Nursing Study Guide (Units 1–4)

Unit 1: Nursing Theories, Concepts, and Self-Concept

1. Define the terms: Holistic Care, Concepts, Theories and Nursing Theory, Models
• Holistic Care: An approach to healthcare that considers the whole person, including their physical,
emotional, social, cultural, and spiritual well-being.
• Concepts: Abstract ideas or mental representations of phenomena, such as pain, health, or stress,
which are the building blocks of theories.
• Theories and Nursing Theory: A theory is a set of concepts and propositions that explain
relationships among variables; nursing theories specifically guide nursing practice, education, and
research.
• Models: Structured frameworks used to organize and apply nursing theories to real-world practice.

2. Identify the purpose and benefit of philosophies, concepts, theories, and models in nursing.
These elements provide a foundation for nursing knowledge, help guide clinical practice, support
professional decision-making, enhance communication among healthcare providers, and contribute to
better patient outcomes by promoting consistency and clarity in care.

3. Identify the four main types of nursing theories and give an example for each.
• Grand Theories: Broad and abstract; e.g., Orem’s Self-Care Deficit Theory.
• Middle-Range Theories: More focused and testable; e.g., Pender’s Health Promotion Model.
• Descriptive Theories: Describe phenomena without directing specific actions; e.g., Erikson’s
Psychosocial Development Theory.
• Prescriptive Theories: Guide specific nursing interventions; e.g., Kolcaba’s Comfort Theory.

4. Identify the four main types of theoretical models in nursing and give an example for each.
• Practice-Based Models: Rooted in real-world practice, e.g., Nightingale’s Environmental Theory.
• Needs-Based Models: Focus on patient needs, e.g., Henderson’s Need Theory.
• Interactionist Models: Emphasize communication and relationships, e.g., Peplau’s Interpersonal
Relations Model.
• Systems Theory Models: View patients as open systems responding to stressors, e.g., Neuman’s
Systems Model.

5. Identify and describe the four dimensions of self-concept.

1. Self-image: How individuals see themselves physically and socially.
2. Self-esteem: The value individuals place on themselves.
3. Personal identity: A person’s internal sense of individuality and uniqueness.
4. Role performance: How individuals fulfill expected roles in society.

6. Determine how self-concept changes over time.

Self-concept evolves with developmental stages, life experiences, relationships, and changes in
health status. It may strengthen or weaken depending on internal and external factors.
7. Describe ways to enhance client self-concept.
• Provide positive reinforcement and support.
• Involve clients in decision-making and goal-setting.
• Recognize and validate their feelings and achievements.
• Encourage independence and self-care.

8. Discuss the purpose of self-reflective practice for the practical nurse.

Self-reflection helps nurses critically assess their actions, identify strengths and areas for growth,
improve clinical judgment, enhance patient care, and maintain professionalism and accountability.

Unit 2: Critical Thinking and Evidence-Informed Practice

1. Define the following terms:

• Critical Thinking: Purposeful, reflective, and goal-directed thinking that helps nurses make clinical
decisions.
• Nursing Process: A systematic framework consisting of assessment, diagnosis, planning,
implementation, and evaluation to deliver patient care.
• Diagnostic Reasoning: The logical process of analyzing patient data to identify health problems.
• Evidence: Verified information derived from research, practice, or patient preferences.
• Evidence-Informed Practice (EIP): The integration of the best available evidence with clinical
expertise and patient preferences.
• Evidence-Informed Decision-Making: Applying current, relevant evidence in the decision-making
process for patient care.
• Best Practice Guideline (BPG): Recommendations based on the best available evidence to guide
healthcare practices.

2. Understand the term holistic care and how it relates to nursing practice.
Holistic care addresses all aspects of a patient's well-being, including physical, emotional, social,
cultural, and spiritual health. It helps nurses treat the person, not just the illness.

3. Compare the 3 levels of critical thinking and understand how nurses progress from level 1 to 3.
• Level 1 – Basic: Nurses rely on rules and procedures, often needing direction.
• Level 2 – Complex: Nurses analyze situations more independently, recognizing multiple solutions.
• Level 3 – Commitment: Nurses make decisions confidently and take responsibility for them.

4. Identify the 5 components of critical thinking and give examples of each component.
1. Knowledge Base – Understanding disease processes.
2. Experience – Using clinical experience to recognize patterns.
3. Competencies – Applying the nursing process.
4. Attitudes – Confidence, fairness, and curiosity.
5. Standards – Professional and ethical benchmarks for quality care.

5. By using case studies, give examples of standards and attitudes necessary to think critically.
Case studies illustrate how attitudes like responsibility and discipline help nurses evaluate evidence,
think clearly under pressure, and deliver quality care.
6. Identify the various methods the nurse can use to develop critical thinking skills.
• Reflective journaling
• Simulations and case studies
• Clinical debriefings
• Mentorship
• Continuing education and feedback sessions

7. Explain the role of research and evidence-informed practice in the nursing profession.
Research provides the foundation for best practices. Evidence-informed practice ensures care is
based on sound evidence, leading to better outcomes.

8. Describe the various kinds of ‘evidence’ available for the nurse to use to guide their practice.
Types include:
• Research studies
• Systematic reviews
• Clinical guidelines
• Patient values
• Clinical experience

9. Utilize technology to locate RNAO Best Practice Guidelines.

Visit [RNAO.ca/bpg](http://rnao.ca/bpg), use search terms related to your topic (e.g., 'wound care'),
and download current, evidence-based guidelines.

