Fundamentals Success - Dwi Rahmawati
Fundamentals SuccessA Course Review Applying Critical Thinkingto Test TakingSECOND EDITIONFABK003-FM[i-xxii].indd i3/18/08 7:09:15 PM
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Fundamentals SuccessA Course Review Applying CriticalThinking to Test TakingSECOND EDITIONPatricia M. Nugent, RN, MA, MS, EdDProfessor EmeritusNassau Community CollegeGarden City, New YorkPrivate Practice – President of Nugent Books, Inc.Barbara A. Vitale, RN, MAProfessor EmeritusAdjunct ProfessorNassau Community CollegeGarden City, New YorkPrivate Practice – Professional Resources for NursingF. A. DAVIS COMPANY PhiladelphiaFABK003-FM[i-xxii].indd iii3/18/08 7:09:16 PM
F. A. Davis Company1915 Arch StreetPhiladelphia, PA 19103www.fadavis.comCopyright 2008 by F. A. Davis CompanyCopyright 2008 by F. A. Davis Company. All rights reserved. This book is protected bycopyright. No part of it may be reproduced, stored in a retrieval system, or transmitted inany form or by any means, electronic, mechanical, photocopying, recording, or otherwise,without written permission from the publisher.Printed in the United States of AmericaLast digit indicates print number: 10 9 8 7 6 5 4 3 2 1Publisher, Nursing: Robert G. MartoneDirector of Content Development: Darlene D. PedersenProject Editor: Padraic J. MaroneyDesign and Illustrations Manager: Carolyn O’BrienAs new scientific information becomes available through basic and clinical research,recommended treatments and drug therapies undergo changes. The author(s) and publisherhave done everything possible to make this book accurate, up to date, and in accord withaccepted standards at the time of publication. The author(s), editors, and publisher are notresponsible for errors or omissions or for consequences from application of the book, andmake no warranty, expressed or implied, in regard to the contents of the book. Any practicedescribed in this book should be applied by the reader in accordance with professionalstandards of care used in regard to the unique circumstances that may apply in each situation.The reader is advised always to check product information (package inserts) for changesand new information regarding dose and contraindications before administering any drug.Caution is especially urged when using new or infrequently ordered drugs.ISBN 13: 978-0-8036-1921-0ISBN 10: 0-8036-1921-9Authorization to photocopy items for internal or personal use, or the internal or personaluse of specific clients, is granted by F. A. Davis Company for users registered with theCopyright Clearance Center (CCC) Transactional Reporting Service, provided that the feeof .10 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. Forthose organizations that have been granted a photocopy license by CCC, a separate systemof payment has been arranged. The fee code for users of the Transactional Reporting Serviceis: 8036-1921-9/08 0 .10.FABK003-FM[i-xxii].indd iv3/18/08 7:09:17 PM
Dedicated toJoseph VitaleandNeil NugentFor their love and support,particularly during the production of this bookFABK003-FM[i-xxii].indd v3/18/08 7:09:17 PM
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AcknowledgmentsMany people at F. A. Davis were essential to the production of this book. We especially wantto thank Bob Martone, Publisher for Nursing, whose skills of listening, focusing, and prodding were instrumental to the publication of this edition. He shared our enthusiasm for thisproject throughout the publishing process without losing his sense of humor, and we valuehis knowledge and friendship. We gratefully acknowledge Padraic Maroney, Project Editor,for his editorial expertise and keeping the project on task. Thanks also go to the entire F.A.Davis staff, especially to Louise Bierig, Developmental Editior; Lisa Thompson, Production Project Editor; and Bob Butler, Production Manager; all who competently transformedour manuscript into a book.Special recognition goes to all the nursing students and faculty who participated in fieldtesting sessions and focus groups for their commitment to excellence and generosity in sharing their time, energy, and intellects. Finally, but most importantly, we would like to thankour husbands, Neil and Joseph, for their love, senses of humor, enthusiasm for life, and theirattempts to keep our compulsive natures under control. Their support was essential to thecompletion of this book and they are loved and appreciated by us.viiFABK003-FM[i-xxii].indd vii3/18/08 7:09:18 PM
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ReviewersGloria Coschigano, APRN-BC, MSAssistant ProfessorWestchester Community CollegeValhalla, New YorkAmy Elinskas, MS, RNNursing InstructorSt. Elizabeth College of NursingUtica, New YorkMindy Heutinick, MSN, RN, ANP-CInstructorWilliam Jewell CollegeLiberty, MissouriBarbara Maxwell, RN, MSN, MSAssociate ProfessorState University of New York at UlsterStone Ridge, New YorkixFABK003-FM[i-xxii].indd ix3/18/08 7:09:18 PM
