Chapter 08: Critical Thinking: A Lifelong Journey My Nursing Test Banks

Chapter 08: Critical Thinking: A Lifelong Journey

Test Bank

MULTIPLE CHOICE

1. A first-postoperative-day patient received pain medication 6 hours ago. He states he is not experiencing pain but refuses to deep breathe and ambulate as ordered. The nursing student caring for him consults her instructor, asking whether it might be advisable to administer pain medication. The student is using

a.

the right brain hemisphere.

b.

the intrapersonal learning style.

c.

linguistic memory.

d.

critical thinking.

ANS: D

The student has questioned the reason for the patients refusal to deep breathe and ambulate and has suggested that a possible cause may be the presence of discomfort that could be relieved by medication. This qualifies as critical thinking. The action described is not a good example of right brain hemisphere use or use of the intrapersonal learning style, and it is not related to linguistics.

DIF: Cognitive Level: Application REF: p. 90 OBJ: 2

TOP: Critical thinking KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity

2. A strategy a nurse might use to improve critical thinking skills is to

a.

avoid challenging situations.

b.

take observations at face value.

c.

think about the meaning of relevant theory while giving patient care.

d.

implement the first solution thought of when solving patient care problems.

ANS: C

Mentally reviewing related theory while providing care helps ensure safe, effective care that meets established standards. Avoiding challenging situations gives no opportunity for critical thinking. The remaining options do not use critical thinking.

DIF: Cognitive Level: Application REF: p. 90 OBJ: 7

TOP: Critical thinking KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Client Care Environment

3. The nursing student tells a peer, Once I begin studying, I dont dare take a break. If I stop for even 5 minutes, I know Ill never go back to studying. The peer identifies this statement as

a.

negative thinking.

b.

random thinking.

c.

ruminative thinking.

d.

all-or-nothing thinking.

ANS: D

All-or-nothing thinking is characterized by making up ones mind and not considering any additional facts. The thinking is black and white, without grays. Negative thinking occurs when the mind is stuck on negative thoughts and cannot move to other thinking. Random thinking is characterized by intermittent thoughts without purpose or goal. Ruminative thinking occurs when the individual focuses on a situation or scene and repeatedly replays it in the mind.

DIF: Cognitive Level: Application REF: p. 90 OBJ: 1

TOP: Critical thinking KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

4. A patient tells the nursing student, I keep thinking of the mistake I made that led to the accident. I cant get it out of my mind. Now my son has a broken leg. The nursing student correctly identifies this as

a.

random thinking.

b.

habitual thinking.

c.

ruminative thinking.

d.

directed thinking.

ANS: C

Ruminative thinking replays the same situation repeatedly without reaching an outcome. Random thinking involves many thoughts or scenes running aimlessly through the mind. Habitual thinking involves routines performed as if on automatic pilot. Directed thinking is purposeful and outcome oriented.

DIF: Cognitive Level: Analysis REF: p. 90 OBJ: 1

TOP: Critical thinking

KEY: Nursing Process Step: Assessment (Data Collection)

MSC: NCLEX: Safe, Effective Care Environment

5. Which question should be asked by a nursing student who is developing a plan to increase his critical thinking ability so as to achieve higher grades?

a.

Do I comprehend information from textbooks and classes?

b.

I wonder how to improve my overall efficiency?

c.

Ill have to learn from my mistakes.

d.

Someone needs to check my conclusions.

ANS: A

This question deals with an important aspect of using critical thinking in nursing. One must comprehend the information and then be able to recall and apply it. I wonder how to improve my overall efficiency is a diffuse question and does not lend itself to planning without first being narrowed and better focused. The other two options are not questions.

DIF: Cognitive Level: Comprehension REF: p. 91 OBJ: 7

TOP: Critical thinking KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

6. The student reads a definition of a nursing term and is asked to state whether the sentence is true or false. The cognitive level of this exercise is

a.

knowledge.

b.

comprehension.

c.

application.

d.

analysis.

ANS: A

Knowledge refers to the ability to recall and repeat memorized information. The other options are higher cognitive levels.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

7. When an instructor asks a nursing student to answer a question in her or his own words and give an example, the cognitive level utilized is

a.

knowledge.

b.

comprehension.

c.

application.

d.

analysis.

