Fundamentals chapter 15 critical thinking process test bank
A nursing instructor needs to evaluate students' abilities to synthesize data and identify relationships between nursing diagnoses. Which learning assignment is best suited for this instructor's needs? a. Concept mapping b. Reflective journaling c. Lecture and discussion d. Reading assignment with a written summary
A
A patient continues to report postsurgical incision pain at a level of 9 out of 10 after pain medicine is given. The next dose of pain medicine is not due for another hour. What should the critically thinking nurse do first? a. Explore other options for pain relief. b. Discuss the surgical procedure and reason for the pain. c. Explain to the patient that nothing else has been ordered. d. Offer to notify the health care provider after morning rounds are completed.
A
In which order will the nurse use the nursing process steps during the clinical decision-making process? 1. Evaluating goals 2. Assessing patient needs 3. Planning priorities of care 4. Determining nursing diagnoses 5. Implementing nursing interventions a. 2, 4, 3, 5, 1 b. 4, 3, 2, 1, 5 c. 1, 2, 4, 5, 3 d. 5, 1, 2, 3, 4
A
Which findings will alert the nurse that stress is present when making a clinical decision? (Select all that apply.) a. Tense muscles b. Reactive responses c. Trouble concentrating d. Very tired feelings e. Managed emotions
A,B,C,D
Anticipate how a patient might response to a treatment is
Analycity
A nurse has seen many cancer patients struggle with pain managment because they are afraid of becoming addicted to the medicine. Pain control is a priority for cancer care. By helping patients focus on their values and beliefs about pain control, a nurse can best make clinical decisions. This is an example of:
Applying ethical criteria.
A nurse is pulled from the surgical unit to work on the oncology unit. Which action by the nurse displays humility and responsibility? a. Refusing the assignment b. Asking for an orientation to the unit c. Admitting lack of knowledge and going home d. Assuming that patient care will be the same as on the other units
B
A nurse is reviewing care plans. Which finding, if identified in a plan of care, should the registered nurse revise? a. Patient's outcomes for learning b. Nurse's assumptions about hospital discharge c. Identification of several actual health problems d. Documentation of patient's ability to meet the goal
B
A patient is having trouble reaching the water fountain while holding on to crutches. The nurse suggests that the patient place the crutches against the wall while stabilizing him or herself with two hands on the water fountain. Which critical thinking attitude did the nurse use in this situation? a. Humility b. Creativity c. Risk taking d. Confidence
B
Which action indicates a registered nurse is being responsible for making clinical decisions? a. Applies clear textbook solutions to patients' problems b. Takes immediate action when a patient's condition worsens c. Uses only traditional methods of providing care to patients d. Formulates standardized care plans solely for groups of patients
B
While caring for a hospitalized older-adult female post hip surgery, the nurse is faced with the task of inserting an indwelling urinary catheter, which involves rotating the hip into a contraindicated position. Which action should the nurse take? a. Postpone catheter insertion until the next shift. b. Adapt the positioning technique to the situation. c. Notify the health care provider for a urologist consult. d. Follow textbook procedure with contraindicated position.
B
A A nurse prepares to insert a Foley catheter. The procedure manual calls for the patient to lie in the dorsal recumbent position. The patient complains of having back pain when lying on her back. Despite this, the nurse positions the patient supine with knees flexed as the manual recommends and begins to insert the cath- eter. This is an example of:
Basic critical thinking. In the basic critical thinking level, a learner trust that experts have the right answer for a problem. Thinking is concrete and based on a set of rules or principles. Basic critical thinking don,t have the capacity to think and make clinical decison on their own.
Concepts for a Critical Thinker
Be a Truth seeking ,Open-mindedness ,Analyticity Systematicity ,Self-confidence ,Inquisitiveness ,Maturity
Critical Thinking and Clinical Judgment Skills (Analysis)
Be open-minded as you look at information about a patient. Do not make careless assumptions. Does the data reveal a problem or trend that you believe is true, or are there other options?
Critical Thinking and Clinical Judgment Skills (Interpretation)
Be orderly in collecting data about reasoning while looking for patterns to emerge. patients. Apply Categorize the data Gather additional data or clarify any data about which you are uncertain.
When a nurse try to understaind a patient's and family caregivers's perspective of why a patient is falling at home . The nurse applies the intellectual standard of
Broad, to understaind all points of views
A nurse is using the critical thinking skill of evaluation. Which action will the nurse take? a. Examine the meaning of data. b. Support findings and conclusions. c. Review the effectiveness of nursing actions. d. Search for links between the data and the nurse's assumptions.