10. Describe what a nurse can do to ‘stay current’ in their practice.

• Attend workshops and conferences
• Subscribe to professional journals
• Participate in lifelong learning
• Engage in peer review and mentorship
• Follow updated clinical guidelines

Unit 3: Assessment and Nursing Diagnosis

1. Define the following terms:

• Validation: The act of confirming data accuracy and completeness.
• Data Analysis: Organizing and interpreting collected data to identify health concerns.
• Nursing Diagnosis: A clinical judgment about the patient’s response to health conditions.
• Medical Diagnosis: The identification of a disease or condition by a physician.
• Cues and Inferences: Cues are observable data; inferences are conclusions drawn from those cues.
• Diagnostic Label, Related Factor, Defining Characteristics: Label is the problem, related factor is the
cause, and characteristics are signs/symptoms.

2. Describe the assessment and diagnosing phase of the nursing process.

Assessment includes gathering subjective and objective data. Diagnosis involves analyzing the data
to determine the patient's health issues.
3. Identify the characteristics of the nursing process and explain why it is a dynamic process.
It’s client-centered, flexible, and ongoing. The process adapts to changes in the patient’s condition or
environment.

4. Describe the benefits of the nursing process for the client, the nurse, and for the profession.
Clients receive individualized and continuous care. Nurses get a structured decision-making tool. The
profession gains credibility and consistency.

5. Identify the relevance of the assessment phase in guiding nursing practice.

It forms the foundation for identifying problems, setting goals, and selecting interventions.

6. Differentiate objective and subjective data, and primary and secondary data, and provide an example of
each.
Objective: Observable (e.g., BP 120/80).
Subjective: Patient-reported (e.g., headache).
Primary: From the patient.
Secondary: From family or records.

7. Identify the various sources of data and what type of data they provide.
Sources include the client, family, health team, medical records, and literature. These provide both
subjective and objective data.

8. Describe how validation, analysis, cues and inferences relate to the assessment phase of the nursing
process.
They ensure data accuracy, help identify patterns, and support sound clinical judgment.

9. Describe the negative implications if data is not documented accurately or is omitted.

Errors, legal issues, ineffective care, and patient safety risks.

10. Identify the relevance of the diagnosis phase of the nursing process in guiding nursing practice.
It directs goal-setting and interventions to address patient-specific health problems.

11. Differentiate between a medical diagnosis and a nursing diagnosis and give examples of each.
Medical: Pneumonia – diagnosed by a physician.
Nursing: Impaired gas exchange – focuses on patient response.

12. Identify the mandate of NANDA International and their role in creating nursing diagnoses terminology.
NANDA develops standardized, research-based nursing diagnosis terminology.

13. Describe the characteristics of, components and formats for writing nursing diagnoses. Provide an
example of a nursing diagnosis.
Uses PES format: Problem, Etiology (related to), and Signs/Symptoms (as evidenced by). Example:
Acute pain related to surgical incision as evidenced by grimacing.

14. Identify the three types of nursing diagnoses and provide an example of each.
• Actual: Acute pain
• Risk: Risk for falls
• Health Promotion: Readiness for enhanced learning
15. Identify ways in which a nurse can minimize errors in formulating a diagnosis.
Validate data, use clear language, avoid assumptions, consult resources, and use NANDA
guidelines.

Unit 4: Planning, Implementation, and Evaluation

1. Define the following terms:

• Setting Priorities: Ranking patient problems based on urgency and patient needs.
• Goal: A broad statement describing a desired patient outcome.
• Outcome: A specific, measurable result of care.
• Plan of Care: A documented plan that guides nursing actions.
• Consultation: Seeking help from another professional.
• Standard Nursing Intervention: Pre-approved actions supported by best practice guidelines.
• Clinical Practice Guidelines and Protocols: Recommendations for standardized care.
• Medical Directives and Standard Orders: Physician-approved treatments a nurse can initiate.
• Nursing Intervention Classification System: A taxonomy that categorizes nursing actions.
• Standard of Care: The legal and professional benchmark of expected nursing performance.

2. Identify the relevance of the planning phase of the nursing process in guiding nursing practice.
It helps prioritize actions, allocate resources, and coordinate care to meet goals.

3. Discuss how establishing a nursing diagnosis assists a nurse in setting priorities for client care.
It clarifies the most pressing health issues, helping to prioritize and organize care based on urgency
and client needs.

4. Discuss the difference between goals and expected outcomes and provide examples of each.
Goal: Improve mobility. Outcome: Patient walks 20 meters with cane by day 3.

5. Explain the importance of client participation in the establishment of goals or desired health outcomes.
It ensures goals are realistic, meaningful, and improves patient engagement.

6. Describe the various components of a SMART goal.

SMART = Specific, Measurable, Achievable, Realistic, Timed.

7. Compare between various categories of interventions including: nurse-initiated, physician initiated, and
collaborative.
Nurse-initiated: repositioning. Physician-initiated: administering medication. Collaborative: working
with physiotherapists.

8. Describe and compare direct and indirect nursing measures.

Direct: Hands-on actions like wound care. Indirect: Supportive actions like charting.

9. Discuss the concepts to consider when selecting an intervention.

Consider safety, evidence, patient preferences, and available resources.

10. Outline the activities required to successfully implement the plan of care.
Reassess the patient, organize resources, perform actions, and document care.
11. Identify and describe the five elements of the evaluative process.
1. Set criteria
2. Collect data
3. Interpret results
4. Document findings
5. Revise care plan if needed.

12. Identify different types of evaluative measures.

Physical assessments, lab results, patient feedback, and observation.

13. Describe how evaluation leads to discontinuation, revisions, or modification of a plan of care.
If goals are met, the plan can end. If not, adjust goals, interventions, or diagnoses.