FINAL EXAM- NR224
FUNDAMENTALS
1. Infectious disease stages:
a. Incubation: Interval between entrance of pathogen into body and appearance of
first symptoms (e.g., chickenpox, 14 to 16 days after exposure; common cold, 1 to
2 days; influenza, 1 to 4 days; measles, 10 to 12 days; mumps, 16 to 18 days;
Ebola 2 to 21 days (CDC, 2015b).
b. Prodromal: Interval from onset of nonspecific signs and symptoms (malaise, low-
grade fever, fatigue) to more specific symptoms. (During this time
microorganisms grow and multiply, and patient may be capable of spreading
disease to others.) For example, herpes simplex begins with itching and tingling
at the site before the lesion appears.
c. Illness Stage: Interval when patient manifests signs and symptoms specific to type
of infection. For example, strep throat is manifested by sore throat, pain, and
swelling; mumps is manifested by high fever, parotid and salivary gland swelling.
d. Convalescence: Interval when acute symptoms of infection disappear. (Length of
recovery depends on severity of infection and patient's host resistance; recovery
may take several days to months.)
2. What are the normal levels of WBCs in the blood?
a. 5,000 to 10,000 mm3 but typically rises to 15,000 to 20,000 mm3 and higher
during inflammation. Fever is caused by phagocytic release of pyrogens from
bacterial cells, which causes a rise in the hypothalamic set point.
3. How does the nurse teach patients about infection control?
a. Keep it dry
b. Change dressing
c. Adequate diet
d. Hydration
e. Shower but no bath
4. Risk factors for patients with pneumonia
a. Age
b. Heart failure
c. Dysphagia
d. Immobility
e. smokers
f. Smokers
g. Immunocompromised
5. How to assess pulse?
a. Palpate bilaterally except for carotid artery
6. Rate for pulses: 60-100 bpm
7. A patient wound has become infected, what does the nurse do?
a. Assess white blood cells
b. Temperature
c. Fever
d. Erythema or redness
e. Swelling
8. Critical thinking
Page 1 of
,FINAL EXAM- NR224
a. Basic critical thinking is concrete and based on a set of rules or principles, such
as the guidelines in a hospital procedure manual. The nurse’s approach is not
accurate, as accuracy requires use of all of the facts (e.g. the patient’s
discomfort). A critical thinker is willing to take risks in trying different ways to
solve problems; following one basic approach is not risk taking. This is also not
an example of reflection.
b. Discipline is being thorough in whatever you do. Using known criteria for
assessment and evaluation, as in the case of pain, is an example of discipline
c. The correct order of the steps of the scientific method are: 1. Identifying the
problem, 2. Collecting data, 3. Formulating a question or hypothesis, 4.
Testing the question or hypothesis, and 5. Evaluating results of the test or
study.
d. The nurse relies on experience and the ability to adapt a procedure such as a
dressing change (complex critical thinking) to make it successful.
e. A nurse’s specific knowledge base will vary but includes basic nursing education,
continuing education courses, and additional college degrees. In addition, it
includes the knowledge gained from a nurse reading the nursing literature, and
acquiring information and theory from the basic sciences, humanities, behavioral
sciences, and nursing. Nurse’s knowledge base also involves a different way of
thinking holistically about patient problems.
f. Reflection, using a pain rating scale to be precise and specific, and nursing
assessment (the first step of the nursing process) are examples of critical thinking
skills. Explaining a procedure based on policy is not critical thinking – however
performing a procedure following policy is basic critical thinking. Offering
support to a colleague is an important way to assist another in managing stress but
is not a critical thinking skill.
g. Diagnostic reasoning begins when you interact with a patient or make physical or
behavioral observations. An expert nurse sees the context of a patient situation
(e.g., Patient lives alone, has fallen in past, observes patterns and themes and
makes a diagnostic decision
h. Critical thinking is a continuous process characterized by open-mindedness,
continual inquiry, and perseverance, combined with a willingness to look at
each unique patient situation and determine which identified assumptions are
true and relevant (Heffner and Rudy, 2008).
i. Critical thinking encompasses the following: Recognizing that an issue
exists, analyzing information, evaluating information, and making
conclusions (Settersten and Lauer, 2004).
j. Nurses who apply critical thinking in their work focus on options for solving
problems and making decisions rather than rapidly and carelessly forming quick,
simple solutions.
k. Critical Thinking Skills:
i. •Interpretation: Be orderly in data collection. Look for patterns to
categorize data (e.g., nursing diagnoses [see Chapter 17]). Clarify any data
you are uncertain about.
