hi guys it's me Professor D and welcome back to my YouTube channel on this video I'm going to be covering critical thinking and health assessment so this is a great video for the new nursing students who are just getting in Fundamentals of Nursing this is going to help you a lot if you've graduated already you're studying for your boards well this is bringing you back to the basics because you need these Basics this is your foundation right for answering lots of test questions so I think this video is going to be very beneficial to you now before we get started I'm going to ask you please if you feel like my Channel or my videos have brought some substance to your life it's helped you in some way I'm asking you to please help support me and help support my channel how can you do this like this video You're Gonna Love It Go ahead and like this video now subscribe to my channel if you haven't done so already share one of my videos with a friend a co-worker a colleague a nursing instructor share it on your social media profile if you can don't forget I have audio lessons available for you on my website nexusnursing Institute com and also almost daily you can catch recovering a variety of nursing questions on my other social media platforms such as Tick Tock Instagram and Facebook all right guys before we get started I want to start off with a prayer if you're not into that that's fine just fast forward if you are Close Your Eyes by your head father God thank you Lord thank you Jesus for all that you've done for us thank you for waking us up this morning thank you for the breath of life in our bodies thank you for the health of our children our parents our loved ones those who are supporting us and rooting us on and encouraging us not to give us give up thank you for that father God lord we ask for forgiveness for our sins each and every one of us father God we know we fall short of your glory but Lord we tell you thank you Jesus that the minute we ask for forgiveness it's already been given we don't have to live in condemnation we don't have to be kicking ourselves for our mistakes thank you for that father God Lord I'm asking you please we're about to go over this information father God I pray for every viewer that's watching this Lord what whatever the reason is that they came to watch this video I asked let you please help them help them to understand this information father God help them to retain this information Jesus Christ father God when they're studying Lord help them to retain the information that they're learning and be able to think critically through them and answer the questions appropriately father God each and every person that's watching Lord I also pray for their support system the people who are helping them to continue and not give up I pray that you bless them Father God and encourage them Lord and these students who are watching these videos Lord move those obstacles out of their way father God those barriers that are keeping them from succeeding Lord I ask that you please remove them and you bless them Father God and you help them to be a blessing to others father God allow them to use that license to be a blessing to others and let your light shine through them every single day every single moment father God thank you for this gift that you've given me Jesus that I'm able to explain this information in a way that seems to ReSound with the viewers father God that they seem to be able to understand this information father God I ask that you come you continue to speak through me and let it not be me going over this information and pouring into these students Let It Be You Lord just use me as a vessel to do this Lord I Thank you I praise your name and I give you all the glory for everything you've done for us and that you will continue to do for us in Jesus Christ we pray amen all right guys sorry I know that prayer was kind of long but it is what it is let's get started first question the process by which a nurse uses purposeful thinking informed reasoning Reflections and thinking about clinical situations is called a clinical judgment commit be critical thinking see decision making or D problem solving what do you guys think and guys the correct answer is critical thinking this is informed reasoning guys this is not being a robot this is using the information that you learned from research or your textbook and also using um experience that you can draw from to getting a conclusion and not being a robot and being rigid and staying within a box that's critical thinking now let's look at the wrong answer choices we have one clinical judgment that's using your nursing experience to figure out what your next assessment or your next intervention is going to be guess what that's part of critical thinking but critical thinking encompasses so much more Troy C decision making that's actually using the scientific um process to um come to a con to come to a conclusion to figure out what your next nursing assessment or your intervention is going to be that's part of critical thinking but it does encompass all of critical thinking Choice D problem solving that's focusing on like one specific problem that's zeroing in on the problem and looking for a resolution but critical thinking encompasses so much more you're not being a robot you're using um you're using um what's what I'm looking for you're using reasoning you're using your clinical experience you're using what you learn in the textbook you're putting it all together for it to make sense to help your patient because that's the thing of when it comes to um critical thinking every patient is different so you cannot be rigid you have to be able to be flexible because patients are all different they're all unique they're all complex all right so guys the correct answer is critical thinking do not be a robot I cannot stress this enough all right next question it's crucial for the nurse to be able to make sound decisions using critical thinking because a is the most efficient use of the nurse's time and resources B it uses previously learned knowledge and predictable situations see most clients have problems which there are no textbook answers or D nurses can recognize problems rapidly and provide Speedy responses to situations what do you guys think what's the answer and guys the correct answer is C