Chapter 08: Critical Thinking My Nursing Test Banks

Chapter 08: Critical Thinking

Potter: Essentials for Nursing Practice, 8th Edition

MULTIPLE CHOICE

1.A registered nurse is caring for a patient in the trauma unit who had been involved in a motor vehicle accident. Although the patient denied pain, during the nurses assessment, the nurse observed that the patient groaned when moving and was protective of the right arm. The nurse believed the patient had pain and reported it to the primary health care provider, who ordered a radiograph (x-ray) of the right arm. The radiograph revealed a fractured arm. Which technique did the nurse use?

a.

Intuition

b.

Critical thinking

c.

Perseverance

d.

Reflection

ANS: B

The nurse used critical thinking. Critical thinking involves recognizing that an issue (e.g., patient problem) exists, analyzing information related to the issue (e.g., clinical data about a patient), evaluating information (including assumptions and evidence), and drawing conclusions. Intuition is an inner sensing or gut feeling that something is so. Reflection is a part of critical thinking that involves the process of purposefully thinking back or recalling a situation to discover its purpose or meaning. Perseverance means to also keep looking for additional resources until you find a successful approach.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF: 106 OBJ: Discuss the nurses responsibility in making clinical decisions.

TOP: Nursing Process: Assessment MSC: NCLEX: Basic Care and Comfort

2.A registered nurse is caring for a postoperative patient whose systolic blood pressure has dropped 10 points during the shift. The nurse remembers that this was similar to a situation that happened in the past when a patient developed an internal bleed. Based upon the nurses thoughts, which skill did the nurse use?

a.

Intuition

b.

Critical thinking

c.

Nursing process

d.

Reflection

ANS: D

The nurse is using reflection when thinking about a situation in the past that was similar. Reflection is a part of critical thinking that involves the process of purposefully thinking about or recalling a situation to discover its purpose or meaning. Critical thinking involves recognizing that an issue (e.g., patient problem) exists, analyzing information related to the issue (e.g., clinical data about a patient), evaluating information (including assumptions and evidence), and drawing conclusions. Intuition is an inner sensing or gut feeling that something is so. The nursing process is a five-step approach that incorporates diagnostic reasoning and clinical decision making.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF: 107 OBJ: Describe how reflection improves clinical decision making.

TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Adaptation

3.A nurse is admitting a 73-year-old woman with a fractured ulna and radius to the trauma unit of the hospital. The patients daughter and son-in-law are present. The nurse notices that the patient does not make eye contact when answering questions and the nurse senses that something is not right about the situation. Which technique did the nurse use?

a.

Intuition

b.

Critical thinking

c.

Nursing process

d.

Reflection

ANS: A

The fact that the nurse senses something is not right about the situation is intuition. Intuition is the inner sensing or gut feeling that something is so. For example, a nurse walks into a patients room and, by looking at the patients appearance without the benefit of a thorough assessment, senses that he or she has worsened physically. Reflection is a part of critical thinking that involves the process of purposefully thinking about or recalling a situation to discover its purpose or meaning. Critical thinking involves recognizing that an issue (e.g., patient problem) exists, analyzing information related to the issue (e.g., clinical data about a patient), evaluating information (including assumptions and evidence), and drawing conclusions. The nursing process is a five-step approach that incorporates diagnostic reasoning and clinical decision making.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 108 OBJ: Discuss the nurses responsibility in making clinical decisions.

TOP: Nursing Process: Assessment MSC: NCLEX: Safety and Infection Control

4.A student nurse is administering an enema with an instructor in the room. The patient states that he or she can no longer hold the enema solution. The student nurse acknowledges the patients request and begins to tell the patient to go to the bathroom but asks the instructor if this is OK. The instructor suggests that the patient wait a few minutes to give the enema solution time to be absorbed into the bowel. In this situation the student nurse demonstrates what level of critical thinking according to Kataoka-Yahiro and Saylors model?

a.

Level 1: Basic

b.

Level 2: Complex

c.

Level 3: Commitment

d.

