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Clinical Reasoning

By Tracy Levett-Jones
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A nurse’s clinical reasoning ability is a key factor in the provision of quality care and the prevention of adverse patient outcomes. This unique book provides a series of authentic, engaging and meaningful scenarios that will guide you through the clinical reasoning process while challenging you to think critically and creatively about the nursing care you provide. It will promote deep learning and opportunities for you to rehearse how you will respond to real clinical situations in ways that are both person-centred and clinically astute.
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Pearson Australia
Table of contents
  • Chapter 1: Clinical reasoning: What it is and why it matters 
  • Chapter 2: Caring for a person experiencing an adverse drug event
  • Chapter 3: Caring for a person with fluid and electrolyte imbalance
  • Chapter 4: Caring for a person experiencing respiratory distress and hypoxia
  • Chapter 5: Caring for a person with a cardiac condition
  • Chapter 6: Caring for a person with an acquired brain injury
  • Chapter 7: Caring for a ‘challenging’ patient
  • Chapter 8: Caring for a person with an autoimmune condition
  • Chapter 9: Caring for an older person with altered cognition
  • Chapter 10: Caring for a person experiencing pain
  • Chapter 11: Caring for a child with type 1 diabetes
  • Chapter 12: Caring for a person receiving blood component therapies
  • Chapter 13: Caring for a person requiring palliative care
  • Chapter 14 : Ethical and legal dimensions of clinical reasoning
  • Glossary
  • Index
Features & benefits
  • Each chapter includes two linked clinical scenarios. A sequential, step-through approach is used and an ‘unfolding story’ presented. Web links to relevant resources are included. A series of multiple choice, true/false, rank and sort, and short answer questions are provided and you will be asked to make decisions at critical junctures. The scenarios are an opportunity to test out your knowledge, to make mistakes and to learn from those mistakes.
  • The scenarios have been adapted from real clinical situations and are of varying levels of complexity. In this instance complexity refers not to acuity but to clinical situations for which there is not an immediate and pre-defined response. This includes patient encounters that require the nurse to thoughtfully collect appropriate information, to interpret and make sense of that information, and to plan, initiate, evaluate and reflect on the effectiveness of nursing interventions.
  • The scenarios portrayed take place in a range of health care and community settings.
  • While most chapter emphasise how effective clinical reasoning skills can help you recognise and manage patient deterioration early and, in effect, “rescue” the patient; Chapter 14 considers the ethical implications of withholding potentially lifesaving treatments when an attempt to “rescue” may not be in the person’s best interests or does not accord with their wishes. These are some of the most difficult clinical decisions that can be made and require effective clinical and moral reasoning skills.
  • The selection of scenarios is deliberate and framed by Australia’s National Health Priority Areas. The clients/patients profiled are of different ages and from different cultural backgrounds; and the key concepts that feature in the book are linked to patient safety and quality care.

Key Pedagogy:

  • Answer responses are provided online as formative feedback. Please note that in some cases a variety of responses is acceptable.
  • Learning outcomes are listed at the beginning of each chapter and will help orientate you to what you will learn.
  • Key concepts integrated throughout this book include person-centred care, holistic practice, therapeutic, intra and interprofessional communication, cultural sensitivity, and patient safety. The integration of these concepts will help you to transfer your learning to new clinical situations leading to application and a deeper understanding. Pathophysiology and safe medication practices are also integrated throughout the book. Additionally, there are key concepts linked to each chapter. 
  • Suggested readings are provided and you can either read in preparation for undertaking the learning activities or challenge yourself by seeing how much you already know. Specific readings are provided from LeMone and Burke’s Medical-surgical nursing: Critical thinking in client care (Australian ed), Kozier and Erb’s Fundamentals of Nursing and other relevant resources; however, the same information can be accessed in most foundational or medical surgical textbooks. Additional readings are provided at the end of each chapter and these will help you to build on your knowledge about topics of interest.
  • Reflective thinking is the final stage of the clinical reasoning cycle and in order for you to maximise your learning guided reflection questions are provided at the end of each scenario. Answers to these questions are not provided as their purpose is to help you think broadly, critically and creatively about what you have learned and most importantly, how your learning will inform you future practice. These questions may also be used to design assignment questions, for tutorial discussion, or to structure debriefing following simulation sessions.
  • A glossary of terms is provided online and at the end of the book.
Author biography