most clients have problems for Rich for which there are no textbook answers and that's why you can't be a robot you have to be able to think outside the box you have to be able to be flexible because each patient they're unique they're complex so you're hardly ever going to get an exact situation in real life guys that you see in the textbook let's look at the wrong answer choices a it's the most efficient use of the nurse's time and resources stop right there when it comes to testing and I keep telling you guys it's because it's true the right answer is never going to be the answer where you're concerned about time money resources staff equipment forget about it in the testing world it's a perfect world so one's false two it uses previously learned knowledge in predictable situations again the whole point of critical thinking is understanding that patients are not going to be predictable they're not going to be the same they are unique they are complex so you have to learn how to bend and be flexible and think outside of the box it's not going to be concrete okay nursing students and nursing students you guys always want everything black and white and that's why you get so upset with these test questions right because you'll choosing answer choices you're trying to fight with your instructor says well the book says this and because the correct answer Choice was one word off you're all freaked out but that is how to be able to think critically everything's not always going to be exact and precise I know you're gonna I know you don't want to hear it but that's the truth that's what it is Choice D nurses can recognize problems uh rapidly and provide Speedy responses to situations this is important this is important we need this but it doesn't answer our question that is not why we use critical thinking you see how Choice D is such a beautiful answer Choice what did I tell you about the beautiful answer choices go back and see if it answers our question and our ad questions asking us why is it crucial to use critical thinking and the correct answer is because you're not always going to get that textbook answer you have to always think outside of the box you have to be willing to be flexible choice is a correct answer next question a nurse with a six years labor and delivery experience is floated to the Intensive Care Unit in this situation the nurse will most likely function at the level of a advanced beginner be competent C novice or C proficient deep proficient what do you think I think and guys the correct answer is C novice look how they tried to throw you off because they told you this patient this person has been a nurse for six years okay great but where they've been working for six years labor and delivery now they're being floated to ICU I've told you guys this a million times I I don't care how long the person's been a nurse if they are floating to a new floor that they have no experience as you're going to treat them the same as you would in LPN which means you're going to give them the most stable patient they're still a registered nurse they can still provide care for the patient but you're going to give them the most stable patient because you're going to consider them as what a new grad an LPN you're going to give them the most stable patient and guys I say this as an LPN because I keep talking about this because I still feel some type of way that somebody got their panties in a bunch and wrote a whole book in my comment section about how I'm being disrespectful to the LPNs I am not the reason I'm telling you treat them as an LPN is because I want you to get it right on test questions the same way I teach you to um when it comes to LPNs you're going to give them the most stable patient when it comes to new grads you're going to give them the most stable patient that's what I mean I'm not being disrespectful to the LPNs I just want you guys to get the correct answer right and so that's how you have to think when you have a new RN excuse me not urine when you have an experienced RN but they're floating to the new floor just like you would give the LPN the most stable patient just like you would give a new grad the most stable patient you're going to give that RN the most stable patient even though they've had 20 years of experience they've had 20 years of experience somewhere else not on your floor there haven't had any experience um caring for your type of patients right and so that's why C is the correct answer a novice nurse let's look at the wrong answer choices a advanced beginner so an advanced beginner is a nurse that has a very they're brand new nurse basically they're brand new alerts they have a little experience to draw on they've been a nurse for less than a year a year or less choice to a competent nurse this is a nurse with two to three years worth of experience that they can draw from proficient nurse this is a nurse with three to five to ten to 15 years of experience well let's keep it three to five because then you have expert but proficient um this is a nurse that has three to five years of experience that they can draw from but that six-year nurse that is floating to your floor they have no experience with your type of patient so you're going to consider them a novice nurse and you're going to give them the most stable patient a nurse is working in the ICU when assessing the clients the nurse notes one of them who was scheduled to transfer to a step down unit as soon as the bed becomes available has a respiratory rate of 18 to 20 breasts per minute and an oxygen saturation of 92 percent when earlier was 93. the client denies any complaints the nurse calls a physician requests x-ray in arterial blood gases the nurse is working at which better level of Competency in nurses a advanced beginner B competent C expert or D proficient what do you guys say and guys the correct answer is e expert take a look at the question this nurse was able to recognize subtle changes and act immediately they as soon as they recognize these subtle changes they were able to act and call the health care provider and ask for some orders okay this is an expert nurse let's look at the other choices choice a so Advance a beginner this is um a new nurse that's not flexible they're not flexible because they have no experience to draw from so they're going only