Critical Thinking
The nurse finds that a patient who had radical prostatectomy has incision pain, fever, and nausea. Based on the findings, the nurse concludes that the patient has infection at the surgical site. Which critical thinking skill has the nurse applied? 1 Analysis 2 Inference 3 Evaluation 4 Interpretation
1 Critical thinking skills are applied in nursing practice to make complex decisions. In the given scenario, the nurse has drawn a conclusion from the data. This indicates the application of analysis in nursing practice. Inference involves look at the meaning and significance of the nurse's findings. When the nurse to looks at all patients' situations objectively, the nurse is using evaluation skills. Interpretation involves finding patterns after organizing or collecting a patient's data during assessment.
A child tells the nurse, "My father abuses me every day after drinking alcohol. It makes me feel so depressed." The nurse then speaks with both the parents. Which critical thinking attitude is the nurse showing? 1 Fairness 2 Discipline 3 Risk taking 4 Perseverance
1 The nurse listens to the child's problem carefully and understands the situation. Before making a decision, the nurse speaks with both parents to understand the complete problem. The nurse's actions indicate fairness in clinical practice. Discipline involves the use of scientific and practice-based criteria for nursing activities such as assessment and evaluation. Questioning a health care provider about treatment related to a patient indicates risk taking in practice. Perseverance involves persistently doing something in different ways despite delays in response in order to achieve success. In the given situation, the nurse is not showing perseverance.
Which critical thinking attitude motivates the nurse to communicate and know more about a patient? 1 Curiosity 2 Creativity 3 Perseverance 4. self-confidence
1 Curiosity motivates the nurse to communicate and know more about a patient. Creativity and perseverance are attitudes conducive to communication, because they motivate the nurse to identify innovative solutions. Self-confidence is important, because the nurse who conveys confidence and comfort while communicating can more readily establish an interpersonal caring relationship.
Which technique should the student nurse follow to develop critical thinking skills and bring theory into practice? 1 Reflective journaling 2 Concept mapping 3 Meeting with colleagues 4 Meeting with patients
1 Reflective journaling involves recollecting daily incidences and writing them down for further reference. This helps improve critical thinking skills and clarifies concepts for further reference. Concept mapping helps nurses better understand the patient's problems and secondary disease conditions. Meeting with colleagues and patients helps develop knowledge and expertise in clinical situations.
The nurse works in a long-term care facility and understands that integrity is an essential attitude in critical thinking. Which behaviors indicate the nurse's understanding of integrity? Select all that apply. 1 Following the highest standards of practice 2 Questioning own knowledge and beliefs 3 Always having a sense of curiosity about the patient's condition 4 Being honest about and willing to accept own mistakes or inadequacies 5 Continually looking for more resources until a successful approach is found
1, 2, 4 In critical thinking, integrity means the nurse should follow the highest standards of practice. Nurses should be honest and accept their own mistakes or inadequacies. Nurses should be open-minded and, if need arises, should question themselves. Having curiosity about the patient's condition is not part of integrity. Perseverance involves looking for more resources until a successful approach is found.
The nurse understands that interpretation is an important skill in critical thinking. In which activities can the nurse implement interpretation skills? Select all that apply. 1 Being orderly in data collection 2 Looking for patterns to categorize data 3 Making assumptions 4 Being open-minded about information 5 Clarifying any doubtful data
1,2,5 Interpretation is an essential skill in critical thinking. The nurse should be orderly in data collection, so that all aspects of a patient's health are considered. Categorization of the data can indicate a patient problem or need. Clarifying doubtful data is also important in critical thinking. Making assumptions and being open-minded to information are analytic skills, not interpretation skills.
A 40 year old patient is admitted with severe pain in the lower abdomen. A newly hired nurse is assigned to care for this patient. Which levels of critical thinking according to Kataoka-Yahiro and Saylor's model should the nurse use? Select all that apply. 1 Basic 2 Complex 3 Advanced 4 Intermediate 5 Commitment
1,2,5 There are three levels of critical thinking: basic, complex, and commitment. In the basic level, nurses follow whatever instructions experts or manuals tell them. At this level the nurse's experience is low. In the complex level, the nurse begins to analyze the situation independently and does not just follow the experts. At the commitment level, the nurse anticipates when to make decisions without assistance from others. The experience is high at this level.
Which will help the nurse apply critical thinking skills in the day-to-day routine in an acute care setting? Select all that apply. 1 Discipline 2 Punctuality 3 Responsibility 4 Perseverance 5 Privacy
1,3,4, It is important for the nurse to have discipline, responsibility, and perseverance in order to have critical thinking. Being exactly on time (punctual) is not essential for critical thinking. The nurse should be available regularly and whenever the patient needs him or her. Privacy is not a component of critical thinking.