Level 4: Expert

ANS: A

The student nurse is at the basic level because he or she asked the instructor what to do. At the basic level of critical thinking a learner trusts that experts have the right answers for every problem. Thinking is concrete and based on a set of rules or principles. Complex critical thinkers begin to separate themselves from experts. In complex critical thinking you learn to synthesize knowledge. This means that you develop a new thought or idea based on your experience and knowledge over time. The third level of critical thinking is commitment. You anticipate the need to make choices without assistance from others. You accept accountability for whatever decisions you make. There is no level 4 in this model.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:109

OBJ: Describe the components of a critical thinking model for clinical decision making.

TOP: Nursing Process: Implementation MSC: NCLEX: Basic Care and Comfort

5.A nurse is describing risk taking, creativity, and integrity in nursing care. What is the nurse explaining?

a.

Attitudes of critical thinking

b.

Competencies of critical thinking

c.

Standards for critical thinking

d.

Nursing process for critical thinking

ANS: A

The fourth component of the critical thinking model is attitudes. Paul (1993) identifies 11 attitudes that are central features of a critical thinker of which risk taking, creativity, and integrity are examples. Kataoka-Yahiro and Saylor (1994) describe critical thinking competencies as the cognitive processes a nurse uses to make judgments about the clinical care of patients. There are three competencies: general critical thinking (scientific method, problem solving, and decision making), specific critical thinking in clinical situations (clinical inference, diagnostic reasoning, and clinical decision making), and specific critical thinking in nursing (nursing process). The standards for critical thinking include intellectual standards and professional standards. The nursing process is a five-step approach that incorporates diagnostic reasoning and clinical decision making.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:115-116

OBJ: Discuss the critical thinking attitudes used in clinical decision making

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

6.A nurse is using the scientific method to solve a patient situation. Which action should the nurse take first?

a.

Collect data.

b.

Identify a problem.

c.

Formulate a question.

d.

Evaluate the results.

ANS: B

Identifying the problem is the first step in the scientific method. The steps of the scientific method are as follows: Identify the problem; Collect data; Form a question or hypothesis; Test the question or hypothesis; Evaluate results of the study. Collect data is the second step. Formulate a question is the third step. Evaluate the results is the last step.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF: 110 OBJ: Discuss critical thinking skills used in nursing practice.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

7.A registered nurse is explaining a procedure to a patient who speaks another language. Which action by the nurse reflects critical thinking?

a.

Teach with unfamiliar explanations.

b.

Explain using medical jargon.

c.

Use vague descriptions.

d.

Obtain an interpreter.

ANS: D

Critical thinkers use language precisely and clearly. If you do not obtain a professional interpreter when communicating with patients who speak a different language, you are taking the risk of miscommunicating important information. When you use incorrect terminology, jargon, or terminology with which a patient is unfamiliar, or vague descriptions, communication is ineffective.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 108 OBJ: Discuss the nurses responsibility in making clinical decisions.

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

8.A patient receiving blood after an abdominal surgery notified the nurse that the IV pump was alarming. The nurse checked the pump and determined that the tubing was kinked. The tubing was straightened out and the nurse left the room. Five minutes later the IV pump again alarmed. The nurse returned to find the tubing was again kinked. On further investigation, the nurse discovered that the IV tubing had become twisted. This is an example of which behavior on the part of the nurse?

a.

Effective problem solving

b.

Diagnostic reasoning

c.

Scientific method

d.

Commitment level of critical thinking

ANS: A

Effective problem solving involves evaluating the solution over time to be sure that it is still effective and if a problem occurs you try different options, which the nurse did in this scenario. In commitment, you anticipate the need to make choices without assistance from others. The nurse did not anticipate the need as evidenced by the fact the nurse did not fully investigate until the second time. The scientific method is one formal way (in this scenario the nurse did not use the formal approach) to approach a problem, plan a solution, test the solution, and come to a conclusion; it is usually used in research. In diagnostic reasoning, the information a nurse collects and analyzes leads to a diagnosis of a patients condition. Nurses do not make medical diagnoses; they make nursing diagnoses, which is a part of diagnostic reasoning. This scenario deals with an equipment problem, not a patient health problem (diagnostic reasoning).

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF: 111 OBJ: Discuss the nurses responsibility in making clinical decisions.

TOP:Nursing Process: Implementation

MSC: NCLEX: Pharmacological and Parenteral Therapies

9.A patient on a pediatric unit who underwent an appendectomy for a ruptured appendix 3 days ago complains of acute pain and has a high fever. The nurse is concerned that the patient may have an infection and notifies the primary health care provider of the change in the patients condition. This concern is based on the nurses experience as a pediatric nurse. The nurses ability to make a tentative conclusion regarding this patients situation based on observed data is known as what?

a.