from the textbook it takes them a while to figure out um the subtle changes and to even act on it that's your um Advanced beginner they're very rigid they're focusing on the rules they're staying within the box they're not flexible at all Choice B A competent nurse they're starting to be more flexible they're able to notice the changes but they're not as flexible as an expert nurse okay so the competent nurse they're starting to be more flexible but they are able to notice the subtle changes and um they're not able to react as quickly as the expert nurse or even the professionals now let's do D the professioners they see the subtle changes but they're not able to react as rapidly as the expert nurse okay so uh C is the correct answer one thing I want to um mention about the competent nurse again they're able to see the subtle changes but they're still slow they're not able to react and do the nursing interventions and call the healthcare provider as quickly as say the expert nurse would be able to or even the proficient nurse would be able to do all right a nurse is confused about the best way to confirm placement of a small flexible feeding tube before giving a boneless feeding colleagues on the unit suggest several different methods the best process by which to deter by the best process by which to determine a policy outlining the appropriate course of action is a critical reasoning be evidence-based practice see problem solving or deep professional judgment what do you guys think and guys the correct answer is B evidence-based practice you're not sure about what to do and you have nurses all giving you different suggestions on what you should do what are you going to do you better use evidence-based practice you better go to The Proven research The Proven science on what has been shown to work and that's what you're going to do it's B guys because let me tell you something at the end of the day all of those nurses that are giving you different suggestions none of them are going to be standing with you before the Board of Nursing not one of them it's just going to be you and the Board of Nursing so you better use evidence-based practice all right next question a nurse who's alert to changes confident open-minded proactive and questioning is displaying which characteristics a alfaro's attitudes and characteristics of a critical thinker B Benders five levels of Competency in nurses see Hawk's model of critical thinking and registered nurses or D Universal intellectual standards what is your answer guys and guys the correct answer is a alfaro's attitudes and characteristics of a critical thinking of a critical thinker by the way there are 29 of these there are 29 attitudes and characteristics of the critical thinker is a correct answer a level then there's five levels of Competency in nursing you know I can't speak banners five levels of Competency in nurses um FYI there are five of those levels C Hawk's model of critical thinking in registered nurses that's made up that doesn't exist and choice D Universal intellectual standards this actually it encourages nurses to be thoughtful and to think about um clinical problems and so the correct answer for this question is a a nurse brings a client a medication to schedule once a day with food the medication administration record listed as being due at 9am the client refuses the medication asking to take it later the nurse replies that's okay I can give it to you with your lunch if you like which statement about the nurses which statement about the nurse is correct the nurse a is being flexible and logical B just made a medical error C needs to call the doctor or D should tell the patient to take the medication now and the correct answer is a the nurse is being flexible and they're logical go back to the question this medication is only ordered once a day once a day so as long as she gives that medication that one time with food she's fine so the patient doesn't want to take in the morning no no problem you can take it with your lunch you can even take it with your dinner it's once a day with food the nurse is being flexible and they're being logical choices b c and d are absolutely unnecessary all right let's do a select all that applies how do we treat select all that apply as true or false let's go at the beginning of the shift a nursing student is meeting with the registered nurse assigned to the student's client the nurse should provide the student nurse should provide the RN with which information select all the applied remember guys we use this as true or false we don't try to Clump them together a assessment the student will make absolutely that is very important at the beginning of the shift we need to make sure we're on the same page so the student nurse needs to tell the registered nurse what assessment she's going to be making yes true we're going to keep that b documentation the student will complete absolutely Which documents which documentation and what type of documentation will you be doing so the registered nurse can correct the student and address it Tracy medications the student will administer absolutely we're going to talk about this at the beginning of this shift so you tell me what medications you plan to administer so you can go look those medications up talk to me about those medications and then afterwards I'll watch you give those medications and correct anything that needs to be corrected true treatments the students can perform true the reason for it the same I gave you for Tracy same thing e what type of students going to lunch false not necessary it is the beginning of the shift we need to talk about the plan for the patient okay things change all the time you might not even get a lunch break so let's talk about your lunch break that is not a priority and we're going to talk about that later as a matter of fact as a nursing instructor I'm gonna have an attitude and an issue if you just came in and you want to talk about your lunch why because we're worried about the patient right and that's how you're supposed to be thinking when you're testing when you're testing it's always about the patient it is never about you so the correct answer choices is a b c and d a nurse is collecting a health history form from a client and feels the client is not reliable one recommended way to rep to