Judgement: the decision made regarding a course of action based on a critical
analysis of data.
o Modify interventions based on client’s response
o Determine client outcomes desired/achieved
,STUDY GUIDE EXAM 1 2
Heuristics vs. formal structure in problem solving
Heuristics:
o Shortcut mental strategies that help simplify information
o Discrete and often unconscious process for problem solving
o Allows for quick problem solving based on experiences
o Uses “trial and error” or “rule of thumb”
A structured approach to problem solving and decision making
increases clinical reasoning
Traditional (formal) structure in Problem Solving
o Effective Model
o Weaknesses
Time is needed for proper implementation
Lack of initial objective-setting step
o Identify the problem
o Gather data to identify the causes and consequences of the problem
o Explore alternative solutions
o Evaluate each alternative
o Select appropriate solution
Decision-making happens here
o Implement Solution
o Evaluate results
Critical elements used in decision making (POSSIBLE SATA ON EXAM)
State a clear objective
Gather data carefully
Take the time necessary
Use an evidence-based approach
Generate many alternatives
Think Logically
Choose and act decisively
Learning strategies to increase critical thinking (i.e. case studies, simulation, etc.)
Case Studies:
o Provide stories that impart learning
Often unfold over time
Simulations:
o Provide opportunities for learning w/no risk to patients or organizational
performance
Problem-based learning (PBL):
, STUDY GUIDE EXAM 1 3
o Provides opportunities for learners to address and learn from authentic
problems vicariously
Often in small groups
Comparing the decision making process with the nursing process
MANAGERIAL DECISION-MAKING MODEL:
o Determine the decision and the desired outcome (set objectives)
o Research and identify options
o Compare and contrast these options and their consequences
o Make a decision
o Implement an action plan
o Evaluate Results
NURSING PROCESS: A PROBLEM-SOLVING AND DECISION-MAKING MODEL
o ASSESS
o DIAGNOSE
o PLAN
o IMPLEMENT
o EVALUATE
Book table 1.1
DECISION-MAKING PROCESS SIMPLIFIED NURSING PROCESS
IDENTIFY THE DECISION ASSESS
COLLECT DATA
IDENTIFY CRITERIA FOR DECISION PLAN
IDENTIFY ALTERNATIVES
CHOOSE ALTERNATIVE IMPLEMENT
IMPLEMENT ALTERNATIVE
EVALUATE STEPS IN DECISION EVALUATE
EBP in decision making
Keep abreast of the evidence
Use Multiple sources of evidence
Use evidence to support clinical interventions and teaching strategies
Find established sources of evidence
Implement and evaluate nationally sanctioned clinical practice guidelines
Question and challenge nursing traditions
Dispel myths and traditions not supported by evidence
Collaborate w/other nurses locally and globally
Interact w/other disciplines to bring nursing evidence to the table
