Question 1

The nurse comes up with creative methods to help soothe agitated patients with dementia when the usual approaches fail.Which term best describes the action of the nurse?

Accepted Answer

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 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 patient's condition.Nurses do not make medical diagnoses; they make nursing diagnoses,which is a part of diagnostic reasoning.

Question 2

The nurse asks another nurse for assistance when trying to determine the best way to manage a postoperative patient's pain.Which critical thinking attitude is demonstrated by the nurse?

Accepted Answer

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 provider's 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.

Question 3

The nurse inappropriately assumed that the patient did not require pain medication due to a history of substance abuse.Which critical thinking concept did the nurse fail to use?

Accepted Answer

Analysis is demonstrated when the nurse keeps an open mind when forming judgments about patient assessment findings.The nurse failed to carefully analyze assessment findings by mistakenly assuming that the patient did not require pain medication due to a history of substance abuse.Criticism and organization are not critical thinking skills.Maturity is reflecting on your own judgments and realizing multiple solutions are acceptable.

Question 4

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.Which term most accurately describes the thought process of the nurse?

Accepted Answer

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.Intuition is an inner sensing or "gut feeling" that something is so.Confidence is the belief that an intuition or belief is correct.Discipline is thoroughness and control over one's actions.

Question 5

The nurse suspects that a patient is being abused by the spouse based on the presence of many unexplained bruises and the nonverbal behavior of the patient.Which critical thinking technique was used by the nurse?

Accepted Answer

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 patient's room and,by looking at the patient's appearance without the benefit of a thorough assessment,senses that he or she has worsened physically.Curiosity is the desire to learn more about something.Fairness is the ability to remain impartial.Humility is the quality of being modest or unassertive.

Question 6

Which action by the nurse is an example of a workaround?

Accepted Answer

A workaround is a shortcut that may endanger patients in an attempt to save time.Medication bar codes should always be scanned before administration to patients to prevent errors.Scanning bar codes after administration in an attempt to save time is a workaround.Prioritization of patient care,assisting other staff members,and seeking assistance are not examples of workarounds.

Question 7

In a facility with an outbreak of Clostridium difficile,the nurse manager determines that staff members are continuing to use alcohol-based hand sanitizer when caring for patients with Clostridium difficile infection despite the policy which requires hand hygiene using soap and water.Which step of the scientific method was performed by the nurse manager?

Accepted Answer

The problem is identified when the nurse manager determines that staff members are not following agency policy about hand hygiene.The nurse manager could hypothesize that a reminder program will increase employee compliance with the hand-hygiene policy.The nurse manager could implement a patient/visitor survey to determine if employees are compliant with the hand-hygiene policy.Evaluation is done after the reminder program is implemented to determine the rate of employee compliance.

Question 8

The nurse implements interventions to address risk for falls after noting that the patient is unsteady when getting out of bed.The nurse is using which skill in this situation?

Accepted Answer

The nurse used diagnostic reasoning by using data (unsteady patient)to arrive at a patient's health problem/nursing diagnosis (risk for falls).Diagnostic reasoning is the analytical process for determining a patient's 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 falls.

Question 9

Which behavior demonstrates basic critical thinking expected of beginning nursing students?

Accepted Answer

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.

Question 10

Which is the best tool that the nurse can use to make sense of the patient's multiple medical diagnoses,assessment findings,and medications?

Accepted Answer

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.

Question 11

Which patient's need constitutes the highest priority for the nurse?

Accepted Answer

The patient with sudden onset of slurred speech and right-sided weakness has signs of an acute stroke.This patient must be treated immediately to preserve neurological function and prevent permanent deficits.The discharged patient and the constipated patient will have to wait until the nurse has taken care of the stroke patient.The nurse can delegate care for the incontinent patient to the nursing assistant.

Question 12

A nurse uses personal experience as well as knowledge of body mechanics and medical equipment in order to determine the safest way to transfer the paraplegic patient from the bed to the wheelchair.Which critical thinking concept is demonstrated by the nurse?

Accepted Answer

Explanation is demonstrated when the nurse uses personal experience and applicable knowledge bases to determine the best plan of care for the patient.Scientific knowledge and experience to choose strategies you use in the care of patient is explanation; it supports your findings and conclusions.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.Development is not a critical thinking skill.

Question 13

The nurse is caring for a patient who is having severe pain despite regular doses of narcotic pain medication.The nurse suspects that the patient may be experiencing neuropathy and obtains an order for gabapentin which relieves the patient's pain.Which term most accurately describes the action of the nurse?

Accepted Answer

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.

Question 14

The experienced trauma nurse determines that the patient may have suffered a cervical spinal cord injury as the patient is unable to feel or move the arms or legs.Which term best describes the nurse's ability to make this conclusion?

Accepted Answer

The nurse demonstrated clinical inference by using extensive experience to reach the conclusion that the patient had suffered a spinal cord injury.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.Standardized criteria do not assist the nurse to realize that the patient suffered a spinal cord injury.

Question 15

The new nurse keeps a diary to record experiences,patient encounters,and feelings when beginning work in the nursing profession.Which critical thinking action is used by the nurse?

Accepted Answer

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.

Question 16

The nurse readily accepts an opportunity to become certified in wound care and ostomy management.Which critical thinking concept is demonstrated by the nurse?

Accepted Answer

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 learning's sake.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.

Question 17

The nurse feels strongly that the patient may be suffering from physical abuse.The nurse reports the situation to protective services even though the physician insists that the patient is simply accident-prone.Which component of critical thinking leads the nurse to file the report even though the physician believes it is not needed?

Accepted Answer

The nurse's confidence in the assessment of the patient's situation leads the nurse to file a report with protective services even though the physician believes it is not needed.Fairness is the ability to listen to both sides of a discussion.Discipline is demonstrated when the nurse takes the time to do the job thoroughly.Creativity is demonstrated when the nurse uses imagination skills to come up with new solutions or ideas.

Question 18

Which action of the nurse demonstrates clinical decision making?

Accepted Answer

The nurse demonstrates clinical decision making when solving problems and formulating nursing diagnoses for patients.An example of this is the determination that the patient is at risk for constipation due to use of postoperative narcotic pain medication.Application of a hydrocolloid dressing is implementation of the physician's order.Assessment (health history and mucus membranes)forms the starting point for clinical decision making.

Question 19

The nurse becomes very skilled at feeding patients with dysphagia after working on a rehabilitation unit for many years.Which component of critical thinking allows the nurse to function at this high level of practice?

Accepted Answer

The nurse has become very skilled at feeding stroke patients due to many years of experience.The nurse is not taking a risk with patients as the nurse is very skilled.The nurse demonstrates integrity and responsibility by carefully maintaining high professional standards of care for patients.

Question 20

Which action by the nurse best demonstrates independent thinking?

Accepted Answer

The nurse demonstrates independent thinking by initiating swallow precautions when the patient shows signs of aspiration.The nurse took the initiative to act when signs of aspiration were noted.Independent thinking is not demonstrated by performing routine oral care,teaching the patient how to inject insulin,or using active listening skills.

Quiz 8: Critical Thinking