Scientific method

b.

Clinical inference

c.

Effective problem solving

d.

Data collection

ANS: B

The nurse used clinical inference because of previous experience as a pediatric nurse and pieces of evidence of acute pain and a high fever. Clinical inference is the process of drawing conclusions from related pieces of evidence and previous experience with the evidence. An inference involves forming patterns of information from data before making a nursing diagnosis. The scientific method is one formal way (in this scenario the nurse did not use the formal approach) to approach a problem, plan a solution, test the solution, and come to a conclusion; it is usually used in research. Effective problem solving involves evaluating the solution over time to be sure that it is still effective and if a problem occurs you try different options. Data collection is a component of assessment in the nursing process. In diagnostic reasoning you use patient data that you gather or collect to logically identify a problem. The nurse in this scenario is past data collection and is making a tentative conclusion.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:111

OBJ: Explain the relationship between clinical experience and critical thinking.

TOP: Nursing Process: Assessment MSC: NCLEX: Reduction of Risk Potential

10.A patient with cancer is undergoing outpatient chemotherapy. The clinic nurse notes that the patients white blood cell count is very low and has little energy. The plan of care is based upon the nursing diagnosis Risk for Infection. The nurse provides patient teaching in order to reduce the risk for infection. The nurse is using which skill in this situation?

a.

Medical diagnosis

b.

Scientific method

c.

Diagnostic reasoning

d.

Data collection

ANS: C

The nurse used diagnostic reasoning by using data (low white blood cells and little energy) to arrive at a patients health problem/nursing diagnosis (Risk for Infection). Diagnostic reasoning is the analytical process for determining a patients health problems. It requires you to assign meaning to the behaviors and physical signs and symptoms presented by a patient. Nurses do not make medical diagnoses; they make nursing diagnoses. The scientific method is one formal way (in this scenario the nurse did not use the formal approach) to approach a problem, plan a solution, test the solution, and come to a conclusion; it is usually used in research. Data collection is a component of assessment in the nursing process. In diagnostic reasoning you use patient data that you gather or collect to logically identify a problem. The nurse in this scenario is past data collection and has made a nursing diagnosis: Risk for Infection.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF: 111 OBJ: Discuss critical thinking skills used in nursing practice.

TOP: Nursing Process: Evaluation MSC: NCLEX: Safety and Infection Control

11.A nurse is caring for an elderly lady who recently experienced a stroke and who coughs/chokes after eating or drinking. The nurse knew that the patient was at risk for aspiration because of the stroke and was concerned that the patient may have impaired swallowing. The nurse develops a care plan based on the nursing diagnosis Impaired Swallowing. Which skill is the nurse using to make this nursing diagnosis?

a.

Medical diagnosis

b.

Scientific method

c.

Diagnostic reasoning

d.

Data collection

ANS: C

The nurse used diagnostic reasoning to arrive at a nursing diagnosis. During diagnostic reasoning, the information a nurse collects and analyzes leads to a diagnosis of a patients condition. Nurses do not make medical diagnoses; they make nursing diagnoses. The scientific method is one formal way (in this scenario the nurse did not use the formal approach) to approach a problem, plan a solution, test the solution, and come to a conclusion; it is usually used in research. Data collection is a component of assessment in the nursing process. In diagnostic reasoning you use patient data that you gather or collect to logically identify a problem. The nurse in this scenario is past data collection and has made a nursing diagnosis: Impaired Swallowing.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF: 111 OBJ: Discuss critical thinking skills used in nursing practice.

TOP: Nursing Process: Evaluation MSC: NCLEX: Reduction of Risk Potential

12.Which situation represents a nurse using clinical decision-making skills?

a.

Collecting information about a patient and coming to a conclusion about his or her health problems

b.

Developing a new idea based on experience and knowledge over time

c.

Selecting appropriate treatment after forming diagnostic conclusions

d.