Page 2 of
, FINAL EXAM- NR224
ii. •Analysis: Be open-minded as you look at information about a patient.
Do not make careless assumptions. Do the data reveal what you believe is
true, or are there other options?
iii. •Inference: Look at the meaning and significance of findings. Are there
relationships between findings? Do the data about the patient help you see
that a problem exists?
iv. •Evaluation: Look at all situations objectively. Use criteria (e.g., expected
outcomes, pain characteristics, learning objectives) to determine results of
nursing actions. Reflect on your own behavior.
v. •Explanation: Support your findings and conclusions. Use knowledge and
experience to choose strategies to use in the care of patients.
vi. •Self-regulation: Reflect on your experiences. Identify ways that you can
improve your own performance. What will make you believe that you
have been successful?
9. Levels of critical thinking
a. Level 1 is Basic: At the basic level, nurses think concretely on the basis of a set
of rules or principles, following a step-by-step process without deviation from the
plan. Following a procedure step by step without adjusting to a patient’s unique
needs is an example of basic critical thinking.
b. •Level 2 is Complex: Complex critical thinking analyzes and examines choices
independently. Nurses learn to think beyond and synthesize knowledge. In
complex critical thinking, a nurse learns that alternative and perhaps
conflicting solutions exist.
c. •Level 3 is Commitment: Commitment is the third level of critical
thinking. Nurses anticipate needs and make choices without assistance
from others.
10. Five componentsof critical thinking
a. •Level 1 is Basic: At the basic level, nurses think concretely on the basis of a set
of rules or principles, following a step-by-step process without deviation from the
plan. Following a procedure step by step without adjusting to a patient’s unique
needs is an example of basic critical thinking.
b. Level 2 is Complex: Complex critical thinking analyzes and examines choices
independently. Nurses learn to think beyond and synthesize knowledge. In
complex critical thinking, a nurse learns that alternative and perhaps conflicting
solutions exist.
c. •Level 3 is Commitment: Commitment is the third level of critical thinking.
Nurses anticipate needs and make choices without assistance from others.
11. Critical Thinking Attitudes that a nurse needs: See Table 15-3, p. 200)
a. Confidence
b. Independence
c. Fairness
d. Responsibility
e. Risk taking
f. Discipline
Page 3 of
FUNDAMENTALS
1. Infectious disease stages:
a. Incubation: Interval between entrance of pathogen into body and appearance of
first symptoms (e.g., chickenpox, 14 to 16 days after exposure; common cold, 1 to
2 days; influenza, 1 to 4 days; measles, 10 to 12 days; mumps, 16 to 18 days;
Ebola 2 to 21 days (CDC, 2015b).
b. Prodromal: Interval from onset of nonspecific signs and symptoms (malaise, low-
grade fever, fatigue) to more specific symptoms. (During this time
microorganisms grow and multiply, and patient may be capable of spreading
disease to others.) For example, herpes simplex begins with itching and tingling
at the site before the lesion appears.
c. Illness Stage: Interval when patient manifests signs and symptoms specific to type
of infection. For example, strep throat is manifested by sore throat, pain, and
swelling; mumps is manifested by high fever, parotid and salivary gland swelling.
d. Convalescence: Interval when acute symptoms of infection disappear. (Length of
recovery depends on severity of infection and patient's host resistance; recovery
may take several days to months.)
2. What are the normal levels of WBCs in the blood?
a. 5,000 to 10,000 mm3 but typically rises to 15,000 to 20,000 mm3 and higher
during inflammation. Fever is caused by phagocytic release of pyrogens from
bacterial cells, which causes a rise in the hypothalamic set point.
3. How does the nurse teach patients about infection control?
a. Keep it dry
b. Change dressing
c. Adequate diet
d. Hydration
e. Shower but no bath
4. Risk factors for patients with pneumonia
a. Age
b. Heart failure
c. Dysphagia
d. Immobility
e. smokers
f. Smokers
g. Immunocompromised
5. How to assess pulse?
a. Palpate bilaterally except for carotid artery
6. Rate for pulses: 60-100 bpm
7. A patient wound has become infected, what does the nurse do?
a. Assess white blood cells
b. Temperature
c. Fever
d. Erythema or redness
e. Swelling
8. Critical thinking
Page 1 of
,FINAL EXAM- NR224
a. Basic critical thinking is concrete and based on a set of rules or principles, such
as the guidelines in a hospital procedure manual. The nurse’s approach is not
accurate, as accuracy requires use of all of the facts (e.g. the patient’s
discomfort). A critical thinker is willing to take risks in trying different ways to
solve problems; following one basic approach is not risk taking. This is also not
an example of reflection.
b. Discipline is being thorough in whatever you do. Using known criteria for
assessment and evaluation, as in the case of pain, is an example of discipline
c. The correct order of the steps of the scientific method are: 1. Identifying the
problem, 2. Collecting data, 3. Formulating a question or hypothesis, 4.
