PART 1. Introduction: Developing Clinical Judgment
1. Transitioning from the nursing process to clinical judgment
Review of the nursing process and critical thinking
Expanding from the nursing process to clinical judgment
New nursing graduates and clinical judgment
The National Council of State Boards of Nursing Clinical Judgment Measurement Model
Thinking and discussion questions
References
2. Applying the NCSBN clinical judgment measurement model to ensure client safety
Overview of the NCSBN CJMM
Applying the cognitive skills of the NCSBN CJMM
Applying the NCSBN CJMM for thinking exercises in this workbook
Enhanced hot spot thinking exercises
Cloze thinking exercises
Extended drag and drop thinking exercises
Extended multiple response thinking exercises
Matrix thinking exercises
Thinking and discussion questions
Bibliography
PART 2. Clinical Judgment for Clients Across the Life Span Experiencing Commonly Occurring Health Problems
3. Perfusion: Common Health Problems
Exemplar 3A. Heart failure (Medical-surgical nursing: Older adult)
Exemplar 3B. Sickle cell disease (Pediatric nursing: Adolescent)
4. Clo ing: Deep Vein Thrombosis
Exemplar 4. Deep vein thrombosis (Medical-surgical nursing: Middle-age adult)
5. Gas exchange: Common Health Problems
Exemplar 5A. Asthma (Pediatric nursing: School-age child)
Exemplar 5B Chronic obstructive pulmonary disease (Medicalsurgical nursing: Middle-age adult)
6. Elimination: Benign Prostatic Hyperplasia
Exemplar 6. Benign prostatic hyperplasia (Medical-surgical nursing: Older adult)
7. Nutrition: Common Health Problems
Exemplar 7A Cholecystitis/cholecystectomy (Medical-surgical nursing: Middle-age adult)
Exemplar 7B. Peptic ulcer disease (Medical-surgical nursing: Middle-age adult)
8. Mobility: Common Health Problems
Exemplar 8A. Fractured hip/open reduction internal fixation (Medical-surgical nursing: Older adult)
Exemplar 8B. Fractured radius and medial epicondyle (Pediatric nursing: Preschool child)
Exemplar 8C. Osteoarthritis/total knee arthroplasty (Medicalsurgical nursing: Middle-age adult)
Exemplar 8D. Parkinson disease (Medical-surgical nursing/mental health nursing: Older adult)
9. Metabolism: Common Health Problems
Exemplar 9A. Diabetes mellitus (Medical-surgical nursing: Middle-age adult)
Exemplar 9B. Hyperthyroidism/thyroidectomy (Medical-surgical nursing: Middle-age adult)
10. Cellular regulation: Breast Cancer
Exemplar 10 Breast cancer (Medical-surgical nursing: Middleage adult)
11. Inflammation: Common Health Problems
Exemplar 11A Crohn’s disease (Medical-surgical nursing: Young adult; middle-age adult)
Exemplar 11B. Appendicitis/appendectomy (Pediatric nursing: Late school-age child)
12. Infection: Common Health Problems
Exemplar 12A. Cellulitis (Medical-surgical nursing: Middle-age adult)
Exemplar 12B. Respiratory syncytial virus (RSV) (Pediatric nursing: Infant)
13. Sensory perception: Cataracts
Exemplar 13. Cataracts (Medical-surgical nursing: Older adult)
14. Cognition: Common Health Problems
Exemplar 14A. Delirium (Mental health nursing: Older adult)
Exemplar 14B. Alzheimer’s disease (Mental health nursing: Middle-age adult)
15. Mood and affect: Depression
Exemplar 15. Depression (Mental health nursing: Adolescent)
16. Stress and coping: Generalized Anxiety Disorder
Exemplar 16. Generalized anxiety disorder (Mental health nursing: Young adult)
17. Reproduction: Uterine Leiomyoma/Hysterectomy
Exemplar 17. Uterine leiomyoma/hysterectomy (Medicalsurgical nursing: Middle-age adult)
PART 3. Clinical Judgment for Childbearing Families
18. Reproduction: Childbearing Family
Exemplar 18A. Uncomplicated prenatal woman
Exemplar 18B. Complicated prenatal woman
Exemplar 18C. Uncomplicated intrapartum care
Exemplar 18D. Complicated intrapartum care
Exemplar 18E. Uncomplicated postpartum care
Exemplar 18F. Complicated postpartum care
Exemplar 18G. Uncomplicated newborn care
PART 4. Clinical Judgment for Clients Across the Life Span
Experiencing Complex Multisystem Health Problems
19. Perfusion: Complex Health Problems
Exemplar 19A. Myocardial infarction (Medical-surgical nursing: Middle-age adult)