ANS: B

Comprehension refers to the ability to understand information, recall it, and identify examples. Knowledge is the ability to recall and repeat memorized information. Application refers to being able to use learned information in new situations. Analysis refers to being able to break down complex information into its basic parts and relate the parts to the whole.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

8. The nursing student has learned the principles of determining and recording intake and output. When the student cares for a patient who has had a liquid breakfast and has voided twice and vomited once, the student documents intake and output in the patients chart using the cognitive level known as

a.

knowledge.

b.

comprehension.

c.

application.

d.

analysis.

ANS: C

Knowledge refers to recalling memorized information. Comprehension refers to repeating information in ones own words or identifying an example. Analysis refers to breaking down complex information and relating the parts to the whole picture. Application calls for being able to use learned material in new situations. Because the student documents the intake and output, he is using information learned.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

9. During morning report, the nursing student receives a description of the assigned patients current problems. When the student determines the priority nursing intervention, she is processing information at the cognitive level known as

a.

knowledge.

b.

comprehension.

c.

application.

d.

analysis.

ANS: D

Analysis is used when the individual organizes and prioritizes. This scenario suggests a higher level of functioning than cited in the other options.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: Planning

MSC: NCLEX: Safe, Effective Care Environment

10. Which factor that influences critical thinking provides the best rationale for using a team meeting to plan care for a patient?

a.

Collaboration

b.

Moral development

c.

Self-confidence

d.

Maturity

ANS: A

Collaborative effort promotes critical thinking skills; thus, care planning by a knowledgeable group is likely to result in creative solutions to problems. The other options do not provide a rationale for using team planning sessions.

DIF: Cognitive Level: Analysis REF: p. 91|p. 93 OBJ: 7

TOP: Critical thinking KEY: Nursing Process Step: Planning

MSC: NCLEX: Safe, Effective Care Environment

11. Which remark by a nurse demonstrates the use of critical thinking?

a.

I just let my thoughts flow.

b.

My mind is made up. Why listen further?

c.

I play and replay a situation, like using instant replay.

d.

I think about what other information I need before proceeding.

ANS: D

Critical thinking requires the individual to have access to all necessary information. This is accomplished by collecting and verifying data in an organized way, arranging data in an organized way, looking for gaps in information, and then proceeding with data analysis.

DIF: Cognitive Level: Application REF: pp. 90-91 OBJ: 2

TOP: Critical thinking

KEY: Nursing Process Step: Assessment (Data Collection) MSC: NCLEX: N/A

12. A nurse is caring for a postpartum patient. The nurse assesses the patients fundus, notes that it is deviated to the side, and instructs the patient to void. The nurse understands that this intervention should allow the fundus to effectively contract. The nurses thinking is purposeful and outcome oriented. This is an example of

a.

directed thinking.

b.

habitual thinking.

c.

nonfocused thinking.

d.

ruminative thinking.

ANS: A

Directed thinking is purposeful and outcome oriented. Habitual thinking involves any routine that is important but does not require one to think hard about how to do it. Nonfocused thinking occurs when the brain is engaged out of habit without much conscious thought. Ruminative thinking occurs when the same situation or scene is replayed in the mind over and over, without reaching an outcome.

DIF: Cognitive Level: Application REF: p. 90 OBJ: 1

TOP: Critical thinking KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

13. A nurse is performing routine vital signs on patients. The nurse has obtained vital signs many times before and is able to do so without much conscious thought. This is an example of

a.

directed thinking.

b.

negative thinking.

c.

ruminative thinking.

d.

nonfocused thinking.

ANS: D

Directed thinking is purposeful and outcome oriented. Negative thinking occurs when the mind is stuck on negative thoughts and blocks worthwhile thinking. Ruminative thinking occurs when the same situation or scene is replayed in the mind over and over, without reaching an outcome. Nonfocused thinking occurs when the brain is engaged out of habit, without much conscious thought.

DIF: Cognitive Level: Application REF: p. 90 OBJ: 1

TOP: Critical thinking KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

14. A nursing instructor encourages student nurses to use critical thinking in the clinical setting. The instructor understands that critical thinking

a.

uses both logic and intuition.

b.

is driven by the nurses needs.

c.

entails nonpurposeful thinking.

d.

is based on nonscientific methods.

ANS: A

Critical thinking entails purposeful, informed, outcome-focused thinking that uses both logic and intuition; is driven by the patients, familys, and communitys needs; and is based on the principles of the nursing process and scientific methods.