Testing the question or hypothesis, and 5. Evaluating results of the test or
study.
d. The nurse relies on experience and the ability to adapt a procedure such as a
dressing change (complex critical thinking) to make it successful.
e. A nurse’s specific knowledge base will vary but includes basic nursing education,
continuing education courses, and additional college degrees. In addition, it
includes the knowledge gained from a nurse reading the nursing literature, and
acquiring information and theory from the basic sciences, humanities, behavioral
sciences, and nursing. Nurse’s knowledge base also involves a different way of
thinking holistically about patient problems.
f. Reflection, using a pain rating scale to be precise and specific, and nursing
assessment (the first step of the nursing process) are examples of critical thinking
skills. Explaining a procedure based on policy is not critical thinking – however
performing a procedure following policy is basic critical thinking. Offering
support to a colleague is an important way to assist another in managing stress but
is not a critical thinking skill.
g. Diagnostic reasoning begins when you interact with a patient or make physical or
behavioral observations. An expert nurse sees the context of a patient situation
(e.g., Patient lives alone, has fallen in past, observes patterns and themes and
makes a diagnostic decision
h. Critical thinking is a continuous process characterized by open-mindedness,
continual inquiry, and perseverance, combined with a willingness to look at
each unique patient situation and determine which identified assumptions are
true and relevant (Heffner and Rudy, 2008).
i. Critical thinking encompasses the following: Recognizing that an issue
exists, analyzing information, evaluating information, and making
conclusions (Settersten and Lauer, 2004).
j. Nurses who apply critical thinking in their work focus on options for solving
problems and making decisions rather than rapidly and carelessly forming quick,
simple solutions.
k. Critical Thinking Skills:
i. •Interpretation: Be orderly in data collection. Look for patterns to
categorize data (e.g., nursing diagnoses [see Chapter 17]). Clarify any data
you are uncertain about.
Page 2 of
, FINAL EXAM- NR224
ii. •Analysis: Be open-minded as you look at information about a patient.
Do not make careless assumptions. Do the data reveal what you believe is
true, or are there other options?
iii. •Inference: Look at the meaning and significance of findings. Are there
relationships between findings? Do the data about the patient help you see
that a problem exists?
iv. •Evaluation: Look at all situations objectively. Use criteria (e.g., expected
outcomes, pain characteristics, learning objectives) to determine results of
nursing actions. Reflect on your own behavior.
v. •Explanation: Support your findings and conclusions. Use knowledge and
experience to choose strategies to use in the care of patients.
vi. •Self-regulation: Reflect on your experiences. Identify ways that you can
improve your own performance. What will make you believe that you
have been successful?
9. Levels of critical thinking
a. Level 1 is Basic: At the basic level, nurses think concretely on the basis of a set
of rules or principles, following a step-by-step process without deviation from the
plan. Following a procedure step by step without adjusting to a patient’s unique
needs is an example of basic critical thinking.
b. •Level 2 is Complex: Complex critical thinking analyzes and examines choices
independently. Nurses learn to think beyond and synthesize knowledge. In
complex critical thinking, a nurse learns that alternative and perhaps
conflicting solutions exist.
c. •Level 3 is Commitment: Commitment is the third level of critical
thinking. Nurses anticipate needs and make choices without assistance
from others.
10. Five componentsof critical thinking
a. •Level 1 is Basic: At the basic level, nurses think concretely on the basis of a set
of rules or principles, following a step-by-step process without deviation from the
plan. Following a procedure step by step without adjusting to a patient’s unique
needs is an example of basic critical thinking.
b. Level 2 is Complex: Complex critical thinking analyzes and examines choices
independently. Nurses learn to think beyond and synthesize knowledge. In
complex critical thinking, a nurse learns that alternative and perhaps conflicting
solutions exist.
c. •Level 3 is Commitment: Commitment is the third level of critical thinking.
Nurses anticipate needs and make choices without assistance from others.
11. Critical Thinking Attitudes that a nurse needs: See Table 15-3, p. 200)
a. Confidence
b. Independence
c. Fairness
d. Responsibility
e. Risk taking
f. Discipline
Page 3 of
