A nurse is caring for a patient in a long-term care facility who ...

[P68T]

A nurse is caring for a patient in a long-term care facility who has not been sleeping well. She notes that the patient is new to the facility, has been refusing therapy, and is also not eating well.
 
  The nurse interprets this to mean that the patient has been having trouble adjusting. The nurse decides to meet with the patient's care team. The team decides to assess the patient's willingness to participate in group recreational activities, The patient agrees to participate. After 1 week, the nurse reevaluates the plan of care and notes that the patient has been sleeping much better. Which of the following terms best describe processes used in the nurse's plan? (Select all that apply.)
  a. Clinical judgment
  b. Evidence-based practice
  c. The nursing process
  d. Collaborative care planning
  e. Positive reward process

Question 2

A new nurse appears to be second-guessing herself and is constantly calling on the other nurses to double-check their plan of care or rehearse what they will say to the doctor before she call on the patient's behalf.
 
  This seems to be annoying some of the nurse's coworkers. What is the nurse manager's best response?
  a. Explain to coworkers that this is a characteristic of critical thinking and is important for the new nurse to improve reasoning skills.
  b. Agree with the staff and have someone follow and work more closely with a preceptor.
  c. Have a talk with the nurse and suggest asking fewer questions.
  d. Tell the staff that all new nurses go through this phase, and ignore their behavior.

[Laurenleakan]

Answer to Question 1

ANS: A, C, D
Clinical judgment is a reflective process by which the nurse notices, interprets, responds, and reflects in action. The nursing process is a process by which the nurse assesses, diagnoses, implements, and evaluates the nursing care plan. Consulting and gaining input from the healthcare team is collaborative care planning. Evidence-based practice refers to using interventions found in research studies. The positive reward process is not a term used in care planning.

Answer to Question 2

ANS: A
Reflection-on-action is critical for development of knowledge and improvement in reasoning. It is where learning from practice is incorporated into experience. Inquisitiveness is a characteristic of critical thinking and reflects a desire to learn even when the knowledge may not appear readily useful. The manager should promote this. Suggesting the nurse work more closely with a preceptor implies that the manager thinks the nurse needs to learn more and increase confidence. In reality, this nurse is demonstrating a characteristic of critical thinking. Suggesting that the nurse ask fewer questions would hamper the development of the nurse as a critical thinker. All new nurses do go through a phase of asking more questions at one time, but dismissing the nurse's behavior with this explanation is simplistic and will discourage critical thinking.

[P68T]

TYSM

[CAPTAINAMERICA]

Excellent