DIF: Cognitive Level: Application REF: p. 90 OBJ: 2

TOP: Critical thinking KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

15. A nursing student demonstrates the ability to break down complex information into its basic parts and relate those parts to the whole picture. This is an example of what cognitive level?

a.

Analysis

b.

Knowledge

c.

Application

d.

Comprehension

ANS: A

Analysis means being able to break down complex information into its basic parts and relate those parts to the whole picture. Knowledge refers to the ability to recall and repeat information one has memorized. Applicationmeans being able to use learned material in new situations. Comprehension refers to the ability to very basically understand information, recall it, and identify examples of that information.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

16. A student nurse recalls that sleeping medications are administered at 2100. When the student is questioned about why sleeping medications are given at this time, the student states, I memorized that sleeping pills are given at 2100. I have no idea why. The student is using what cognitive level?

a.

Analysis

b.

Knowledge

c.

Application

d.

Comprehension

ANS: B

Analysis means to be able to break down complex information into its basic parts and relate those parts to the whole picture. Knowledge refers to the ability to recall and repeat information one has memorized. Applicationmeans being able to use learned material in new situations. Comprehension refers to the ability to very basically understand information, recall it, and identify examples of that information.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

17. A student nurse recently learned during a lecture about Maslows hierarchy of needs. During the clinical rotation, the student is able to prioritize patient care based on Maslows hierarchy of needs. The student is using what cognitive level?

a.

Analysis

b.

Knowledge

c.

Application

d.

Comprehension

ANS: C

Analysis means to be able to break down complex information into its basic parts and relate those parts to the whole picture. Knowledge refers to the ability to recall and repeat information one has memorized. Applicationmeans being able to use learned material in new situations. Comprehension refers to the ability to very basically understand information, recall it, and identify examples of that information.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

18. A nurse is caring for a postpartum patient who is hemorrhaging. The nurse considers several possibilities for postpartum hemorrhaging, including retained placental fragments, a full bladder, and uterine atony. The nurse is using what cognitive level?

a.

Analysis

b.

Knowledge

c.

Application

d.

Comprehension

ANS: A

Knowledge refers to the ability to recall and repeat information one has memorized. Comprehension refers to the ability to very basically understand information, recall it, and identify examples of that information.Application means being able to use learned material in new situations. Analysis means to be able to break down complex information into its basic parts and relate those parts to the whole picture.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

19. A nursing student demonstrates the ability to recall and repeat memorized information but does not understand the information. This is an example of what cognitive level?

a.

Analysis

b.

Knowledge

c.

Application

d.

Comprehension

ANS: B

Knowledge refers to the ability to recall and repeat information one has memorized. Comprehension refers to the ability to very basically understand information, recall it, and identify examples of that information.Application means being able to use learned material in new situations. Analysis means to be able to break down complex information into its basic parts and relate those parts to the whole picture.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

20. A nursing student demonstrates the ability to basically understand information, recall it, and identify examples of that information. This is an example of what cognitive level?

a.

Analysis

b.

Knowledge

c.

Application

d.

Comprehension

ANS: D

Knowledge refers to the ability to recall and repeat information one has memorized. Comprehension refers to the ability to very basically understand information, recall it, and identify examples of that information.Application means being able to use learned material in new situations. Analysis means to be able to break down complex information into its basic parts and relate those parts to the whole picture.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

21. A nursing student demonstrates the ability to use learned material in new situations. This is an example of what cognitive level?

a.

Analysis

b.

Knowledge

c.

Application

d.

Comprehension

ANS: C

Analysis means to be able to break down complex information into its basic parts and relate those parts to the whole picture. Knowledge refers to the ability to recall and repeat information one has memorized. Applicationmeans being able to use learned material in new situations. Comprehension refers to the ability to very basically understand information, recall it, and identify examples of that information.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

22. Clinical judgments about patients that result from critical thinking have what as their basis?

a.

Evidence

b.

Assumptions

c.

Ethical principles

d.

Personal preference of the nurse

ANS: A

Judgments should be made on the basis of facts or evidence, rather than assumptions, whims, or the nurses preference. In addition, decisions are influenced by ethical principles, with the nurse choosing to do the right thing for the patient.

DIF: Cognitive Level: Comprehension REF: p. 90 OBJ: 2

TOP: Critical thinking KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

COMPLETION

1. The NCLEX-PN examination includes items that require various levels of thinking to answer a test item. These various levels are called ____________________.