Which attitudes are essential for critical thinking? Select all that apply. 1 Confidence 2 Risk avoidance 3 Fairness 4 Discipline 5 Curiosity
1,3,4,5, Certain attitudes are essential for critical thinking. Nurses should have confidence in their knowledge and abilities. Nurses should be fair in the care they provide. Discipline helps in thorough and critical assessment of any problem. Curiosity helps the nurse question existing practices and improves the standard of care. Risk-taking abilities help the nurse implement new standards of care, but the risks should always be calculated.
Critical thinking is required for selection of suitable interventions for the patient. What abilities will the nurse have that will help decide suitable nursing interventions? Select all that apply. 1 Functioning within a particular setting of the healthcare unit 2 Directing the consultation to the right professional 3 Knowing the scientific rationale for the intervention 4 Aligning a consultation to identify the problems of the patient 5 Possessing the necessary psychomotor and interpersonal skills
1,3,5, The selection of suitable nursing interventions requires the ability to be competent in three areas of critical thinking. These three areas include the ability to function within a particular setting, knowing the scientific rationale for the intervention, and possessing the necessary psychomotor and interpersonal skills. Directing consultation to the right professional and consulting to identify the general problem area are steps of consultation.
The nurse understands that critical thinking is important in making clinical decisions. The scientific method is one approach to critical thinking and consists of five important steps. Arrange the steps of the scientific method in the correct sequence. 1. Evaluating results of the study 2. Formulating a question or hypothesis 3. Identifying the problem 4. Collecting data 5. Testing the question or hypothesis
1. Identifying the problem 2. Collecting data 3. Formulating a question or hypothesis 4. Testing the question or hypothesis 5. Evaluating results of the study The scientific method is a general critical thinking approach. It is not specific to clinical nursing and can be applied to other practices as well, especially nursing research. The scientific method consists of five steps. The first steps are to identify the problem that exists and collect relevant data. The data are helpful to formulate a question or a hypothesis that can be tested, which is the next step. The final steps are to test the hypothesis and evaluate the results.
A registered nurse teaches a group of nursing students about critical thinking. Which statement if made by the nursing student indicates the need for further learning? 1 "All factors should be considered during assessment." 2 "Clinical judgments and decisions should be made before anticipating the information." 3 "The nursing knowledge should be integrated with the knowledge from other disciplines." 4 "It requires the synthesis of knowledge, experience, and information gathered from the patients."
2 Clinical judgments should be made after analyzing the data and not before anticipating the information. All the factors (such as knowledge, experience, standards, and attitudes) should be considered during an assessment to make appropriate nursing diagnoses. Nursing knowledge should be integrated with knowledge from other disciplines in order to provide better care and hygiene. Effective critical thinking requires the synthesis of knowledge, experience, and information gathered from patients.
The nurse applies critical thinking while implementing interventions with patients. Which action is the nurse likely to perform? 1 Carry out the interventions as per standing orders. 2 Review all potential complications associated with the interventions. 3 Carry out the interventions and be prepared for any complications. 4 Carry out the interventions as per the orders given by the healthcare practitioner.
2 The nurse should apply critical thinking before implementing the interventions by reviewing the required interventions. The nurse should also review all the possible complications associated with the interventions in order to avoid them. Standing orders are followed in certain emergency medical situations. In other conditions, the nurse should review the complications and not blindly follow interventions. The nurse should review the possible complications before performing the action, not after it.
The nurse wishes to use critical thinking skills in clinical practice. Which are obstacles to the development of critical thinking? Select all that apply. 1 Curiosity 2 Overconfidence 3 Self-confidence 4 Biased views 5 Failure to accept mistakes
2, 4, 5 Critical thinking requires certain attitudes. The nurse should be confident but not overconfident. An overconfident nurse may not be open to suggestions and modifications. The nurse who has biased views may not be open to ideas and may have an inclination towards a particular goal or outcome. This is a major obstacle to critical thinking. Nurses should accept their own mistakes; failure to do so may hinder the process of critical thinking. Curiosity and self-confidence are helpful attitudes in critical thinking.
The nurse received the "Employee of the Year" award for knowledge, courage, honesty, and objectivity. Which concept of critical thinking does the nurse possess, according to Facione and Facione (1996)? 1 Analyticity 2 Systematicity 3 Truth seeking 4 Self-confidence
3 The nurse has exhibited truth seeking, which is characterized by courage, honesty, and being objective about asking questions in a situation. Analyticity is characterized by anticipating possible consequences and using evidence-based knowledge. Systematicity is characterized by organization, focus toward work, and working hard in any inquiry. Self-confidence is characterized by trust and executing practice in a refined process.