Exemplar 19B Atrial fibrillation/stroke (Medical-surgical nursing: Older adult)
Exemplar 19C Hypovolemic shock (Medical-surgical nursing: Older adult)
20. Mobility: Spinal Cord Injury
Exemplar 20. Spinal cord injury (Pediatric nursing: Adolescent)
21. Cognition: Traumatic Brain Injury
Exemplar 21. Traumatic brain injury (Medical-surgical nursing: Older adult and young adult)
22. Infection: Sepsis
Exemplar 22. Sepsis (Medical-surgical nursing: Older adult)
23. Gas exchange: Chest Trauma
Exemplar 23. Chest trauma (Medical-surgical nursing: Middleage adult)
24. Elimination: Complex Health Problems
Exemplar 24A. Chronic kidney disease (Medical-surgical nursing: Middle-age adult)
Exemplar 24B. Intestinal obstruction (Medical-surgical nursing: Young adult; older adult)
25. Metabolism: Complex Health Problems
Exemplar 25A. Diabetic ketoacidosis (Pediatric nursing: Adolescent)
Exemplar 25B Cirrhosis (Medical-surgical nursing: Older adult)
Exemplar 25C. Acute pancreatitis (Medical-surgical nursing: Middle-age adult)
26. Tissue integrity: Burns
Exemplar 26. Burns (Medical-surgical nursing: Young adult)
27. Stress and coping: Substance Use Disorder
Exemplar 27. Substance use disorder (Pediatric nursing/mental health nursing: Adolescent)
28. Management of care: Complex Health Problems
Exemplar 28. Complex health problems (Medical-surgical nursing: Middle-age and older adult)
PART 5. Pharmacology for Nursing
29. Pharmacology in management of common health problems
Exemplar 29A. Drugs that affect nutrition and elimination (Medical-surgical nursing: Older adult; pediatric nursing)
Exemplar 29B. Drugs that affect clotting (Medical-surgical nursing: Middle-age and older adult)
Exemplar 29C. Drugs that affect perfusion (Medical-surgical nursing: Middle-age and older adult)
Exemplar 29D. Drugs that promote comfort and metabolism (Medical-surgical nursing: Middle-age and older adult)
Exemplar 29E Drugs that manage infection (Medical-surgical nursing [young and middle-age adult]; pediatric nursing)
30. Pharmacology in management of complex health problems
Exemplar 30A. Drugs that affect perfusion and gas exchange (Medical-surgical nursing: older adult; pediatric nursing: Adolescent)
Exemplar 30B. Drugs that affect immunity (Medical-surgical nursing: Young adult; middle-age adult)
Exemplar 30C. Drugs that manage psychoses (Mental health nursing: Young adult)
Exemplar 30D. Drugs that manage emergencies (Medicalsurgical nursing: Young adult; older adult)
Answer key
Chapter 3 Perfusion: Common health problems
Chapter 4 Clotting: Deep vein thrombosis
Chapter 5 Gas exchange: Common health problems
Chapter 6 Elimination: Benign prostatic hyperplasia
Chapter 7 Nutrition: Common health problems
Chapter 8 Mobility: Common health problems
Chapter 9 Metabolism: Common health problems
Chapter 10 Cellular regulation: Breast cancer
Chapter 11 Inflammation: Common health problems
Chapter 12 Infection: Common health problems
Chapter 13 Sensory perception: Cataracts
Chapter 14 Cognition: Common health problems
Chapter 15 Mood and affect: Depression
Chapter 16 Stress and coping: Generalized anxiety disorder
Chapter 17 Reproduction: Uterine leiomyoma/hysterectomy
Chapter 18 Reproduction: Childbearing family
Chapter 19 Perfusion: Complex health problems
Chapter 20 Mobility: Spinal cord injury
Chapter 21 Cognition: Traumatic brain injury
Chapter 22 Infection: Sepsis
Chapter 23 Gas exchange: Chest trauma
Chapter 24 Elimination: Complex health problems
Chapter 25 Metabolism: Complex health problems
Chapter 26 Tissue integrity: Burns
Chapter 27 Stress and coping: Substance use disorder
Chapter 28 Management of care: Complex health problems
Chapter 29 Pharmacology in management of common health problems
Chapter 30 Pharmacology in management of complex health problems
References
Elsevier
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DEVELOPING CLINICAL JUDGMENT FOR PROFESSIONAL NURSING
AND THE NEXT-GENERATION NCLEX-RN® EXAMINATION
ISBN: 978-0-323-71858-5
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Executive Content Strategist: Lee Henderson
