[Music] hi guys it's me professor D and welcome back to my channel on this video I want to cover the nursing process and critical thinking and guys this is what all of your test questions are based on so that's what I'm going to be covering in this video if you have not done so already please be sure to press that like and subscribe button below that will keep those videos in the content going so let's just jump right into it first question the nurse decides to administer tablets of Tylenol instead of the intramuscular Demerol she has previously been providing her orthopedic client which step of the nursing process does this address one assessment two nursing diagnosis three planning or four implementation now give you a moment to think about your answer and guys the correct answer is for implementation whenever a nurse is performing an action she's doing something that is implementation remember add PI ADP ie a is your assessment assessment is gathering information anything that gets you information whether that's doing a physical assessment looking at the patient whether it's going through the chart to get information asking the patient a question or family members a question anything that gives you information that is part of the assessment - nursing diagnosis guys nursing diagnosis is based on the medical diagnosis so let me give you example if the patient has a medical diagnosis of asthma okay the nursing diagnosis is the patient's reaction to the medical diagnosis so the patient has asthma your nursing diagnosis can be impaired gas exchange okay your nursing diagnosis is always going to be the patient's action to the medical diagnosis then you have three planning planning is deciding what you're going to do for that patient what you want the goals for that patient to be what you want the outcome to be that is planning and then of course implementation which I explained to you already implementation is the action what the patient what the nurse is doing for the patient next question the nurse has a multiple client assignments on the surgical unit on beginning the shift the nurse needs to determine which post-operative client should be seen first of the following the nurse should should go to see the client who one has a documented blood pressure of 90 over 52 was medicated for back pain 10 minutes ago 3 has in order to be out of bed and ambulating or 4 requires instructions from wound care before discharge and I'll give you a moment to think about your answer and guys the correct answer is one that patient has a blood pressure of 90 over 50 please if you have not already watched my video on priority make sure you watch that the priority video covers which patients you have to see first who's I don't want to say most important but which patient is going to be a priority and number one is an example of that priority patient okay 90 over 50 that blood pressures too low okay and patient's blood pressure is part of what physiologic integrity remember anything that affects the patient's physiologic integrity they're who you're going to be running to first because physiologic integrity is what's keeping that patient alive blood pressure fluid and electrolytes nutrition airway breathing circulation the list goes on make sure you guys watch that video if you feel like you don't know the priority patients too well so number one that blood pressure 90 over 50 that's who you're running to and they even gave you a hand in the question they told you the patient just came from surgery let me explain to you any patient that comes from surgery you have three concerns that you're going to be watching out for the most number one bleeding that patient hemorrhaging out guess what that blood pressure of 90 over 50 possibly that patient can be bleeding that's why their blood pressures going down okay what else are we worrying about the post-op patient besides bleeding infection we're gonna be looking at those WBC's we're gonna be watching out for scientists symptoms of infection and the third concern any patient who had surgery we're concerned about them developing clots DVTs right that's why it's so important for us to get that patient out of bed we want them to have circulation we want blood moving so they don't get DVT okay so infection bleeding and DVT are three biggest concerns for patient that just had surgery next question which of the following is the best example of a nurses use of reflection one the nurse places our client experiencing respiratory difficulties in the high follows position two the nurse calls the provider when the client reports feeling childen achy while having an oral temperature of 100 point two three while caring for a client with a history of asthma the nurse assesses the clients pulse-ox reading when he doesn't sound right or for a nurse tells a client when you refuse to go to physical therapy earlier today I believe you were upset about something else besides the appointment time I'll give you a moment to think about your answer [Music] and the correct answer is for reflection guides is when you go back to a moment in time you you repeats a patient something that happened and you allow them that time to think about it into answer so the patient's reflecting about something that happened earlier the patient was upset earlier and then nurse is noting hey I noticed you were said earlier but it kind of seemed like you're upset about something else and the nurse is quiet being quiet that quiet that time of quiet that's the foremost therapeutic communication because you're allowing that pace of time to kind of think about their feelings and to verbalize an answer so number four is a correct answer when you're thinking back when you're going thinking back to get a deeper understanding that's what reflection it next question which of the following nursing situations best reflects accountability one the nurse takes oncology nursing certification exam two the nurse thousand incident report regarding a medication error three the nurse assesses the client for possible cause of his pain for the nurse tells the client I don't know but I will find out for you and the correct answers to the nurse files an incident report regarding medication error that is that nurse taking accountability for their actions they taking responsibility okay now let me talk to you guys about incident reports because there's some couple things that are very important that you guys have to know number one the incident report never ever ever ever ever look at me my eyeballs while I tell you this so you can understand and never forget never goes in the patient's chart do you hear me incident report is for the facility okay it goes in a different book it's for the