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Integrative Practicum Program
Questioning Strategies for use with LCC Evalucation Tool

A. PLANS SAFE AND EFFECTIVE HEALTH CARE

• What are the usual signs/symptoms of this diagnosis/disease?
• How do your assigned patient’s signs and symptoms differ from the expected clinical picture?
• What 3 lab values are most pertinent to your patient’s diagnosis?
• What are the 3 high priorities for your patient today?
• What are the major complications that you need to assess for?
• What are your goals for the patient based on the patient needs you’ve identified?
• Why is the patient getting this drug ? What are the common side effects?
• You gave 24 units of NPH and 6 units of Regular insulin now, when would you want to assess the patient for symptoms of hypoglycemia?

B. IMPLEMENTS SAFE AND EFFECTIVE NURSING CARE

• Talk through this procedure before we get into the patient’s room.
• You tell me that your post-op patient’s BP is dropping, pulse is rising, they c/o increasing pain at the surgical site and have not voided since surgery. What’s your next action?
• What care of the patient’s central line is needed?
• Which IV line is this med going to be infused through?

C. PARTICIPATES IN HEALTH TEACHING AND DISCHARGE PLANNING

• What learning needs does your patient have today?
• How do you plan to evaluate what your patient retained from the teaching you provided?
• Is there any follow-up teaching or additional information you need to give to your patient prior to discharge? Have you documented it?
• Which patients on our team may need a social work consult re: discharge.
• Do you feel this patient is ready for discharge? Anything else we can do to ensure a successful transition to home?

D. INITIATES AND MAINTAINS EFFECTIVE VERBAL AND WRITTEN COMMUNICATION

•  In addition to the patient’s telling you he was hurting, what nonverbal indications of pain did you notice?
• How do you think your feelings about the patient’s aggressive behavior affected your response to him?
• Are you aware of how your facial expression changed when the C.N.A. reported those vital signs to you?
• The assessment you charted is nearly identical to that of the last shifts. Did nothing change or improve during our shift?
• Does your charting reflect the actions done in response to patient concerns or changes?

E. COORDINATES CARE FOR A GROUP OF PATIENTS

• Based on the change-of-shift report, which patient do you think you should see first?
• If you have a patient complaining of chest pain, a unit of blood to hang for a patient with a HGB of 10.3, and an NG tube to re-insert because your patient just pulled it out, what will you do first?
• Given all of the things you need to do in the next hour, is there anything that could be delegated to an LPN or CNA?
• Is there a way that you could modify that dressing change so that you use fewer supplies?
• Are there any community/hospital resources that your patient may benefit from by contacting?
• How will you plan your patient’s activity around the P.T. schedule?

F. FUNCTIONS WITHIN ETHICAL AND LEGAL FRAMEWORK OF NURSING

• What do you need to learn this term in order for you to feel ready to graduate?
• What would you think/do if you suspected another nurse or staff was falsifying care?
• How do you perceive interactions between our shift and the next?
• You had mentioned that you were having some difficulty in your relationship with Nurse G. How are you doing with that at this point? Have you thought about some strategies for managing your self with this nurse?
• When I give you feedback about something you did incorrectly and you give me a series of excuses about why you did it, it makes it difficult for me to give you that feedback, and yet it is my responsibility to do that. What would be helpful to me would be for you to hear me out and then I will listen to what you have to say about it. Do you think that would work for you?
  

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