Tracy Levett-Jones, PhD, RN, MEd & Work, BN, DipAppSc(Nursing), is the Deputy Head of School (Teaching and Learning) in the School of Nursing and Midwifery at the University of Newcastle. Her research interests include: clinical reasoning, clinical education, belongingness, interprofessional communication, simulation and patient safety. Tracy’s doctoral research explored the clinical placement experiences of students in Australia and the United Kingdom. She has a broad clinical background and prior to her academic career worked as a nurse educator, nurse manager and clinician. Tracy has authored three books on clinical education, twelve book chapters and more than 50 peer reviewed journal publications. She has been awarded eight teaching and learning awards including the 2010 Pearson/Australian Nurse Teacher Society Nurse Educator of the Year Award and an Australian Learning and Teaching Council Award for Teaching Excellence.


Dr Jennifer Dempsey, DN, RN, RPN, M Nurs. Studies, Grad Dip Nurs
Senior Lecturer, Director of Clinical Education, The School of Nursing & Midwifery, The University of Newcastle

Ms Frances Dumont, RN, MSN, BN, BEd
Dementia Delirium Clinical Nurse Consultant, Hunter New England Health 

Mr Nathan Haining, RN, BN, Grad cert. Crit care
Clinical Nurse Educator, Neuroscience, Westmead Hospital

Dr Kerry Hoffman, RN, BSc, Grad Dip. Ed., Dip. Health Sc., MN, PhD
Lecturer, The School of Nursing & Midwifery, The University of Newcastle

Dr Sharyn Hunter, PhD, RN, BSc( Hons),  Grad Cert(Aged Care) Grad Cert Tertiary Teaching
Lecturer, The School of Nursing & Midwifery, The University of Newcastle 

Ms Raelene Kenny RN, MNursing (Critical Care), GradCertEd (Adult & Org Learning), GradCert Tertiary Teaching
Lecturer, The School of Nursing & Midwifery, The University of Newcastle 

Professor Tracy Levett-Jones, PhD, RN, MEd & Work, BN, DipAppSc(Nursing)
Deputy Head of School (Teaching and Learning), The School of Nursing & Midwifery, The University of Newcastle

Associate Professor David Newby, BPharm, PhD
Acting Discipline Lead, Clinical Pharmacology, The School of Medicine and Public Health
The University of Newcastle

Ms Caroline Phelan, RN, MPH, BN, PhD candidate
Clinical Nurse Consultant Pain Management, Hunter Integrated Pain Service
Ms Lorinda Palmer, MN, RN, BSc., Dip. Ed, Grad Dip (Nurs)
Lecturer, The School of Nursing & Midwifery, The University of Newcastle, PhD candidate

Ms Victoria Pitt, RN, MNur (Research), Grad Dip Nurs (Pal.care), Grad Cert Tert Teaching, Dip ApSc (Nursing), PhD candidate
Lecturer, The School of Nursing & Midwifery, The University of Newcastle

Ms Loretto Quinney, RN,RM,CCRN,BaApp.Sc,Grad Cert Mng
Lecturer, The School of Nursing and Midwifery, CQUniversity
Dr Rachel Rossiter, D.HSc, RN, MN (NP), M.Counselling, B.Counselling, B.Hlth Sc
Director Postgraduate Coursework Programs, The School of Nursing & Midwifery, He University of Newcastle

Mr Peter Sinclair, RN, BN, Renal Cert, MPhil candidate
Lecturer, The School of Nursing & Midwifery, The University of Newcastle
Chair, The Nephrology Educators Network

Dr Teresa Stone, PhD, RN, RMN, BA M Health Management, GradCert Tertiary Teaching
Bachelor of Nursing Program Convenor, The School of Nursing & Midwifery, The University of Newcastle

Dr Kerry Reid-Searl, PhD,RN,RM,BHlth Sc,MClin Ed.
Assistant Dean Simulation, The School of Nursing and Midwifery, CQUniversity
Associate Professor Pamela van der Riet, PhD, RN, MEd , BA Dip ED (Nursing), ICU/CCU cert
Deputy Head of School, The School of Nursing & Midwifery, The University of Newcastle

Ms Lea Vieth, RN, BN
Paediatric Nurse, Rockhampton Hospital

Ms Bree Walker, RN, BN
Nurse Educator, Paediatrics, Rockhampton Hospital

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