Deck 4: Competencies for Professional Nursing Practice

Question 1

You are assigned to care for Ms. C., an 81-year-old patient who was admitted today with symptoms of increasing shortness of breath over the last week. She is currently receiving oxygen through a nasal cannula at 3 L/min. You go into the room to assess her. You find that she is sitting up in bed at a 60-degree angle. She is restless and her respirations appear labored and rapid. Her skin is pale with circumoral cyanosis. You ask if she feels more short of breath. Because she is unable to catch her breath enough to speak, she nods her head yes. Which action should you take first?
Listen to her breath sounds.
Ask when the shortness of breath started.
Increase her oxygen flow rate to 6 L/min.
Raise the head of the bed from 75 to 85 degrees
Based on knowledge you have learned, you realize the patient's symptoms indicate acute hypoxemia, so improving oxygen delivery is the priority. The other actions also are appropriate, but they are not as critical as the initial action.

Answer 1

In this scenario, the first action you should take is to listen to Ms. C.'s breath sounds. This immediate assessment will provide crucial information about her respiratory status and help determine the underlying cause of her increased shortness of breath. Breath sounds can reveal the presence of fluid, wheezing, or other abnormalities that may require urgent intervention.
While increasing the oxygen flow rate may seem like an appropriate response to her symptoms of acute hypoxemia, it is essential to assess her breath sounds before making any changes to her oxygen therapy. This is because increasing the oxygen flow rate without proper assessment could potentially lead to oxygen toxicity or worsen underlying conditions such as carbon dioxide retention in patients with chronic obstructive pulmonary disease (COPD).
After assessing her breath sounds, you can then determine the most appropriate next steps, which may include adjusting her oxygen therapy, raising the head of the bed to improve ventilation, or seeking additional medical interventions based on the findings of your assessment.
It is also important to monitor her vital signs, provide reassurance, and stay with her while awaiting further orders from a healthcare provider. If her condition appears to be deteriorating rapidly, you should call for immediate medical assistance.

Question 2

What do all of the following scenarios have in common?
An elderly male becomes acutely confused and refuses to follow directions for his safety.
A teen comes into an urgent care setting requesting information about sexually transmitted infections.
A mother visits a school nurse and requests information about how the school handles sex education.
A team leader needs to rearrange assignments when one team member goes home sick.
Nursing staff in an intensive care unit need to develop an evacuation plan.

Answer 2

All of the scenarios listed involve communication and the need for clear information exchange in healthcare or educational settings. Here's what they have in common:
1. **The need for effective communication:** Each scenario requires the individuals involved to communicate effectively to achieve a desired outcome, whether it's managing a patient's acute confusion, discussing sensitive health information, understanding school policies, adjusting work assignments, or planning for emergencies.
2. **Health and safety considerations:** Each scenario has an underlying focus on health and safety, from the immediate health of an elderly patient and the prevention of sexually transmitted infections to the broader concerns of sex education in schools, maintaining team functionality in the workplace, and preparing for potential crises in a healthcare facility.
3. **Adaptability and problem-solving:** The situations call for adaptability and problem-solving skills. Whether it's dealing with an unexpected behavioral issue, addressing a teen's health concerns, discussing educational content with a parent, rearranging work due to staff illness, or developing an emergency plan, each scenario requires a tailored approach to solve the problem at hand.
4. **Educational and informational needs:** In several scenarios, there is a need to provide or request information for educational purposes, such as learning about sexually transmitted infections, understanding sex education policies, or creating an evacuation plan.
5. **Collaboration and teamwork:** Except for the individual teen's request, all other scenarios involve multiple people and require teamwork and collaboration to address the situation effectively. This includes working with family members, school staff, work colleagues, or a team of healthcare professionals.
In summary, these scenarios are connected by the themes of communication, health and safety, adaptability, education, and collaboration, all of which are crucial in effectively managing diverse situations in healthcare and educational environments.

Question 3

You will be taking care of a patient in a nursing home for the first time. Your assignment is to care for an older man who has heart disease. In addition, he has five other medical problems and takes 20 medications. While developing a plan of care for this patient, you can identify 8 to 10 nursing problems. You have no previous experience with nursing homes, and most of what you have heard and read about them is negative. Will you find yourself dreading the clinical day and expecting a negative experience before you even begin?

