3. What is another name for a decubitus ulcer?
1. Skin tear 2. Pressure ulcer 3. Surface abrasion 4. Penetrating wound
CHAPTER1 FUNDAMENTALS OFCRITICALTHINKINGRELATED TOTESTTAKING 17
CRITICAL-THINKING STRATEGY
Recognize keywords.
Recognize who the client is.
Ask what the question is asking.
Critically analyze options in relation to the question.
Eliminate incorrect options.
What is another namefor a decubitus ulcer?
There is no client in this question.
What is another name for decubitus ulcer?
To answer this question you must know the alternate name for a decubitus ulcer. It is information you must recollect from your memory. You do not have to know the description or characteristics of other types of wounds to answer this question.
Rationales:
1. A skin tear is a break in the continuity of thin, fragile skin caused by friction or shearing force.
2. A pressure ulcer is impaired skin (reddened area, sore, or lesion characterized by sloughing of tissue) over a bony prominence caused by pressure that interferes with the delivery of oxygen to body cells.
3. An abrasion is the scraping or rubbing away of the superficial layers of the skin.
4. A penetrating wound occurs when a sharp object pierces the skin and injures underlying tissues.
Options 1, 3, and 4 are not other names for a decubitus ulcer and can be eliminated.
questions is to understand the information. See TEST SUCCESS: Test-Taking Techniques for Beginning Nursing Students for specific study techniques related to comprehension-level questions.
U
SE AC
RITICAL-T
HINKINGS
TRATEGY TOA
NSWERC
OMPREHENSION-L
EVELQ
UESTIONS1. How does the medication docusate sodium (Colace) facilitate defecation?
1. Softens stool
2. Forms a bulk residue 3. Irritates the intestinal wall 4. Dilates the intestinal lumen
18 FUNDAMENTALSSUCCESS: A Q & A REVIEWAPPLYINGCRITICALTHINKING TOTESTTAKING
CRITICAL-THINKING STRATEGY
Recognize key words.
Recognize who the client is.
Ask what the question is asking.
Critically analyze options in relation to the question.
Eliminate incorrect options.
The medication docusate sodium (Colace) facilitates defecation by:
There is no client.
How specifically does docusate sodium (Colace) facilitate defecation?
The word in the stem that indicates this is a comprehension-level question is facilitate.
What is the consequence of taking ducosate sodium (Colace)?
You need to scrutinize each option to identify whether the description in the option correctly explains how or why docusate sodium (Colace) works to facilitate defecation.
Rationales:
1. Docusate sodium (Colace) softens and delays the drying of feces by lowering the surface tension of water permitting water and fat to penetrate the feces.
2. Bulk-forming laxatives, such as psyllium hydrophilic mucilloid (Metamucil), increase the fluid, gaseous, or solid bulk in the intestines.
3. Irritants or stimulants, such as bisacodyl (Dulco- lax), irritate the intestinal mucosa or stimulate intestinal wall nerve endings, which precipitates peristalsis.
4. Large-volume enemas, not medications, enlarge the lumen of the intestine, which precipitates peristalsis.
Options 2, 3, and 4 do not accurately describe the therapeutic action of docusate sodium (Colace) and can be eliminated.
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2. How does the interviewing technique of paraphrasing promote communication?
1. Requires patients to defend their points of view
2. Limits patients from continuing a rambling conversation
3. Allows patients to take their conversations in any desired direction 4. Offers patients an opportunity to develop a clearer idea of what they said
CHAPTER1 FUNDAMENTALS OFCRITICALTHINKINGRELATED TOTESTTAKING 19
CRITICAL-THINKING STRATEGY
Recognize keywords.
Recognize who the client is.
Ask what the question is asking.
Critically analyze options in relation to the question.
Eliminate incorrect options.
The interviewing technique of paraphrasing promotes communication because it:
There is no client.
How does paraphrasing promote communication?
The word in the stem that indicates that this is a comprehension-level question is promote.
What is the consequence of paraphasing?
You need to scrutinize each option to identify whether the description in the option correctly explains how paraphrasing works to promote communication.
Rationales:
1. This describes the results of challenging state- ments that usually are barriers to communication.
2. This describes one purpose of the interviewing skill of focusing, which is the use of questions or state- ments to center on one concern mentioned within a wordy, confusing conversation.
3. This is the purpose of open-ended questions or statements.
4. Paraphrasing involves actively listening for patient concerns that are then restated by the nurse in similar words. This intervention conveys that the nurse has heard and understood the message and gives the patient an opportunity to review what was said.
Options 1, 2, and 3 do not accurately describe how paraphrasing works to promote communication and can be eliminated.
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3. Turning patients every 2 hours prevents pressure ulcers because:
1. Relieving weight on the capillaries allows oxygen to reach body cells 2. Moving promotes muscle contractions that increase the basal metabolic rate 3. Keeping the extremities dependent allows blood to flow to distal cells by gravity 4. Dropping of the abdominal organs by gravity relieves pressure against the
diaphragm
20 FUNDAMENTALSSUCCESS: A Q & A REVIEWAPPLYINGCRITICALTHINKING TOTESTTAKING
CRITICAL-THINKING STRATEGY
Recognize keywords.
Recognize who the client is.
Ask what the question is asking.
Critically analyze options in relation to the question.
Eliminate incorrect options.
Turningpatients every 2 hours prevents pressure ulcers because:
The patient is the client.
How does turning a patient prevent a pressure ulcer?
The word in the stem that indicates that this is a comprehension-level question is prevents.
What is the consequence of turning patients every 2 hours?
You need to scrutinize each option to identify whether the description in the option correctly explains how turning a patient relieves pressure and prevents a pressure ulcer.
Rationales:
1. Capillary beds are compressed and blood flow is obliterated with excessive external pressure (12 to 32 mm Hg). Changing position removes the weight of the body off dependent areas, permitting blood to flow through the capillaries and supporting gaseous exchange at the cellular level.
2. Muscle contraction expends energy that raises the basal metabolic rate; however, this is unrelated to the development of pressure ulcers.
3. Blood flow to the extremities will increase when they are kept below the level of the heart; however, this is unrelated to the development of pressure ulcers.
4. Relieving pressure against the diaphragm by abdominal organs allows for greater thoracic expansion; however, this is unrelated to the development of pressure ulcers.
Options 2, 3, and 4 do not accurately explain how turning relieves pressure thereby preventing a pressure ulcer and can be eliminated.