Clarifying the problem and analyzing possible causes

ANS: C

Clinical decision making is a problem-solving activity that focuses on selecting appropriate treatment after forming diagnostic conclusions. Clinical decision making requires careful reasoning so that a nurse chooses the option for the best patient outcome on the basis of the patients condition and priority of the problem. Collecting information about a patient and coming to a conclusion about his or health problems is diagnostic reasoning. Clarifying the problem and analyzing possible causes is a part of problem solving. In complex critical thinking you learn to synthesize knowledge. This means that you develop a new thought or idea based on your experience and knowledge over time.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:112

OBJ: Describe the components of a critical thinking model for clinical decision making.

TOP: Nursing Process: Assessment MSC: NCLEX: Management of Care

13.A new registered nurse working for a busy unit of an acute care teaching hospital begins the shift with four patients. Which patient should the nurse attend to first?

a.

Patient who needs assistance in ambulating the hall

b.

Patient whose blood pressure suddenly drops and who passes out (faints)

c.

Recovering stable surgical patient whose family has just arrived

d.

Recovering patient who is resting quietly watching television

ANS: B

A patients whose blood pressure drops and faints needs to be addressed first. Critical thinking and clinical decision making are complicated because nurses care for multiple patients in fast-paced and unpredictable environments. When you work in a busy setting, use criteria such as the clinical condition of a patient (stable vs. unstable), Maslows hierarchy of needs (patients blood pressure is an active lower need problem), the risks involved in treatment delays (if the blood pressure is not treated the patients condition could get worse), and patients expectations of care to decide which patients have the greatest priorities. A patient who needs assistance in ambulating the hall can be delegated to the nursing assistant personnel. The surgical patient is stable so does not need to be addressed first. The recovering patient resting quietly is not a priority.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF: 112 OBJ: Discuss the nurses responsibility in making clinical decisions.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

14.A nurse is teaching a group of nursing students about the nursing process. In which order should the nurse list the steps?

a.

Assessment, diagnosis, planning, implementation, and evaluation

b.

Diagnosis, assessment, planning, implementation, and evaluation

c.

Planning, evaluation, diagnosis, implementation, and assessment

d.

Evaluation, diagnosis, planning, implementation, and assessment

ANS: A

The nursing process is a systematic process that incorporates diagnostic reasoning and clinical decision making through five steps: assessment, diagnosis, planning, implementation, and evaluation. Assessment is the first step, not diagnosis, planning, or evaluation.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:112-113

OBJiscuss the relationship of the nursing process to critical thinking.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

15.Upon checking a medication order, the nurse notices that the dosage is more than three times the normal range for this medication. The nurse calls the primary health care provider to question the order. Which critical thinking attitude did the nurse use?

a.

Confidence

b.

Risk taking

c.

Fairness

d.

Curiosity

ANS: B

If your knowledge causes you to question a health care providers order, do so. This illustrates risk taking. To be confident is to feel certain in your ability to accomplish a task or goal such as performing a nursing procedure or making a diagnostic decision; do not let a patient think that you are unsure of performing care safely. Fairness is listening to both sides in any discussion and dealing with situations justly. Curiosity is always asking why.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:115-116

OBJ: Discuss the critical thinking attitudes used in clinical decision making.

TOP:Nursing Process: Evaluation

MSC: NCLEX: Pharmacological and Parenteral Therapies

16.A nurse is caring for a patient who underwent an above-the-knee amputation that requires a dressing change, a skill the nurse has never done. The nurse asks another nurse to help with the dressing change for the amputated leg. The nurse is demonstrating which critical thinking attitude?

a.

Humility

b.

Confidence

c.

Risk-taking

d.

Fairness

ANS: A

Critical thinkers who use humility admit what they do not know and try to find the knowledge they need to make a proper decision. Humility is recognizing when one needs more information to make a decision. When a nurse is new to a clinical division and unfamiliar with the patients, he or she should ask for an orientation to the area and ask nurses regularly assigned to the area for assistance. If your knowledge causes you to question a health care providers order, do so. This illustrates risk taking. To be confident is to feel certain in your ability to accomplish a task or goal such as performing a nursing procedure or making a diagnostic decision; do not let a patient think that you are unsure of performing care safely. Fairness is listening to both sides in any discussion and dealing with situations justly.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:115-116

OBJ: Discuss the critical thinking attitudes used in clinical decision making.

TOP: Nursing Process: Evaluation MSC: NCLEX: Basic Care and Comfort

17.A student nurse in the last semester of nursing school found that keeping a journal of clinical experiences helped the student nurse understand why certain actions were taken and to evaluate whether there was a better way of approaching the task. The student nurse has found that this has helped strengthen critical thinking skills. Which skill for developing critical thinking did the student nurse use?

a.