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A Message toNursing InstructorsFollowing the popularity of the first edition of Fundamentals Success: A Course Review Applying Critical Thinking to Test Taking, we again conducted focus groups with nursing studentsand nursing faculty to determine if the book continued to meet their needs or if additionalneeds emerged. Nursing faculty still are concerned about assisting students with developing intellectualreasoning skills and supporting students’ personal qualities that promote effective inquiry.Faculty continued to ask, “HOW CAN WE HELP OUR STUDENTS TO THINKCRITICALLY?” Although beginning nursing students alluded to the concerns identified by faculty, theirgreatest concern was the need for more fundamentals-of-nursing questions with which topractice test taking. Students still stated, “WE WANT MORE FUNDAMENTALS OFNURSING QUESTIONS!” Even though Alternate Item Formats have appeared on NCLEX examinations since thespring of 2003, both students and faculty continued to say, “WE WANT ADDITIONALEXAMPLES OF ALTERNATE ITEM FORMATS!” In recent focus groups, students shared their concerns about preparing for and taking anexamination at the end of a fundamentals of nursing course that addresses multiple fundamental concepts, principles, and theory. Students stated, “WE WANT TO PRACTICETAKING A FUNDAMENTALS FINAL EXAMINATION!” With the advent of NCLEX examinations being administered on a computer, most students indicated that they now take their nursing examination on a computer. Studentssaid, “WE WANT TO PRACTICE TEST TAKING USING A COMPUTER!”This book addresses these felt needs.“HOW CAN WE HELP STUDENTS TO THINKCRITICALLY?”The entire premise of this book is based on the beliefs that: People use critical thinking all the time in their daily livesNurses continue to use critical thinking in their professional livesPeople can enhance their critical-thinking skillsStudents can use critical-thinking skills when taking a nursing examinationChapter 1, Fundamentals of Critical Thinking Related to Test Taking: The RACEModel, discusses the topic of critical thinking in relation to everyday living and introducesthe Helix of Critical Thinking. The Helix of Critical Thinking schematically representsthe cognitive and personal competencies involved in critical thinking. This model is thendiscussed relative to the cognitive processes used in nursing (the nursing process, problemsolving, decision-making, diagnostic reasoning, and the scientific method). Maximizingyour critical thinking abilities is presented in the context of personal competencies thatfoster critical thinking. Information related to being positive, reflective, inquisitive, andcreative are explored, and strategies to overcome barriers to the development of these competencies are interwoven throughout the discussion. The application of critical thinkingxiFABK003-FM[i-xxii].indd xi3/18/08 7:09:18 PM
xiiA MESSAGETONURSING INSTRUCTORSapplied to test taking begins with a brief overview of educational domains, components ofa multiple-choice test question, and the cognitive levels of nursing questions. Finally, themain component of this textbook is presented – The RACE Model. The RACE Modelis a formula for using critical thinking when answering multiple-choice questions on anursing examination. The theoretical framework of the RACE Model is explained andthen applied to three sets of sample test items that span the cognitive domains of knowledge, comprehension, application, and analysis. This illustrates the increasing complexityof critical thinking required as the difficulty of questions increase in relation to the samenursing content.“WE WANT MORE FUNDAMENTALS OF NURSING QUESTIONS!”This book contains 1227 questions, which reflect a depth and breadth that comprehensively address the content commonly included in a fundamentals of nursing curriculum.They have been clustered by chapter into the related domains of: Chapter 2—Nursing Within the Context of Contemporary Health Care; Chapter 3—PsychosocioculturalNursing Care; Chapter 4—Essential Components of Nursing Care; and Chapter 5—BasicHuman Needs and Related Nursing Care.“WE WANT ADDITIONAL EXAMPLES OF ALTERNATE ITEM FORMATS!”Chapter 6, Alternate Item Formats, presents information regarding the NCLEX itemformats introduced in April 2003 by the National Council of State Boards of Nursing. Formats include: multiple-response items, fill-in-the-blank items, hot-spot items, chart/exhibititems, ordered-response (drag and drop) items, and standard multiple-choice questionsthat require the student to refer to a graphic image, picture, or chart/table to answer thequestion. In this edition, 78 additional Alternate Item Formats were added for a total of103 items. In addition, numerous examples of the newly developed Chart/Exhibit Items byNCLEX have been included.“WE WANT TO PRACTICE TAKING A FUNDAMENTALS FINAL EXAMINATION!”To address this need, a 100-item Comprehensive Final Book Exam is presented in thetext (Chapter 7). This provides students with an opportunity to integrate fundamental content learned in subunits of study into one examination.