ANS:

cognitive levels

The NCLEX-PN exam includes items that require various levels of thinking to answer a test item. These various levels are called cognitive levels. The cognitive levels used on the NCLEX-PN examination are knowledge, comprehension, application, and analysis.

DIF: Cognitive Level: Application REF: p. 90|p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

2. The cognitive levels used on the NCLEX-PN examination are knowledge, comprehension, application, and ____________________.

ANS:

analysis

The NCLEX-PN includes items that require various levels of thinking to answer a test item. These various levels are called cognitive levels. The cognitive levels used on the NCLEX-PN examination are knowledge, comprehension, application, and analysis.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

MULTIPLE RESPONSE

1. To describe critical thinking in nursing to a peer, which characteristics would the nurse mention? (Select all that apply.)

a.

Random use

b.

Patient focused

c.

Uses logic and intuition

d.

Bases judgments on assumptions

e.

Does not require ongoing evaluation

ANS: B, C

Critical thinking in nursing attempts to find a solution for a patient problem or need. It is purposeful and uses both logic and intuition. Critical thinking is purposeful rather than random. Judgments are based on evidence rather than assumptions. Critical thinking is constantly re-evaluating and self-correcting.

DIF: Cognitive Level: Application REF: p. 90 OBJ: 2

TOP: Critical thinking KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

2. During a performance evaluation, the evaluator describes several behaviors of the nurse. Select the observations that indicate the nurse uses critical thinking. (Select all that apply.)

a.

I have noted that you base care on patient needs.

b.

Your caregiving is guided by identified outcomes.

c.

You use professional standards as guidelines.

d.

You tailor interventions to the circumstances.

ANS: A, B, C, D

Each behavior is consistent with the advanced way of thinking known as critical thinking and with use of clinical judgment.

DIF: Cognitive Level: Analysis REF: pp. 90-91 OBJ: 2

TOP: Critical thinking KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

3. An instructor tells a nursing student, I have noticed that you sometimes engage in nonfocused thinking. Which behaviors are consistent with the instructors observation? (Select all that apply.)

a.

The student consistently looks for solutions to problems.

b.

The student makes up his mind quickly and ignores additional facts.

c.

The student focuses on the negative aspects of nearly every situation.

d.

The student looks for creative ways to improve situations.

ANS: B, C

The student who makes up his mind quickly and ignores additional facts is an example of all-or-none thinking, a type of nonfocused thinking. The student who focuses on the negative aspects of nearly every situation is an example of negative thinking, another type of nonfocused thinking. The remaining options are goal oriented and purposeful; therefore, they are not examples of nonfocused thinking.

DIF: Cognitive Level: Analysis REF: pp. 90-91 OBJ: 1

TOP: Critical thinking KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

4. To think critically, it is necessary to do which of the following? (Select all that apply.)

a.

Access information

b.

Comprehend information

c.

Recall the comprehended information when needed

d.

Store comprehended information in short-term memory only

e.

Know what to do when information is not in long-term memory

ANS: A, B, C, E

To think critically, it is necessary to access information, comprehend information, store comprehended information in long-term memory, recall the comprehended information when needed, and know what to do when information is not in long-term memory.

DIF: Cognitive Level: Comprehension REF: p. 91 OBJ: 2

TOP: Critical thinking KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

5. A nursing student determines that she needs to increase her reading effectiveness. Identify two effective strategies for accomplishing this goal that can be implemented immediately. Select all that apply.

a.

Read one word at a time.

b.

Move her lips while reading.

c.

Read recreational literature more slowly than technical material.

d.

Underline unfamiliar words.

ANS: B, D

Moving the lips while reading increases understanding for readers who are auditory learners. Underlining unfamiliar words signals the need to determine the definition of the word and thus enhance ones medical vocabulary.

DIF: Cognitive Level: Comprehension REF: p. 93 OBJ: 6

TOP: Reading Effectively KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

6. Which of the following are the cognitive levels used in the NCLEX-PN examination? (Select all that apply.)

a.

Analysis

b.

Intuition

c.

Application

d.

Knowledge

e.

Correlation

f.

Comprehension

ANS: A, C, D, F

The NCLEX-PN exam includes items that require various levels of thinking to answer a test item. These various levels are called cognitive levels. The cognitive levels used on the NCLEX-PN examination are knowledge, comprehension, application, and analysis.

DIF: Cognitive Level: Application REF: p. 94 OBJ: 4

TOP: Cognitive levels KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

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