Professional standards

b.

Nursing process

c.

Concept mapping

d.

Purposeful reflection

ANS: D

Purposeful reflection leads to a deeper understanding of issues and the development of judgment and skill. One activity that will help a nurse develop into a critical thinker is reflective journaling. A concept map is a visual representation of meaningful relationships between concepts (e.g., patient problems or nursing diagnoses and interventions), which then form propositions. The primary purpose of a concept map is to synthesize relevant data about a patient such as assessment data, nursing diagnoses, health needs, nursing interventions, and evaluation measures. The nursing process is a systematic process that incorporates diagnostic reasoning and clinical decision making through five steps: assessment, diagnosis, planning, implementation, and evaluation. Professional standards for critical thinking refer to ethical criteria for nursing judgments (e.g., advocacy, patient autonomy, and beneficence), evidence-based criteria used for assessment and evaluation, and criteria for professional responsibility.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 118 OBJ: Describe how reflection improves clinical decision making.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

18.A new nurse who has just begun working for an oncology unit is frustrated with trying to figure out the relationships between a patients problems and appropriate nursing interventions. What is the best tool that the nurse can use to synthesize data into meaningful information?

a.

Concept map

b.

Reflective journal

c.

Plan of care

d.

Intellectual standards

ANS: A

A concept map is a visual representation of meaningful relationships between concepts (e.g., patient problems or nursing diagnoses and interventions), which then form propositions. Concept maps are visual road maps that highlight the meanings of these relationships. The primary purpose of a concept map is to synthesize relevant data about a patient such as assessment data, nursing diagnoses, health needs, nursing interventions, and evaluation measures. Reflective writing requires you to record your clinical experiences in your own words in a personal journal. In the nursing process, a plan of care is written to guide nursing care, but it does not show relationships as well as does a concept map. Paul (1993) identified 14 intellectual standards universal for critical thinking. An intellectual standard is a guideline or principle for rational thought, but it does not show relationships like a concept map does.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 118 OBJ: Discuss the nurses responsibility in making clinical decisions.

TOP: Nursing Process: Evaluation MSC: NCLEX: Management of Care

19.A nurse walks into a room and finds a patient to be severely confused. The nurse examines and observes the patient closely and thinks about other situations with severely confused patients before making a nursing diagnosis. Which skill is the nurse using?

a.

Clinical inferences

b.

Reflective journaling

c.

Accountability

d.

Intuition

ANS: A

Part of diagnostic reasoning is clinical inference, the process of drawing conclusions from related pieces of evidence and previous experience with the evidence. An inference involves forming patterns of information from data before making a nursing diagnosis. Reflective writing requires you to record your clinical experiences in your own words in a personal journal. Intuition is an inner sensing or gut feeling about something. Accountability refers to being answerable for ones actions.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF: 111 OBJ: Discuss critical thinking skills used in nursing practice.

TOP: Nursing Process: Assessment MSC: NCLEX: Safety and Infection Control

20.A nurse is using scientific knowledge and experience to choose strategies to use in the care of a patient. Which critical thinking skill is the nurse using?

a.

Analysis

b.

Evaluation

c.

Explanation

d.

Self-regulation

ANS: C

Scientific knowledge and experience to choose strategies you use in the care of patient is explanation; it supports your findings and conclusions. Analysis is being open-minded as you look at information about a patient. Do not make careless assumptions in analysis. Evaluation is looking at all situations objectively and systematically and using criteria to determine results of nursing actions. Self-regulation is reflecting on your experiences and identifying ways you can improve your own performance.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF: 107 OBJ: Discuss critical thinking skills used in nursing practice.

TOP: Nursing Process: Evaluation MSC: NCLEX: Management of Care

21.A nurse is alert to potentially problematic situations in a patient and is using evidence-based knowledge. Which concept for a critical thinker is the nurse using?

a.

Maturity

b.

Analyticity

c.

Systematicity

d.

Inquisitiveness

ANS: B

Analyticity is being alert to potentially problematic situations and using evidence-based knowledge. Maturity is reflecting on your own judgments and realizing multiple solutions are acceptable. Systematicity is being organized, focusing, and working hard in any inquiry. Inquisitiveness is being eager to acquire knowledge and learning explanations even when applications of the knowledge are not immediately clear and to value learning for learnings sake.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:107OBJescribe characteristics of a critical thinker.