C
The patient appears to be in no apparent distress, but vital signs taken by assistive personnel reveal an extremely low pulse. The nurse then auscultates an apical pulse and asks the patient whether there is any history of heart problems. The nurse is utilizing which critical thinking skill? a. Evaluation b. Explanation c. Interpretation d. Self-regulation
C
Which action demonstrates a nurse utilizing reflection to improve clinical decision making? a. Obtains data in an orderly fashion b. Uses an objective approach in patient situations c. Improves a plan of care while thinking back on interventions effectiveness d. Provides evidence-based explanations and research for care of assigned patients
C
Which action should the nurse take to best develop critical thinking skills? a. Study 3 hours more each night. b. Attend all inservice opportunities. c. Actively participate in clinical experiences. d. Interview staff nurses about their nursing experiences.
C
Which action should the nurse take when using critical thinking to make clinical decisions? a. Make decisions based on intuition. b. Accept one established way to provide care. c. Consider what is important in a given situation. d. Read and follow the heath care provider's orders.
C
Which patient scenario of a surgical patient in pain is most indicative of critical thinking? a. Administering pain-relief medication according to what was given last shift b. Offering pain-relief medication based on the health care provider's orders c. Asking the patient what pain-relief methods, pharmacological and nonpharmacological, have worked in the past
C
A nurse changed a patient's surgical wound dressing the day before and now prepares for another dressing change. The nurse had difficulty removing the gauze from the wound bed yesterday, causing the patient discomfort. Today he gives the patient an analgesic 30 minutes before the dressing change. Then he adds some sterile saline to loosen the gauze for a few minutes before removing it. The patient reports that the procedure was much more comfortable. Which of the following describes the nurse's approach to the dressing change?
Complex critical thinking ( beging to separate then self from experts, you analyze the clinical situation and examine choices more independly.) Experience ( nursing is a practice of dicipline.with experience you begin to understand clinical situations,anticipate and recognize cues of patient's health patterns, and interpret the cues as relevant or irrelevants)
5. A nurse on a busy medicine unit is assigned to four patients. It is 10 AM. Two patients have medications due and one of those has a specimen of urine to be collected.one pt is having complications from surgery and is being prepared to return to the opering room. The fourth pt requires instructions about activities restriction before going home, what will be the best clinical desicion
Consider availability of assistive personal to ontain the specimen Combine activities to resolve more than one patient problem Analyze the diagnose/ problem and decides with are most urgent based on patient's need
A charge nurse is supervising the care of a new nurse. Which action by a new nurse indicates the charge nurse needs to intervene? a. Making an ethical clinical decision b. Making an informed clinical decision c. Making a clinical decision in the patient's best interest d. Making a clinical decision based on previous shift assessments
D
A nurse is using a critical thinking model to provide care. Which component is first that helps a nurse make clinical decisions? a. Attitude b. Experience c. Nursing process d. Specific knowledge base
D
A nurse is using professional standards to influence clinical decisions. What is the rationale for the nurse's actions? a. Establishes minimal passing standards for testing b. Utilizes evidence-based practice based on nurses' needs c. Bypasses the patient's feelings to promote ethical standards d. Uses critical thinking for the highest level of quality nursing care
D
A nurse who is caring for a patient with a pressure ulcer applies the recommended dressing according to hospital policy. Which standard is the nurse following? a. Fairness b. Intellectual standards c. Independent reasoning d. Institutional practice guidelines
D
The nurse enters a room to find the patient sitting up in bed crying. How will the nurse display a critical thinking attitude in this situation? a. Provide privacy and check on the patient 30 minutes later. b. Set a box of tissues at the patient's bedside before leaving the room. c. Limit visitors while the patient is upset. d. Ask the patient about the crying.
D
Which action by a nurse indicates application of the critical thinking model to make the best clinical decisions? a. Drawing on past clinical experiences to formulate standardized care plans b. Relying on recall of information from past lectures and textbooks c. Depending on the charge nurse to determine priorities of care d. Using the nursing process
D
A nurse enters a 72-year-old patient's home and begins to observe her behaviors and examine her physical condition. The nurse learn the pt live alone and notice brusing on the pt' leg. When watching he walk the nurse notice that she has unsteady gait and leans to one side. The pt admits to having fallen in the past. The nurse identifies the patient as a having nursing diagnosis of risk for fall. This ecenario is an expample of
Diagnostic reasoning ( once you gather information about your pt you begin the analitytical process for determining a patient's health problem)
By using known criteria in conducting an assessment such as reviewing with a patient the typical characteristics of pain, a nurse is demonstrating which critical thinking attitude?
