Chapter 4-Critical Thinking in Nursing-Final Exam Adaptive Quiz
Which action by the nurse demonstrates humility? -A willingness to try new ideas -Admission of mistakes -Upholding high standards of care -Always taking the suggestions of others
-Admission of mistakes A nurse who can admit his or her mistakes and is aware of his or her own limitations reflects humility. A nurse who is willing to try new ideas is a risk taker. A nurse always follows the highest standards for patient care even in the face of adversity; this is integrity. Nurses must be open-minded and listen to others' opinions but also must be able to think independently before coming to a final conclusion.
Which characteristics would the nursing student adopt to become a good critical thinker? Select all that apply. -Analysis -Inquisitiveness -Diagnostic ability -Systematic thinking -Overconfidence
-Analysis -Inquisitiveness -Systematic thinking To be a critical thinker, it is essential to be analytical. The nursing student should analyze a problem and estimate the possible results. The nurse should also be systematic in order to stay organized and focused on the work. Inquisitiveness—to always ask "why?"—is necessary to learn more and acquire knowledge and understanding. Establishing a nursing diagnosis is a part of the nursing process and not a concept for critical thinking. The nurse should have self-confidence but should not be overconfident. The nurse should be open-minded and mature enough to accept mistakes for the betterment of the patient if required.
Which activities are involved in the assessment phase of the nursing process? Select all that apply. -Asking the patient about his complaints -Asking about the patient's current medications -Teaching the patient and his family about medications -Asking about the patient's past and family medical history -Determining if the patient and his family understand the information about the medication
-Asking the patient about his complaints -Asking about the patient's current medications -Asking about the patient's past and family medical history Assessment is the first step in the nursing process. It involves asking the patient about medical conditions, the related complaints, and current medications, including prescription medications and over-the-counter drugs. It also involves assessment of the patient's past and family medical history. The collection of this assessment data is required for the next step of the nursing process. Teaching the patient and his family about medications is part of the implementation phase of the nursing process. Determining if the patient and the family understand the information about medications is part of the evaluation phase of the nursing process.
Which stages of patient care are included in the nursing process? Select all that apply. -Assessment -Intervention -Nursing diagnosis -Rehabilitation -Pathological reports and screening
-Assessment -Intervention -Nursing diagnosis A nursing process consists of five phases of patient care. The first phase is assessment, in which the nurse collects data from the patient by interviewing the patient and by performing a physical examination. Diagnosis is the second step, in which the nurse formulates the specific need statement of the patient based on the assessment data. Intervention is the third step and includes nursing care to meet the patient needs identified during assessment and diagnosis. Rehabilitation and pathological reports and screening are not stages of patient care.
The nurse reads the institution's procedure manual to review how to insert a urinary catheter for a patient. Which level of critical thinking is the nurse using? -Commitment -Scientific method -Basic critical thinking -Complex critical thinking
-Basic critical thinking This is an example of basic critical thinking, in which the nurse trusts that experts have the right answers for how to insert the catheter and thus goes to the procedure manual. Thinking is concrete and based on a set of rules or principles. Commitment is not a level of critical thinking. The scientific method and complex critical thinking are not required for this level of critical thinking and are used for more complex situations.
Which behaviors are obstacles to the development of critical thinking? Select all that apply. -Curiosity -Biased views -Self-confidence -Overconfidence -Failure to accept mistakes
-Biased views -Overconfidence -Failure to accept mistakes Critical thinking requires certain attitudes. A nurse should be confident but not overconfident. An overconfident nurse may not be open to suggestions and modifications. A nurse who has biased views may not be open to ideas and may have an inclination toward a particular goal or outcome. This is a major obstacle to critical thinking. The nurse should accept his or her mistakes; failure to do so may hinder the process of critical thinking. Curiosity and self-confidence are helpful attitudes in critical thinking.
A patient with depression says, "I've really been struggling with insomnia this week." The nurse replies, "Am I correct that you're saying you've been having difficulty sleeping this week?" Which intellectual standard of critical thinking is the nurse demonstrating? -Logic -Depth -Clarity -Accuracy
-Clarity The nurse is rechecking the patient's concern by rephrasing and restating what the patient said. This helps ensure clarity regarding the problem. Logic is an intellectual standard of critical thinking that helps in finding the relationship between the problem and the conclusion made. Depth refers to the critical thinking standard that involves the assessment of the factors that led to the problem. Accuracy is the intellectual standard that involves the method of verifying and validating the data collected from the patient.
According to Paul, which intellectual standards should a nurse possess for critical thinking? Select all that apply. -Clear -Intuitive -Plausible -General -Complete
-Clear -Plausible -Complete According to Paul, there are 14 intellectual standards that are universal for critical thinking: clear, precise, specific, accurate, relevant, plausible, consistent, logical, deep, broad, complete, significant, adequate (for purpose), and fair. These are guidelines or principles to enhance rational thinking that can be used in daily nursing practice. Intuition is an example of inference, and general is not an intellectual standard.