TOP: Nursing Process: Assessment MSC: NCLEX: Reduction of Risk Potential

22.A surgical unit uses Betadine to prep the skin before surgery. A nurse is using the scientific method to decide if soap and water is better than Betadine for preparing the skin for surgery. A nurse washes one group of patients with soap and water and washes another group of patients with Betadine. Which step did the nurse implement?

a.

Identifying the problem

b.

Forming the question or hypothesis

c.

Answering the question or hypothesis

d.

Evaluating the results of the test or study

ANS: C

When the nurse washes one group with soap and water and the other with Betadine, the nurse is answering the question or hypothesis. Identifying the problem would be an increase in infections or adverse reactions from Betadine. Forming the question or hypothesis would be, Does soap and water vs Betadine reduce the incidence of infections or adverse reactions? Evaluating the results would occur when the nurse compared the incidence of infection or adverse reactions for each of the two groups.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 110 OBJ: Discuss critical thinking skills used in nursing practice.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

23.Which patient situation indicates the nurse used fairness?

a.

The nurse used original thinking to find solutions outside the standard routine.

b.

The nurse asked why the interventions were used to help the patient.

c.

The nurse did not allow personal attitudes to influence delivery of care.

d.

The nurse followed the six rights when giving medication to a patient.

ANS: C

Fairness means the nurse deals with situations justly. This means that bias or prejudice does not enter into a decision. For example, regardless of how you feel about obesity, you do not allow personal attitudes to influence the way you deliver care to patients who are overweight. Creativity involves original thinking. This means you find solutions outside of the standard routines of care while still following standards of practice. A critical thinkers favorite question is, Why? and represents curiosity. Following the six rights is being responsible and accountable.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:115-116

OBJ: Discuss the critical thinking attitudes used in clinical decision making.

TOP: Nursing Process: Evaluation MSC: NCLEX: Management of Care

24.Which information indicates the nurse has a correct understanding of critical thinking?

a.

It is a continuous process characterized by open-mindedness.

b.

It is the same thing as the nursing process.

c.

It is a haphazard method of providing nursing care.

d.

It is moving from writing a plan of care to thinking.

ANS: A

Critical thinking is a continuous process characterized by open-mindedness, continual inquiry, and perseverance, combined with a willingness to look at each unique patient situation and determine which identified assumptions are true and relevant. It is not the same thing as the nursing process, but the nursing process is a specific critical thinking competency. It is not a haphazard method; it is logical, with attitudes and standards. Although critical thinking helps write a care plan, actually writing a care plan is a step (planning) in the nursing process.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF: 106 OBJ: Discuss critical thinking skills used in nursing practice.

TOP: Nursing Process: Evaluation MSC: NCLEX: Management of Care

25.While a nurse is assessing a patients chest pain, the patient states, The pain hurts in the middle of my chest. The nurse asks, Can you tell me where the pain is exactly and describe what it feels like? Which attitude for critical thinking is the nurse using?

a.

Integrity

b.

Discipline

c.

Planning

d.

Nursing diagnosis

ANS: B

The nurse is being thorough, which is using the critical thinking attitude of discipline. A disciplined thinker misses few details and follows an orderly or systematic approach when collecting information, making decisions, or taking action. A person of integrity is honest and willing to admit to any mistakes or inconsistencies in his or her own behavior, ideas, and beliefs. Planning and nursing diagnosis are steps in the nursing process, not attitudes for critical thinking.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:115-116

OBJ: Discuss the critical thinking attitudes used in clinical decision making.

TOP: Nursing Process: Assessment MSC: NCLEX: Basic Care and Comfort

MULTIPLE RESPONSE

1.A nurse is teaching the staff about the major elements in the critical thinking model. Which information should the nurse include in the teaching session? (Select all that apply.)

a.

Intricate

b.

Attitudes

c.

Standards

d.

Experience

e.

Competence

ANS: B, C, D, E

According to the model, there are five elements of critical thinking: knowledge base, experience, competence (e.g., problem solving or clinical decision making), attitudes, and standards. Intricate is not an element in the critical thinking model.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:113

OBJ: Describe the components of a critical thinking model for clinical decision making.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

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