The nurse has been working on a surgical unit for 3 weeks. A patient requires a Foley catheter to be inserted, so the nurse reads the procedure manual for the institution to review how to insert it. Which level of critical thinking is the nurse using? 1 Commitment 2 Scientific method 3 Basic critical thinking 4 Complex critical thinking
3 This is an example of basic critical thinking, in which the nurse trusts that experts have the right answers for how to insert the Foley catheter and thus goes to the procedure manual. Thinking is concrete and based on a set of rules or principles.
The registered nurse is caring for a patient who is terminally ill. Which observations made by the nurse when evaluating the patient's outcomes indicate the use of experience as a critical thinking skill? 1 Clinical symptoms of an improved level of comfort 2 Perseverance in seeking successful comfort measures 3 Characteristics of the resolution of grief in the patient 4 Previous responses to planned nursing interventions for symptom management
4 Experience is the critical thinking skill a nurse will use to evaluate the previous patient responses to planned nursing interventions for symptom management or loss of a significant other. A clinical symptom of an improved level of comfort is evaluated by using the critical thinking skill of knowledge. Perseverance in seeking successful comfort measures is evaluated using attitudes as a critical thinking skill. Characteristics of the resolution of grief in the patient are evaluated by using knowledge as a critical thinking skill.
Which critical thinking attitude should the nurse possess to identify new solutions to patient-related problems? 1 Curiosity 2 Creativity 3 Integrity 4 Humility
B. Creativity Creativity is a critical thinking attitude that helps the nurse identify new ways to help a patient when traditional techniques are not working. Curiosity is an attitude by which the nurse can explore the patient's conditions and emotions. Integrity is related to the honesty of the nurse. The nurse can feel humility, but this is not an attitude that leads to new solutions.
The nurse tries to apply the concept of critical thinking in clinical practice. Which are characteristics of critical thinking? Select all that apply. 1 Open-mindedness, continual inquiry, and perseverance. 2 Reliance on lab reports and diagnostic results to assess patients. 3 Recognition of an issue, analysis of related information, and formation of conclusions. 4 Imagination and exploration of alternatives, consideration of ethical principles, and informed decision making. 5 Low consideration of what the patient says, preference for diagnostic tests and scientific data.
1 Open-mindedness, continual inquiry, and perseverance. 3 Recognition of an issue, analysis of related information, and formation of conclusions. 4 Imagination and exploration of alternatives, consideration of ethical principles, and informed decision making. Critical thinking is a continuous process characterized by open-mindedness, continual inquiry, and perseverance. It may help the nurse to be open to new ideas and incorporate modifications. Critical thinking involves recognizing that an issue exists, analyzing information about the issue, evaluating information, and making conclusions. It is a step-by-step process to come to a logical solution for a client health problem. A critical thinker considers what is important in each clinical situation, imagines and explores alternatives, considers ethical principles, and makes informed decisions about the care of clients. Critical thinking does not depend on only the diagnostic reports and analysis.
Which components can restrict the student nurse's ability to move from a basic level to a complex level of critical thinking? Select all that apply. 1 Inexperience 2 Inflexible attitude 3 Weak competency 4 Lack of specific knowledge base 5 Lack of policy related to procedures
1, 2, 3 Student nurses mostly apply the basic level of critical thinking in practice because they are still learning and are task oriented. The student's inexperience due to less exposure, inflexible attitude due to less practice, and weak competency due to less exposure can restrict the ability to move from a basic level to a complex level of critical thinking in practice. Student nurses work in all domains and believe that experts have the right answer for every problem. Therefore, they do not acquire a domain-specific knowledge base. The student nurse uses a specific hospital procedure manual in practice, which is developed with a good set of standards. Therefore, lack of policy related to procedures will have no role in the student nurse's advancement in critical thinking skills.
The nurse is teaching a group of nursing students about the use of concept maps in developing critical thinking skills. Which statements are true about concept maps? Select all that apply. 1 A concept map is more suitable for patients who have a single nursing diagnosis. 2 A concept map is a visual presentation of relationships between problems and interventions. 3 A concept map helps to better synthesize relevant data about the patient. 4 A concept map gives a more specific or focused view of a patient's health situation. 5 A concept map helps to form meaningful patterns from diverse patient information.
2,3,5 A concept map helps connect theory and practice and helps develop critical thinking skills. A concept map is a visual presentation of the interrelationship that exists between problems and interventions. It helps to synthesize relevant data. The data may include assessment data, diagnostic data, and other related history. Once the interrelationship between the problems and interventions is established, meaningful patterns are formed that help in clinical reasoning and decision making. The concept map is not suitable for patients with a single nursing diagnosis; it is most useful for patients with multiple diagnoses and collaborative problems. The concept map does not give a focused view of the patient; instead, it gives a holistic view of the patient and the patient's health problems.