A patient with a plaster of Paris casting on the elbow joint prefers to bathe every other day. The nurse insists that the patient take a bath every morning to maintain hygiene. Which error of critical thinking process does this nursing action depict? -Illogical thinking -Lack of information -Closed-mindedness -Erroneous assumptions
-Closed-mindedness A nurse who is closed-minded performs the interventions without adequately considering the preferences of the patient. This may interfere with fulfilling the requirements of the patient. Illogical thinking involves the nurse's inability to follow a systematic approach while addressing an issue. Sometimes the nurse may overlook important information related to the findings in the patient and draw conclusions without obtaining complete information. Erroneous assumptions are false assumptions made by the nurse without proper evaluation and validation.
Which techniques would the student nurse use to develop critical thinking skills and bring theory into practice? Select all that apply. -Concept mapping -Reflective journaling -Meeting with patients -Discussion with colleagues -Memorizing clinically relevant facts
-Concept mapping -Reflective journaling -Discussion with colleagues Reflective journaling involves recollecting the daily incidences and writing them down for further reference. This helps improve critical thinking skills and clarifies concepts for further reference. Concept mapping is a teaching-learning strategy that has been linked with improved critical-thinking skills in nurses. Whether in an academic setting or in the clinical area, discussion of a problem, issue, or situation with colleagues may improve critical thinking. Through dialogue with others who have expertise or experience with the issue being faced, knowledge gaps can be filled, erroneous assumptions exposed, and unconscious biases addressed. Meeting with patients and memorizing clinically relevant facts helps develop knowledge, not critical thinking.
A student nurse is assigned to care for a patient admitted to the hospital with severe abdominal pain. Which concept of critical thinking would the student nurse adopt when approaching the patient? -Integrity -Curiosity -Risk taking -Confidence
-Confidence The nursing student needs to be confident when introducing oneself to the patient. The student should speak with conviction and must never give the patient the impression that he or she is unable to perform the assigned tasks. Integrity is reviewing one's own position and recognizing when interests conflict with those of the patient. Curiosity is the desire to explore more. Risk taking is being courageous and questioning interventions if needed.
A nurse attempting to decrease the patient's adverse reactions to prescribed medications is unable to find information about the medication in any of the hospital databases or electronic health records. Which action should the nurse take in this situation? -Avoid administering the medication. -Contact the hospital pharmacist. -Contact the primary health care provider. -Ask the patient for written consent before administering.
-Contact the hospital pharmacist. When a primary health care provider prescribes a medication, the nurse is knowledgeable of its use, the expected outcome, and any adverse effects and drug interactions. The nurse requests the information from the pharmacist when the information is not available in any of the resources available. The nurse cannot avoid administering the medication if the information is unavailable. Instead, the nurse obtains the information from another resource. The nurse contacts the pharmacist rather than informing the primary health care provider. The patient's written consent is required only if the drug is still under trial or if it has potentially harmful adverse reactions.
Which critical thinking attitude would the nurse possess to develop new solutions to patient-related problems? -Curiosity -Creativity -Integrity -Humility
-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 a technique by which the nurse can explore the patient's conditions and emotions. Integrity tests the knowledge and beliefs of the nurse. A nurse can feel humility, but it is not an attitude that leads to new solutions.
The nurse instructs the parents of a malnourished child to make the child's food colorful and attractive. Which trait of critical thinking is the nurse exhibiting? -Fairness -Curiosity -Discipline -Creativity
-Creativity Nurses require various traits such as fairness, risk taking, creativity, curiosity, discipline, and perseverance. In this case, the nurse is trying to stimulate the appetite of the child by instructing the parents to make the food colorful and attractive. This shows that the nurse is using the trait of creativity. Fairness is the trait of a nurse who avoids personal bias while caring for a patient. Curiosity is the trait of a critical thinking nurse who always tries to ask "why?" A disciplined nurse follows a systematic approach to plan and achieve goals.
In which way does a concept map improve critical thinking skills? Select all that apply. -Data in a plan of care can be visualized. -Learning can be summarized when preparing for exams. -Understanding of subject matter can be enhanced. -Practical application of learned skills is achieved. -Assessment data can be organized in a meaningful way.
-Data in a plan of care can be visualized. -Learning can be summarized when preparing for exams. -Understanding of subject matter can be enhanced. -Assessment data can be organized in a meaningful way. Concept mapping is a teaching-learning strategy used in nursing to enhance nurses' critical thinking skills. A concept map can help create care plans by organizing and visualizing data. Nurses can use a concept map as a method to summarize learning while preparing for examinations. Concept maps also help in better understanding of a subject. Concept maps also help in organizing and collecting data for further assessment and evaluation to solve problems. While concept maps are useful for organizing information, they do not provide a means of practically applying skills. Simulation and role-playing are effective techniques for practical application.