facility so that they can find know what the mistake was and they can start creating measures so it doesn't happen again okay an incident report should never even be mentioned in the patient's chart okay you guys follow me because I promise that's gonna be a test questions make sure you guys understand that so incident report that's the patient taking that's excuse me the nurse being accountable for her actions but something very important you have to remember about the into the report it's for the facility it does not go into the patient's chart and I cannot stress that enough next question which of the following nursing actions is of the best example of problem solving one requesting an IV team to start an antibiotic drip on the client with a history of being a difficult stick to offering to call the kitchen to provide an alternate breakfast for a client who does not like cook cereal three try several different wound dressings to determine which one the client can apply the most effectively or for calling another pain medic calling for another pain medication order when the current drug results in the client experiencing nausea let me reread that because it sounded weird number four calling for another pain medication order when the current drug results in the client experiencing nausea and I'll give you a moment to think about your answer and the correct answer is three trying several different wound dressings to determine which one the client can apply most effectively problem solving is trying different things to figure out what works and then using what works so that's what problem solving is you don't pass the buck you pass it on to somebody else to do your job for you problem solving is trying you keep trying different things to see which one works and you stick to what works next question which of the following nursing interventions is the best example of the implementation step of the nursing process one determining the clients ankle edema is worse after he ambulate s' two asking the client to rate his ankle pain after receiving oral pain medication three arranging for the client to receive pain medication 30 minutes before his ordered ambulation or for crushing the clients pain medication to facilitate easier swallowing and thus minimizing the risk for choking and the correct answer is for crushing the clients pain medication remember as I told you guys before implementation is action that's what you're doing for the patient if you guys take a look at number one in to determining asking those are what assessment anything that gathers information for you is part of the assessment number three arranging for the client to receive pain medication that's planning your planning what you're going to do for that patient so number four are crushing that's the action you're actually doing something for the patient and that is what implementation is next question a clinical nursing instructor as the nursing student to describe a critical thinker which of the following represents the best response one a person with the education educational background to solve problems to a person who finds the problem and does what it takes to fix it three it's someone who uses a scientific method to solve problems or for someone who uses a system to work through and solve a problem and the correct answers to a person who finds the problem and does what is best to fix it right and as nurses how do we do that ad pi okay the first thing we do is assess we get information to find out what is going on with that patient then we come up with our nursing diagnosis we use the information from the assessment to figure out what is wrong how is the body reacting to the medical diagnosis then is your P planning what is our outcome what do we want to see happen with this patient what are our goals for this patient right then you have your I implementation actually carrying out the plan that's the action what are you doing for this patient that was based on your plan and then finally e evaluation whatever you do whatever your implementation is you always have to go back and see if it worked because if it worked great we're gonna keep monitoring the patient but if it didn't work you're going right back to a assessment and you're starting all over again okay so that's why the correct answer is to a person who finds a problem and does what is best to fix it and our very last question which of the following statements are made by the nurse regarding a personal reflection related to client care requires follow-up by the units nurse manager one Mary and I were comparing foot wound dressing techniques to I've been caring for orthopedic clients for ten years and I think I've seen at all three I can't believe that my client isn't improving after two weeks of physical therapy for I always win my orthopedic surgery clients on to oral pain medications on post-op day number four and I'll give you a moment to think about your answer and guys the correct answer is four because what they're asking us is which one is wrong and number four is wrong I always leave my orthopedic surgery clients well guys if you guys don't understand why I just said always make sure you watch my video on how to answer questions that you have no idea what the answers are okay and I'll just give you a little snippet you stay away from those answers that's say always never only those all-inclusive answers you stay away from those aren't going usually wrong and this questions asking us which one is wrong and it's number four the nurse says that she always medicates her patients on swings her patients off of the medications on day four here's a problem with that everybody's not the same one person's body reacts differently than another person's beat the body so you're not supposed to always do the same thing that's why we have the nursing process that's why you have to assess your patient right because the information you get from that assessment may be that patient needs to be weaned off on day two instead of day four maybe that patient needs to be weaned off day six instead of day four you're not going to know that unless you follow the nursing process which starts by assessment so that's why that's the wrong answer you don't treat all your patients the same absolutely not guys make sure you watch that video on how to answer nursing questions if you have no clue what the answer is it's very informative and I believe it's gonna help you I hope this video was helpful to you if it was please be sure to leave a comment and also comment on any content that you'd like me to cover and clarify for you please do not forget to press that like and subscribe button thank you so much for joining me and I'll see you next time you