TEST QUESTIONS AND ANSWERS SURE A+
✔✔Nursing Process: Diagnosis - ✔✔only/ giving assessment to rn
✔✔Nursing Process: Planning/Outcomes Identifications - ✔✔Planning/Care plan built
by RN
✔✔Nursing Process: Implementation (putting a decision or plan into effect) - ✔✔Carry
out planned interventions. Interventions, education, environment/development
considerations.
✔✔Nursing Process: Evaluation - ✔✔re-evaluation and make suggestions. Compare
response/results to the original goals, plan of care.
✔✔Data Collection - ✔✔LPN's collect data, RN's complete Assessments.
✔✔2 main types of data - ✔✔Objective vs Subjective
✔✔Objective Data - ✔✔As the nurse what do you see on the pt
✔✔Subjective Data - ✔✔(Symptoms) Only what the pt tells you
, ✔✔clinical observation - ✔✔Is related to/or conducted in a healthcare setting involving
direct observation of the patient.
✔✔Judgement - ✔✔Your interpretation that influences your actions to take.
✔✔Clinical Judgement - ✔✔Clinical or medical decision the nurse makes (a conclusion
about a patient's needs, concerns, or health problems. Whether or not you should take
action.)
✔✔Why do we need Clinical Judgement? - ✔✔Professional, legal and ethical- to give
safe competent individual patient centered care. To make decisions and solve problems
in healthcare environment
✔✔How do we develop Clinical Judgement? - ✔✔Nursing process ADPIE , Clinical
Judgement, diagnosing and evaluating.
✔✔SPICES: - ✔✔A tool that can be used to obtain information necessary to prevent
health alterations in older adult patients.
✔✔SPICES: S - ✔✔SLEEP Disorders
✔✔SPICES: P - ✔✔PROBLEMS with Eating or Feeding
✔✔SPICES: I - ✔✔Incontinence bowel and/or bladder
✔✔SPICES: C - ✔✔Confusion meds made them disoriented
✔✔SPICES: E - ✔✔EVIDENCE of Falls
✔✔SPICES: S(2) - ✔✔SKIN Breakdown
✔✔Epworth Sleepiness Scale - ✔✔Tool used to measure average daytime sleepiness.
determines if person is getting enough sleep.
Scored 0-6:
healthy 7-8
borderline 9-10 seek medical attention! (Most nursing students)
✔✔Maslow's Hierarchy of Needs Theory - ✔✔offers a pyramid of physiological, safety,
social, esteem, and self-actualization needs
✔✔Critical thinking is - ✔✔Thinking with a purpose
✔✔Collaboration - ✔✔multidisciplinary approach to share patient information increased
patient safety, and has better patient outcomes