The nurse must notify the surgeon if a patient's postoperative wound collection device drains more than 100 mL over 24 hours. Which phase of the nursing process is the nurse acting in when the drainage device is observed and the amount of drainage currently in it is documented? -Planning -Evaluation -Diagnosis -Intervention
-Evaluation In this example the nurse is evaluating the amount of drainage to determine if there is a change in the amount of drainage, which indicates the progress of wound healing or alerts to the need to notify the surgeon.
In which way would the nurse confirm the effectiveness of a previously untried intervention in an ethical manner? Select all that apply. -Follow evidence-based practice. -Perform intervention without informing the patient. -Try interventions irrespective of their beneficial effects. -Give priority to scientific knowledge over the patient's beliefs. -Focus on the patient's values and beliefs related to the new intervention.
-Follow evidence-based practice. -Focus on the patient's values and beliefs related to the new intervention. While experimenting with newer interventions, the nurse should act ethically and try interventions only if evidence supports their beneficial effects. The nurse should focus on the patient's rights and beliefs so that interventions are faithful and beneficial to the patient. The patient should be informed before the intervention. Priority should be given to patient's rights over scientific knowledge. The nurse should not try interventions that are likely to have no beneficial effects.
Which character traits are needed by a nurse to develop the ability to think critically? Select all that apply. -Honesty -Creativity -Validation -Confidence -Clarification
-Honesty -Creativity -Confidence Critical thinking is an art that helps make the process of thinking more clear, precise, and accurate. Character traits such as fair-mindedness, honesty, creativity, and confidence help nurses to develop critical thinking. Nurses have to validate and clarify the information obtained after assessing patients. Validation and clarification are components of critical thinking.
Which critical thinking attitudes would the nurse adopt when caring for a patient who has not followed treatment recommendations, which has resulted in a complication? Select all that apply. -Hostility -Integrity -Fairness -Punctuality -Confidence
-Integrity -Fairness -Confidence The nurse must always treat the patient with fairness, integrity, and confidence to promote positive outcomes for him or her. The nurse should never be hostile to the patient. While punctuality is an important factor for a nurse, it does not affect the patient's compliance.
Which concept in the Critical Thinking Model focuses on teamwork and conflict management? -Interpersonal skills -Technical competencies -Maintaining high standards -Theoretical and experiential knowledge
-Interpersonal skills The Critical Thinking Model includes four concepts: critical thinking characteristics, theoretical and experiential knowledge, interpersonal skills, and technical competencies. Interpersonal skills such as teamwork, conflict management, and advocacy are important in critical thinking. Technical competencies indicate the skill and expertise of the nurses attained during nursing practice. These are not associated with teamwork and conflict management. Maintaining high standards is key to developing a critical-thinking character and helps ensure the delivery of quality care, but it does not specifically relate to teamwork and conflict management. Theoretical and experiential knowledge help in proper assessment and effective care plan development; however, they do not help in conflict management.
Which processes require critical thinking skills? Select all that apply. -Creativity -Judgment -Risk taking -Problem solving -Decision making
-Judgment -Problem solving -Decision making Judgment, problem solving, and decision making are processes that require critical thinking because they all require proper evaluation and validation of the gathered information. Creativity and risk taking are traits required by a nurse to become an effective critical thinker.
Which component of critical thinking is being used when the nurse reviews relevant clinical principles in a textbook prior to caring for a patient? -Experience -Problem solving -Knowledge application -Clinical decision making
-Knowledge application When the nurse reviews knowledge that pertains to a patient's clinical situation, this facilitates critical thinking and enhances application of cognitive learning to clinical practice. Experience is what the nurse already knows about a given situation. The knowledge gained from the review of the textbook can be applied to problem solving or clinical decision making, but neither concept reflects actively using resources to gain specific knowledge.
Which concepts are included in the intellectual standards of critical thinking? Select all that apply. -Logic -Humility -Relevance -Risk taking -Significance
-Logic -Relevance -Significance The nurse uses the intellectual standards of critical thinking while addressing an issue. The intellectual standards of critical thinking include logic, relevance, significance, breadth, depth, and accuracy. The nurse uses logic to combine the thoughts of an issue and draws a conclusion from the combination of thoughts. The nurse focuses on the facts that are directly related to the problem under consideration. This indicates relevance. The nurse focuses on points of significance and concentrates on the most important points of the available information to draw a conclusion. Humility and risk taking are traits that a nurse possesses to become a critical thinker.