Answer 3

It is natural to feel some apprehension and uncertainty when faced with a new and challenging clinical assignment, especially when it involves caring for a patient with multiple medical problems and complex medication management. However, it is important to approach the situation with an open mind and a willingness to learn and adapt.

Instead of dreading the clinical day and expecting a negative experience, it would be more beneficial to focus on the opportunity to gain valuable experience and knowledge in caring for a patient with complex health needs. By approaching the assignment with a positive attitude and a willingness to learn, you can turn this potentially daunting experience into a valuable learning opportunity.

It may also be helpful to seek guidance and support from experienced colleagues or mentors in the nursing home setting. They can provide valuable insights and tips for managing the care of a patient with multiple medical problems and complex medication regimens. Additionally, taking the time to familiarize yourself with the nursing home's policies and procedures, as well as the specific needs and preferences of the patient, can help you feel more prepared and confident in your ability to provide quality care.

Overall, while it is natural to feel some apprehension about a new and challenging clinical assignment, approaching it with a positive attitude, a willingness to learn, and seeking support from experienced colleagues can help alleviate any negative expectations and turn the experience into a valuable learning opportunity.

Question 4

Think about a clinical experience that was troubling to you. Reflect on what bothered you about the experience. What could you have done differently? What were the reasons behind your actions? Try to create and clarify meaning or a new understanding of the particular situation.

Question 5

Beginning nursing students often tend to focus primarily on their routines, including to get their list of tasks done, including assessments, ordered treatments, daily care, and charting. What if an unexpected situation occurred during the day? Do you think you would be able to reason, plan, and take appropriate action-think critically?

Question 6

Which of the following should a nurse meeting the Nurse of the Future: Nursing Core Competencies manifest?

A) Professionalism
B) Patient-centered care
C) Systems-based practice
D) Teamwork and collaboration
E) All of these are correct.

Question 7

Which competency was identified during the Quality and Safety Education for Nurses (QSEN) project?

A) Patient-centered care
B) Informatics
C) Safety
D) Quality improvement
E) All of these are correct.

Question 8

The KSA in the QSEN Project and Nurse of the Future Model reflect learning domains including which of the following?

A) Cognitive
B) Psychomotor
C) Affective
D) All of these are correct.

Question 9

The statement, "The Nurse of the Future will demonstrate accountability for the delivery of standard-based nursing care that is consistent with moral, altruistic, legal, ethical, regulatory, and humanistic principles" best reflects which competency?

A) Professionalism
B) Leadership
C) Communication
D) Patient-centered care
E) Teamwork and collaboration

Question 10

Which of the following behaviors of the nurse demonstrates clinical judgment?

A) Critical thinking
B) Problem solving
C) Ethical reasoning
D) Decision making
E) All of these are correct.

Question 11

The nurse who is administering medications should take measures to avoid interruptions to prevent which type of error?

A) Skill-based
B) Rule-based
C) Knowledge-based
D) All of these are correct.
E) None of these is correct.

Question 12

Which description best illustrates Tanner's conclusions about thinking like a nurse?

A) It should occur as a detached objective exercise.
B) It is a form of engaged moral reasoning.
C) It is most influenced by objective data about the situation.
D) All of these are correct.
E) None of these is correct.

Question 13

The student nurse develops a visual representation of the relationships among concepts related to the physiologic manifestations observed in the care of the patient in the clinical setting. What is the name of this technique?

A) Journaling
B) Concept mapping
C) Reflection
D) All of these are correct.
E) None of these is correct.

Question 14

Which of the following characteristics is indicative of critical thinking?

A) Critical thinking is rational and reasonable.
B) Critical thinking requires reflection.
C) Critical thinking is based on preferences.
D) Critical thinking requires reflection and is based on preferences.
E) Critical thinking is rational and reasonable and requires reflection.

Question 15

Which of the following characteristics is observed in nurses who are critical thinkers?

A) Inflexible
B) Tend to oversimplify
C) Empathetic
D) Tend to base judgments on personal feelings
E) None of these is correct.