Discipline A diciplined thinkier misses few details and orderly or systemic when colleting information,making decisions,or taking action. For example you have a pt who is in pain instead of only asking the patient, how severe is your pain or a scale from 0-10 ? You also ask more specific questions about the chapter of pain. " how long you noticed", what makes the pain worse."? Being diciplinated helps you identify problems more accurately and select the most appropiate interventions.
Which of the following describes a nurse's application of a specific knowledge base during critical thinking?
Initiative in reading current evidence from the literature Considering holistic view of patient needs Reviewing policy and Application of nursing theory procedure manual
problem solving
Involves evaluation a situation over time, identify a possible solution, and trying a solution over time to make sure is effective For example, helping an old woman to organize her medication on a correct way which help her keep on tract o her correct consume. After done that follow with the patient on her next visit to find out that the pt has organized her meds correctly.
scientific method of critical thinking
Is a methodical way to solve problem using reasoning. 1.identifying the problem 2. Collect data 3. Formulate a question or hypothesis 4.test the question or hypothesis 5. Evaluate results
Concept mapping
Is a visual representation of a patient problems and intervention that shows their relationships to one another.it is nonlinear picture of a patient to be used for comprehensive care planning.
critical thinking skills
Is the ability to think in a systematic and logical manner with openness to question and reflects on the reasoning process.
Critical Thinking and Clinical Judgment Skills (Evaluation)
Look at all situations objectively. Use criteria (e.g. expected outcomes, pain characteristics, learning objectives) to determine results of nursing actions. Reflect on your own behavior.
Critical Thinking and Clinical Judgment Skills (Inference)
Look at the meaning and significance of findings. Are there relationships among findings? Does the data about the patient help you see that a problem exists?
Be tolerant of the patient's views and beliefs is
Open- mindedness
Critical Thinking and Clinical Judgment Skills (Self-regulation)
Reflect on your experiences. Be responsible for connecting your actions with outcomes. Identify the ways you can improve your own performance. What will make you believe that you have been successful?
7. A nurse just started working at a well-baby clinic. One of her recent experiences was to help a mother learn the steps of breast- feeding. During the first clinic visit the mother had difficulty positioning the baby during feeding. After the visit the nurse con- siders what affected the inability of the mother to breastfeed, including the mother's obesity and inexperience. The nurse's review of the situation is called:
Reflection. The ability to act on a previous situationand considering relevant issues. It involves posedul thinking back or recalling a situation to discover it porpuse of meaning
A nurse is preparing medications for a patient. The nurse checks the name of the medication on the label with the name of the medication on the doctor's order. At the bedside the nurse checks the patient's name against the medication order as well. The nurse is following which critical thinking attitude:
Responsible
An aspect of clinical decision making is knowing the patient. Which of the following is the most critical aspect of developing the ability to know the patient?
Spending time establishing relationships with patients
Critical Thinking and Clinical Judgment Skills (Explanation)
Support your findings and conclusions. Use knowledge and experience to choose strategies to use in the care of patients.
Organized assessment on the basic of patient priorities is
Systematicity
In which of the following examples is a nurse applying critical thinking skills in practice?
The nurse thinks back about a personal experience before administering a medication subcutaneously. The nurse uses a pain-rating scale to measure a patient's pain. The nurse gathers data on patient with a mobility limitation to identify a nursing diagnosis.
Interference on critical thinking
The process of drawing conclusions from related pieces of evidences and previous experience with the evidence.when you make inference you form patten of information from data before making a diagnosis. Ex: "tonya noted that Mr. Lason was laying in a position to splint movement of his incision, had a tense facial expression, and experienced tenderness when his wound was palpeted.tonya infer that Mr. lason has a level of disconfor. She demonstrated diagnostic reasoning by identifying the nursing diagnosis of Acute pain.
Be objective in asking questions of a patient is
Thrust seeking
Decision Making Process
When you face a problem or a situation and you need to choose a course of action from several options. Examples of decision making is to determine which patient care priority requires first response.choosing a type of dressing for a patient with a surgical wound , or selecting the best teaching approach for a family caregiver who will assist a patient who is returning home after stroke.
diagnostic reasoning process
the process of analyzing health data and drawing conclusions to identify diagnoses. Analytical process for determining a patient's health problem, once you gather information from the patient.