Which strategies focus on improving critical thinking skills through written work? Select all that apply. -Noting key facts -Reviewing study notes -Simulating realistic scenarios -Verbalizing thoughts -Identifying knowledge gaps
-Noting key facts -Reviewing study notes -Identifying knowledge gaps Written work is one tool that can help improve critical thinking skills. Strategies for written work include identifying gaps in knowledge and maintaining organized study notes of key points while reading. It is then important to target those knowledge gaps while reviewing the study notes to consolidate learning. Simulation provides a way for students to apply knowledge in a realistic, but safe, environment. It is not a strategy for written work. Verbalization of thoughts refers to thinking aloud.
Which statement describes a characteristic of critical thinking? Select all that apply. -Open-mindedness, continual inquiry, and perseverance -Reliance on lab reports and diagnostic results to assess patients -Recognition of an issue, analysis of related information, and formation of conclusions -Low consideration of what the patient says; preference to diagnostic tests and scientific data -Imagination and exploration of alternatives, consideration of ethical principles, and informed decision making
-Open-mindedness, continual inquiry, and perseverance -Recognition of an issue, analysis of related information, and formation of conclusions -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 patient 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 patients. Critical thinking does not depend on only the diagnostic reports and analysis.
Which intellectual trait is characterized by staying determined until achieving a goal? -Integrity -Humility -Risk taking -Perseverance
-Perseverance The nurse who has the intellectual trait of perseverance stays determined and keeps trying until the goal is achieved. Integrity refers to being honest and willing to adhere to nursing principles in the face of unpleasant situations. Humility refers to having a humble nature without arrogance or overassertiveness while delivering nursing care. The nurse who has the trait of humility can deliver effective nursing care to the patients within the limitations of nursing practice. The nurse who has the intellectual trait of risk taking tries new ideas to improve the quality of the nursing care.
A nursing instructor observes that a student nurse is caring for the American patients on the unit first and then attending to the needs of the European patients. Which error of critical thinking does this nursing action depict? -Personal bias -Illogical thinking -Lack of information -Closed-mindedness
-Personal bias The nurse should avoid personal bias in order to deliver effective care to patients. In this case, the nurse is caring for American patients first and then attending to the needs of European patients. This indicates that the nurse is showing personal bias toward the American patients. Illogical thinking is characterized by the nurse's failure to address a problem systematically. Sometimes the nurse may overlook the important data related to the patient's medical condition, which may lead to erroneous assumptions. The nurse is open-minded to improve the quality of nursing practice. Closed-mindedness may cause a nurse to overlook important instruction, advice, or information offered by colleagues or patients and lead to incorrect assumptions and ineffective nursing care. In this case, there is no evidence that the student nurse has demonstrated closed-mindedness by ignoring or overlooking instruction or advice.
Which process helps in linking thoughts and ideas to develop a solution? -Judgment -Reasoning -Problem solving -Decision making
-Reasoning Reasoning is the process of thinking logically to connect ideas in a meaningful way. Therefore reasoning is helpful in scientific inquiry and solving problems. Judgment is a decision made after systematic analysis of the problem. Problem solving is the process of using a scientific and analytical approach for finding solutions to a problem. Decision making refers to the process of making a choice from the various available options after making proper assumptions.
Which statements are true of concept maps? Select all that apply. -They are used for patients with a single nursing diagnosis. -Relevant data about the patient can be better synthesized. -A more focused view of a patient's health situation will result. -Meaningful patterns from diverse patient information are generated. -They are visual presentations of relationships between problems and interventions.
-Relevant data about the patient can be better synthesized. -Meaningful patterns from diverse patient information are generated. -They are visual presentations of relationships between problems and interventions. 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 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 used 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 his or her health problems.
The health care team works to resuscitate a child with renal failure without success. When the nurse attempts to speak with family, the mother says, "You can't make me feel better; you don't know what it's like to lose a child." Which journal entries would help the nurse reflect on this clinical experience? Select all that apply. -The history of the child's illness -Data entry of time of day, who was present, and condition of the child -The meaning the experience had for the nurse with respect to her understanding of dealing with a patient's death -Description of the efforts to resuscitate the child, what was used, and questions about the child's response -A description of what the nurse said to the mother, the mother's response, and how the nurse might approach the situation differently in the future
-The meaning the experience had for the nurse with respect to her understanding of dealing with a patient's death -Description of the efforts to resuscitate the child, what was used, and questions about the child's response -A description of what the nurse said to the mother, the mother's response, and how the nurse might approach the situation differently in the future The nurse can reflect on the effects of the treatment and what was difficult or confusing about the outcome. The nurse reviews the meaning of the experience to help improve understanding of personal comfort and competence in dealing with death and how to respond in the future. The nurse reflects on the communication approach used with the mother to consider if it was appropriate. Reflecting is thinking that examines actions and beliefs. The history of the child's illness and data concerning dates, attendees, and the condition of the child do not contribute to this reflection.