verify some of the client data is to a ask client the same questions but in a different manner B confront the client with your suspicions three find a question find and question a secondary source or a d have another nurse try to get data from the client and guys the correct answer is C find and question a secondary source such as a spouse such as a child such as a family member right when I say child I mean adult child right but you're gonna you're going to find a secondary source because you don't think the information the patient's giving you is reliable maybe the patient has dementia maybe the patient has deliriums there's some kind of confusion whatever the case is the information coming out of their mouth you it's not valid to you so why would you a ask them the same question a different way if they're not reliable even if you ask the question a different way whatever comes out of their mouth may not be valid Choice C let's stop and confront do we ever confront patients absolutely not you should have immediately gotten rid of that answer Choice and then D have another nurse try excuse me even if you get another nurse it's still the same patient that you feel is not reliable so why would you go get another nurse to come and interview the same patient that you don't trust the information coming out of their mouth does that make any type of sense absolutely not so we're going to try to find a reliable source again such as a spouse an adult child a family member to get the information that we need that we can depend to be valid for our patients so sees the correct answer next question the nurse is collecting a health history on a middle-aged African-American male the nurse asks about past blood pressure screening because of incidence of hypertension is higher in this ethnic group than in others this is an example of age a generalization based on the nurse's limited experience with African Americans be biased and the nurse should not question the client about blood pressure screening C stereotyping the client based on the client's ethnic or racial group or a deed using valid research data to focus questions on the client's specific risks and guys the correct answer is D using valid research data to focus questions on the client's specific risk this is using scientific research and evidence guess what African Americans are just being black you are at risk for hypertension you are at risk for heart disease so that nurse is doing the right thing um a this is not a generalization because this is based again on scientific research and data Choice B is wrong this is not a bias again this is based on scientific research and data and see this is not stereotyping this is based on scientific research and data these the correct answer moving on a client had surgery yesterday and is complaining of pain the best action by the nurse is to a ask the patient which paying medication he or she took last B do a complete assessment of the pain C prepare to administer the ordered pain medication or do you repay report the client's complaints thoroughly and get the pain medication what's the correct answer the correct answer guys is B do a complete assessment of the pain notice it didn't say do a complete assessment um head to toe it didn't say do just a complete thorough assessment just a complete assessment of the pain because guess what that complete assessment of the pain finding out what kind of pain do you have when did it start it what does it feel like what level of pain do you have when did you last get your pain medication which is Choice a notice how Choice B includes Choice a Choice B is an umbrella question umbrella question is an ant or answer I should say that's an answer choice that includes another answer choice I know some of you guys chose a but B is the better answer because B includes a you're going to do an assessment of the pain now Choice C is wrong because it says prepare to so we're going to just give another pain medication without assessing that patient without asking them about the pain the quality of the pain um how long they've had the pain the location of the pain where they last got their pain medication that patient just had surgery so let's say they had abdominal pain they had abdominal surgery right and they're complaining of pain but the pain is not even at the abdominal site the pain they're having is right here in the chest so you can never assume just because a patient had a surgery that the site of pain is where they had surgery you have to ask questions asking questions and getting information that's what an assessment anything you do to get information is an assessment asking questions looking in the patient's chart looking at that patient doing the physical assessment on that patient okay so B is the correct answer choice guys I'm sorry if I see meat uh this morning I haven't had my coffee yet so I'm annoyed but you know I love you I'm not being mean to you guys all right next question a client's being admitted to the hospital and the nurse has the client's electronic record including the past medical history excuse me what should the nurse do with this information a copy the information from the electronic database to the mission database B not use it because the preferred because it's preferred to ask the clients about past history at each encounter see save time and skip this part of the history taking because the record's electronic or D verify with the client that the list is current complete and correct and guys the correct answer is d that information that you have review it with that patient see if anything's change see if anything's incorrect can correct if there's any medication that gets discharged any medications that's been ordered anything that you have to place a phone call to the healthcare provider and say hey there's a discrepancy which one is it you're going to do D let's look at the other choices a copy the information from the electronic database to the admission database that is being a robot you are not critically thinking at all don't you know when a patient moves from one place to another the ball can get dropped things can get lost in the crack and you want to make sure that doesn't happen so you're not going to be a robot and just copy everything from one thing to another absolutely not you're going to do what