“WE WANT TO PRACTICE TEST TAKING USING A COMPUTER!”In this edition a CD-ROM, containing two, 75-item Comprehensive Course Exit Exams,has been included. This meets the need voiced by students to practice test taking on a computer as well as taking a comprehensive examination that integrates subunits of fundamentals of nursing content.Questions for inclusion were selected considering content validity and the results of anelaborate field-testing process that included statistical item analyses and focus groups withstudent nurses and nursing faculty to ensure quality questions. Every question in the bookhas rationales for the correct and incorrect answers. These questions can be used to applythe RACE Model to answer the questions, practice test taking, and study or review nursingcontent. Each section of questions in Chapters 2 through 5 is preceded by a list of keywordscommonly associated with the content included in that area. Knowing the definition of thesewords and understanding information, concepts, and principles associated with these wordswill build a theoretical base for answering the questions in the content area. In addition, aGlossary of more than 250 English words commonly encountered on nursing examinationsis included in the back of the book for consideration by the reader. Familiarity with thesewords will refocus the challenge of a nursing examination away from the form of the test andback to the nursing content of the test.SUMMARYWhen we wrote the first edition, our goals were to produce more quality fundamentals ofnursing questions and to design a model to assist nursing students to use critical-thinkingstrategies when taking a nursing test. Based on the feedback we received from students andFABK003-FM[i-xxii].indd xii3/18/08 7:09:19 PM
A MESSAGETONURSING INSTRUCTORSxiiifaculty, we achieved these goals. In this edition, we addressed the emerging needs of students and faculty by including: 103 Alternate Item Formats (particularly Chart/Exhibit Format Items) A 100-item Comprehensive Final Book Exam A CD-ROM with two 75 Comprehensive Course Exit ExamsPatricia M. NugentBarbara A. VitaleFABK003-FM[i-xxii].indd xiii3/18/08 7:09:19 PM
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A Message toNursing StudentsFollowing the resounding success of the first edition of Fundamentals Success: A CourseReview Applying Critical Thinking to Test Taking, we continue to hear the same comment fromstudents, “MORE QUESTIONS, WE WANT MORE QUESTIONS!” We continue tohear from nursing faculty, “HOW CAN WE HELP OUR STUDENTS TO THINKCRITICALLY?” Even though Alternate Item Formats have appeared on NCLEX examinations since the spring of 2003, both students and faculty continue to say, “WE WANT ADDITIONAL EXAMPLES OF ALTERNATE ITEM FORMATS.” In addition, emergingrequests from students include, “WE WANT TO PRACTICE TAKING A FUNDAMENTALS FINAL EXAMINATION!” and “WE WANT TO PRACTICE TEST TAKING USING A COMPUTER!”This book addresses these felt needs.If you are similar to the average nursing student, you read assigned chapters in yourtextbook and articles in nursing journals, review your classroom notes, complete computerinstruction programs related to nursing content, practice nursing skills in a simulated laboratory, and apply in the clinical area what you have learned. All of these activities are excellent ways for you to expand and strengthen your theoretical base and become a safe practitioner of nursing. However, they may not be enough for you to be successful when takinga nursing examination. You need to practice test taking as early as possible in your programof study and with questions appropriate for your level of nursing education. In addition, youmust be aware of, strengthen, and expand your cognitive competencies (intellectual reasoning skills) and personal competencies (individual attitudes or qualities) reflected in TheHelix of Critical Thinking, and then utilize these components of critical thinking whenanswering nursing questions.In this book, we discuss personal competencies and present the RACE Model to provideyou with a blueprint for applying critical thinking to answering multiple-choice questions innursing. The components of the RACE Model are:RACE————Recognize what information is in the stem.Ask, What is the question asking?Critically analyze the options in relation to the question asked in the stem.Eliminate as many options as possible.The theoretical framework of the RACE Model is explained and then applied to threesets of sample test questions that span the cognitive domains of knowledge, comprehension,application, and analysis. This illustrates for you the increasing complexity of critical thinking required as the difficulty of questions increases in relation to the same nursing content.In addition, the book contains 1227 multiple-choice questions organized into 24 contentareas commonly included in a fundamentals of nursing curriculum. When