Questions on Nursing Australia 2022

Running head: NURSING
Levett Jones Cycle
Name of the Student
Name of the University
Author’s Note

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Table of Contents
Question 1.............................................................................................................................. 2
Question 2.............................................................................................................................. 2
Question 3.............................................................................................................................. 3
Question 4.............................................................................................................................. 3
Question 5.............................................................................................................................. 4
Question 6.............................................................................................................................. 5
Question 7.............................................................................................................................. 5
Question 8.............................................................................................................................. 6
Question 9.............................................................................................................................. 6
Reference-............................................................................................................................. 7

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Question 1
According to Levett-Jones et al., (2010) stated that in acute care settings, to manage
emergent conditions a nurse must assess the situation carefully to recognise deteriorating
conditions and apply clinical reasoning skills to manage the situation. Clinical reasoning
composes of steps such as “collecting cues”, “processing information”, “identifying
problems”, establishing goals”, “action plan”, “evaluate outcomes” and “reflection”. Hunter
and Arthur (2016) suggested that an emerging nurse must have proper psychomotor skills to
judge a situation and act likewise. They interviewed various clinical educators whose ideas
varied considerably, but most were of the opinion that student’s reasoning skill can be
assessed efficiently with the Levett-Jones clinical reasoning cycle. The clinical reasoning can
help the professionals to make appropriate decisions by diagnosis, prevention and proper
treatment protocol of the patients by application of the clinical skills. An inefficient clinical
reasoning skill can lead to failure of diagnosis, and implementation of proper medical
interventions, and management of complicated cases. With proper reasoning skills, the
quality of patient-based approach is enhanced. The Nursing and Midwifery Board of
Australia (2019), standard 1.2 emphasizes that a nurse must fulfil the duty of care while
examining the patients and efficiently should intervene with the situation. Critical thinking and
analysing is a very important aspect of nursing education. Levett-Jones, Courtney-Pratt and
Govind (2019) revealed that nurses with proper clinical reasoning skills have positive patient
outcomes. Clinical reasoning is often associated with the clinical skills, critical thinking,
professional judgement, scientific reasoning along with scholarly rationality and basis.
Therefore, the implementation of a proper clinical reasoning based skills, can improve the
traditional methods of medicine practice. It can generate new scientific ideas, based on
evidences, which can improve the comprehensive care of the patients. Some other aspects
of critical reflection while reasoning is not only logic or ideas, but also deduction, analysis,
evaluation and application for patient safety.
Question 2
In case of Mrs. Williamson the primary focus area will be her metatarsal bone
fracture in her left foot and excessive pain. Cenatiempo et al., (2019) revealed that pure
dislocation or proximal fracture in the tarsal bones can cause weaker ligaments, and
decreased mobility of the individual. Nencini and Ivanusic (2016) suggested that pain
associated with bone fractures can be due to stimulation of periosteum or bone marrow by
sensory neurons. They informed that peripheral sensory neurons intervening bone are
actively associated with the pain symptoms. The additional factor that might be considered

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here is her history of hypertension, which is not resolving even being under anti-hypertensive
medication.
Question 3
Massey, Chaboyer and Anderson (2017) revealed that patient safety is heavily
dependent on the nurse’s instant action and critical thinking ability. They were of the belief
that noticing the vital signs and symptoms to detect the deteriorating condition of the patient,
to escalate the level of care. They revealed that nurses being the front-line medical
personnel should notice the changing symptoms immediately, or it will further aggravate the
situation of patients, leading to the elevation of the physical and physiological conditions,
even leading to death. The Nursing and Midwifery Board of Australia NMBA), (2019)
standard 10.2 suggested that communicating properly with the patients and the
multidisciplinary team is necessary while collecting information. The nurse must show
empathy and be approachable to the patients, so that the patients can feel free and cosy,
and share all the details without hesitation. Mrs. Williamson is presented with left foot
metatarsal fracture and hypertension. Her blood pressure is 145/90, temperature 36.80C,
pulse rate 110pm, respiration rate 18breaths pm, and oxygen saturation is 95%. She is
prescribed 1000mg of Panadol every 6 hrs, and Avapro 150mg/day. She is admitted in the
orthopaedic ward for examining her aggravating pain and redness in the left foot, as she is
unable to bear any weight. Mrs. Williamson is presented with high blood pressure inspite of
consuming anti-hypertensive medication, which can be an indication for resistant
hypertension syndrome. Doroszko et al. (2016) revealed that resistant hypertension can be
diagnosed when the patient despite being treated with antihypertensive medication, does not
respond. So, to confirm resistant hypertension, tests needs to be performed. Mrs. Williamson
is experiencing excessive pain despite of taking pain meds. So, pain assessment can be
performed in the patient. Fillingam et al., (2016) revealed that to classify the level and nature
of pain, pain assessment can be necessary. It quantifies the kind of pain and pain
assessment tool can be helpful to intervene in the situation. The patient does not socialize
after her husband’s death and is restless in the hospital. So, depression assessment can be
done in the patient. Bauer et al., (2018) highlighted that routine symptom monitoring and
measuring the level can be effective in treatment of depression.
Question 4
Samadbeik et al., (2017) revealed that in nursing practice information processing
from the observation is a very essential part in diagnosing the medical condition of the
patient. For patient-centred approach, the correct processing of the data is very necessary to