Director, Content Development: Laurie Gower
Senior Content Development Specialist: Laura Goodrich
Publishing Services Manager: Julie Eddy
Senior Project Manager: Jodi M. Willard
Design Direction: Amy Buxton
Printed in China
Contributors
Jessica Hoy, RN, MSNE, PCCN-K, Assistant Professor of Nursing, College of Saint Scholastica, Duluth, Minnesota
Tami Li le, DNP, MSN, BSN, Corporate Director of Nursing, Vista College, Richardson, Texas
Sabrina Olson, MSN, RN, Professor, Butler Community College, El Dorado, Kansas
Janet Schueller, MSN, RN, Curriculum Chairperson, Professor, Butler Community College, El Dorado, Kansas
Reviewers
Ki y Cashion, RN-BC, MSN, Clinical Nurse Specialist, Department of Obstetrics and Gynecology, Division of MaternalFetal Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
Brigid Chvilicek, MSN, RN, CPNP, Faculty of Nursing, Wenatchee Valley College, Wenatchee, Washington
Monica Dobbins, RN, Nursing Instructor, Butler Community College, El Dorado, Kansas
Jessica Hoy, RN, MSNE, PCCN-K, Assistant Professor of Nursing, College of Saint Scholastica, Duluth, Minnesota
Kay R. Jansen, DNP, RN, Undergraduate Program Director, University of Wisconsin Milwaukee, College of Nursing, Milwaukee, Wisconsin
Tami Li le, DNP, MSN, BSN, Corporate Director of Nursing, Vista College, Richardson, Texas
Lisa M. Pugsley, MSN, RN, CNE, CPN, Instructor of Nursing, Georgia Gwinne College, Lawrenceville, Georgia
Acknowledgments
Publishing a textbook would not be possible without the combined efforts of many people. With that in mind, I would like to extend my deepest gratitude to many people who were such an integral part of this journey.
My contributing authors provided excellent manuscripts to underscore the clinical relevancy of this publication. I give special gratitude to Meg Blair, who was extremely valuable as a project resource from beginning to end. The reviewers expert clinicians and instructors from around the United States provided invaluable suggestions and encouragement throughout the development of this book.
The staff of Elsevier has, as always, provided us with meaningful guidance and support throughout every step of the planning, writing, revision, and production of this new title. Executive Content Strategist Lee Henderson worked closely with me from the early stages of this title to help me hone and focus the project from start to finish. Senior Content Development Specialist Laura Goodrich then worked with me from vision to publication.
Senior Project Manager Jodi Willard was, as always, an absolute joy with whom to work. Her unwavering a ention to detail, flexibility, and conscientiousness helped to make this title consistently readable while making the production process incredibly smooth. Also, a special thanks to Publishing Services Manager Julie Eddy. Designer Amy Buxton is responsible for the beautiful cover and the interior design.
My acknowledgments would not be complete without recognizing the dedicated team of Educational Solutions Consultants and other key members of the Sales and Marketing staff who helped to put this book into your hands.
Exemplars
Medical-surgical nursing
Young adult
Burns, Exemplar 26, 163
Crohn’s Disease, Exemplar 11A, 70
Drugs That Affect Immunity, Exemplar 30B, 187
Drugs That Manage Emergencies, Exemplar 30D, 191
Drugs That Manage Infection, Exemplar 29E, 182
Intestinal Obstruction, Exemplar 24B, 152
Traumatic Brain Injury, Exemplar 21, 136
Middle-age adult
Acute Pancreatitis, Exemplar 25C, 160
Breast Cancer, Exemplar 10, 67
Cellulitis, Exemplar 12A, 77
Chest Trauma, Exemplar 23, 145
Cholecystitis/Cholecystectomy, Exemplar 7A, 44
Chronic Kidney Disease, Exemplar 24A, 149
Chronic Obstructive Pulmonary Disease, Exemplar 5B, 35
Crohn’s Disease, Exemplar 11A, 70
Deep Vein Thrombosis, Exemplar 4, 28
Diabetes Mellitus, Exemplar 9A, 61
Drugs That Affect Clo ing, Exemplar 29B, 175
Drugs That Affect Immunity, Exemplar 30B, 187
Drugs That Affect Perfusion, Exemplar 29C, 177
Drugs That Manage Infection, Exemplar 29E, 182
Drugs That Promote Comfort and Metabolism, Exemplar 29D, 179