answering thesequestions you can use critical thinking by applying the RACE model and practice test taking. When examining the rationales for the correct and incorrect answers you can reviewfundamentals of nursing content and identify what you still need to study.For your personal development, each of the fundamentals of nursing content areasis preceded by a list of keywords, nursing/medical terminology, concepts, principles, orinformation associated with the topics presented. In addition, a Glossary of 250 Englishwords commonly found in nursing multiple-choice questions is included at the end of thetextbook. Familiarity with these words will refocus the challenge of a nursing examinationaway from defining the words in a test question and back to the theoretical content beingevaluated in the test question.xvFABK003-FM[i-xxii].indd xv3/18/08 7:09:19 PM
xviA MESSAGETONURSING STUDENTSWHY YOU SHOULD READ THIS TEXTBOOK: FEATURES AND BENEFITSFABK003-FM[i-xxii].indd xviFEATUREBENEFITS103 questions with formats otherthan multiple-choice.These questions will:Expose you to the alternate types of question formats thatappear on NCLEX examinations.Allow you to practice nursing questions that incorporatemultiple-response items, fill-in-the-blank items, hot-spotitems, chart/exhibit items, ordered-response (drag anddrop) items, and questions that use graphic illustrations,tables/charts, or pictures.Reduce anxiety concerning alternate item formats you willbe confronted with on NCLEX.Key word lists at the beginningof each content chapter thatinclude vocabulary, concepts,nursing/medical terminology,principles, and information.These words encourage you to focus on the criticalcomponents of a topic of study. Understanding thesecritical components expands your theoretical baseand provides a strong foundation for more advancedconcepts.Glossary that identifies and definesordinary English words thatappear frequently in nursingexaminations.Familiarity with these words reduces the challenge of a testquestion because you can center your attention on thetheoretical content presented in the question.A discussion of maximizing yourcritical-thinking abilities includingthe attitudes and qualities ofsuccessful critical thinkers andstrategies to overcome barriers tocritical thinking.This discussion provides a basis for a self-assessment inrelation to these qualities and introduces strategies thatyou can use to overcome barriers to your critical thinking.This discussion should motivate you to maintain a positivemental attitude and be reflective, inquisitive, and creativewhen thinking.The RACE Model is introducedand applied to a variety ofsample questions.These concrete examples model the critical-thinkingprocesses involved when answering increasingly complexmultiple-choice questions in nursing. This facilitatesthe imitation of the critical-thinking activities used in theexamples when you are confronted with answering amultiple-choice question in nursing. Ultimately, when youcan critically analyze a question and answer it correctly, youwill feel empowered and your test anxiety will decrease.1227 quality fundamentals ofnursing questions.These questions allow you to practice test taking and applythe use of critical thinking via the use of the RACE model.This should increase your critical-thinking skills, promoteyour self-confidence, build your stamina when takingtests, and reduce test anxiety.Rationales for the correct andincorrect answers for everyquestion.Reviewing the rationales for every question will:Reinforce what you know—This increases trust in yourability and promotes a sense of security.Teach you new information—This increases yourknowledge and builds self-confidence.Identify what you still need to learn—This focuses andprioritizes your study activities so that the return on youreffort is maximized.100-item Comprehensive CourseExit ExamThis provides you with an opportunity to integratefundamental content learned in subunits of study into oneexamination.Two 75-item ComprehensiveCourse Exit Exams on a CDROM.This provides you with an opportunity to practice testtaking on a computer as well as taking a comprehensiveexamination that integrates subunits of fundamentals ofnursing content.3/18/08 7:09:19 PM
A MESSAGETONURSING STUDENTSxviiTo increase your knowledge of fundamentals of nursing theory and experience success onnursing examinations, it is important for you to use this book—Fundamentals Success: ACourse Review Applying Critical Thinking to Test Taking, Second Edition. Although thisbook is valuable for all nursing students regardless of their level of nursing education, it isessential for beginning
nursing content. “WE WANT MORE FUNDAMENTALS OF NURSING QUESTIONS!” This book contains 1227 questions, which refl ect a depth and breadth that comprehen-sively address the content commonly included in a fundamentals of nursing curriculum. They have been clustered by chapter into the related domains of: Chapter 2—Nurs-
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