Formative and Summative Assessment
Bloom`s taxonomy base questions constitute six critical levels, including applying, understanding, remembering information, creating, and evaluating (Tuma & Nassar, 2021). Remembering requires learners to recall facts while applying involves incorporating the knowledge into solving real-time issues. Understanding involves competency and comprehension of meaning. The analysis involves a breakdown into parts and examining each part critically. These levels will be demonstrated in my questions as follows.
- In planning postoperative interventions to promote repositioning, ambulation, coughing, and deep breathing, which actions should the nurse recognize will best enable the patient to achieve desired outcomes:
- Administering adequate analgesics to promote relief or control of pain
- Asking the patient to demonstrate the postoperative exercise every 1 hour
- Giving the patient positive feedback when the activities are performed correctly
- Warning the patient about possible complications if the activities are not performed
Rationale: even when the patient understands the importance of post-operative activities and demonstrates them correctly, it is unlikely that the best outcome will occur unless the patient has sufficient pain relief to cooperate with activities
Bloom`s taxonomy: this tests the understanding level.
- The nurse is working on a surgical floor and is preparing to receive a postoperative patient from the post-anesthesia care unit (PACU). What should the nurse`s initial action be upon the patient`s arrival?
- Assess the patient`s pain
- Assess the patient’s vital sign
- Check the rate of the IV infusion
- Check the physician`s post-operative orders
Rationale: the highest priority action by the nurse is to assess the physiologic stability of the patient. This is accomplished by taking the patient`s vital signs. The other actions can then take place in a rapid sequence.
Bloom`s taxonomy level: this question tests analysis. The learner must break down the option and involve critical thinking to decide which action should take place first.
- A patient is having elective cosmetic surgery performed on her face. The surgeon will keep her at the surgery center for 24 hours after surgery. What is the nurse`s postoperative for this patient?
- Manage patient pain
- Control the bleeding
- Maintain fluid balance
- Manage oxygenation status
Rationale: the nurse`s priority is to manage the patient`s oxygenation status by maintaining an airway and ventilation. With surgery on the face, there may be swelling that could compromise her ability to breathe (Zhang & Li, 2022). Pain, bleeding, and fluid imbalance from the surgery may increase her risk of airway edema causing airway obstruction and respiratory suppression, indicating managing oxygenation status as the priority.
Bloom`s taxonomy: understanding level. The student is required to comprehend the patient situation before choosing the priority choice among the others.
- The nurse is caring for a 54-year-old unconscious female patient who has just been admitted to the PACU after an abdominal hysterectomy. How should the nurse position the patient?
- Lateral position with head supported on a pillow
- Prone position with a pillow supporting the abdomen
- Supine position with the head of the bed elevated 30 degrees.
- Semi-fowler`s position with the head turned to the right
Rationale: placing the unconscious patient in a lateral recovery position aids in keeping the airway open and reduces the risk of aspiration.
Bloom’s taxonomy level: remembering level as the learner is required to recall the specifics of the course and apply it to answer the question.
- The patient had abdominal surgery. The estimated blood loss was 400ml. The patient received 300ml of 0.9% saline during surgery. Post-operatively, the patient is hypotensive. What should the nurse anticipate for this patient?
- Blood administration
- Restoring the circulating volume
- An ECG to check the circulatory status
- Return to surgery and check for internal bleeding
Rationale: restoring circulation with IV fluids is the priority. Although blood may restore circulation but there are no manifestations in this patient indicating the need for blood. An ECG would be done if there is no response to the fluid administration. Change in level of consciousness or distended abdomen would warrant returning the patient to surgery.
Bloom`s taxonomy: application level. The student is required to incorporate knowledge to be able to solve real-time problems.
Davidson, M., & Litchfield, K. (2021). Patient recovery and the post-anaesthesia care unit. Anaesthesia & Intensive Care Medicine, 22(10), 607–610. https://doi.org/10.1016/j.mpaic.2021.07.013
Tuma, F., & Nassar, A. K. (2021). Applying Bloom’s taxonomy in clinical surgery: Practical examples. Annals of Medicine and Surgery (2012), 69(102656), 102656. https://doi.org/10.1016/j.amsu.2021.102656
Zhang, L., & Li, X. (2022). Staged nursing intervention: The effect of the compliance in liver cancer patients with interventional therapy. Journal of Oncology, 2022, 7517821. https://doi.org/10.1155/2022/7517821