assess ask questions get information Choice B not use it because it's preferred to ask clients about past history at each encounter yes you're always going to ask the patient about their past history at each encounter but you're going to use what you got which is all this information that would be so dumb if you had all this information did not use it and just ask the patient about the medications they're taking ask them about their history that would be the dumbest thing in the world you would be dropping the ball because you have this information right now why not confirm it and ask questions Troy C save time to stop right there in the perfect world when you are testing we don't care about time resources um Staffing equipment we got all of that unless there's an emergency where time is important because we gotta rush and get that patient to the or right unless it's something like that we don't care about saving time we don't care about saving money we don't care about saving resources we don't care about limiting the staff or um Staffing we always have enough staff it's a perfect world when you're testing D is the correct answer choice to assess precipitating factors the nurse interviewer would ask a do you remember the first time you had this problem B how many times have you had this problem related to activity see what measures relieve this problem for you or D what were you doing when you first noticed this problem what is the correct answer and guys the correct answer is D what were you doing when you noticed this problem go back to the question the question is asking us about precipitating factors when we see precipitating factors what they're really asking asking us is the cost the trigger what brought this on so it's important for us to know what were you doing when this happened where were you when this happened when did this happen because maybe um it might have something to do with the environment that's a trigger or an activity that's a trigger or a certain time of day that's a trigger so when you see that word um precipitating what they're really asking you is about cause or trigger and D is the correct answer choices a b and c don't give us a clue to the cause and Trigger like they do D is the correct answer choice because the psychosocial assessment includes many more personal aspects of the client's history the most significant variable that may affect the quality and usefulness of the collected data is the a nurse's ability to establish a therapeutic relationship be nurses difficulty in differentiating normal from abnormal C reluctance of most clients to share information with health care providers or D value the client places on health interview what do you guys think and guys the correct answer is a the ability to establish a therapeutic relationship you're going to be asking very personal very sensitive and maybe some embarrassing questions they have to trust you heck they have to even like you so it's very important at the beginning that you establish a therapeutic relationship and you start off with the simple questions such as a history just very simple and you save those embarrassing personal questions towards the end when you've established that trusting relationship b c and d they're not going to get you much you have to establish that um personal uh therapeutic relationship not personal guys excuse me therapeutic relationship that is what's most important to get um because go back to the question they're asking about the quality and the usefulness that real gritty information that we need you have to have that therapeutic relationship so it has to be established it is the correct answer choice all right we are down to our last questions I'm going over my time all right a client brought to the emergency department in serious condition and needs an operation within the next hour which of the following principles does a nurse use to guide their health history select all that applies remember how we treat select all the ply as true or false let's go a assess the client's current health status of course this patient's about to go into surgery so we need to assess them right now figure out what's going on B collect data pertinent pertinent to the immediate problem very true we need to get information that's important to us now the immediate problem that's happening with the patient Tracy strive to collect only apartment data while being through yes pertinent as an important what's important to us right now this is emergency patients about to go into surgery we can have this long drawn out history we just need information that's important to us right now absolutely true Choice C update the database when the client's condition allows true look at the end of choice C when the client's condition allows so it's very important that we update their information when their condition allows very true Choice E uses systemic approach to gather the client's entire health history we don't have time for all of that that word entire just threw the whole thing out there's a reason they're telling us that this is an emergency and the patient's going to surgery in an hour they're giving us a sense of urgency right so this is not the time to get an entire health history we just need pertinent information what's important to us right now to help our patients so the correct answer is choices a b c and d and that is the end of this video guys let me know what you thought about this video if you'd like to see more information or more videos on uh critical thinking and assessing the patient please let me know in the comment section and I'll be sure to make more for you if there's anything that I have covered that you'd like to see me covered let me know in the comment section please help engage the more that you guys engage in the comments section really helps the algorithm it helps my videos go out to um more viewers and it allows me to have more time to make videos for you so I'm asking you please support my channel that way don't forget I have audio lessons available for you on my website Nexus nursinginstitute.com and of course almost daily you can catch me covering different nursing questions on my other social media platforms such as Tick Tock Instagram and Facebook thank you so much for watching this video and you guys will catch me on the next video